By all accounts, Cindy Smith’s 92-year-old father was a man of humor and dignity. A World War II veteran and retired county planner, he had lost some of his eyesight and needed a walker, but his wit remained razor-sharp. So when an aide in his California assisted living home chirped, “Let me help you, sweetheart,” he quipped back with deadpan brilliance: “What, are we getting married?”
The moment was funny — but revealing. It’s a striking example of a widespread communication habit that too often diminishes older adults: elderspeak.
What Exactly Is Elderspeak?
You may not know the term, but you’ve likely heard it — or even used it without realizing. Elderspeak is a pattern of speech used with older adults that mimics baby talk. It’s often laced with terms of endearment like “honey,” “sweetie,” and “dearie.” It features sing-song tones, overly simplified vocabulary, slow pacing, and an exaggerated or condescending tone.
“It stems from an ageist assumption of fragility or dependence,” explains Clarissa Shaw, a dementia care researcher at the University of Iowa. “It’s communication that, although usually well-meaning, implies incompetence.”
Even subtler forms — like using plural pronouns (“Are we ready for our bath?”) or tag questions (“You’re ready for lunch now, right?”) — undermine autonomy. The intention may be kindness, but the impact is often condescension.
The Cost of Kindness Gone Awry
Studies show that elderspeak isn’t just irritating — it can actually harm older adults, particularly those living in care facilities or dealing with cognitive decline.
In one notable study led by gerontologist Kristine Williams and her team, video recordings of interactions between nursing home staff and dementia patients revealed that elderspeak was used in 84% of conversations. And it wasn’t just about words: elderspeak increased the likelihood of what’s called “resistance to care.” That’s when residents turn away, refuse help, cry, or even lash out.
“These behaviors are often labeled as symptoms of dementia,” said Williams. “But they may actually be triggered by the way we communicate.”
Changing the Way We Talk: The CHAT Model
Recognizing the harm, Williams and Shaw developed a training program called CHAT (Changing Talk). This simple, three-session model uses real-life video examples to raise awareness among caregivers and reduce the use of elderspeak.
In facilities that implemented CHAT, the results were profound:
- Elderspeak dropped from 35% to 20% of interactions.
- Resident resistance to care dropped from 36% to 20%.
- Use of antipsychotic medications declined — a clinically meaningful result, even if not statistically significant due to small sample size.
Given that such medications carry FDA black box warnings for use in frail elderly populations, reducing their use through better communication is no small feat.
Now, CHAT has moved online and is being tested in 200 nursing homes across the country — a promising sign of systemic change in eldercare.
Real Lives, Real Impact
Carol Fahy, a psychologist from Hawaii, recalls visiting her mother in an Ohio assisted living facility and watching, horrified, as staff addressed her blind and aging mother as “sweetie” and styled her hair into toddler-like pigtails.
“There was a falseness about it,” she said. “It doesn’t make someone feel good. It’s actually alienating.”
Although tempted to correct the staff, Fahy feared retaliation. Eventually, she moved her mother to a new facility. Her story echoes a common dilemma faced by family members — how to advocate for loved ones without creating conflict.
But resistance doesn’t have to be confrontational, Shaw insists. “Patients and families can express their preferences clearly and kindly.”
Navigating Cultural Nuances
Communication styles don’t exist in a vacuum — they’re shaped by culture. In Latin America, for example, diminutives like manito (little hand) or pastillita (little pill) can reflect affection rather than condescension.
Felipe Agudelo, a Colombian-born health communication professor, reminds us that context matters. His 80-year-old mother doesn’t mind these terms; to her, they signal warmth. “It’s important to negotiate meaning,” he says. “You have the right to say, ‘I’d prefer something else,’ and the caregiver has the opportunity to adjust.”
Standing Up With Grace
Sometimes, speaking up works — as Lisa Greim, a 65-year-old retired writer in Colorado, recently demonstrated. When her mail-order pharmacy began calling her daily, assuming she needed reminders to take her medication (“It’s hard to remember our meds, isn’t it?”), she had enough.
“They were gently condescending,” she said. She informed them she had a full supply, would reorder when needed, and politely asked them to stop calling.
They did.
Why Words Matter
Elderspeak is a subtle reminder of how much language shapes dignity. While the person using it might mean well, the unintended message — “You’re less capable, less adult, less autonomous” — can sting deeply.
As a society that is aging rapidly, we must reexamine how we speak to and about older adults. Ditching “honey” and “sweetie” isn’t about being politically correct — it’s about being respectful.
After all, growing old doesn’t erase adulthood. It’s a continuation of a rich, complex, intelligent life. And everyone, at every stage, deserves to be spoken to with that truth in mind.