Thursday, February 4, 2010

Elderspeak in Nursing Homes: Sweetie, Can We Talk?

Elderspeak is a form of baby talk that most adults would not ordinarily use in conversations with other adults. As a hospice volunteer in nursing homes, I noticed elderspeak being used often with older residents, especially those who had dementia. For example, “Hi, Mr. Smith. I hope you’re enjoying your day? Did you have a good dinner?” might become a singsong version of, “Hey, Handsome. Are you behaving today? Did you eat all your dinner veggies like a good boy? You did? That’s my baby!” Imagine what an everyday adult would think about being addressed in this manner. But some nursing home staff members, caregivers, and others think nothing of speaking to residents in this manner. Unfortunately, stereotypes about the elderly often result in adults using elderspeak when speaking to seniors in general, regardless of the location.

Use of elderspeak implies that the resident is not competent enough to be spoken to on an adult level. Even when residents get used to being spoken to in elderspeak and seem not to mind, their self-esteem may be lowered. In addition, using elderspeak perpetuates stereotypes about the elderly and encourages ageism. Elderspeak research by the University of Kansas School of Nursing reports that elderspeak use by nursing home staff increased the probability of resistance to care in older adults with dementia. These residents responded frequently with screaming or yelling, negative comments, and crying. It is far more helpful to respectfully use adult speech with clarity, while keeping in mind the uniqueness of each individual.

Born and raised in the South, I was taught at an early age that all adults were entitled to the respect of being called by their formal names, such as "Miss Jones." Imagine my shock as a teenager the first time I was allowed to drive a car to pick up my grandmother from her job as a cook at a segregated white school. Young students of all ages were calling her "Lou." She allowed it because she needed the job. But the embarrassment in her eyes when she saw me witness this will never be forgotten. That night, my mother told me I couldn't pick up my grandmother from work anymore. For many older African Americans, being called by their first names or nicknames without their consent carries painful memories of historical racist condescension.

You can read researched elderspeak views of certified nursing assistants (CNAs) here.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at booksellers such as Amazon.


  1. Thank you for addressing this. I find that language largely condescending and thoughtless.

  2. This is just one more reason we must demand that every dementia caregiver be provided special training for these most fragile of our loved ones. When my mom was in long term care, I remember her being called these "endearing" names like sweetie, MaMa, etc. Another issue was voice volume. Yelling at a dementia victim does nothing to help her better understand the words being spoken to her. Dementia is not a hearing disorder!

    Along these same lines, I have started a blog on the under-treatment of pain in dementia. Please visit and comment on this site - We must be the voice for our dementia friends who are suffering in silence. Candy

  3. I agree with Candy. We don't do enough formalized training in elder care.

  4. While I agree that the condescending language and tone is unnecessary, both my mother and husband appreciated hearing an endearing name AFTER they knew the caregiver for a while. If not, mother would make faces behind their back and then talk just like them to their faces. They got the hint soon enough. Not all patients are as 'forgiving' as she was. ;-) Karen

  5. It is important to respect your elders. I admit, having someone live with me who has Alzheimer's, has made it challenging.
    Sometimes, the only way she will respond to what I want is if I talk to her in a sicky-sweet voice. But then there is my dad who is a proud, strong man with COPD who gets talked to like he is a little old man, and it ticks us both off!
    That's why I work hard to be patient and kind to them (both in my care)... and why I have a website Here 2 Help Services with information for various subjects. Awareness is important.