Elderspeak: The Language of Ageism

Elderspeak: The Language of Ageism

by | | Communication, End of Life, geriatric care management, Health & Wellness, Hospital Care, Medical

As a geriatric care manager, some days leave little time to prepare dinner. On those days I stop into my local deli. I am usually greeted by: “What will it be today young lady?” Yes, a lady, I hope, but young…not unless you think casting my first presidential vote in 1968 (Nixon-Humphrey) puts me in the young category. Yet, as this food emporium often puts food on the table, I don’t take issue with their choice of words. I will, however, not be as benevolent with a neurologist I recently brought a client to, who, as she exited the examining room, tapped Janet on the shoulder and said: “be a good girl.”

“Be a good girl,” this is the language of ageism or as it is known, “elderspeak.” The National Institute of Health defines elderspeak as “an inappropriate simplified speech register that sounds like baby talk”. Conversing with an older adult as one might talk to a four-year-old. But unlike the four-year-old who has years ahead to accrue his or her accomplishments, the older adult has amassed years of notable achievements, both in their personal and their professional worlds. For Janet, she had established a mortgage brokerage company and was also an instructor at a local adult education school where she taught a class on Victorian novelists. But yet, her neurologist, especially her neurologist chose these as her departing words.

Elderspeak presents itself in other ways as well. Often, it implies the older person is not competent to understand what is being asked or told to him or her. Words like, “honey,” “sweetie,” and “dear” are frequent. Pronoun choice can also present itself in a tactless way. “Are we ready for a bath?” Really? Is the caregiver, family member, or nursing home staff intending to hop in the bathtub with the senior adult? I doubt it. Instead, how about, “Are you ready for a bath?” Certainly, saves on towels and enhances self-esteem. The other pet peeve of pronoun choice is just that, the adult senior becomes invisible and is a generic “he” or “she.” No acknowledgement of their given name or their presence. Finally, another property of elderspeak is exaggerated slowness in speech with someone without hearing disabilities. For an elder with hearing challenges, slow speech in a low voice tone may well be appropriate.

In considering these faces of elderspeak consider the following suggestions: Talk in a normal tone. Make eye contact and pick up on any visual cues. Never be condescending, this may require taking a step back to look at the words we chose to use.

As an Aging Life Care Consultant®, the dignity of each of my clients takes uppermost priority. It becomes even more important when their current abilities and well-being are compromised. Words matter and voice intonation can be felt. Both contribute to how a person feels about themselves, and how others perceive that person. Let’s work to make elderspeak an extinct language.

As Rare as Venus Passing Across the Face of the Sun

As Rare as Venus Passing Across the Face of the Sun

by | | Aging in Place, Communication, End of Life, Family, geriatric care management, Health & Wellness, Medical, Westchester

On June 5th and 6th 2012, the world was able to witness planet Venus passing across the face of the sun for about 6 hours causing a small black dot to appear on the sun’s surface. This event will not reoccur until 2117. I didn’t see the passing in 2012, and I can confidently say I will not see it in 2117. Yet in my world of being a geriatric consultant, I did see something equally as extraordinary. A senior adult called this Aging Life Care® Consultant to inquire about my services and how I might, one day, help her. A senior adult inquiring about help for herself, as rare as Venus passing across the sun.

This call was a first for me. I was accustomed to counseling adult children in such matters as dementia, in-home and residential alternatives, and overcoming parental resistance. I asked Isabel (not her real name) what prompted her call. She explained that her adult children lived at a distance, and she wanted to prepare for whatever the future may hold. She was 84. There was nothing compelling going on at the time, so I described how I could potentially be of help. A year later, I heard back from Isabel. She asked that I come to her home so that she could meet me and vice versa. Two years passed before I heard from her again, this time she asked if I could help her find a companion for a couple of days a week. Because I had done what we call in the trade, “a meet and greet,” I had a good idea of what type of companion would work best with her. Luckily, she was available, and the match was a successful one.

The passage of time brought conditions that required more care and eventually the need for a fulltime companion. None of this lessened Isabel’s astuteness to her needs, especially her hearing loss which was impacting on the activities she enjoyed in the community and with friends and families.  I am accustomed to seniors finding less effective and more irritating hearing solutions telling others: “To just speak louder.” Not Isabel. In keeping with this proactive senior, she headed to an audiologist to be fitted for hearing aids. They have helped, but even with regular adjustments, not to the degree she hoped.

