Ageism and Elderspeak

Written by Meg Pemberton
Photo by Paul Cripps on Flickr

Lately I’ve been spending more time than I care to, running from one medical appointment to another; perhaps a part of my own aging. However, I prefer to see it as taking care of myself. That’s my story and I’m sticking to it! Either way, I’ve been reminded of how impactful ageism can be, particularly as a result of elderspeak. When someone you’ve never met calls you sweetie or honey, how does that make you feel? Is it ageism or is the person themselves just a sweetheart? Why does it matter? Let’s take a look at ageism and elderspeak.

What is Ageism?

Ageism can be defined as prejudicial attitudes and discrimination towards the elderly. Stereotypes regarding older adults lead to ageism and how society treats them. Assumptions about what it means to be old, how the elderly should behave, and what we might expect as we age lead us to treat the older adults we encounter differently than we treat those the same age as we are. Do you see older adults as frail, infirm, grumpy people? Do you speak to the elderly differently than others?

What is Elderspeak?

Elderspeak can be defined as the infantilizing of communication, with older adults, by slowing speech, speaking louder, and using terms of endearment inappropriately. Typically we see young people using elderspeak when communicating with the older adults in their lives. It’s one thing to talk to you grandparents this way yet quite something different when communicating with someone you don’t know.

Who Speaks Elderspeak?

In the healthcare setting, elderspeak is fairly common. As a young nursing student I was taught to not use terms of endearment with my patients. I learned not to make assumptions about their hearing. It’s something you learn to be aware of yet still may find yourself doing. Nurses, Certified Nurse’s Aides, Physicians, and other healthcare providers are guilty of using elderspeak. In fact, outside of the healthcare arena, families may use elderspeak as they interact and care for their elderly loved ones. Their familiarity may make this a nonissue. The intent is not malicious. It is a result of stereotyping and ageism.

Most older adults find elderspeak to be disrespectful and demeaning. Nearly 50% of older adults receiving healthcare reported use of elderspeak by their caregivers. While some may enjoy terms of endearment most do not appreciate being called honey or sweetheart particularly by strangers. When I’m addressed in this manner I feel that I am no longer seen for who I am. My wrinkles shouldn’t give anyone permission to call me “sweetie.”

Negative Impact of Elderspeak

The Gerontological Society of America has shared research regarding the impact of elderspeak on our elderly. Using elderspeak to improve communication with the elderly is not effective. Various studies have shown that elderspeak actually creates communication issues leading to social isolation, cognitive decline, and negative behaviors. The use of elderspeak can actually precipitate the breakdown of communication. When used to communicate with someone who has dementia, elderspeak can provoke aggressive behavior, outbursts, anger, withdrawal, and wandering.

Avoiding Elderspeak

Monitoring how we communicate with our elderly loved ones is easy enough. Some practical tips for effective communication with the elderly follow.

  • Don’t assume they are hard of hearing; use normal pitch and volume. However, face them directly when speaking, with your lips level with theirs. Do not cover your face.
  • Reduce background noise and distractions.
  • Be mindful of your nonverbal behavior.
  • Be an active listener; pay attention to their words and nonverbal behavior.
  • Be respectful, no baby talk!
  • Be patient. Some older adults may be slow to process an answer to a question. However, this does not mean they are any less engaged or less smart than when they were younger.

Communication tactics for those with dementia include the following. (You can find more from the Alzheimer’s Association here.)

  • Call the person by name.
  • Use short, simple sentences.
  • Speak slowly and clearly.
  • Patiently wait for their response.
  • Repeat information or responses to questions as needed.
  • Do not correct them; agree with them and move on.
  • Turn questions into answers. Instead of asking if they have to go to the bathroom, say here is the bathroom.
  • Don’t argue; redirect them.

Easing the Eldercare Journey with Good Communication

Easing the journey, as with most things, starts with ourselves. However, this can be very difficult for caregivers, particularly family caregivers. My mom struggled to communicate effectively with my dad (who had Alzheimer’s). She had a difficult time learning not to correct him. She found it hard to agree and move on. When dad was aggressive or had outbursts, she took it personally. Arguments ensued, stress levels increased, and they both suffered.

Caregivers hired to work in the older adult’s home and those in healthcare facilities use elderspeak with great frequency. They too take things personally and find it difficult to communicate effectively. If you have a loved one being cared for by a professional caregiver, at home or in a facility, be observant, don’t be afraid to share tactics for effective communication with your loved one.

The next time someone calls you sweetie or honey, feel free to correct them. I haven’t had the gumption to do so myself. I smile and move on. I choose to see it this way, I’ve earned my wrinkles. They tell the story of my life and I’m rather proud of them.

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