Elderspeak: Babytalk Directed at Older Adults

Photo by Neighborhood Centers

About a year after I started volunteering at a skilled nursing home, I observed a set of new teenaged volunteers who came to help with a craft at the monthly meeting of the Red Hat Society.  

I heard several of the volunteers speak slowly and loudly, using a sing-song voice.  In response, I saw many of the residents roll their eyes.   

Unfortunately, I had flashbacks to when I first started as a volunteer.   I had altered my speech inappropriately as well, hoping to be supportive but coming off as patronizing instead.

I have since learned to identify the features of elderspeak.  More importantly, I’ve learned to change my attitude.   

[Note: The links to this post were refreshed in January of 2018 to reflect current research.]

At its core, elderspeak communicates a condescending attitude.   And from that attitude the person’s language might demonstrate the following features of elderspeak:

•  Speaking slowly
•  Speaking loudly
• Using a sing-song voice
• Inflecting statements to sound like a question
• Using the pronouns “we,” “us,” and “our” in place of “you.”: “How are we doing today?"
• Using pet names such as “sweetheart,” “dearie,” or “honey"
• Shortening sentences
• Simplifying syntax (sentence structure)
• Simplifying vocabulary
• Repeating statements or questions
• Answering questions for the older adult: “You would like your lunch now, wouldn’t you?”
• In other ways talking for the older adult: “You are having a good time on the patio today, I see. And you have your pink sweater on, which you love. Right?”
• Asking people questions that assume role loss, idleness and powerlessness such as “Who did you used to be?” “What did you used to do?” 

This post also appears at the fabulous blog Changing Aging.  

Dr. Susan Kemper published several classic articles in the 1990s that describe the features of elderspeak. Since then many other studies have been conducted in an effort to further describe features, measure the effects, and suggest alternatives. 

For a more academic description of elderspeak based on videotaped interactions in a skilled nursing facility, see this 2004 article by Williams, Hummert, and Kemper. 

Even though this list describes various ways in which people sometimes alter their speech when talking to older adults, a couple of misperceptions generate the communication problem:

• Elderspeak assumes that the older adult is dependent, frail, weak, incompetent, childlike, etc.
• Elderspeak assumes that the speaker has greater control, power, value, wisdom, knowledge, etc than the older adult listening.
• Elderspeak assumes that all older adults equally suffer from memory problems, hearing problems, stamina problems, etc.

Public health experts such as Dr. Becca Levy have found that when older adults are exposed to the patronizing language of elderspeak, their performance on tasks decreases and their rates of depression increase.  

Other studies show that even people with moderate to severe dementia can tell when people are talking down to them, and it decreases their level of co-operation.  

I have witnessed this myself.   

One of the residents, who was a retired nurse struggling with dementia, was trying to care for another resident.  The activity director and two certified nurse assistants tried to redirect her away from her neighbor’s apartment.   The employees were using dulcet tones with her, and she quickly replied: “Don’t you get all sweet on me. I won’t be treated this way!”   

People of all levels of cognition preserve the ability to read tone.   

Managing nurses might consider providing training on how to transform elderspeak into more effective acts of communication.  For example, a 2017 study  by Corwin suggests replacing elderspeak with blessings, jokes, and narratives as productive forms of communication.

As the percentage of older adults increases in the US, the need for communicating effectively will be more apparent in many fields, not just health care. 2000 US Census data shows that Americans aged 65+ outnumber the combined populations of London, Moscow, and New York.

About a year before I started my gerontology program, I had the privilege to meet a friend’s nonagenarian mother who had traveled to Wichita from western Kansas.  I unwisely raised my voice and spoke slowly to her: “HOW. ARE. YOU. TODAY?”  She shot back a very energetic, rapid-fire reply--putting me in my place. 

Since that day, I assume that older adults have full hearing and full cognition when I first address them.   If their reply indicates otherwise, then I make moderate adjustments, but I still address them as independent, empowered individuals.

Have you caught yourself using elderspeak?  Has anyone ever talked down to you before?  How is this problem parallel for second language speakers or those managing a disability?  Can you think of any other features of elderspeak? 

Related:

PC Terms for AgingShoulder Pain and Ageism
Modify Conversation with Older Adults as Needed
Talking with Older Adults in a Crisis