'Elderspeak' Can Damage an Older Adult's Health


"It's time to take your pills now, sweetie."

"Hey, chief; you ready for your rehab appointment?"

"Let's go to the bathroom now, honey."

Just seeing these often-uttered phrases on a computer screen may set your teeth on edge. That's because countless caregivers have either heard (or been on the receiving end of) so-called "Elderspeak"—the slow, simplistic, exaggerated tone of voice that people often adopt when addressing older adults. Peppered with terms of endearment such as "sweetie," "hun," and "chief," this communication style, even when well-intentioned, can breed resentment and miscommunication between older adults and their care providers, and result in quite a few negative health consequences.

Studies indicate that more than 20 percent of the interactions between residents and staff members in long-term care facilities involve some variation of Elderspeak. Most of the time, the goal of the individuals who adopt this speech pattern is to enhance communication with older residents, not degrade it.

Even so, there's no denying the detrimental effects these words can have.

Words can hurt

The familiar children's rhyme—"Sticks and stones may break my bones, but words can never hurt me."—is wonderful in theory, but research on how Elderspeak can affect an aging adult's well-being and self-esteem refutes the logic of this claim.

A group of scientists, led by Rebecca Levy, Ph.D., a professor at the Yale School of Public Health, discovered that older individuals who were subjected to negative stereotypes of aging were far more likely to have memory and balance problems. On the other hand, other studies have shown that older people who have a more optimistic attitude about aging could potentially outlive their not-so-positive counterparts by more than seven years.

Levy's study didn't investigate Elderspeak in particular, but individuals who encounter condescending communication styles from their doctors, nurses and even other people out in the community, may be more prone to succumbing to a doom-and-gloom outlook about getting older.

Kristine Williams, RN, Ph.D., did delve into the specific effects of Elderspeak on older adults' health. Williams, an associate professor of nursing at the University of Kansas, found that people with Alzheimer's became more aggressive and resistant to care when their care providers used Elderspeak.

Not only does this hurt the person with Alzheimer's, it also impacts the welfare of the men and women who are caring for them. "The disruptive interaction adds to staff stress, burnout, and high turnover, and increases the costs of care," says Williams in a press release.

Why do people use Elderspeak?

Men and women who employ Elderspeak often aren't doing so out of malice or ill-intent. The more likely cause for their changes in speech pattern when addressing the aged is a phenomenon referred to as "Communication Accommodation Theory (CAT)," which argues that people change how they act and speak based on who they are conversing with. This alteration is practically subconscious, and is often made with the intent of fostering stronger interactions by catering to the perceived deficits of the other conversant(s). However, when it comes to evaluating and accommodating an older adult's conversational needs, younger people are prone to over-exaggeration, and thus overcompensation, in the form of Elderspeak.

Indeed, there are certain scenarios that appear more likely to inspire instances of Elderspeak in professional care providers, according to a new survey of certified nursing assistants (CNA) from several long-term care facilities in the Midwest, conducted by Minnesota State University and Oklahoma State University scientists.

Three main factors—familiarity with the resident, whether the resident had dementia, and whether the resident was alone or there are other people present during the interaction—all appeared to influence whether a nursing home or assisted living staff member felt comfortable using Elderspeak to address a resident. CNAs were more likely to engage in Elderspeak when they knew the resident well, if the resident had dementia and/or there were no family members or other residents present.

The key to combating Elderspeak

One of the best ways for family and professional caregivers to combat the compulsion to engage in Elderspeak is to focus on the strengths of the older adult, rather than their weaknesses. "Negative factors/cues appear to increase the likelihood and perceived appropriateness of Elderspeak use," study authors note. "Perhaps actively attending to residents' strengths as opposed to solely deficits or perceived deficits would be beneficial."

Have you ever caught yourself addressing an older adult with Elderspeak? How do you keep your loved one's strengths in mind, even as you cater to their physical and mental care needs?

You May Also Like

Free AgingCare Guides

Get the latest care advice and articles delivered to your inbox!


I knew I was a senior when a young sales clerk called me Ma'am instead of Miss or Mrs.
I'm 62 and already some people in the community use elderspeak to me. I've been called sweetie a good bit. I don't mind. I kind of find it endearing, since I've always been a rough, independent type. It is mainly cashiers nearing middle age that do it. Everyone who has called me sweetie has been African American, so there may be something cultural. It is meant well and received well. No problem. The first time it happened I remember getting on Facebook and writing that I knew I was getting old. Someone had called me sweetie. :)

People call my mother sweetie and honey all the time. She seems to like the endearing terms. I imagine that there are some people that it would bother, but we're not two of them. Personally, however, I know that older people are the same inside as they once were unless there is dementia. I talk to elders the same as I would talk to a middle-aged person. I do find it degrading when people address elders like they were children. It is more in the content of what they are saying and not really to do with terms of endearment. Doctors can be very guilty of this, saying things like, "Now, you know you ought to be doing this or that." It sounds like they are talking to a child.
Yah, Heart2Heart, I know what you mean about those endless put-downs that a mother makes to make herself appear better somehow: which she always does especially when we are with people who are brand new acquaintances or if we are in a public place and she wants attention or feels insecure. I HATE that. It's such a no win: if I get defensive, that makes it all worse. If I don't say anything, I look like a moron.
Last week when her new friend was sitting on the couch and turned to me instead of her, I answered some questions and responded to the lady. My mother said loudly, "My daughter has such a big mouth." or something like that. I was wearing a scarf around my neck. I lifted it up from my neck and put it in my teeth and laughed like I was gagging myself for her.

Next time I got to remember this one: "It's a small person indeed who feels they must cut off the heads of those around them to feel taller."