Elderspeak. We’ve all heard it: baby-talk for seniors, an almost unconscious reaction to those we deem cognitively impaired, or hopelessly out of date. It’s a kind of pretend-communication with those who seem unreceptive, or beyond the pale of verbal comprehension.
Although the term is aptly descriptive and eerily evocative of rows of beds with wrinkled heads whose staring eyes peek out from where their bodies are tucked, I have to admit I had not heard the word before seeing an article in the CBC News. It described a study published in The Gerontologist about the way a group of nuns cared for their elderly colleagues from their convent: http://www.cbc.ca/news/health/nuns-elderly-1.4039508
‘The sisters caring for cognitively impaired elderly nuns in a Midwestern convent spoke to their care recipients in a way that sounded strikingly different to linguistic anthropologist Anna Corwin. The nuns rarely used “elderspeak” — a loud, slow, simple, patronizing and common form of baby talk for seniors. Instead, Corwin reports, they told jokes, stories and blessed the sick nuns, all the while speaking to them like they were completely capable, even though their ability to communicate was significantly diminished.’
‘The nuns in the infirmary suffered from dementia, Alzheimer’s disease, aphasia, stroke and neurological deterioration, and all had limited or impaired communication abilities. Sometimes the caregiver nuns held the sick nuns’ hands, and sometimes they massaged their legs, Corwin said.’
It all sounds so… sensible. So empathetic. And yet, so often we are frustrated by our apparent inability to effectively communicate that elderspeak becomes a sort of default –almost as if those to whom we are speaking are not really listening, or, depending on their condition, are minimally aware of our presence. And this can be especially prevalent among overworked care providers in geriatric wards.
‘Kristine Williams, a professor at the University of Kansas School of Nursing in Kansas City, trains nursing home providers to use less elderspeak. Her studies found that communication training can reduce the number of diminutives, terms of endearments and collective pronouns senior caregivers use.’ But training to do what?
The nuns offer an interesting option. ‘The caregiver nuns had long-established deep relationships with their elder charges, Williams noted. “They are in almost a family-like relationship, as opposed to someone who’s a nursing assistant in a home,” she said.’ And what they offered, was not condescension or inadvertent humiliation. Not patronage or mere toleration. ‘”They see these older adults, even when they’re lying in bed moaning and can’t move, as not being reduced by these chronic conditions but still as whole individuals.”’
The study was an interesting one, and yet its findings should not surprise us. ‘Beauty doth varnish age, as if newborn, and gives the crutch the cradle’s infancy’ as Shakespeare said. In other words, finding beauty in old age can transform it and make it bearable –in this case both for the aged as well as the caregiver.
Now that I think about it, I suspect I learned that years ago when I was a beginning medical student and visiting my aunt Shirley who was hospitalized after a stroke. She was stored –that’s the only word to describe it- in an older part of an already-old hospital on a ward –a large room, really- lined on both walls with beds like a dormitory. And for the most part, as I described above, all one could see looking down the rows were heads peeking out from neatly tucked bedsheets, white hair splayed across the pillows or stuck to the scalp with sweat. Some had eyes that moved, but mostly it was a room of mouths –none speaking, all busy with just the chore of breathing.
Shirley was one of the exceptions, propped as she was by a series of pillows and a cloth bib whose tethers kept her from tipping over the bed railings and onto the floor. Her voice was slurred and indistinct, so I had trouble hearing what she had to say, but I could tell she was getting better because she was complaining about the woman in the bed next to hers.
“There’s nothing there,” she kept saying, her eyes pointed at the head beside her that was staring, unblinking, at the ceiling. “They’ve put me in an empty room, dear, and I don’t like it.”
My aunt had always been gregarious, some might even say nosy, so to be confined to a room where she couldn’t extract vital gossip and life histories, was a type of exile for her. A punishment.
“You seem to have improved each time I come here,” I said, trying to cheer her up. For my part, the ward depressed me. “They’re obviously treating you well,” I added, quickly running out of small talk.
Part of her mouth smiled, but most of her face seemed still asleep. Not at all happy.
“Your aunt is improving, sir,” a soft voice said from behind me.
I turned and saw a short, smiling, grey-haired nurse dressed in white trousers and a white shirt buttoned up to his neck. His eyes were twinkling, and he was gazing at my aunt as if he, too, was proud of what she’d accomplished. There weren’t very many male nurses then, so I was surprised. “I expect they’ll be transferring you to another ward, soon, Shirl,” he added locking her eyes in his and ignoring me for a moment. “So quit complaining, eh?” He chuckled when he saw her smile broaden and the rest of her face follow suit. He reached out and squeezed her toe through the sheet and wandered off to check on the next bed. Shirley giggled, obviously pleased.
I could hear the nurse talking to that unresponsive woman in the next bed, although he spoke quietly. First, he tilted his head to stare at the ceiling above her bed. Then, he smiled. “You know, Liz, I figure you must have much better eyes than me…” He liberated a skeletal arm whose flesh hung from it like curtains on a window and held it tenderly. “…Because no matter how often I look, I still can’t see whatever it is that you find so interesting up there.” He gently squeezed her hand. “We’re gonna have to discuss this over a beer someday, eh?”
Her face didn’t change, but her breathing seemed a little less laboured. A little slower. More even. “Anyway, is there anything you need me to help you with today?” he said as he ever so gently massaged her arm then flexed and relaxed her fingers. When he’d finished with that arm, he tucked it under the sheets again and repeated the exercise on the other. “I’m going to come back and move you into a different position in a few minutes, Liz, so don’t get too comfortable like that, eh?” He loosened the sheets around her and raised the railings around the bed again that guarded her from falling. “And I’m going to make sure that physiotherapist you like comes with me to massage your legs.” He winked at her flirtatiously and gave her leg a squeeze through the sheet.
“He might as well be talking to the pillow,” Shirley whispered, as he busied himself with the railing. “All she does is stare at the ceiling. She doesn’t seem to notice when I talk to her…”
“So wait for me, Liz. I don’t want to have to go looking all over the ward for you again,” he said, laughing, and wandered off to yet another bed.
“I do like Bill,” Shirley said when he was out of earshot. “He treats us all like family –like we matter.” She was silent for a moment and then, just when I was about to leave, she managed to snag me with her good hand. “But I don’t know how he stays so cheerful here. I think half of the patients don’t even know he’s talking to them.” And her eyes wandered over to the woman in the next bed again. “It must be terribly discouraging for him, don’t you think?”
I glanced at the woman, and for a moment, I thought I saw her eyes flicker as if they were searching for something. Someone. And then, a tear? But maybe it was just a trick of the light, because, as her face relaxed a tiny bit, they closed and she began to snore. Not loudly, not as if she couldn’t breathe –but quietly, comfortably, and slipped from the waking dream, into yet another more peaceful one further inside.