Imagine, as an adult, being asked whether you need to go potty, referred to as dear or young man, or told that you’re adorable. It would be patronizing, infantilizing, and an easy way to stoke anger because, past childhood, we expect to be treated with dignity and respect.
But using such patronizing language is a common trap to fall into when speaking to older individuals. Regardless of good intentions, slipping into this type of speech denies them dignity and can harm their health in the long run. Yes, older individuals may be vulnerable and require more care, particularly if they are experiencing cognitive or physical decline. The tendency to, say, slow down your speech or use smaller words is understandable. But, when you’re talking to grandparents, older parents, any elderly person, such language — an example of what’s called “elderspeak” — should be avoided as much as possible.
What Is Elderspeak?
Elderspeak is a term used to describe the patronizing way people tend to talk down to older adults. It could involve repetition (It’s lunchtime. Time for lunch.), speaking slowly and in a higher voice (HOW. ARE. YOU. TODAY?), using more basic vocabulary and sentence structure (Is your tummy rumbling? Must be time for dinner), and using collective pronouns such as “we” when you mean “you” (“Do we want to put on our sweater?”) It’s infantilizing, condescending, infuriating, and can make those that are subject to it doubt their own capability.
While it comes from a well-intentioned place — when we view someone as vulnerable it’s easy to want to speak to them in a way that matches that judgement — elderspeak falls under the umbrella of ageism and works to discriminate against older people. It might be used by doctors, professional caretakers, or an elderly person’s family members. Regardless of who is guilty of elderspeak or what their intentions were, exposure to it is associated with a number of negative outcomes. In addition to simply making a person feel like a child, elderspeak can result in social isolation, cognitive decline, increased dependence, and resistance to caregivers. It also can make elderly people more likely to rate themselves as worse communicators. In the long run, it can actually erode their communication skills.
“Language is basically a use-it-or-lose-it kind of function, to some extent,” says Dr. Anna Corwin, a linguistic anthropologist, assistant professor of anthropology at Saint Mary’s College of California, and author of forthcoming book, Embracing Age. “If you are never interacting with people using complex language, over an extended period of time that seems to be connected to cognitive decline.”
Dr. Kerstin Gerst Emerson, a gerontologist and Clinical Associate Professor at the University of Georgia College of Public Health who studies loneliness and mental health in older minority adults, worries that exposure to elderspeak might make someone hesitant to speak up in a healthcare setting or avoid social situations altogether.
Emerson points out that elderspeak is particularly problematic in any situation where there’s a power differential. Doctors in particular need to be wary of it because of the power they hold. But family members should remain vigilant too, as their comfort level with the older adults in their family might make it easy to slip into condescending speech and disrespectful habits.
While, yes, communication does need to shift when you’re speaking to someone experiencing hearing loss or cognitive decline. But elderspeak, while tempting to use, isn’t the answer. However, the line between elderspeak and accommodating someone with communicative difficulties is simply a bit more nuanced.
While you should never use condescending terms of endearment, speak in a high-pitched voice, or say “we” when you mean “you,” there are some elements of elderspeak that can be helpful when dealing with individuals who are experiencing physical or cognitive impairment.
For instance, when speaking to an older person who has hearing loss or is confused, it’s okay to slow down, raise your volume, and repeat yourself, Corwin says. There’s no need to dumb your language down, however. Research shows that using shorter speech doesn’t lead to greater comprehension in adults experiencing memory loss. Plus, speaking too slowly or too loudly can cause additional confusion.
“If you’re someone with cognitive impairment, and someone’s slowly speaking, you may start to lose track of what they’re saying, you might be confused why they’re shouting certain words that you why some of them are being drawn out,” Emerson adds.
Regardless, it’s important to use complex language even if the person you’re speaking to can’t respond in the same capacity.
Uniquely American Phenomenon
Corwin’ research identifies three alternatives to elderspeak that allows those with even the most advanced communicative difficulties to be exposed to complex language without having to respond in a way that others understand: blessings, jokes, and stories.
Why? Her research took place in a convent, because nuns are widely known for aging “well,” often avoiding the decline in mental health as well as chronic conditions that so often plagues older adults.
She found that blessings were a particularly powerful tool, because even when sisters responded in a way that nobody could understand, the interaction was successful, because the recipient was god, not the people in the room. Jokes and stories are similarly useful, since participating in them doesn’t require much more than a laugh or a smile.
Interestingly, anthropologists agree that elderspeak is unique to America. It’s not found in other countries, or even within the convents that Corwin observed. She concluded that much of why nuns age with such dignity is because they eschew traditional American ideas of what successful aging looks like. While nuns involve each other meaningfully in daily activities even as their abilities change, Americans tend to subscribe to the idea that people who’ve taken the right steps throughout their life will never lose independence or productivity. This myth frames the inevitable decline that comes at the end of a long life as a moral failure.
“It has to do with these really complex cultural ideals of what makes a valuable person,” says Corwin. “Americans have a lot of stigma around aging. In popular culture, even in the medical field, we tend to imagine older adults as less valuable or less competent or less than younger adults.”
Emerson agrees and emphasizes the way our media portrayals of older adults reinforce bias about their value.
“Ageism, I would argue, is one of the last accepted isms in our country,” says Emerson, who notes that awareness is one of the greatest tools we have for combatting it.
A study conducted across five nursing homes in Kansas found that just three hours of training on elderspeak lead caregivers to use fewer inappropriate nicknames and collective pronouns, use longer sentences, and speak in a way that was less controlling and more respectful.
“The word respect is always key,” Emerson says. “This is an amazing human who’s had 80 years of life and has so many incredible stories. It’s valuing them and realizing that these are people who have lived a long life, and have had more experiences than you have.”
How to Avoid Falling into “Elderspeak”
Elderspeak can be divided into two categories. The first is when you automatically and indiscriminately speak down to an older person because you assume they’re less competent. The second is when you change your speech in an attempt to accommodate someone who actually has a hearing or cognitive impairment.
The first kind, motivated by implicit bias, is more straightforward. Stopping it is simple, if not necessarily easy. Consider what assumptions or stereotypes you make about older adults, and how that informs the way you speak to them. In short: speak to them the way you’d want to be spoken to.
“The key is to notice when you’re speaking to an older adult, are you changing the way you’re speaking? Is it different than when you are speaking to any other adult?” says Corwin.
Avoiding the second kind requires more nuance: you’ll have to toe the fine line between accommodating someone and patronizing them. It’s important, then, to speak only as slowly and loudly as is helpful, and to still use complex language. Corwin’s elderspeak alternatives — blessings, jokes, and stories — are helpful formats for communicating respectfully with someone who can’t respond in the same way.
If you do catch yourself engaging in elderspeak, Corwin says it’s important to acknowledge it and apologize, just like any other circumstance in which you realize you’ve been rude. When confronting someone else about it, Emerson warns that they’ll likely get defensive, so try to avoid accusations and frame it as something many well-meaning people do that’s not as helpful as we might think.
It can be startling to realize that the way you’re speaking to a loved one is harmful, but awareness is the first step towards change. Elderspeak doesn’t happen in a vacuum. When you live in a culture that sees and portrays older adults as less valuable, competent, and worthy of respect, that informs how you speak to them, whether you’re conscious of it or not. And while good intentions don’t negate the harm, realizing the harm you’re causing is the first step towards stopping it. Once you notice the habit, it will be hard to miss. Only then you can speak to older adults with the respect they deserve.