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More PsychNotes: Aging and Lifespan Issues

“I'm Old, Not Stupid!” Patronizing Speech and the Elderly
by Monica A. Frank, PhD

In recent years my husband, a senior citizen who uses a cane, complains how restaurant staff talk to him. At first I thought he was being overly sensitive and would tell him that's just how they talk. However, one particular time it was noticeable even to me. The server used a high pitched patronizing voice when she talked to him and when she turned to me (I'm much younger than him) she used a normal tone. Then she turned to him and changed voices again. I could barely restrain myself from bursting out in laughter because it was so comically obvious.

Apparently, this is a significant problem for older adults (as well as those with mental illness) especially when hospitalized or in a nursing home. My husband, being a very assertive person, will ask the wait staff to speak to him in a normal tone, but usually, they don't even recognize what they are doing. As a result, he comes across as a cantankerous old man.

Patronizing speech includes high pitched tone of voice, slower and/or louder speech, simplified vocabulary and grammar, repetition, overly personal, praise for minor accomplishments, terms of endearment, and third person reference (“What do WE want?”). It has been found to be demoralizing and leads to withdrawal, lowered self-esteem, and feeling loss of control. Such speech has not been shown to have an effective purpose.

A research study by Ryan and colleagues (2000) examined the dynamic of patronizing speech by nursing home staff and predictably found that residents rated patronizing nurses more negatively although they had also come to expect and tolerate such treatment. However, this research further examined residents responses to patronizing speech and found residents who were more assertive were viewed as less competent. However, when they used humor as a response they were rated more favorably and still appeared assertive.

These results show that how an older adult responds to patronizing speech can impact the overall quality of the interactions with the staff. It is unfortunate, however, that those who are most vulnerable must alter their approach rather than the staff refraining from being patronizing.