Please Don't Call Me "Dearie": The Problem With Elderspeak

Imagine walking into a café at 45.

The person serving you says:

Good morning. What can I get you?

Now imagine walking into exactly the same café at 80 and hearing:

Hello, my lovely! And what can we get for you today, young man?

Perhaps it is affectionate. Perhaps the person means absolutely nothing by it. But something has changed.

Not you.

The way you are being spoken to.

There is a name researchers use for some forms of this: elderspeak.

Why do perfectly capable adults sometimes start being spoken to differently simply because they have got older?

What is elderspeak?

Elderspeak is not simply being friendly to an older person. It describes a particular style of communication that can include:

• speaking unnecessarily slowly;
• exaggerated intonation or a higher-pitched voice;
• simplifying language unnecessarily;
• repeating information that has already been understood;
• using collective language such as “Are we ready for our bath?”;
• speaking about somebody while they are present rather than speaking to them;
• uninvited terms of endearment;
• overly directive language; and
• assuming somebody does not understand.

Not every example is automatically offensive. Someone with hearing loss may genuinely benefit from clearer speech. Someone with cognitive impairment may benefit from communication that is appropriately simplified. A long-standing friend calling somebody “love” may be completely different from a stranger doing it because they perceive that person as old.

The problem is the assumption:

Getting older does not make you a child.

But is it not just being nice?

Most elderspeak probably is not malicious. It may come from affection, a desire to help, habit, nervousness, workplace culture or genuine concern. A person may be trying to make a conversation easier.

But good intentions do not automatically produce good communication.

A 2021 concept analysis bringing together 83 theoretical and research articles found that elderspeak was generally perceived as patronising. It identified implicit ageism as an important factor behind it.

Implicit ageism means that we may unconsciously associate older age with frailty, dependence, confusion, hearing loss or reduced competence. We then change our behaviour before knowing whether any of those assumptions apply to the person in front of us.

That can be uncomfortable to recognise because the speaker may feel caring while the listener feels diminished. Both things can be true: the intention may be kind, and the effect may still be patronising.

When “helpful” communication makes things worse

Some of the clearest research into elderspeak comes from residential dementia care. In a study of videotaped interactions between nursing-home staff and residents with dementia, researchers examined communication style and what happened next during everyday care.

The probability of resistance-to-care behaviour was higher following elderspeak than following normal adult communication:

Resistance-to-care might include saying no, pulling away, responding negatively or refusing assistance. The important point is not to label somebody “difficult” too quickly.

It is worth asking whether they are reacting to the care itself — or to the way they are being treated while care is offered.

The person is still there

Dementia can change memory, language, understanding, behaviour and decision-making. Communication may genuinely need adapting. That is different from infantilising somebody.

A 2026 qualitative meta-synthesis of elderspeak in healthcare settings similarly described a tension between caring intentions and the effects of care, control and routine. It concluded that these communication practices can constrain autonomy, participation and personhood even when they are used by people trying to help.

That is why person-centred communication matters. The aim is not to pretend that everybody has identical abilities. It is to respond to the individual in front of you rather than to a stereotype about age.

Ageism can be surprisingly subtle

Elderspeak is not limited to care homes.

• The doctor: looking at the adult child and asking “How has Mum been feeling?” while Mum is sitting right there.
• The shop: calling an older stranger “young man” because their actual age is apparently something that needs pretending away.
• The family: automatically taking over someone’s online banking because “all this technology must be confusing”.
• The car: assuming someone should stop driving because they have reached a particular birthday rather than considering their actual capability.
• The restaurant: giving information to the younger family member rather than the older customer.
• The technology shop: explaining something at kindergarten level before establishing what the customer already knows.

Offering help is not ageism.

Assuming help is needed because of age can be.

There is another side to this

Some people like being called “love”, “darling”, “dear” or “sweetheart”, particularly in regions and cultures where these are common forms of friendly address. Some people do not.

That does not mean the answer is a ridiculous rule saying nobody can ever call an older person “dear”. Context, relationship and preference matter.

The principle is simpler:

Do not change how you treat another adult purely because of assumptions you have made about their age.

How to speak without elderspeak

1. Start with normal adult conversation. Speak to the person as you would speak to another adult.
2. Do not assume hearing loss. If someone has not heard you, speak more clearly before simply shouting.
3. Speak to the person. Do not automatically address the relative, carer or younger person beside them.
4. Ask rather than assume. “Would you like me to explain that?” is different from assuming an explanation is required.
5. Adapt when necessary. If someone has hearing, visual or cognitive difficulties, adjust communication according to their needs.
6. Give people time. Taking longer to answer does not mean someone does not understand.
7. Use their name. If you are unsure whether a term of endearment is welcome, their preferred name is usually safer.
8. Respect choice. Support does not mean taking control unnecessarily.

Apply the Age Watchers framework

How we want to be treated

Age Watchers is not about fighting ageing or pretending we are younger than we are. It is about maintaining health, capability, choice, independence, connection and purpose.

That means rejecting the assumption that age automatically equals incapacity.

The goal is not to treat an 80-year-old like they are 40. It is to treat an 80-year-old like they are an adult.

Most elderspeak probably begins with kindness. That is what makes it worth noticing. You do not have to intend disrespect to accidentally communicate it.

So perhaps the simplest rule is:

Start with the person.
Not their age.
Speak normally.
Listen.
Adapt when necessary.
Allow people to tell you what they need rather than deciding for them.

Frequently asked questions

Sources / Further reading

• Williams KN, Herman R, Gajewski B, Wilson K: Elderspeak communication: impact on dementia care. American Journal of Alzheimer's Disease & Other Dementias (2009; published online 2008).
• Williams KN et al.: Elderspeak’s Influence on Resistiveness to Care: Focus on Behavioral Events. American Journal of Alzheimer's Disease & Other Dementias (2009).
• Shaw CA, Gordon JK: Understanding Elderspeak: An Evolutionary Concept Analysis. Innovation in Aging (2021).
• Lillekroken D, Röthig A, Bjørnnes AK: Elderspeak in Healthcare Settings: How Care, Control and Personhood Intersect in Care Communication — A Qualitative Meta-Synthesis. Journal of Advanced Nursing (2026).