Elderspeak Views of Certified Nursing Assistants (CNA Research)

What is elderspeak? Basiclly, it’s baby talk that most adults would not think of using in conversations with other adults. As a hospice volunteer in nursing homes, I noticed elderspeak being used often. For example, “Hi, Mr. Smith. I hope you’re enjoying your day? Did you have a good dinner?” might become a singsong version of this: “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 the average 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 way.

This research on elderspeak focused on the perspectives of certified nursing assistants (CNAs) who frequently spend time with older residents. The goal was to learn more about the intent and conditions under which elderspeak is used. Participants who were interviewed included 26 CNAs who worked in long-term care facilities. It should be noted that half of the CNAs reported that elderspeak is more appropriate with individuals with dementia and that others believed elderspeak was always inappropriate.

These were the findings regarding the intended purposes of CNAs using elderspeak:

1)   Make residents feel more comfortable.

2)   Make caregivers seem friendlier.

3)   Help residents better comprehend verbal communication.

4)   Increase the likelihood that residents cooperate during caregiving tasks.

Based on these findings, more staff education is needed that incorporates previous research results. For example, elderspeak research reported in Behavior Therapy states that resistiveness to care has been linked to communication by staff using elderspeak. This study examined videotapes of nursing home residents with dementia interacting with staff.

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, research studies indicate that their self-esteem may be lowered. In addition, using elderspeak perpetuates negative stereotypes about the elderly.

On a personal note, I was raised in the Jim Crow South and was taught that children should never call adults by their first names. For many African Americans, including adults addressing other adults, this was not only a practice of respect, but mandatory in society under certain racial conditions. After I received my driver’s license at sixteen, I felt proud when I was told I could start picking up my grandmother from her job as a cook at a segregated white school.

Imagine my distress when I arrived at the school and saw young children calling my grey-haired grandmother “Lou.” She allowed it because she needed the job, but words cannot describe the humiliation in her eyes when she saw me and realized I had witnessed how she was treated there. That night, my mother told me I couldn’t pick up my grandmother from work again. For many older African Americans, being called by their first names without their permission by younger adults is connected to painful memories of historical injustices.

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 online and offline booksellers.

Hospice and Nursing Homes Blog

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.

Hospice and Nursing Homes Blog