If you walk along the hallways of a hospital, doctor’s office or senior living facility, chances are you’ll encounter “elderspeak.” You may have been on the receiving end of elderspeak yourself — or you may have used it inadvertently when communicating with others.
As common and as tempting as it may be to use with aging adults, elderspeak can be frustrating and demeaning. Let’s review the definition of elderspeak and go over some ways you can avoid using it with your older friends and relatives.
What Is Elderspeak?
Consider this hypothetical situation: A nurse is conducting morning rounds and walks into the room of an 85-year-old patient. The nurse sees the patient waking and says, “Good morning, sweetheart. Can you be a good girl for me and sit up in bed to take your meds?”
That’s an example of elderspeak.
The National Center to Reframe Aging, which is dedicated to ending ageism, defines elderspeak as an inappropriate, simplified speech register that sounds like baby talk and is commonly used with older adults.
Elderspeak can be found in many places other than health care facilities — in our homes and everyday interactions with older people.
Why Does Elderspeak Happen?
Leaders in the fields of psychology and aging say elderspeak arises from the implicit biases people have toward aging. Some researchers even call elderspeak and its overly accommodating tone the language of ageism. The subconscious motivation to use elderspeak is based on stereotypes that older people need coddled simplicity to understand what’s going on.
Even though elderspeak is ostensibly used to express care and help the person understand a situation or request, it’s interpreted as exerting control in a condescending way. When spoken to in the tone and pattern of elderspeak, older adults can develop a negative self-perception or may even resist care.
Types of Elderspeak: What to Watch For
Elderspeak uses a particular tone — as if addressing a young child — and often includes oversimplified, patronizing language combined with voicing an intent of control or aggression. It usually brings out a high-pitched and overly nurturing tone and may include inappropriate terms of endearment (such as “sweetie”) and a collective “we” pronoun rather than an independent “you” (as in “How are we feeling today?”).
Researchers at the University of Iowa analyzed elderspeak and identified several of the forms it can take:
- Overaccommodating: The speaker makes an effort to infuse their tone with niceness and understanding as if to keep the older person appeased with pleasantness.
- Example: “I know it’s not fun, but won’t it be lovely if we just take our medicine? Then we can go sit outside for a while!”
- Oversimplifying: The speaker assumes the older adult has decreased communication ability and intentionally uses basic language, often with a childish vocabulary range.
- Example: “The nice man in the big white car isn’t scary. He’s our friend who takes us to the place where we get the food!”
- Infantilizing or Using “Motherese”: The speaker frames their language with informal endearments, like “honey,” and using a sing-song voice and rhythmic or exaggerated speech pattern.
- Example: “Good morning, punkin’-wunkin’! Who’s ready for a ba-ath?!”
- Over personalizing: The speaker exaggerates a compliment or the importance of something in a way that sounds caring and encouraging on the surface but has an element of condescension and behavior manipulation.
- Example: “You got yourself ready and into that chair like a pro! You’re just all kinds of independent today, aren’t you?”
- Masking Control or Aggression: The speaker keeps a seemingly pleasant tone but is overly directive with commands or uses phrases that don’t match the conveyed vocal emotion.
- Example: “I said to zip up your coat, please. We have to get moving, or we’re going to be late again, and you know how mad that makes me.”
Negative Impact of Elderspeak on Older Adults
Many people, particularly when on the receiving side, consider elderspeak to be patronizing, infantilizing and generally disrespectful. Being spoken to this way can affect how a person feels they are perceived, and it often doesn’t align with their self-image. An elderly person may internalize this social inequity in several ways, ranging from resigning to believing they deserve to be treated like a child to reacting with defiance to assert themselves.
Elderspeak can have real health and quality-of-life effects, such as:
- Resistance to care, which can threaten overall physical health
- Damage to self-esteem and confidence
- Increased risk of depression and social isolation
- Reduced cognitive functioning, including an impact on comprehension
Potentially the most significantly damaging result is resisting care. An elderly person who refuses to take medicines, eat and keep up with hygiene can spiral in a serious situation very quickly.
Particularly in health care settings, researchers from the University of Iowa note that using elderspeak doubles the probability that an older adult patient will rebel and resist care. Another group that included the same researchers also explored what happens when caregivers take measures to avoid elderspeak. They found that just a 10% reduction in elderspeak was associated with a 77% decrease in the likelihood the person would resist care as well as a notable decrease in the severity of the rejection of care.
Avoiding Elderspeak: Best Practices and Strategies
Making the effort to avoid elderspeak and adopt anti-ageist language improves the quality of life of older adults and can reduce aggression, agitation and psychosocial symptoms.
To give older loved ones the best care and contribute to their best quality of life, aim to adopt practices like these to help you break away from elderspeak:
- Think Before You Talk: Consider what you are about to say to older adults, how you are going to address them when walking into the room and how your communication will make them feel. The goal is to use respectful and age-appropriate language.
- Speak Clearly and Slowly: Don’t default to speaking loudly or shouting around older people with the assumption that they’re hard of hearing. Also take care not to talk so fast that you can’t be understood well. Speak clearly and slowly, though not in a way that is obvious and exaggerated.
- Maintain Eye Contact and Be an Active Listener: Everyone wants to be seen and heard, especially older adults.
- Respect Autonomy and Preferences: Maybe an older relative wants to get dressed in private. Maybe they like to read their book in a chair and not on the sofa. Maybe they have an interest in fashion and may enjoy choosing what they wear or having a say in how their hair is styled. As long as a preference is not harmful, respect it.
- Consider the Lives They Have Lived: Older adults have not regressed to being children. The older adult in your care has had a lifetime of rich experiences — from going to school to working in a career to raising a family and experiencing pain, love and loss. Wisdom built over time deserves respect.
- Honor the Older Adult’s Life and Intelligence: Engage with empathy and understand their perspective. Remember, older adults have much to teach about life.
- Avoid Assumptions: If you’re unsure of something, ask for clarification. For example, an older adult may not want to eat at the dinner table with their family or friends some evening. Rather than guess why, talk to them to learn how they feel and don’t force them to do something they don’t want to do.
- Use a Positive and Affirming Tone: Keep the golden rule in mind and aim to speak to older people the same way you want to be spoken to. You can be polite, accepting and reassuring while still being firm, critical and assertive when needed. For example, if they’re in a disagreeable mood, you wouldn’t want to dismiss it by snapping, “What do you have to complain about?” Instead, you might offer positive validation by saying “Seems like a rough day today. That’s OK. What can I do to help so we can get done what we need to get done?”
- Seek Feedback and Adjust Your Communication Style Accordingly: Let the older adult guide you on what social interaction features work best with them. If you can’t read their reactions, it doesn’t hurt to ask for preferences.
Everyone wants to be heard, counted and respected. This is just as true of older adults as it is with anyone. Elderspeak undermines this by patronizing those who have lived rich and fulfilling lives. Respectful communication with the elderly is key to acknowledging their worth and helping support their continued health and well-being.
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