Pneumonia and Shingles Vaccines for Elders
Elder Reading Habits: Classic Novels

The Dangers of Elderspeak

Some of you may know Marcy Belson as she is a regular contributor to our companion blog, The Elder Storytelling Place, and comments here at TGB too.

Last weekend she emailed about a visit to the emergency room. Not to worry - she was quickly back home and is on the mend. Why I mention it is this part of her note to me:

”I did have to listen to a youngish nurse tell me that "us older people tend to ignore or not realize we have symptoms". Maybe so. Maybe not.”

If I had been the nurse, I would have assumed that Marcy was not ignoring symptoms at all; just hoping they were something temporary that would go away on their own – until they didn't and it became urgent that she seek medical attention.

What Marcy got instead was that faux intimacy practiced toward elders by some professionals when they are trying not to roll their eyes at what they perceive as stupidity.

Unfortunately, it is a common occurrence that the default attitude of many younger people – usually strangers - toward the old is that we are none too bright.

They often talk to us more loudly than necessary, they like to explain the obvious and tend to call us “dearie,” “hon” or – the worst - “young lady” when we haven't been anywhere near that category for a few decades.

(Do old men get this too or is it just women who are patronized in this manner?)

There is a name for this kind of demeaning speech. It's called “elderspeak” and being the target of it can shorten an old person's life by up to 7.5 years according to the estimable Yale University associate professor of psychology, Becca Levy, because it reinforces a person's negative perception of their age:

“In a long-term study of 660 people over age 50 in a small Ohio town, published in 2002,” reported The New York Times, “Dr. Levy and her fellow researchers found that those who had positive perceptions of aging lived an average of 7.5 years longer, a bigger increase than that associated with exercising and not smoking.

”The findings held up even when the researchers controlled for differences in the participants’ health conditions.” [emphasis added]

Further, in the same Times story, nurse gerontologist and associate professor at the University of Kansas School of Nursing, “Dr. [Kristine] Williams, noted that members of the healthcare community are among the worst offenders in using elderspeak:

“…Dr. Williams and a team of researchers videotaped interactions in a nursing home between 20 residents and staff members.

They found that when nurses used phrases like ‘good girl’ or ‘How are we feeling?’ patients were more aggressive and less cooperative or receptive to care. If addressed as infants, some showed their irritation by grimacing, screaming or refusing to do what staff members asked of them…

“She added that patients who reacted aggressively against elderspeak might receive less care.”

Anyone who has been reading this blog for awhile can likely guess that I don't suffer elderspeak for a moment anywhere, any time. No one has ever tried it twice with me. But there can be times when it's not possible to fight back.

In another news story from 2008 about Levy's elderspeak study, 78-year-old, retired school teacher, Elaine Smith, was quoted:

"I was in hospital for two months after a fall and the whole time was subjected to condescending treatment and phrases such as 'sweetie,' 'dear' and 'good girl,' she said.

“I often didn't feel strong enough to answer back. But even worse, I felt that this sort of attitude and message was grinding me down. It reduces your self-esteem and at times I felt it was just easiest to give in to the stereotype that I didn't know what I wanted or needed."

It shouldn't be necessary to spend time and money on expensive research to prove that treating old people like babies is bad for their health. It ought to be obvious. What you can do is fight back every time it happens to you or someone you're with. The next elder will thank you.


At The Elder Storytelling Place today, Vicki E. Jones: A Scream in the Night

Comments

I live in the South and it is common practice for women (especially women in service positions) to call everyone "hon" or "sweetie" or "dearie". I never can tell if they are doing it to me because of my white hair, or just because they are southern!

The research on nursing home resident responses to elderspeak is very telling. I hope this information is shared at staff inservices. Our older adults deserve to be treated as adults.

I do agree that this is a problem. If you really want to hear some egregious examples, go into a nursing home and listen to how they speak to the residents.

However, I will say that many nurses get into a bad habit of speaking generally to people as though they are children; especially hospital nurses.

Ronni:
At a convenience store, when a clerk says "Thanks, hon," I answer, "You're welcome,sweetie-pie."

Unfortunately, they always miss the sarcasm.

I was visiting a nursing home recently and this elderspeak was rampant. "Who's gonna be a good girl then?"

Demeaning and demoralizing. I could see residents were antagonistic towards the staff, including my elderly aunt who muttered under her breath.

Speaking out might harm those we wish to protect. I've heard of revenge nightmares in my ongoing studies and dramas about elder abuse.

