Speak to Me Like an Adult: The Implications of Elderspeak
By Katelynn Shimanski
By 2030, it is estimated that around 3 million adults aged 65+ will be living in nursing homes. While many of these individuals have experienced loss of health or functional independence, they still have cognitive functioning and a need for social interaction. Social interaction is critical for "successful aging," but most socialization opportunities are interactions with staff. As such, the use of elderspeak by staff can reinforce dependency and contribute to physical, cognitive, and functional decline (Williams, Kemper, & Hummert, 2003).
Elderspeak refers to a style of communication that features characteristics including slower rate, elevated pitch and volume, greater repetition, exaggerated intonation, inappropriate terms of endearment, and simpler vocabulary and grammar than normal adult speech. An example of elderspeak is referring to someone as “little lady” rather than their name. This way of communicating is patronizing, as it questions the competence of the older adult listener. The speech characteristics of elderspeak are derived from the harmful stereotype that older adults are less competent communicators (Cunningham & Williams, 2007; Williams, Kemper, & Hummert, 2003). While individuals who use elderspeak may think that they are being considerate, research has shown that elderspeak does not improve older adults' comprehension. In fact, it can have the opposite effect.
Gerontology professor Susan Kemper, with the University of Kansas, paired up older adult listeners and younger speakers for a study on elderspeak. The older adults were instructed to listen without interrupting or expressing that they were having difficulty understanding what the speaker was saying. Despite the listeners not expressing any difficulty understanding, the speakers consistently reverted to using elderspeak. Kemper’s study found that elderspeak did not help with the listener’s understanding, and instead caused the older adult to view themself as cognitively impaired (Kemper, 1994).
Various studies have found that nursing staff frequently use elderspeak when working with adults in a long-term care setting. Elderspeak is most often used when assisting with activities of daily living such as eating, toileting, or bathing. The use of elderspeak results in communication breakdown, and increased problem behaviors in older adults. Observational studies of nursing care for individuals with dementia found that staff communication triggered behaviors such as measurable aggression, withdrawal, vocal outbursts, and wandering. These behaviors resulted in disrupted care and contributed to staff stress, burnout, turnover, and increased costs (Herman & Williams, 2009; Williams, Herman, Gajweski, & Wilson, 2009).
Communication is an essential aspect of older adult care. Especially when caring for individuals with dementia, effective communication can increase participation in social interaction and connectedness with others. It can also result in a higher quality of care by reducing resistiveness to care. Not only are interventions aimed at reducing staff use of elderspeak necessary, but past research has suggested they are very effective (Cunningham & Williams, 2007).
It is important to recognize that elderspeak is also an issue outside of nursing homes and assisted living facilities. Everyone, not just caregivers, should remember that older adults are people too and that they have their own lives and experiences. Those who use elderspeak often don’t have malicious intentions. Even so, using elderspeak contributes to a power differential and causes harm. It is important to recognize the signs of elderspeak and understand how you can avoid elderspeak and have meaningful conversations with the older adults in your own life. Sanford Health recommends making sure to address individuals by their preferred name and asking questions to get to know others on a deeper level. At the very least, we all have an obligation to be considerate when communicating both verbally and non-verbally. At some point, we will all become older adults and will want that same level of respect from those who communicate with us.
references
Cunningham, J., & Williams, K. N. (2007). A case study of resistiveness to care and elderspeak. Research and Theory for Nursing Practice: An International Journal, 21(1), 45-56. http://dx.doi.org/10.1891/rtnpij-v21i1a006
Herman, R. E., & Williams, K. N. (2009). Elderspeak’s influence on resistiveness to care: Focus on behavioral events. American Journal of Alzheimer's Disease and Other Dementias, 24(5), 417-423. http://dx.doi.org/10.1177/1533317509341949
Kemper, S. (1994). Elderspeak: Speech accommodations to older adults. Aging, Neuropsychology, and Cognition, 1(1), 17–28. https://doi.org/10.1080/09289919408251447
Next Avenue. (2019, January 23). The negative effects of Elderspeak. Next Avenue. Retrieved April 9, 2022, from https://www.nextavenue.org/negative-effects-elderspeak/
Prevent 'elderspeak' when addressing older adults. Sanford Health News. (2021, September 7). Retrieved April 10, 2022, from https://news.sanfordhealth.org/senior-services/prevent-elderspeak-older-adults/?msclkid=e14089a5b38111ec93e1ab4461558e09
Williams, K. N., Herman, R., Gajewski, B., & Wilson, K. (2009). Elderspeak communication: Impact on dementia care. American Journal of Alzheimer's Disease and Other Dementias, 24(1), 11-20. http://dx.doi.org/10.1177/1533317508318472
Williams, K., Kemper, S., & Hummert, M. L. (2003). Improving nursing home communication: An intervention to reduce elderspeak. The Gerontologist, 43(2), 242-247. http://dx.doi.org/10.1093/geront/43.2.242