Elderspeak:  An  Investigation  of  OlderViews

Kathleen  Fairchild,  Jonathan  C.  Baker,  &  Jeffrey  Buchanan

Elderspeak

TopographySlower  Rate  &      frequent  RepetitionExaggerated  IntonationElevated  Pitch    &    VolumeVocabulary  RestrictionsDiminutives  &  Inappropriate  ReferencesTag  QuestionsCollective  Pronoun  Substitutions  

Why  study  Elderspeak?

Used  frequently  in  caregiving  settingsPrevious  research  with  a  variety  of  different  populations  (e.g.,  caregivers,  community-­‐dwelling  older  adults,  nursing  home  residents)  has  found  mixed  results  regarding  Elderspeak.  

Implications  of  Elderspeak

Potential  trigger  for  resistiveness to  careMay  be  aversive  and  lead  to  escape  maintained  behaviorMay  hinder  communication  between  older  

adults  and  caregiversMay  cause  older  recipients  to  view  themselves  

as  less  competent  May  cause  speaker  to  be  viewed  as  less  

competent

Current  Study

PurposeAdd  to  existing  literature  regarding  the  perceptions  of  community  dwelling  older  adults  toward  ES

If  community  dwelling  older  adults  find  elderspeakaversive  it  is  likely  that  nursing  home  dwelling  older  adults  will  as  well.

Current  Study46  participants  over  the  age  of  55  living  in  Mankato  and  St.  James

RecruitmentGender

35  female11  male

Age55-­‐95;  mean  age  was  71

Ethnicity97.8%    Caucasian2.2%  Puerto  Rican

Participants  were  randomly  assigned.Scenarios  (ES  vs.  No  ES)

23  in  each  groupES:  19  females,  4  malesNo  ES:  16  females,  7  males

Example  of  Non  ES  scenario  (control)

Nursing  Assistant:  Mrs.  Jones,  it  is  time  to  get  ready  for  bed!  Resident:  Oh  is  it  that  time  alreadyNursing  Assistant:  Yes  it  is.  Can  I  help  you  help  you  change  out  of  your  clothes  and  put  your  nightclothes  on?  Resident:  I  have  to  use  the  restroom  first.  Nursing  Assistant:  All  right,  I  will  lay  out  your  clothes  while  you  use  the  restroom.

Example  of  Elderspeak Scenario

Nursing  Assistant:  Time  for  us  to  get  ready  for  bed!    Resident:  Oh  is  it  that  time  already?  Nursing  Assistant:  It  sure  is  honey.      Now  let  me  help  you  get  your  clothes  off  and  get  you  into  

jamiesResident:  I  have  to  use  the  restroom  first.Nursing  Assistant:  All  right,  Sweety,  I  will  lay  out  your  clothes  while  you  use  the  potty.    

Measures

The  Positive  and  Negative  Affect  Schedule  (PANAS)  (Watson,  Clark,  &  Tellegen,  1988)

Measures  how  the  participant  feels  at  a  given  moment

5  point  Likert scale  20  items  Subscales

Positive  Affect  Negative  Affect

Measures

Emotional  Tone  Rating  Scale  (Hummert,  Shaner,  Garstka &  Henry,  1998)

nursing  assistant5  point  scale  

12  itemsSubscales

CaringRespect  Control

Qualitative  Data

Qualitative  DataEveryone

GenderAgeEthnicityFamily  member  in  a  long  term  care  facility

Qualitative  DataThe  participants  that  listened  to  the  ES  scenario  were  asked  additional  questions  to  further  assess  their  opinions  of  ESAttempted  to  assess:

Is  this  type  of  communication  appropriateIf  they  had  previously  experienced  this  type  of  communicationUnder  what  circumstances  might  this  type  of  communication  be  appropriate  or  inappropriateIf  this  type  of  communication  affected  their  perception  of  the  resident  or  nursing  assistant.

Hypothesis

PANASES  scenarios  will  have  higher  NA  scores  and  lower  PA  scoresNon  ES  scenarios  will  have  neutral  PA  and  NA  scores.

Emotional  Tone  Rating  ScaleES  will  be  viewed  as  less  respectful,  more  controlling,  and  less  warm  Non  ES  will  be  viewed  as  neutral  in  respect,  control,  and  warmth  subscales.  

Results

A  series  of  one-­‐way  between  subjects  ANOVAs  were  conducted  to  test  hypotheses.Bonferroni Correction  indicated  that  the  minimum  alpha  level  should  be  p=.0451

PANAS

No  statistical  significance

0102030405060708090100

Mean

 Score PA

NA

Elderspeak No Elderspeak

Emotional  Tone  Rating  Scale

*  statistically  significant  at  p  <  .01

0

10

20

30

40

50

60

70

80

90

100

Respect  * Caring Control

Mean

 Score

Series1

Series2

ES

No  ES

Qualitative  Data

All  Participants37%  participants  have  had  a  family  member  placed  in  a  nursing  home56%  of  participants  were  retired

Elderspeak Scenario  Participants  83%  of  participants  found  Elderspeak inappropriate56%  of  participants  in  the  ES  condition  had  personally  experienced  being  addressed  with  Elderspeak.

Under  What  Circumstances  might  ES  be  appropriate?

Working  with  individuals  with  dementia  or  low  cognitive/physical    abilitiesCertain    Cultures

Individuals  from  the  South

Never75%  of  males84%  of  females

Understandable  but  inappropriate

Does  this  type  of  communication  affect  your  

competenceYes  /  Negatively

100%  of  males  ;  73%  of  females

No  11%  of  females

Somewhat  negatively  16%  of  females

Does  this  type  of  communication  affect  your  perception  of  the  nursing  home  

residentYes

75%  of  males26%  of  females

No  answer21%  of  females

Summary

Elderspeak was  found  to  be  less  respectful.Was  not  found  to  be  less  caring  or  more  controlling.  Participants  that  heard  ES  found  it  inappropriate

Found  similar  results  to  Ryan,  et  al  (1991)CNA  was  viewed  negatively  when  using  ESAffected  perception  of  resident

Adds  to  literatureSuggests  that  ES  is  viewed  as  less  respectfulMay  result  in  negative  reactions  or  consequences

LimitationsShould  have  asked  both  groups  if  they  found  the  nurses  communication  appropriate  to  compare  the  two  groups.Small  sample  size  

More  men  would  have  been  helpful  to  evaluate  gender  differencesCultural  Differences

PANASMay  have  been  helpful  to  have  participants  fill  out  survey  before  and  after  the  recording  to  see  if  the  recording  affected  their  initial  mood.  

ScenarioCaregiving scenario  may  have  affected  how  controlling  the  aid  sounded  regardless  of  ES.  

Recommendations  for  Future  Research

behaviorDetermine  what  the  function  is  for  staff  that  engage  in  this  kind  of  verbal  behaviorEvaluate  gender  and  cultural  differences  regarding  ESUse  different  scenarios  and  compare  perceptions.  

CaregivingEveryday  conversation

Qualitative  interview  about  ESWhenWhere

Thank  you!

Contact  information:Kathleen  Fairchild

Kathleen.fairchild@siu.edu

Thank  you  Dr.  Buchanan,  the  members  of  my  committee,  and  the  behavioral  research  team  for  their  invaluable  

participation.