XO
WWW

I was very defensive of my MIL's dignity when nurses and others spoke to her like that. My MIL was a force to be reckoned with, not a "sweetie," "honey," or "dear." I let them know it, too, even if I just had to say, "Her name is Addy," or "Mrs Prior," depending on the circumstances.

I don't go back to stores or restaurants where they do that to me.

I loath elderspeak. While my mother was dying we had hired care givers at home and many were excellent, but some were so impossible that I took them aside and told them: speak normally, my mother is not in kindergarten. With one visiting nurse, the sing-song tone went away immediately, even though she said, oh, it's just my naturally bubbly personality. Ha, it wasn't. I'm sure in her mind I was the worst bitch in the world. But I made myself clear.

It's such a vulnerable position to be receiving care: what are some ways people could stop this "elderspeak" short of murdering the person who's speaking to them that way? Some of these are people who must be seen daily....

Language is so important.

Janet makes a good point. Nurses in general seem to think some version of elderspeak/baby talk is comforting. It gags me.
If it happens somewhere I have to go frequently, I will say something. Fortunately, it's not an everyday occurrence.

Perhaps we should have buttons made up that say "I'm neither deaf nor senile. I'll let you know when it happens"

About 10 years ago, when I lived in a different city, the office staff in my doctor's office would address older men as Mr. -----, but older women by their first names. When I commented on that, they said they didn't realize they were doing that. My feeling was that older men should get respect, while older women are just old.

How about small incidents of regular, everyday life? For example, I am always addressed as Jackie by the youngsters who work for my dentist. And, I've always encouraged people to call me by my first name. But now am surprised to find that I hate it when they are not personal friends. Of course, this mode of speaking began out of a desire to be egalitarian and friendly. But it has morphed into something which feels undermining and even unnatural. Once a big fan of first names, I now feel they convey a clear lack of respect for older people. But I am shy and I guess a little starchy by nature, and feel very uncomfortable drawing attention to myself by saying, "please call me Mrs. Herships," especially since I have not been married for 20+ years. I suppose 'Ms." is the answer once again, although that doesn't feel right either.

Thank you, thank you for today's topic, Elderspeak. I have lost count of the many put-downs by a nurse. Now I resolve, I'm not gonna meekly take it any more !!

You asked, "Do old men get this too or is it just women who are patronized in this manner?"

I get "young man" from time to time -- I'm 75 -- but I never let it go by unchallenged. I always tell the jerk or jerkess that I find it demeaning and insulting and the last thing I want is to be young like him/her.

I usually get a surprised, flabbergasted look in return. These people just don't have a clue.

I'm remembering a time when I was in a water aerobics class. The young woman at the front desk asked me if I was an adult--thinking, I presume, I might be a "senior." I stared at her and said, "Well, I'm not a child!"

Thanks for this. Being called "young lady" makes me grind my teeth.

I've never noticed being a victim of elderspeak, but I haven't been hospitalized for several decades and I'm not yet in a nursing home. The few times I've noticed a "hon," it seemed to be southernspeak, with no offense meant and none taken.

Hospitals are so demeaning in every way, and the last time I was a patient in one, I felt very helpless and defenseless. I'm not sure how I'd react, or even if I could react, if I were hospitalized again.

Mentioned above was "good girl." Holy cr*p, that's how I talk to my DOG!

I'm Southern and I'm 69, and I hate being called "Miss Kathryn."

I want to support and underscore all the comments above. Maybe it is my European connections, the fact that I spend a ton of time, mostly work-related, in Germany, but I am particularly touchy about the first-name thing -- from everyone, but most noticeably in clinics when I am called in. First, they call me Ruth, although my name is Ruth-Ellen. But then they call me Ruth, as if I were a child, or their friend or relative, or whatever. At which point, if I am feeling particularly feisty, I will respond by asking if they are summoning Dr. Joeres. I actually hate to do it, I realize that the midwest seems to be a lot less formal than the east coast where I grew up, but it bugs me. It is a reduction, quite literally. I have always railed against women being equated with children, as they were even legally in 19th-c. Germany, but as an elder I certainly don't want to be seen as a child. And when some benighted freshman storms into my office and asks if I am Ruth, I always respond, as pompous as it sounds, no, I am Professor Joeres. grrr.

Great comments! I'm trying to remember how I was addressed during my hospital visits. I think they used my first name usually. Sometimes they used Mrs. Jones, but those two greetings were fine with me.


