Guarding Against Elderspeak

How does it strike you when someone asks you "How do we feel today"? This makes me want to say "I am fine, but I am not sure about you." Using the collective "we" is offensive to some, and it can be especially insulting, even harmful, to elders.

Talking down to or ignoring an elder's ability to speak and understand for herself is a form of age discrimination commonly known as Elderspeak. Elderspeak has many forms but is generally understood as talking to an elder in sweet sing-song speech, as if to a baby. Although typically well-intentioned, using elderspeak is so offensive to some, especially those who recognize their brain function is failing (early Alzheimer's) it can actually cause disruptive behavior and depression. In well elders, Elderspeak can actually cause harm. In a long-term survey of 660 people over age 50 in a small Ohio town, published in 2002, researchers found that those who had positive perceptions of aging lived an average of 7.5 years longer, a bigger increase than that associated with exercising or not smoking (1). The link is that negative attitudes can be damaging to an older person's self-esteem and self-perception.

Elderspeak comes in many forms, both verbal and nonverbal. Common expressions can be perceived as patronizing. It's the little things that matter, such as: calling a person "dear" or "sweetie" with whom you have no history or basis for the endearment; commanding a person to do something as if speaking to a child, such as "let's get you into bed" (this type of language assumes dependency and is demeaning); praising a person, "good boy!" or "look at you, what a good girl!" as if talking to a child or a pet; or referring to a retirement center or a nursing home as an "old folks home" or worse, a "rest home" (just when an elder needs encouragement to be active, we put her to bed!).

Be aware of how you are coming across to an elder. Avoid stereotyping. Refer to an elder by full name, or ask him what he prefers to be called. Avoid plural pronouns, which assume an elder cannot perform a function alone. Do not assume shortened sentences, slow or loud speech, or simplified language is necessary in order to communicate.

Listen more. As a friend or family member, check out your impressions or questions; ask "do you mean to say this?" in the same manner as you would clarify a point with a peer. Don't continually remind an older person of a disability or decreasing memory function. Even if you are the one helping interpret the world's realities to a person with dementia, do so in a respectful way--you both will feel better about it. Pay attention to behavior and subtle clues that indicate feelings, even with those who cannot articulate them. Understanding how you would feel in a frustrating situation might help you differentiate between concluding "this person is demented and that is why he is acting this way" and "I'd be frustrated too if I could not figure out this problem."

As an elder, make it plain you are capable of understanding normal speech. Speak back to the person in an adult way, do not reinforce an offensive style. It takes two to communicate. You can help shape a conversation by responding in a way that indicates the tone you wish the conversation to take.

Elderspeak is subtle and can easily creep into conversation without your knowing it. But if you try, you can increase your awareness of this prejudice and help your friends and loved ones enjoy and respect one another.