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Writer's pictureJosie Hadley
Jun 106 min read

Understanding Elderspeak and Its Implications on Hearing Loss

In recent years, researchers have delved into the phenomenon of how speech patterns change when communicating with aging adults. This type of speech is often referred to as "grayspeak" or "elderspeak." This blog explores the concept of elderspeak, its impact on individuals with hearing loss, and why adopting respectful communication practices is essential.


Understanding Elderspeak


Elderspeak is a specific form of communication often used when addressing older adults. It is characterised by a slower speech rate, exaggerated intonation, simplified vocabulary, and a patronising tone. This style of communication is often well-intentioned, aiming to ensure that older adults understand the message. However, it can be perceived as condescending and infantilising.

The concept gained attention following a 2023 article by Richard Morgan in the New York Times. Morgan recounted how people treated his 93-year-old grandmother differently as her hearing loss worsened. He observed that people, including himself, began speaking to her and other elderly people in a manner reminiscent of addressing toddlers or pets. She could understand the conversation; people just thought she couldn’t due to her hearing loss and age.

 

 Investigating Elderspeak

 

An in-depth exploration of elderspeak is presented in an article titled “Understand Elderspeak: An Evolutionary Concept Analysis” in the NIH National Library of Medicine. Authors Clarissa Shaw, Jean Gordon, and Kristine Williams define elderspeak as “an inappropriate simplified speech register that sounds like baby talk and is commonly used with older adults, especially in health care settings.” Reviewing 83 articles, they categorised elderspeak characteristics based on semantic, syntactic, pragmatic, paralinguistic, and nonverbal traits. Their research revealed that elderspeak stems primarily from ageism, where signs of aging or cognitive impairment prompt younger caregivers to simplify their communication.


The study found that a significant feature of elderspeak is exaggerated prosody and actually hinders comprehension. Older adults often perceive elderspeak as condescending and disrespectful. Additionally, for those with dementia, elderspeak can increase resistance to care, aligning with typical behavioural and psychological symptoms of dementia. The study emphasises the importance of using communication methods that enhance understanding. 


Hearing Loss Among Older Adults


Hearing loss is prevalent among older adults. Lin et al. (2023) note that hearing loss affects a significant portion of the elderly population, impacting their ability to communicate effectively. This condition can range from mild to profound and often requires the use of hearing aids or other assistive devices.

Older adults with hearing loss rely heavily on visual cues, such as lip-reading and facial expressions, to understand speech. Therefore, clear and respectful communication is crucial. Elderspeak, with its exaggerated and often distorted speech patterns, can disrupt these visual cues and make understanding more difficult.


 The Critical Role of Hearing Aids


Addressing the significance of hearing aids, Lin et al. (2023), explored the link between hearing loss and dementia in older adults. The three-year study involved nearly 1,000 participants aged 70 to 84, all with substantial hearing loss.

Throughout the study, cognitive functioning was assessed annually. Those with hearing aids reported significant improvements in both areas over the three years. Lin emphasised, “Hearing loss is very treatable in later life, which makes it an important public health target to reduce the risk of cognitive decline and dementia.”


Lin’s ongoing research continues to monitor cognitive changes, brain scans, and social engagement, aiming to understand better how protecting hearing in older adults can mitigate cognitive decline.


The Impact of Elderspeak on Older Adults with Hearing Loss


  • Reduced Communication Clarity - Elderspeak's slowed and exaggerated speech can distort the natural rhythm and flow of conversation. For individuals with hearing loss, this can make it more challenging to follow along. Instead of aiding comprehension, elderspeak often creates additional barriers, complicating the communication process.

  • Decreased Self-Esteem and Increased Frustration - When older adults are spoken to in a patronising manner, it can significantly impact their self-esteem. Elderspeak implies that they are less capable of understanding and processing information, which can be disheartening and frustrating. This communication style can lead to feelings of infantilisation and disrespect. Morgan (2023) highlights how older adults, even those well into their nineties, are capable of understanding complex concepts and ideas when communicated respectfully. Patronising speech only serves to undermine their confidence and willingness to engage.