At 46 years old, after a bad car accident, I was placed in a nursing home for some time. I was subjected to this kind of treatment, though I didn't have a word for it. It was awful! It was bad enough that my physical circumstances limited my mobility and lifestyle options at that time, that the times I could eat, sleep and poop were governed by an institution, that I had no control over my environment but the condescension made me feel like my personal agency was under constant attack. Even if one has the energy and words to correct a staff member who is doing it, most nursing homes have such turn-over in staff, that it is an exhausting continuous process.

The worst thing I saw, when taking my late MIL to the Dr. Was medical personnel referring questions to me or my husband instead of to her. She was too beaten down to take offense by that point.
The man who sells us his lettuce at the market always calls Terry and me "the kids, " though, and we just laugh. His lettuce is the best.

It is common in the South to use hon and sweetie and Miss Brenda, especially service people; they don't mean anything by it. The common use of most all of the terms is tradition and habit and example. Frankly, it doesn't bother me, and I ignore it; if it did bother me I would definitely speak up. The only person I ever enjoyed calling me "hon" was my father. He's been dead 35 years, and I would love to hear that term of endearment once again.

I was patronized before being an elder because of a hearing loss. Young men particularly talked to me as if I were feeble minded. It really rankles to have someone assume you are either infantile or stupid because you are hearing impaired or old. At last I now fight back, but I put up with it for years because is just seemed easier to do.

Oh dear, this got me off on a long tangent... and I just had to hit delete. No one wants to read a blog post in the comments!

But I have become exceedingly bossy in my age of whitening hair and I'd rip the XXXX uh.. lips off any young whippersnapper who was so bold as to suggest that I "be a good girl".

Life is way too short to get bothered by some of these
"elderisms". Have you noticed the way young women speak over and around their children of 2
or 3? As if they were wallpaper! And taking them out for a walk--all the while on their cell phones not paying
attention to them! No wonder
we have such a gap in generations! They will be the first to complain when their grown children do not pay attention to them.
As far as 'elder speak' make your displeasure known (but be careful if they have a 'needle' or other relatively painful object in their hands!
As I said, life IS short--do your best to enjoy the trip.

Some people just don’t get it. I quit a favorite exercise class b/c the instructor made comments to and about me that I felt offensive. I met her out in the parking lot after one session and tried to explain what she was doing. She appeared stunned and felt herself victimized. I continued with the class a few more times until one day she referred to me as "beautiful"…I quit the class…Believe me, some just don’t get it. But that does not mean I have to take it!!!!

I believe that this pointless assault on dignity is known as "stereotype threat" when the condescending talk is aimed as other groups. When students have to indicate their gender at the start of a math test, the girls do worse! Same with race, if I remember correctly--if the teacher were to say, "People from group X have more trouble with this subject," people from group X will do worse than they otherwise would.

Age, alas, is not exempt. Mostly, we in the stigmatized groups just suck it up and bear it, which is probably a mistake from a health and self-esteem point of view. It certainly feels awful, though the perpetrators NEVER seem to "see a problem" with cruel and casual disrespect.

What are your most effective re-educating rejoinders?

Like Paula, I'm interested in what is effective when dealing with 'elderspeak'. I've tried being direct, being sarcastic, and using gentle reminders that I'm not a girl but a woman,

I was a waitress when going to college in the 1960s and frequently called my diners "hon" or 'sweetie' but it was an ageless thing-from teens to elders, men and women alike....it was a waitress thing back then.

What are others using as rejoinders for being addressed in a demeaning manner?
elle

I think it has to be pointed out to people that they are doing this "elder-speak" thing. It's so pervasive that many people aren't even aware that they do it.

We elders have to do our part too: have you ever noticed that many older people don't converse with kids or young people?

They just give them the 3rd degree, peppering them with questions about their schooling, work, boyfriend or whatever. I actually had to train myself not to do that.

Oh yes, as an elder man I often am addressed by waitresses and other service people as "Hon" or "Sweetie," and it is not appreciated. However,at least an equal number of younger contacts use "Sir" or "Mr. Klade" (if they know my last name. Among male friends of similar age, we often jokingly refer to each other as "young man." Nothing derogatory is implied by that. I have no problem with contacts of any age referring to me by my first name--I don't feel old enough to require a "Sir" or "Mr."

Point well taken Yvonne! It's no excuse, but sometimes it is hard to get student-age people to visit. Will try harder to work on that myself.

My sister was looking for some light day help for my parents and she discovered one agency that called itself "Granny Nannies." Nuff said.

