Mar 18, 2021

I’m not your ‘good girl’ – why older people don’t like being spoken to like a baby

Smiling Elder Woman Waving Her Finger

We have all heard of an older person being called ‘sweetie’ or ‘dear’, or being rewarded with the words ‘good boy’. While this type of language is usually delivered with the best of intentions, speaking to older people as though they are children also is a sign of ageist attitudes and creates the sense that the older person is incompetant.

The issue of talking to aged care residents as though they are children came up on HelloCare’s Aged Care Worker Support Group recently, and we decided to explore the topic.  

Members of the group recognised that ‘elderspeak’, as the practice is called, is disrespectful and patronising, and not in keeping with the first Aged Care Quality and Safety Standard: ‘I am treated with dignity and respect’.

‘Elderspeak’ creates a “downward spiral”

Researchers have shown that elderspeak can even lead to declines in both mental and physical health.

In a study, researchers videoed conversations between 20 residents and staff in aged care homes. 

The researchers found that when the carers used elderspeak, patients became more aggressive, less cooperative and less receptive to care.

When staff spoke to them as though they were children, the older people grimaced, screamed and refused to cooperate with staff.

Dr Kristine Williams, one of the report’s authors, told The New York Times that care staff who use elderspeak don’t realise the implications of the language they’re using. They don’t realise they’re giving older people the message that they’re incompetent.

Little insults lead to negative perceptions of ageing

A fellow researcher, Becca Levy, associate professor of epidemiology and psychology, Yale University, said using ‘elderspeak’ contributes to poor perceptions of ageing.

“Those little insults can lead to more negative images of ageing,” she told The New York Times.

“Those who have more negative images of ageing have worse functional health over time, including lower rates of survival.”

Levy’s research has shown that those who have a positive attitude towards ageing live 7.5 years longer than those with a less positive image of ageing, a larger increase than that associated with exercising more or not smoking.

What is ‘elderspeak’?

As mentioned, elderspeak is the practice of speaking to older people as though they were children.

The examples used by the researchers included ‘good girl’ and ‘honey’. 

They also tested the collective ‘we’, such as in the question ‘how are we feeling?’, which is both grammatically incorrect and implies the older person can not make a decision themselves.

Features of elderspeak include simple vocabulary, short sentences, slow, loud speech and inappropriately intimate terms of endearment.

How should we speak to older people?

Colin McDonnell, dementia consultant at Calvary Care, told HelloCare that speaking to older people as though they are children is humiliating and frustrating for them. 

To begin with, McDonnell says older people should be called by their name and if they have a title, for example professor, then they should continue to be called by that title. 

When you speak to older people, use a “normal” tone and “normal” language, McDonnell said.

“The way we communicate with older people is very important to maintaining their dignity and quality of life,” McDonnell said. 

“It’s upsetting”

Understanding the impacts of elderspeak is particularly important for people living with dementia.

People living with dementia cling to their sense of self or personhood, Williams told The New York Times.

“If you know you’re losing your cognitive abilities and trying to maintain your personhood, and someone talks to you like a baby, it’s upsetting.”

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  1. Thank you. Would you please add on a topic on patronising speech which is similar to the one posted above. Also, please include more references.
    I am planning to do an educational session around this.

    Many thanks.

  2. I feel the most degrading and humiliating term is to be called ‘sweetie’. It makes my skin crawl!

  3. Hi. I found your information on Elder Speak quite valuable. Often we don’t stop to think. I use terms of endearment to my 88 yr old husband but I try to also let him keep positive but he has a fatalistic view and is worried about dying although he knows it will happen. I try to say don’t be so obsessed with dying that you forget to live. I do believe people need to treat older ones with respect. I’m 74 but I love life. I have looked after my former husband and 2 adult children plus helped with 2 Grandaughters who all died of a inherited brain disease and I did try to help them keep their dignity. Plus my Mother who suffered multi infarct dementia. So this information is wonderful. Every nursing home should have a copy. Thankyou very much.

  4. Sweetie and dear are only words used by age care workers because they are the ones that are incompetent because they don’t have the abilityOr are too lazy to try and to remember peoples names it’s something that the age care industry should take responsibility for and encourage their workers to speak by Christian names

  5. I could’t agree more! I will be 74 soon and on my 74th birthday I will have been in residential aged care for fours years. If someone had have told me I’d be in a RACF at 70 I would have laughed at you. But, here I am and despite the fact my health has improved markedly there is no way I could live independently in the community.

    I have suffered from this humiliating language and it makes your blood boil! I’m fortunate I have my faculties in tact and there’s no need to speak to as though I and a doddering old man. I have witnessed many fellow travelers a lot older than me being spoken to like a child just because they have dementia. My hope is this article become required reading before you step on the floor of a nursing home.

  6. This is a very good article highlighting an area that requires more attention and education. Staff are genuinely surprised when told that their well-intentioned terms of endearment can actually be insulting and condescending. They require techniques and coaching on how to interact in a respectful and compassionate way, not that they are not respectful and compassionate, but to assist them to break a habit that comes so naturally to them. They do care and don’t realise in the main that their language could be counter productive.

  7. I recently participated as an RN vaccinator at a COVID-19 vaccination clinic where the senior population was given first priority. I’m up there in age myself. To hear the young nurses suddenly using baby voices and phrases with the elders, as if they were infants, just made me upset, and I spoke up. I was not very popular among the group. I watched family members and caregivers present their person via wheelchair, all the while admiring their strength and commitment to their disabled or dementia-laden loved one. It was lost on the young ones. I should mention that senior nurses once were revered by the newcomers to the profession and those who wanted to learn the ropes – nowadays we’re kicked to the curb.

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