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Wednesday, January 30, 2019

The Power of Words: Elderspeak

As an elder law attorney, I am fortunate to work with people who range in age from younger than I am to almost as old as my grandmother, who was 101¾ when she died!  One of my favorite parts of my job is getting the chance to hear stories from people who were adults before I was even born – I am always learning something new or gaining a different perspective. 

I also work with many people who have had to step into the role of caregiver for their elderly parents or relatives, and I am reminded of helping my mother and her sisters as they cared for my grandmother in her home.  We often commented on the difficult role reversal everyone experienced as my grandma’s children and grandchildren began to take care of her in many of the same was that she took care of us when we were young.  My grandmother was hard of hearing, and as she aged she lost her vision.  In the last decade or so of her life, she needed help eating, dressing, keeping her house clean, and moving around.  In spite of her physical frailty, though, she stayed sharp.  We had to work pretty hard to pull anything over on her, and she always had a comeback for every joke. 

However, I often noticed that sometimes people seemed not to realize that my grandmother was a fully-functioning adult.  We’d meet store clerks, acquaintances, and medical professionals who spoke to her like she was a child.  They would “dumb down” their vocabulary and talk in a high-pitched, sing-song voice.  These well-intentioned people often didn’t seem to realize what they were doing – they seemed to think she would feel more comfortable that way.  Of course, my grandmother was always too gracious and patient to let it bother her too much, but it set my nerves on edge.

I read an article recently that indicated that my grandmother wasn’t the only person who experienced this phenomenon.  It even has a name – “elderspeak.”  It can be easy to fall into the trap of elderspeak – for example, we had to speak very slowly and very loudly for my grandma, with her failing hearing, to understand us.  Sometimes it was just easier to use more simplistic vocabulary rather than taking the time and energy to communicate complex thoughts at the top of our lungs.  Other caregivers report difficulty in maintaining “adult” conversation with their loved ones who have lost their ability to speak or form words.  However, research has shown that using elderspeak when communicating with patients who have dementia may further reduce their cognitive abilities and cause them to become agitated and resistant to care.

Recently, a researcher named Anna Corwin, Ph.D., studied a group of caregivers who excelled at communicating with their elderly patients.  She found that these caregivers used three types of communication with patients who had communication difficulties:

  • They told stories, using “normal” adult language.Their patients could contribute if they wanted to, or they could just listen.
  • They used humor.  Laughter is a universal language.
  • They prayed with their patients.

One thing that these communications had in common was that there was no pressure on the patient to respond.  The caregiver was addressing and including her patient in her conversation, and the patient could choose the level at which he wanted to participate.  

Caring for an elderly relative is mentally and emotionally challenging on many levels.  Communicating with someone who has difficulty hearing or understanding you can stretch your patience to its breaking point.  But, as Corwin points out, “Avoiding elderspeak, just speaking to older people the way we speak to any adult, is really important.  It’s important not to underestimate how powerful that is.”



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