Some time ago I accompanied my 80 year old neighbour to see her consultant after she had been diagnosed with breast cancer.
The consultant (male) spoke to her in a very loud voice and in crude, simplistic language I.e "We are going to take your breast off. Do you understand?"
I told him my friend was neither deaf nor stupid ( she is a retired teacher) and his attitude changed and he started to treat her as an ordinary patient.
But what if she had been alone?

I think we do need to push back when we're subjected to elderspeak. A few years ago, I was taking a flight and the TSA guy greeted me by saying, "How are you, young lady?" I replied, "I"m fine, and I'm not young."

I've also encountered plenty of elderspeak around doing anything online, such as downloading a form from the internet. It's usually expressed by asking whether I have "access to a computer". Rather than just nod, I say that I've used a computer for over 25 years. But why do they even need to ask?

Couple weeks ago I went shopping with my husband for a new cell phone.

We walked into a couple stores looking, asking questions.

The last store we walked into, the young female sales person placed her body squarely in front of mine, looked straight at my husband and extolled the virtues of a phone I'd never be comfortable using.

I make on average 3 calls a month, that's it. I do not like being tethered to a cell phone.

My husband backed away to let me speak, but the clerk kept on selling the wrong phone to him as if I were a fly speck.

I said twice "the phone is for me."

Then I gave my husband "the secret code look," and we walked out.

The clerk was still babbling to his back as we left.

Adios.

Another store off my list.

Having worked as a hospital nurse, I think this colunn should be copied and passed out to each person you encounter who calls you "dear", "good girl", etc.

Nurses are overworked and I don't think that calling someone dear or hon is mean spirited.

At the dentist office recently, I asked about a painful canker sore I had earlier. His response - "as WE get older, our immune system gets weaker..." Having just turned 60, I was mildly offended at the "older" reference but pleased he was inclusive with the "WE" - the dentist being a couple of years younger. And he was pointing out a medical fact. Our bodies change as we age.

NEarly 20 yrs. ago as my mother declined with Alzheimers and we moved her from one assisted living facility to another closer to family, I was asked what my mother preferred to be called (her first name or by Mrs. Cary) - not what I preferred but what SHE preferred. I was struck by the sensitivity of this question and knew I had found a good home for her. Mom was not in the room at the time. I think the social worker would have asked her directly although at the point, Mom wouldn't have responded. Sadly, I had to tell them to call her by her first name because the facility she was in earlier had been doing that for 4 years and she was at the stage where that was what she would respond to, no longer to Mrs. Cary. No one there had asked and they called everyone by their first name (to make it more "family-like" was their rationale). I was too overwhelmed with getting her settled and closing up her apartment to protest. But Mom was of the generation that expected older adults to be addressed formally by younger people (as 90% of the staff were) unless specifically asked to be called by their first name.

After living in Georgia for a few years I kind of liked being called Hon. The people who call you that use it with everyone and it isn't meant to be condescending or disrespectful. What does irritate me though is a doctor having his patients call him Dr. First name. Dr. Steve. Maybe it's because my mother's doctor saw mostly older patients and took advantage. I'm sure that from today I will be more aware of what I am called.

I was in charge of my mother for 18 years (memory) and fired a doctor for that "young lady" and "youngster" stuff. Mom didn't care, but I sure did and I had the power.

If you were doing a study on the elderly, what age range would that entail. The studies that include 50 year olds make my head shake. The 50s were great for me. The stereotype of the menopausal woman actually made me feel quite powerful. I'm a very easy going person but people seemed to think women of that age had a Dr. Jekyll and Mr. Hyde personality and were really careful to not upset menopausal women. The minute I turned 60 was when I realized that I should be thinking about image and speech patterns that differentiate those treated with respect and those treated as invisible or feeble-minded elderly. Think 60 is a tipping point that needs to be researched because it's less about decline and more about perception.

I just found your website and thought that you would like to see a brief video that addresses the topic of elder-speak and what we can do to re-think the language we use in the eldercare community.

http://www.youtube.com/watch?v=6nQJqlTf0t4

I am not an elder but I find it very offensive to be addressed as "hon, sweetie," etc. And yes, I am southern born and bred but my parents raised me to address others properly. At my daughter's wedding reception, the caterer addressed my husband as "sir" and me as "sweetie." The only reason I didn't raise hell was because it was the kids' special day and I didn't want any unpleasantness.