With her mood now wavering and her age passing 88, we spoke about how the diverse world she was accustomed to was receding. Her family suggested consulting with her doctor about an anti-depressant which Isabel thought might be helpful (Again, I am more familiar with the response: “who needs that, I’m not crazy”). Not surprisingly, Isabel also asked me to recommend books about getting older. I mean getting older…. the real McCoy. Step aside Nora Ephron. The vicissitudes of accepting that you have less days on this earth than more. And with some research I shared three books with Isabel that would support what she was feeling.

  • Still Here: Embracing Aging, Changing, and Dying 
  • Growing Old: Notes on Aging with Something Like Grace
  • Helping Yourself Grow Old: Things I Said to Myself When I Was Almost Ninety

 Currently, Isabel and I chat on a regularly irregular basis. Sometimes short because a Zoom is about to start, other times longer. She leads me. I always like to know what she is reading, and we exchange names of books we have enjoyed. Truth be told, some of her nonfiction book recommendations are beyond my comprehension.

As an eldercare consultant I have always felt in the giving, there is receiving. It is so much the case with Isabel. And when the opportunity presents itself, I always remind her that she is my role model. I am not waiting for Venus to pass across the sun.

The Ten Commandments: Strategies for Communication

The Ten Commandments: Strategies for Communication

by | | Alzheimer's, Caregiving, Cognitive Decline, Communication, Connected, Dementia, Westchester

Before you turn away from this blog given its title, let me assure you I am not offering religious guidance. Instead, I want to offer ten communication tips if you are caring for someone with dementia, Alzheimer’s Disease or otherwise. I take no credit for these suggestions, but because I feel each is so relevant, I want to share them with you. They were written in 1996 by Jo Huey, of the Alzheimer’s Caregiver Institute. These approaches were based on her thirty-five years as a caregiver.

  1. Never Argue- instead, agree: What a person with dementia is saying is what they think to be true.
  2. Never Reason- instead divert: Reasoning is a futile effort, because the part of the person’s brain that controls logical thinking has been hindered.
  3. Never Shame- instead, distract: Change the subject as quickly as possible, the person with dementia may not realize what they are saying or doing could be viewed as inappropriate.
  4. Never Lecture- instead reassure: Imagine how much better it would feel if you just smiled and reassured someone with dementia: “I did the same thing yesterday.”
  5. Never say “Remember-” instead, reminisce: A person with Alzheimer’s Disease, cannot remember. So, if you were looking thru a photo album, say “this looks like Phil and Sue when they went camping at Lake George.” The person may use this cue to connect, otherwise, treat the album as just that, photos of people enjoying themselves.
  6. Never say “I told you”-instead, repeat/regroup: As the caregiver, you are the priority. Take a step back, start the conversation the next day. The person with dementia will pick up on your stress, causing the conversation to be frustrating at both ends.
  7. Never say, “You can’t,” instead do what they can: Such an approach is another reminder to a loved one that they are losing their independence. As the caregiver, you are tasked with the responsibility to search for the things that a person with Alzheimer’s can do successfully. This is what we call a “strength based approach.”
  8. Never command/demand, instead ask/model: The adage that actions speak louder than words, is equally relevant to a person with Alzheimer’s Disease. Because your loved one may not pick up on your verbal sense of urgency, it is better to model behavior. For example, if it is meal time sit across from the person and take a few bites of food. They are more likely to mimic your actions than heed your words.
  9. Never Condescend, Instead Encourage/Include: When caring for someone with dementia we may tend to exclude them from conversations regarding their health and overall wellbeing as if they’re not there. Not only can this hurt your loved one’s feelings, but it can result in aggression toward the provider of care. Rather, stand or sit next to them and allow them to be a clear part of the conversation.
  10. Never force, instead reinforce: No one likes to be told they’re doing something wrong. A better approach is to start by telling them what they’re doing well. Then, gently approach what they could be doing better.

In 1996, the same year that Jo Huey compiled these strategies, Motorola came out with their Startac phone. It was the first flip phone. It offered a vibrate alert as an alternative to a ringtone. The phone was so popular that Motorola sold 60 million of these phones at $1,000 a clip. How cell phones have evolved over 26 years. But the advice offered by Jo Huey is as relevant today as it was 26 years ago. I hope her suggestions can offer guidance as you face the challenges that can accompany a dementia diagnosis.