Home' Australian Pharmacist : Australian Pharmacist May 2013 Contents 34 Australian Pharmacist May 2013 I ©Pharmaceutical Society of Australia Ltd.
of Nursing, said care workers often thought
that using words like 'dear' or 'sweetie'
conveyed that they cared and made them
easier to understand.
'But they don't realise the implications
that it's telling older adults that they're
incompetent,' Professor Williams said.
Professor Williams said elderspeak
attitudes were equally hurtful to people
suffering from dementia.
'The main task for a person with Alzheimer's
is to maintain a sense of self and dignity.
If you know you're losing your cognitive
abilities and trying to maintain your dignity,
and someone talks to you like a baby,
it's upsetting to you,' she said.
Speaking to Australian Pharmacist from
Yale University in Connecticut, Dr Levy
said that while there had been no research
into whether there is more awareness of
problems of elderspeak with the rising
ageing population, the problem 'certainly
has not disappeared'.
'It's very important to avoid elderspeak
when getting a health message across,'
Dr Levy told Australian Pharmacist.
'My research is mainly on how negative
stereotypes can have a negative impact on
the health outcomes of various individuals.
'So any form of elderspeak that provokes
negative stereotypes of ageing can
'Clearly if there is an ability to treat people
with as much respect as possible, regardless
of age that will have benefits for them.'
Dr Levy conceded there was some
controversy over the use of terms of
endearment in some situations such as
'However, the key is to be as thoughtful as
possible and not just speak automatically
and throw in terms of endearment,' she said.
'You need to be really thoughtful about
who the person is and see if there are ways
to show them that they are respected and
that their health decisions are valuable.'
Dr Levy said there was no hard and fast rule
on whether health workers should wait for
permission to use a patient's first name.
'One strategy is just to ask people how
they want to be addressed,' she said.
'People are very different in how they like to
be addressed and some people are happy
to be addressed by their first name whereas
others may say they would like to be referred
to as Mrs Jones or whatever their surname is.'
Don't be paternalstic
point to the need not
to speak to them as if
they were children.
Michael O'Neill from
Australia said it was
important not to
be condescending or paternalistic when
speaking to older people.
'The position we have been strong about
is that in regards to advice directed
to older Australians we must ensure
that the comments and feedback are
age appropriate, age specific, and not
paternalistic or ageist in the way the
message is delivered,' he said.
He said for older Australians approaching
health issues and messages in a way
that was not condescending and not
paternalistic was a really important part of
getting a message across.
'Too often we see or hear depictions of
older people being treated almost as
children simply because they are older.
We see the "here petal, here darling"
approach taken in a paternalistic way,'
Mr O'Neill said.
'But we are talking about people who
have been through a lot of life and remain
mature adults and should be approached
in a serious but positive manner.'
Nancy Pachana, Professor, School of
Psychology, University of Queensland,
co-director of the UQ Ageing Mind
Initiative and also National Convenor of
the Australian Psychological Society's
Psychology in Ageing Interest Group, said
elderspeak 'definitely has been shown in
research to be damaging.
'Even with people with cognitive
impairment, elderspeak means the speech of
the person speaking is less comprehensible
and makes the person being spoken to feel
belittled, infantilised and not respected,' she
told Australian Pharmacist.
'I can't stress enough that this elderspeak
is all wrong. Even people with cognitive
impairment can process the tone of
'Everyone has been in hospital and you're
feeling bad and the nurse comes along
with a cup of tea and says "here you go
dearie". Now no one is going to take
offence at that. That would be being too
PC (politically correct).
'But it's in the more professional interaction
with people that you really want to make
sure that you're not slipping into a speech
pattern that is lacking in respe c t .'
Am I being respectful?
Professor Pachana said that in a quick
interaction or if a person was in pain
or distress, then as long empathy was
communicated it was appropriate to use
the endearing terms.
'But I'm talking about examples where a
pharmacist is discussing medication or a
nurse is discussing what they are going to do,
then we must avoid elderspeak,' she said.
'For instance if you're saying: "Here's you
medication and this is what it is for", this is
the time when you have to use respectful
communication and think about "am I being
respectful?". As an example, some older
adults don't like to be called by their first
names. You should use the person's surname
and title until you ask permission if it's ok to
call them by their first name, or if they ask
you to use their first name.
'The second thing is to ask yourself is,
"Am I giving the person permission to ask
questions if I'm not being clear?". That would
involve not speaking too quickly, and pausing
and checking with the person and asking:
"Do you have any questions, is this all clear?"
'It is very easy to communicate to someone
that they don't have power but in a
healthcare situation you want people to
'You need to be really
thoughtful about who
the person is and see
if there are ways to
show them that they
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