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Working with an older client group
Published in Rebecca Allwood, Working with Communication and Swallowing Difficulties in Older Adults, 2022
Elderspeak is often adopted due to perceived incompetence of conversational ability in older adults. It tends to be used with good intentions to facilitate the communication of older adults in conversation. Kemper and Harden (1999) analysed whether there were any aspects of elderspeak that were beneficial to the communication of older adults and found that reducing grammatical complexity and complexity of meaning did facilitate conversation but that characteristics, such as slowing speaking rate and reducing sentence length, were not helpful.
Communication: a person-centred approach
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Corwin (2018) citing several authors and studies describes ‘elderspeak’ as including baby talk and includes aspects such as speaking slowly, an exaggerated tone, high pitch, using simple vocabulary and using we instead of you i.e., ‘Shall we get up now’? instead of e.g., ‘Would you like to get up now’? Corwin also highlights that elderspeak is detrimental to well-being, which is dependent upon interactions that are stimulating. Elderspeak is generally seen as patronising and lacking in respect and as professionals, we must treat all individuals and their families with respect and dignity. McLaughlin (2020) suggests elderspeak can be described as overadjusting communication without meeting needs and highlights some of the detrimental effects upon the person. These include lowering mood, feeling misunderstood, feeling undervalued and feeling incompetent and a burden. Think about how Violet and Bill may feel if just because of their age it is assumed they cannot understand and contribute to decisions about their care.
Normal and Pathological Language in Elderly People
Published in José León-Carrión, Margaret J. Giannini, Behavioral Neurology in the Elderly, 2001
José Miguel Rodríguez Santos, Javier García Orza
When dealing with discourse comprehension, we need to refer to elderspeak. When interacting with elderly people, the rest of the population seems to make use of a way of speaking that is characterized by being slower, has a simplified syntax, vocabulary restrictions, and exaggerated prosody. It is repetitive and redundant speech, which we could consider to be the equivalent of motherese, the simplified speech mothers use with their infants. The origin of elderspeak is rooted in the perception of young adults that older people find it difficult to understand discourse, and its objective is to facilitate comprehension.
Differences in verbal and nonverbal communication between depressed and non-depressed elderly patients
Published in Journal of Communication in Healthcare, 2018
Onur Asan, Sojung Claire Kim, Paul Iglar, Alice Yan
In a recent systematic review of patient-doctor interaction studies, Farzadnia and Giles [17] found empirical evidence that doctors used the CAT’s approximation strategy to communicate with elderly patients. The doctors, however, over-accommodated elderly patients with reduced rate of speech, exaggerated intonation, and/or high pitch (a tactic also known as ‘elderspeak’), which in turn, resulted in patients feeling more distant from their doctors and perceiving the interactions as demeaning [17,21]. As for interpretability strategies, the systematic review revealed that non- or under-accommodation of healthcare providers such as providing insufficient, confusing, inconsistent information could be detrimental to patients. Janssen and MacLeod [22] supported this argument, after qualitatively analyzing interviews with terminally ill patients. Healthcare providers’ poor verbal and nonverbal behaviors when discussing test results, diagnoses, prognoses, and bad news contributed to negative patient outcomes. The analysis found that for interpersonal control, challenges existed for power control especially from the providers’ side. For discourse management and emotional expression strategies, providers were more competent managing medical discourses than patients, and more research would be needed to understand patents’ emotional needs and expectations [17]. Upon conclusion, the authors recommend future research to investigate whether these communication accommodations would vary by different medical fields, different health issues of patients, and/or who is more actively involved in doctor-patient interactions.
The symbiotic relationship of vulnerability and resilience in nursing
Published in Contemporary Nurse, 2020
Leah East, Vanessa Heaslip, Debra Jackson
Vulnerability is a nebulous and contested concept that has been used ambiguously within the nursing and healthcare literature. Predominate perspectives view vulnerability from a negative position, one associated with risk and adversity often associated with potential harm or detrimental outcome (Hurst, 2008; Purdy, 2004), and the inability to protect one’s self (Sellman, 2005). The links between the notions of protection and vulnerability can be somewhat restrictive and negative. This can be explained using Butler’s work on performativity. Butler (2014) argues there is a relationship between individuals and wider societal infrastructures; one’s existence is both performative and relational. It is relational, in that individuals are dependent upon the societal infrastructures and discourses which influence their experiences leading to associated performative behaviours. Let us take the example of older people. Within Western societies discourses, ageing may be linked to negative decline and social productivity, focussing upon frailty and weakness rather than strength and vitality (Grenier, Lloyd, & Phillipson, 2017). This labelling of older people influences nurses’ performative behaviour such as using elderspeak (Kemper, Finter-Urczyk, Ferrell, Harden, & Billington, 1998) infantilising older people as well as through further paternalistic actions, including acting for rather than with older people, thus disempowering them. These actions, we argue, are not undertaken consciously to harm the individual but represent unconscious behaviours arising from the wider societal discourses regarding ageing. These interactions result in an unconscious performative response from the older person leading to behaviours such as passivity and deferring to the decisions made by the nurse. It is this performative and relational aspect of vulnerability which leads to vulnerability being defined in terms of weakness, failure, inequality, inferiority, and dependence (Batchelor, 2006), which is not dissimilar to labelling theory (Parker & Ashencaen Crabtree, 2018).