  • Social Isolation - Communication barriers, exacerbated by elderspeak, can contribute to social isolation. When older adults with hearing loss face frequent misunderstandings and condescension, they may withdraw from social interactions. This withdrawal can lead to loneliness and further isolation, negatively impacting their mental and emotional well-being.

  • Cognitive Decline - Engaging in meaningful conversations is crucial for cognitive health. Reynolds (2023) discusses how hearing aids can help slow cognitive decline in older adults at high risk. Effective communication stimulates the brain and helps maintain cognitive function. Elderspeak, by reducing the quality of these interactions, can deprive older adults of the cognitive stimulation they need, potentially accelerating cognitive decline.



Improving Communication with Older Adults


Adopting more respectful and effective communication strategies is essential for fostering better interactions with older adults, particularly those with hearing loss. Here are some tips:

 

  • Use Clear Speech - Speak clearly and at a natural pace. Avoid speaking too slowly or using exaggerated intonation, as this can distort the message. Use normal intonation and avoid raising your voice, which can make it harder for those with hearing aids to understand.

  • Maintain Eye Contact - Face the person you are speaking to and maintain eye contact. This allows them to use visual cues, such as lip-reading and facial expressions, to help understand the conversation. Avoid talking while turning away or covering your mouth.

  • Reduce Background Noise - Minimise background noise when having a conversation. Turn off the television, close the door, or move to a quieter area. Reducing ambient noise helps the person focus on the conversation without additional auditory distractions.

  • Use Assistive Devices - Encourage the use of hearing aids or other assistive listening devices. These can amplify sound and make it easier for the person to follow the conversation. Be patient and give them time to adjust to using these devices if they are new to them.

  • Be Patient and Understanding - Patience is key when communicating with someone with hearing loss. Give them time to process what you are saying and respond. If they ask you to repeat something, do so without showing frustration. Your understanding and willingness to adapt your communication style can make a significant difference.

  • Ask for Feedback - Regularly check in with the person to see if they are following the conversation and if there is anything you can do to improve communication. This shows that you respect their needs and are committed to effective communication.

 

The Role of Audiologists in Promoting Respectful Communication


Society has a crucial role in promoting respectful communication with older adults. This involves raising awareness about the negative impacts of elderspeak and encouraging more inclusive communication practices. Here are some ways audiologists can help educate their patients' family and their own staff:

 

  • Setting Examples - make sure you and your team don't fall into this trap. Lead by example to show that your see the person not their age or their hearing loss.

  • Education and Training - Providing education and training for caregivers, healthcare professionals, and the general public on effective communication strategies with older adults is crucial. This can include workshops, seminars, and online resources that teach respectful and clear communication techniques.

  • Public Awareness Campaigns - Launching public awareness campaigns can help highlight the importance of respectful communication. These campaigns can use various media platforms to reach a wide audience and promote understanding and empathy towards older adults with hearing loss.

  • Support Services - Offering support services for older adults with hearing loss, such as counselling and social groups, can help them feel more connected and less isolated. These services can also provide a platform for sharing experiences and strategies for effective communication.

  • Inclusive Policies - Advocating for inclusive policies in healthcare, social services, and community programs can ensure that the needs of older adults are met. This can include guidelines for respectful communication and the provision of assistive listening devices in public spaces.

 

Conclusion


Elderspeak can significantly impact older adults, particularly those with hearing loss. By adopting more respectful and inclusive communication strategies, we can help improve their quality of life and foster more meaningful interactions. It is essential for society to recognise the importance of clear and dignified communication and to support older adults in overcoming the challenges they face. Through education, awareness, and inclusive policies, we can create a more respectful and inclusive environment for everyone.

 

 References

 

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