Avoiding Elderspeak: How to Talk With Older Adults More Respectfully

If you’ve ever walked through the halls of a hospital, doctor’s office, or senior living facility, you’ve likely encountered “elderspeak.” Whether you’ve been on the receiving end or have used it without realizing, elderspeak is common but can be problematic when communicating with older adults.

As tempting as it may be to use, elderspeak can feel demeaning and frustrating. Let’s explore what elderspeak is and discuss ways to avoid it when communicating with older adults.

What Is Elderspeak?

Imagine this scenario: A nurse enters the room of an 85-year-old patient during morning rounds. As the patient begins to wake up, the nurse says, “Good morning, sweetheart. Can you be a good girl for me and sit up to take your medicine?”

This is an example of elderspeak.

The National Center to Reframe Aging defines elderspeak as a simplified, often condescending style of communication, similar to baby talk, frequently directed toward older adults.

Elderspeak isn’t limited to healthcare settings. It’s often used in everyday interactions at home and in conversations with older individuals.

Why Does Elderspeak Happen?

Elderspeak stems from implicit biases about aging. Some researchers even describe it as a form of ageism. People may use elderspeak out of a subconscious belief that older adults need extra help or simpler language to understand what’s being said.

While elderspeak may be intended to express care, it often comes across as patronizing or controlling. Older adults may find it condescending and may even resist care when spoken to this way.

Common Types of Elderspeak

Elderspeak often involves using a tone of voice that resembles how you might talk to a child, combined with oversimplified language and an intent to control. Here are some forms of elderspeak identified by researchers at the University of Iowa:

• Overaccommodating: Speaking in an overly sweet or accommodating tone to keep the person happy or calm. Example: “I know it’s not fun, but if we take our medicine, we can go sit outside for a while!”
• Oversimplifying: Using overly basic language, assuming the older adult can’t understand complex information. Example: “The nice man in the big white car is our friend. He’ll take us to get food!”
• Infantilizing: Using terms of endearment, a sing-song voice, or exaggerated speech patterns. Example: “Good morning, punkin’! Ready for a ba-ath?”
• Over-personalizing: Exaggerating compliments in a way that feels condescending. Example: “Look at you! You got yourself ready like a pro today!”
• Masking Control or Aggression: Maintaining a sweet tone while giving orders or expressing frustration. Example: “Zip up your coat, please. We need to go now, or we’ll be late again!”

Negative Impact of Elderspeak

Many older adults find elderspeak patronizing and disrespectful. It can negatively impact their self-esteem, leading to feelings of frustration or defiance. This type of communication can have real effects, such as:

• Resistance to care, which can harm physical health
• Lower self-esteem and confidence
• Increased risk of depression or isolation
• Decline in cognitive functioning

One of the most serious effects is when elderspeak causes an older adult to resist care, which can quickly lead to health complications.

In healthcare settings, researchers have found that elderspeak doubles the likelihood that an older patient will resist care. Reducing the use of elderspeak by just 10% can decrease care resistance by 77%.

How to Avoid Elderspeak: Best Practices

Making an effort to avoid elderspeak and use respectful language can improve an older adult’s quality of life and reduce stress. Here are some ways to do that:

• Think Before You Speak: Consider how your words will make the older adult feel. Use respectful, age-appropriate language.
• Speak Clearly and Slowly: Don’t assume all older adults have hearing difficulties. Speak at a natural pace without shouting or exaggerating your speech.
• Maintain Eye Contact and Listen: Make sure the person feels seen and heard by maintaining eye contact and actively listening.
• Respect Their Preferences: Allow older adults to express their preferences and respect their autonomy.
• Consider Their Life Experiences: Older adults are not children. They have had full lives filled with valuable experiences. Treat them with the respect they deserve.
• Avoid Making Assumptions: If you're unsure, ask. Engage in meaningful conversation to understand their thoughts and feelings.
• Use Positive, Affirming Language: Speak in a way that is both respectful and supportive, without being overly controlling or dismissive.
• Adjust Based on Feedback: Let the older adult guide the interaction, and adjust your communication style as needed.

Conclusion

Everyone deserves to be treated with respect, and this is especially true for older adults. Elderspeak undermines their dignity and self-worth, leading to negative consequences for their health and well-being. By adopting respectful communication practices, we can better support the older adults in our lives and ensure they feel valued and respected.