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Honey, Sweetie, Dearie: There Are Perils in ‘Elderspeak’

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Honey, Sweetie, Dearie: There Are Perils in ‘Elderspeak’

A prime example of elderspeak: Cindy Smith was visiting with her father in his assisted living apartment in Roseville, Calif. An aide who was trying to induce him to do something — Ms. Smith no longer remembers exactly what — said, “Let me help you, sweetheart.”

“He just gave her The Look — under his bushy eyebrows — and said, ‘What, are we getting married?’” recalled Ms. Smith, who had a good laugh, she said.

Her father was then 92, a retired county planner and a World War II veteran; macular degeneration had reduced the quality of his vision and he used a walker to get around, but he remained cognitively sharp.

“He wouldn’t normally get too frosty with people,” Ms. Smith said. “But he did have the sense that he was a grown up, and he wasn’t always treated like one.”

People understand almost intuitively what “elderspeak” means. “It’s communication to older adults that sounds like baby talk,” said Clarissa Shaw, a dementia care researcher at the University of Iowa College of Nursing and a coauthor of a recent article that helps researchers document its use.

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“It arises from an ageist assumption of frailty, incompetence and dependence.”

Its elements include inappropriate endearments. “Elderspeak can be controlling, kind of bossy, so to soften that message there’s ‘honey,’ ‘dearie,’ ‘sweetie,’” said Kristine Williams, a nurse gerontologist at the University of Kansas School of Nursing and another coauthor.

“We have negative stereotypes of older adults, so we change the way we talk.”

Or caregivers may resort to plural pronouns: Are we ready to take our bath? There, the implication “is that the person’s not able to act as an individual,” Dr. Williams said. “Hopefully, I’m not taking the bath with you.”

Sometimes, elderspeakers employ a louder volume, shorter sentences or simple words intoned slowly. Or they may adopt an exaggerated, singsong vocal quality more suited to preschoolers, along with words like “potty” or “jammies.”

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With so-called tag questions — It’s time for you to eat lunch now, right? — “You’re asking them a question but you’re not letting them respond,” Dr. Williams explained. “You’re telling them how to respond.”

Studies in nursing homes show how commonplace such speech is. When Dr. Williams, Dr. Shaw and their team analyzed video recordings of 80 interactions between staff and residents with dementia, they found that 84 percent had involved some form of elderspeak.

“Most of elderspeak is well intended. People are trying to show they care,” Dr. Williams said. “They don’t realize the negative messages that come through.”

For example, among nursing home residents with dementia, studies have found a relationship between exposure to elderspeak and behaviors collectively known as resistance to care.

“People can turn away or cry or say no,” Dr. Williams explained. “They may clench their mouths shut when you’re trying to feed them.” Sometimes, they push caregivers away or strike them.

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She and her team developed a training program called CHAT (for Changing Talk), three hourlong sessions that include videos of communication between staff and patients, intended to reduce elderspeak.

It worked. Before the training, in 13 nursing homes in Kansas and Missouri, almost 35 percent of the time spent in interactions consisted of elderspeak; that number was only about 20 percent afterward.

At the same time, resistant behaviors accounted for almost 36 percent of the time spent in encounters; after training, that proportion fell to about 20 percent.

A study conducted in a Midwestern hospital, again among patients with dementia, found the same sort of decline in resistance behavior.

What’s more, CHAT training in nursing homes was associated with lower use of antipsychotic drugs. Though the results did not reach statistical significance, due in part to the small sample size, the research team deemed them “clinically significant.”

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“Many of these medications have a black box warning from the F.D.A.,” Dr. Williams said of the drugs. “It’s risky to use them in frail, older adults” because of their side effects.

Now, Dr. Williams, Dr. Shaw and their colleagues have streamlined the CHAT training and adapted it for online use. They are examining its effects in about 200 nursing homes nationwide.

Even without formal training programs, individuals and institutions can combat elderspeak. Kathleen Carmody, owner of Senior Matters Home Care and Consulting in Columbus, Ohio, cautions her aides to address clients as Mr. or Mrs. or Ms., “unless or until they say, ‘Please call me Betty.’”

In long-term care, however, families and residents may worry that correcting the way staff members speak could create antagonisms.

A few years ago, Carol Fahy was fuming about the way aides at an assisted living facility in suburban Cleveland treated her mother, who was blind and had become increasingly dependent in her 80s.

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Calling her “sweetie” and “honey babe,” the staff “would hover and coo, and they put her hair up in two pigtails on top of her head, like you would with a toddler,” said Ms. Fahy, 72, a psychologist in Kaneohe, Hawaii.

Although she recognized the aides’ agreeable intentions, “there’s a falseness about it,” she said. “It doesn’t make someone feel good. It’s actually alienating.”

Ms. Fahy considered discussing her objections with the aides, but “I didn’t want them to retaliate.” Eventually, for several reasons, she moved her mother to another facility.

Yet objecting to elderspeak need not become adversarial, Dr. Shaw said. Residents and patients — and people who encounter elderspeak elsewhere, because it’s hardly limited to health care settings — can politely explain how they prefer to be spoken to and what they want to be called.

Cultural differences also come into play. Felipe Agudelo, who teaches health communications at Boston University, pointed out that in certain contexts, a diminutive or term of endearment “doesn’t come from underestimating your intellectual ability. It’s a term of affection.”

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He emigrated from Colombia, where his 80-year-old mother takes no offense when a doctor or health care worker asks her to “tómese la pastillita” (take this little pill) or “mueva la manito” (move the little hand).

That’s customary, and “she feels she’s talking to someone who cares,” Dr. Agudelo said.

