Dear Doctors: My mother is 82 and mentally sharp. She's frustrated because in medical appointments, she often gets talked down to. They call her "young lady," people don't listen to her and when I'm in the room, they talk to me but not to her. Can you give some specifics of what she can say to stop this?
Dear Reader: The pattern of communication you described is widespread enough that it has its own name: Known as elderspeak, it is a style of speech in which an older person is addressed in a simplified and often patronizing way. Rather than the person's name, they may be called pet names like sweetie or honey, or as happened to your mother, young lady. The speaker may use simplified language or adopt a sing-song tone. The older adult's contributions to the conversation may be minimized, brushed aside or even ignored. No matter how well-meant, elderspeak is demeaning. It has the effect of dismissing the older person's status as an adult and chipping away at their dignity. It is also potentially harmful.
Studies into the phenomenon have found it can have emotional and psychological consequences. In addition to being infantilizing and dismissive, repeated exposure can undermine an older adult's self-confidence. When elderspeak enters medical care, the risks can extend to physical health. Older patients can find that hearing or visual limitations are treated as evidence of poor cognition. Physical symptoms may be brushed off as an expected part of aging. In more extreme situations, older patients may not be offered the same diagnostic tests or the same range of treatments as those who are younger.
Dealing with elderspeak means setting boundaries. It is perfectly reasonable for your mother -- or you -- to let her healthcare providers know how she wants to be addressed. Some people are comfortable being on a first-name basis. Others prefer the honorifics of Mrs., Mr. or Ms. If someone slips into elderspeak, be prepared to politely point it out. For example, she could say, "You may not be aware, but you are speaking to me like I am a child." Then follow up by asking them to change course. It can be as simple as, "Please treat me like any other adult." If vision or hearing loss is involved, remind the healthcare professional that it does not affect cognition. "Although I need you to speak clearly and slowly, this doesn't mean my ability to understand you is impaired."
When you accompany your mother for medical care, make it clear that she is in charge of the appointment and that the healthcare provider should direct their remarks to her. It's natural that you would have follow-up questions. However, to preserve the patient-first dynamic, save them for the end of the appointment. If you find that, after repeated requests, a healthcare provider is unable or unwilling to make these adjustments, it is reasonable to consider finding someone else. Awareness of elderspeak and its potential ill effects is growing, and respectful communication is increasingly recognized as an essential part of care.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
