Medical commentary: Elderspeak may be comforting in small doses — but it’s not harmless

I recently went in for a routine colonoscopy — nothing dramatic, just another mile marker on the highway of life.

As the nurse prepped me, she smiled and said, “OK, sweetheart, let’s get you nice and cozy.”

I smiled too — but inside, I flinched. Sweetheart?

I’m a neurologist, a professor, a grown adult in a hospital gown — not a toddler.

What I experienced is called elderspeak. It’s that well-meaning but infantilizing way people sometimes speak to others receiving care.

You’ve heard it — the sing-song tone, the over-enunciation, the collective pronouns: How are we today?” Well, I’m having a colonoscopy, but I hope you are doing just fine.

Though often meant to comfort, elderspeak stems from unconscious bias — the assumption that someone in care needs to be softened or spoken down to. And recent studies are showing just how common it really is. In one analysis of nursing home conversations, 84% of staff-resident interactions involved some form of elderspeak.

In small doses, it might be comforting, but it’s not harmless: in long-term care, it’s linked to more resistance to care — refusing help or even lashing out. Outside of care facilities, this kind of language can quietly erode self-esteem and dignity.

A training program called Changing Talk developed for use in nursing homes, has been shown to cut elderspeak and resistance behaviors nearly in half. And even without formal training, individuals can make respectful changes. One home health care agency in Ohio, instructs its staff to address clients formally — using titles like Mr., Ms. or Mrs.

And if you're on the receiving end of elderspeak? You don’t have to stay silent. Experts suggest calmly expressing your preference: “I’d prefer you use my name.”

It doesn’t need to be confrontational — just clear.