The employees at my father's assisted living facility talk to the residents like they are children. "Honey, doll, sweetheart" are heard all the time; even the director does it. Dad doesn't want me to say anything, even though he hates it. I pointed out that he pays a lot of money to live there and he is entitled to be treated with respect. I did mention it in one of the surveys the facility sends out from time to time, but nothing was ever done.

Even worse than being called "hon" is having your feelings dismissed. It may not bother you, but if it bothers someone else they have a right to speak up.

"As we might do with an aging, know-it-all relative, we have learned to tune out the Tennessean nonesense."—J. T. McGregor


The above quote is from a letter to the editor of the Nashville newspaper in reference to the stance the newspaper took on the contrived, convoluted, and idiotic amendments "we, the people" GOT to vote on in the midterm election.

And the beat goes on---or the verbal beating goes on.

In my Asian culture, it is customary that elders are addressed using terms you may call elderspeak. It's kind of irritating at times, but what can I do? Am I going to ruin my day over such trivial things when the business of feeling happy in the midst of loneliness is of more primordial concern?

Let them talk. Who cares? As long I am upbeat inside, let them eat their hearts out.

While at a BIG BOX store, I was addressed as "Dear" several times. I am in my early seventies and am painfully aware that this is the verbal greeting that one receives. Push finally came to shove, metaphorically speaking, and I railed at the clerk. I asked her if I was sporting antlers. No pun intended that she looked like "A dear caught in the headlights." I then leaned forward, and whispered to her that she was offensive and must never use that greeting again to an older customer.

Hi, I'm Anne, I'm 53 and a health care professional (doctoral level). Because I look much older than my age, people assume I"m in my 60s and they use the Elderspeak on me. I don't live in the American South, I don't have grey hair, but I have lived a hard life and it shows in my face. I had been getting whole big sentences of Elderspeak 10-20 times/day (at essentially every store, restaurant, I couldn't even order a burger at a Wendy's without having to listen to "Yes honey, my dear, would we want Ketchup on our burger now sweetie? Oh dear hun just a moment dear... (after they screwed up the simple burger order)". I also was refused service at empty restaurants because "someone else might come in" . Plus at job interviews in a very slow voice... "are you ...surrrreeee...youuuuu...have ...the ...ennnnergy dear?! "Can you handle the s..t...a....i....r.....s.." One site insisted on cognitive testing - I bowed out - let them find someone else!! It was severely eroding my self-esteem. So I began to speak up as a daily practice, and politely say "don't call me sweetie, honey, huns, dear ...or Old Granny Bunny... especially not Young Lady or Our Poor Old Dear". Most people burst into laughter... and stop the BS. I also tell them I won't shop there, that I won't recommend to others, and that I want my money back if they insist on using the Elderspeak - usually this gets them to stop. But a few people have become threatening and starting screaming at me that its their right to call me what they want ... and that they have a right to their authenticity. One of the screamers at the Airport refused to let me board because I quietly said "Please don't call me dear" - her manager overrode her and away I went. Another screamer threw me out of an (empty) pizza place because I said "Please don't use Elderspeak" (they were using We and the singsong voice and the simple toddler talk). One restaurant had staff who said "Yes, dear, now dear, of course I won't call you dear, now dear, its total respect dear (me - please stop) of course dear, I have other people dear to serve now my dear"....One hospital that had staff that kept saying "Dear" and a doc who said "its just your age" and refused me cardiac investigation... their patient relations agreed to add information on age discrimination to their customer service coaching. What none of them know when they see me.... don't realize I am about to firmly, politely and fairly say "No, please call me that". My biggest problem is the ones that become more abusive and aggressive, turn red, start screaming, get up in my face, lean over me and begin to rant, rave, and rage. This only happens if I'm alone - and I'm quite small so they perceive me apparently as vulnerable (and no physical threat - but some have said that they were afraid of my words). Usually I just leave, if any say "I'll kill you" then I'd call the police (it hasn't gone that far). Remember, the people that do this to me number hundreds, so of course I run across a few really bad apples. Anyone else face this?!! I would love to work with others to change ageism in society - none of us should have to be alone in facing this!!

I believe the issue is is that (like with antisemitic, sexist, racist, classicist and other discriminatory speech), the Elderspeak underlies many darker realities... such as more florid "Granny (and Grandpa) bashing; discrimination in health care that shortens life; poverty among elders, job discrimination... others might add discrimination in relationships/dating, etc. Ageism and its intersection with sexism has effected even some of the most powerful people on Earth (eg// Nancy Pelosi)!

Ageism is real, and Elderspeak is just its "Dearest" Facade!!

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