"ELDERSPEAK" AT THE NURSING HOME

They may not be as sharp as they once were. TheirNursing home staff members are often very caring
memories may be failing. But people withpeople, Niedens said. But the work is demanding and
Alzheimer’s can still sense when someone isturnover is extremely high. Workers may not have
talking down to them. And they don’t like it anythe time to get to know patients as individuals. When
more than the rest of us do. The prevalence ofpeople talk in elderspeak, they may use inappropriate
"elderspeak" at the nursing home ought to be aterms of endearment, simplify their vocabulary and
consideration in selecting this type of senior housing.grammar, repeat things or use a high-pitched voice.
Read more:Collective nouns are often used, as in: “Are we
Dr. Kristine WilliamsKristine Williams (left), a Universityready for our bath?”
of Kansas School of Nursing researcher analyzedWhen elderspeak isn’t sugarcoated, it can be
everyday interactions between nursing homebossy and abrupt.
residents with dementia and the staff who took careThe language is virtually the same that parents might
of them. When the staff called residents demeaninguse to coax or order a small child to do something.
names like “Sweetie” or “Dearie” orWhen researchers played audio recordings of what
spoke to them in the singsong language of baby talk,staff members at day-care centers and nursing
the residents were twice as likely to behomes said, people couldn’t tell whether they
uncooperative as when they were spoken to in awere talking to children or to elderly people.
normal adult tone.For a previous study, Williams recorded a nurse’s
They showed their displeasure in a variety of ways:aide using elderspeak while trying to persuade a
pushing away, issuing threats, grabbing things,nursing home resident to make friends with another
clenching their teeth, crying and screaming, hitting andresident. The two elderly people are sitting next to
kicking.each other in the hallway in wheelchairs. The
Williams has spent years studying how wenurse’s aide, who speaks in a high-pitched voice,
communicate with older people. Addressing thedoes all the talking.
elderly with patronizing language, particularly whenFor her new study, Williams videotaped staff
they appear frail or are institutionalized in nursingmembers at three Kansas nursing homes as they
homes, hospitals, or assisted living facilities acared for 20 residents. The residents ranged in age
pervasive problem, she said.from 69 to 97. They all had a moderate level of
It’s so common that researchers have coined adementia. Most of the staff in the study were
word to describe it: “elderspeak.”certified nursing assistants, but the participants also
“In our society we have negative attitudesincluded nurses, therapists and social workers. They
toward aging,” Williams said. “We develophelped residents with such activities as getting out of
negative stereotypes about (the elder’s)bed in the morning, taking their medications, brushing
competence.”their teeth and going to meals.
Williams, a nurse, worked briefly in a nursing homeAfter analyzing the videos, Williams calculated that
and also provided home health care to elderlythere was a 26 percent chance that residents would
patients earlier in her career. “I recognizedresist care when the staff used normal adult speech.
(elderspeak) right away working with olderBut when the staff used elderspeak, the likelihood
people,” she said. “We use it all the time andthat residents would resist jumped to 55 percent.
don’t recognize how negative it is. It’s a“It could really facilitate care if staff used normal
subconscious thing.”speech,” Williams said. “Resistance to care
Using elderspeak is a symptom of society’stakes a lot of time and is stressful to staff.”
frequently negative attitudes toward elderly people,Williams has tried brief training sessions with nursing
particularly those with dementia, said Michelle Niedenshome staffs to help them avoid using elderspeak,
of the Alzheimer’s Association’s Heart ofand it makes a difference, at least at first.
America chapter, based in Prairie Village.But two months later, she found that staff speech
“There’s this assumption when you’rewas taking on the less respectful tone of elderspeak
older that you’re less than (a full person), anagain. “It’s the language of the nursing
assumption of weakness,” Niedens said. Toohome,” Williams said. “Any kind of habit is
often, she said, the life experiences and relationshipsdifficult to overcome.”
of these people aren’t valued. They are viewed“People with dementia realize they’re losing
simply as people with an illness.their cognitive abilities. One of their challenges is to
Niedens recalled making visits to a nursing homemaintain their sense of identity. If they’re talked
resident with Alzheimer’s disease, a retiredto like an infant, it can be very disturbing,” said
country doctor. “It was clear talking to him thatKU researcher Williams. “They recognize
was his identity,” she said. “I never called himthey’re being talked down to, and they find it
by his first name. We always called himpatronizing and demeaning.
‘Doc.’ It was affirming to him.”