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REPORT: Examining the Prevalence of “Elderspeak” in Long-Term Care

November 20, 2014

Certified nursing assistants’ use of “elderspeak” — a patronizing way of talking to older people — varies depending on the circumstances, a study published in the November Journal of Gerontological Nursing found.

Researchers surveyed 134 certified nursing assistants (CNAs) at nine Midwestern nursing homes and assisted living facilities. The CNAs were asked to rank, on a scale of one to four, the appropriateness of elderspeak in three dozen different scenarios.

The researchers define elderspeak as a “patronizing style of speech that is commonly used when conversing with older adults.”

The characterizations of elderspeak, as identified by the researchers, include:

  • simplified vocabulary and sentence structure;
  • exaggerated intonation and vocal pitch;
  • slowed rate of speech;
  • use of personal terms of endearment (e.g. “sweetie”); and
  • collective pronoun usage.

The CNAs reported that they were least likely to use elderspeak if the resident’s family members or other residents were present, or if they had never interacted with that particular resident before.

They were most likely to use elderspeak if they were familiar with the resident and interacted with him or her on a regular basis. Additionally, CNAs reported they were more likely to use elderspeak if they perceived a resident to be happy, sad, or depressed.

By and large, however, CNAs said they found elderspeak to be mostly inappropriate. Of the 36 scenarios they evaluated using the four-point scale, only three received a mean ranking of 2 or higher, which corresponds to “somewhat appropriate.”

Still, the researchers point out that even occasional use of elderspeak can have detrimental effects. “The use of elderspeak may increase resistance to care, threaten self-esteem and well-being, and increase dependency among residents,” they write.

Training programs specifically designed to improve communication between CNAs and residents could help reduce the use of elderspeak, the researchers conclude.

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