“Come to a place of negotiation,” he advised. “It doesn’t have to be challenging. The patient has the right to say, ‘I don’t like your talking to me that way.’”

In return, the worker “should acknowledge that the recipient may not come from the same cultural background,” he said. That person can respond, “This is the way I usually talk, but I can change it.”

Lisa Greim, 65, a retired writer in Arvada, Colo., pushed back against elderspeak recently when she enrolled in Medicare drug coverage.

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Suddenly, she recounted in an email, a mail-order pharmacy began calling almost daily because she hadn’t filled a prescription as expected.

These “gently condescending” callers, apparently reading from a script, all said, “It’s hard to remember to take our meds, isn’t it?” — as if they were all swallowing pills together with Ms. Greim.

Annoyed by their presumption, and their follow-up question about how frequently she forgot her medications, Ms. Greim informed them that having stocked up earlier, she had a sufficient supply, thanks. She would reorder when she needed more.

Then, “I asked them to stop calling,” she said. “And they did.”

The New Old Age is produced through a partnership with KFF Health News.

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Video: Engineer Is First Paraplegic Person in Space

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Video: Engineer Is First Paraplegic Person in Space

new video loaded: Engineer Is First Paraplegic Person in Space

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Engineer Is First Paraplegic Person in Space

A paraplegic engineer from Germany became the first wheelchair user to rocket into space. The small craft that blasted her to the edge of space was operated by Jeff Bezos’ company Blue Origin.

Capsule touchdown. There’s CM 7 Sarah Knights and Jake Mills. They’re going to lift Michi down into the wheelchair, and she has completed her journey to space and back.

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A paraplegic engineer from Germany became the first wheelchair user to rocket into space. The small craft that blasted her to the edge of space was operated by Jeff Bezos’ company Blue Origin.

December 21, 2025

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This City’s Best Winter Show Is in Its Pitch-Dark Skies

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This City’s Best Winter Show Is in Its Pitch-Dark Skies
Flagstaff mandates that shielding be placed on outdoor lighting so that it doesn’t project skyward. There are also limits on the lumens of light allowed per acre of land.

The result is a starry sky visible even from the heart of the city. Flagstaff’s Buffalo Park, just a couple miles from downtown, measures about a 4 on the Bortle scale, which quantifies the level of light pollution. (The scale goes from 1, the darkest skies possible, to 9, similar to the light-polluted night sky of, say, New York City. To see the Milky Way, the sky must be below a 5.)

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Social media users in the Central Valley are freaking out about unusual fog, and what might be in it

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Social media users in the Central Valley are freaking out about unusual fog, and what might be in it

A 400-mile blanket of fog has socked in California’s Central Valley for weeks. Scientists and meteorologists say the conditions for such persistent cloud cover are ripe: an early wet season, cold temperatures and a stable, unmoving high pressure system.

But take a stroll through X, Instagram or TikTok, and you’ll see not everyone is so sanguine.

People are reporting that the fog has a strange consistency and that it’s nefariously littered with black and white particles that don’t seem normal. They’re calling it “mysterious” and underscoring the name “radiation” fog, which is the scientific descriptor for such natural fog events — not an indication that they carry radioactive material.

An X user with the handle Wall Street Apes posted a video of a man who said he is from Northern California drawing his finger along fog condensate on the grill of his truck. His finger comes up covered in white.

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“What is this s— right here?” the man says as the camera zooms in on his finger. “There’s something in the fog that I can’t explain … Check y’all … y’all crazy … What’s going on? They got asbestos in there.”

Another user, @wesleybrennan87, posted a photo of two airplane contrails crisscrossing the sky through a break in the fog.

“For anyone following the dense Tule (Radiation) fog in the California Valley, it lifted for a moment today, just to see they’ve been pretty active over our heads …” the user posted.

Scientists confirm there is stuff in the fog. But what it is and where it comes from, they say, is disappointingly mundane.

The Central Valley is known to have some of the worst air pollution in the country.

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And “fog is highly susceptible to pollutants,” said Peter Weiss-Penzias, a fog researcher at UC Santa Cruz.

Fog “droplets have a lot of surface area and are suspended in the air for quite a long time — days or weeks even — so during that time the water droplets can absorb a disproportionate quantity of gasses and particles, which are otherwise known as pollutants,” he said.

He said while he hasn’t done any analyses of the Central Valley fog during this latest event, it’s not hard to imagine what could be lurking in the droplets.

“It could be a whole alphabet soup of different things. With all the agriculture in this area, industry, automobiles, wood smoke, there’s a whole bunch” of contenders, Weiss-Penzias said.

Reports of the fog becoming a gelatinous goo when left to sit are also not entirely surprising, he said, considering all the airborne biological material — fungal spores, nutrients and algae — floating around that can also adhere to the Velcro-like drops of water.

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He said the good news is that while the primary route of exposure for people of this material is inhalation, the fog droplets are relatively big. That means when they are breathed in, they won’t go too deep into the lungs — not like the particulate matter we inhale during sunny, dry days. That stuff can get way down into lung tissue.

The bigger concern is ingestion, as the fog covers plants or open water cisterns, he said.

So make sure you’re washing your vegetables, and anything you leave outside that you might nosh on later.

Dennis Baldocchi, a UC Berkeley fog researcher, agreed with Weiss-Penzias’ assessment, and said the storm system predicted to move in this weekend will likely push the fog out and free the valley of its chilly, dirty shawl.

But, if a high pressure system returns in the coming weeks, he wouldn’t be surprised to see the region encased in fog once again.

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