Distrust, Despair and Resistance to Care: Hospital Staff Reports on the prevalence of Elderspeak and their evaluation of an In-service aimed at reducing Elderspeak

Ms Elizabeth Savina1

1Redcliffe Hospital, Metro-North Hospital and Health Service , Redcliffe, Australia

Elderspeak is recognised as a common, but potentially harmful, communication style in aged care and other domains of society. It has been observed in up to 57% of interactions in aged care [1]. Elderspeak can lead to distrust and to older adults withdrawing from the therapeutic relationship. Elderspeak has also been seen to significantly increase the likelihood of Resistance-to-Care behaviours. No studies have looked at the prevalence of Elderspeak in the hospital setting, or at education programmes aimed at hospital staff.

A survey of Queensland Health’s internal resources revealed no in-services focussing specifically on Elderspeak. Additionally, a search for published educational materials on the internet indicated very limited resources. A 20 minute in-service was developed from a review of literature. It was piloted with 20 nursing staff with a special interest in caring for older adults. It covered the nature and underlying causes of Elderspeak as well as practical ways to consciously control the voice to ensure a respectful communication style. The feedback indicated the in-service was highly valued in terms of its relevance and the practical skills developed.

The next phase will see the in-service workshopped with a group of health consumers to ensure that the training is driven by their perspectives. The in-service will be then be delivered to 60 nursing staff. Staff will be asked to rate their frequency of use of features of Elderspeak (Sing-song Voice, High Pitch, Use of Pet Names), how often they perceive their colleagues using them and what patient characteristics are most likely to elicit Elderspeak (e.g. age/frailty/cognitive impairment). They will be asked to rate their confidence in reducing their use of Elderspeak. They will also be asked to rate the significance of any barriers to reducing Elderspeak (e.g. time pressure, cognitive load).


[1] Bradford, L.S., End, C., & Xavier A.L. Impact of an elderspeak in-service training on resident well-being, self-esteem and communication satisfaction. Graduate Student Journal of Psychology 2010. Vol. 12 P. 14-22


Elizabeth Savina has practised as a Speech Pathologist for over 18 years, with the last 10 years focussing on Acute care and Voice Therapy. She has a strong interest in how the quality of the communication between health professionals and consumers influences care outcomes.

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