Judah Gutwein

Whatever words we utter should be chosen with care for people will hear them and be influenced by them for good or ill.

While it’s unknown who said that quote, I was reminded of it while visiting a patient at an adult day care center recently. 

I overheard a conversation between a caregiver and one of the residents. The elderly resident seemed to be anywhere from 70- to 80-years old, yet the staff member was addressing him as though he were but a small child. It wasn’t what he was saying, but how he was saying it.

His language was overly simplified, solicitous and patronizing and his voice modulation was what one would typically reserve when speaking to toddlers.

It wasn’t that this elderly person was cognitively impaired or compromised. In fact, it was clear to me that he was completely alert and oriented. Rather, the caregiver seemed convinced that the only way to reach this fellow was to speak down to him.

This is a recurring theme I’ve seen too often in healthcare settings. We tend to forget that older people are in fact, people. They have the same thought process and can be just as cognitively aware as younger people. In fact, with age comes wisdom and layers of life’s experiences.

“When adults talk to seniors the way they do to a two-year-old, they’re presuming that person is not fully competent, and that’s demeaning,” says Jessica Hehman, Ph.D., assistant professor of psychology and director of the Psychology of Aging Lab at the University of Redlands.

Ageism is pervasive in our culture, and can be detrimental to a person’s well-being,” Hehman says. “And yet, unlike other ‘isms, it comes from a good place in people’s hearts, from wanting to help.”

Yet that is no excuse for the habit.

A classic example of this type of behavior is when doctors or caregivers address the child of an elderly patient in his/her presence, instead of addressing the patient himself/herself.

“It is downright humiliating when the healthcare provider says to my daughter – “And what are ‘WE’ here for today?” – ASK ME! You obviously see me sitting here.” – Emma, age 81

It is my perspective that as caregivers, we really need to revisit how we communicate and interact with older people.

Do we tend to talk “with” them and involve them in our conversations (and really listen to what they have to say), or do we talk “to” them in a patronizing and undignified way without expressing any interest in their feedback and viewpoint?

I would submit the following four very basic elements of proper communication that if adhered to, will ensure effective and respectful dialogue with seniors (and young people too!):

  • Acknowledgement and validation
    First and foremost, we must acknowledge and validate the fact that elderly people are intelligent and proud members of society who continue to richly contribute in all areas of life and have much wisdom to share and impart. To acknowledge this, is to ensure that we won’t talk down to our seniors.
  • Be aware
    Know with whom you are speaking and the issues which may impact how they communicate with you. Senior citizens often have diverse backgrounds and cultural experiences and it is important that you are aware of these important nuances in order to facilitate more effective communication.
  • Be inclusive and engaging
    Don’t just talk ‘to’ the individual, but speak ‘with’ them instead. We need to converse with our seniors in a way that encourages their involvement in the conversation.
  • Be mindful of your tone and inflection
    We ought to remember that seniors are not toddlers and we must choose our tone and words carefully. If a senior feels like they are being spoken to like a child, it will have deleterious consequences on their sense of dignity and well-being.

In the final analysis, words have meaning, but tone and inflection give them life and vigor. Be the catalyst for enhancing life, not for diminishing it.

Judah Gutwein, L.N.H.A., is the director of corporate marketing and business development at Regency Post Acute, Rehab & Nursing Centers.