A Condescending Vernacular: The Problem of Elderspeak

Published: 30th April 2009
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Many people naturally revert to something like baby talk when communicating with people who are elderly. More than simply a way to adjust to cognitive impairments that elders may develop as they age, this tendency is known as "elderspeak." It often consists of using a singsong-type tone, exaggerating and prolonging words or syllables, speaking more slowly than is necessary, limiting vocabulary, repeating statements over and over again, making statements sound like questions, and using diminutives like "honey," "dear," and "sweetie." While elderspeak may be a common practice, studies consistently show that elders dislike being spoken to in this manner and that speaking like this may even be harmful.



Susan Kemper, a distinguished professor of gerontology at the University of Kansas, was given a grant by the National Institute on Aging to study the ways in which young people change their speech patterns when communicating with elders. For her study, Kemper paired older and younger people together as conversation partners. What she discovered was that younger speakers consistently reverted to elderspeak even when older listeners made no indication that they had difficulty comprehending the conversation. Kemper also concluded that elderspeak did not in any way help older listeners to understand what was being communicated, but instead caused older listeners to perceive themselves as cognitively impaired.



In fact, based on another study, Yale professor Becca Levy concluded that perceiving oneself as cognitively impaired actually leads to lower cognitive functioning. Levy says that condescending and patronizing phrases like "good girl" and "How are we feeling today?" can be extremely detrimental. "Those little insults," she tells us, "can lead to more negative images of aging" and "those who have more negative images of aging have worse functional health over time, including lower rates of survival."



Yet the use of elderspeak is ubiquitous in the eldercare industry, particularly in nursing home and assisted living environments. A research team also at the University of Kansas, headed up by professor Kristine Williams, videotaped interactions between twenty staff members and residents in a nursing home. The tapes revealed that when staff members used elderspeak to talk with residents, the residents were invariably less cooperative and receptive to care and more aggressive. Many expressed their frustration at being addressed like infants by making faces, screaming or refusing to reply with staff members' requests.



So why do health care professionals use elderspeak? Williams suggests that many workers see it as a warm and caring way to connect with their patients, adding that "they don't realize the implications" because "it's also giving messages to older adults that they're incompetent." While a small number of caregivers are mindful of these dangers, much still needs to be done to raise awareness about the issue.



Not unlike the similar issue of childcare professionals "talking down" to children, which also impedes cognitive development, the problem of elderspeak is endemic in part because the industry is not set up to support long-term relationships with caregivers. Turnover rates at nursing homes and assisted living centers can often be very high. Staff are typically assigned to care for many residents without being primary caregivers for any of them, making it difficult to form lasting bonds. In-home caregivers, on the other hand, usually attend to only one patient at a time and often for much longer periods of time, creating relationships in which the individual needs of each patient can be understood and supported.



Elderspeak also reflects larger cultural discomforts around the subject of aging. As New York Times journalist John Leland points out, "as long as our culture is uncomfortable with the aging process, I suspect we will be uncomfortable about the language used to describe it."



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