Science
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.
“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.”
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.
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.”
“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.
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.”
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.
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.
new video loaded: Pentagon Releases U.F.O. Files
By Jorge Mitssunaga
May 8, 2026
President Trump has signed off on a plan to fire Dr. Marty Makary, commissioner of the Food and Drug Administration, after a series of clashes over vaping, oversight of the abortion pill and a series of new drug application denials that rattled biotech companies, according to a person briefed on the matter, who was not authorized to discuss it publicly.
Dr. Makary had a high profile for an F.D.A. commissioner, appearing frequently on television and podcasts to sell the work he was doing at the agency on improving the food supply, speeding up some drug approvals and trying to restore agency morale after thousands of staff members left.
He tried to walk the tightrope between the business-friendly Make America Great Again movement, pledging to get rid of regulations that slow down innovation and to attract more drug trials to the United States. He was an ally of Health Secretary Robert F. Kennedy Jr.’s Make American Healthy Again supporters, voicing the skepticism of the pharmaceutical industry and authorizing natural food dyes.
Ultimately, Dr. Makary’s efforts were not enough to overcome the grievances of a growing band of enemies focused on selling tobacco, opposing abortion and seeing biotech therapies authorized.
Mr. Trump’s decision to dismiss him was first reported by The Wall Street Journal.
The decision could still change, given Mr. Trump’s propensity to change his mind Dr. Makary has also proven persuasive with Mr. Trump in beating back previous efforts to oust him.
Leaving the White House Friday evening, Mr. Trump dismissed the idea that Dr. Makary would be fired.
“I’ve been reading about it, but I know nothing about it,” he said.
The White House has pressured Dr. Makary for months to authorize flavored e-cigarettes, according to a person close to the conversations. The approvals were a top wish of major tobacco companies that have been top donors to Mr. Trump. In March, the F.D.A. issued a memo saying that it would only authorize e-cigarettes in flavors such as mint, tea and spices. The memo said the fruit and candy flavors would be unlikely to pass muster, given their appeal to young people.
Pressure continued, though, and on Tuesday the F.D.A. authorized blueberry and mango flavored e-cigarettes by Glas, a small company based in Los Angeles.
Abortion foes including Susan B. Anthony Pro-Life America have continued to turn up the heat on Dr. Makary, reiterating their call for his firing on Thursday. The group’s leaders and others view Dr. Makary as dragging his feet on a safety review of the abortion pill mifepristone, which they viewed as a way to highlight what they believe are dangers of the drug. Former Vice President Mike Pence, who also opposes abortion rights, amplified criticism of Dr. Makary on social media as well.
The administration has been under pressure from conservatives to tighten regulations on the prescribing and dispensing of mifepristone. The Supreme Court is reviewing a federal appeals court ruling that temporarily blocked abortion providers from prescribing the drug through telemedicine and sending it to patients by mail.
Biotech companies and their investors have also raised alarms with the White House about agency decisions to reject a series of treatments for rare diseases. The F.D.A. typically turns down about 20 percent of the applications it receives for drug approvals from companies.
Dr. Makary has been aggressive in defending the decisions, which he said came from career scientists who found the medications ineffective.
Dr. Makary also had to contend with a health secretary who seemed to view the F.D.A. as an avenue for getting his favored products authorized, exemplified by Mr. Kennedy’s social media post saying that the agency would end its “war on” stem cell treatments, peptides and raw milk. Mr. Kennedy pushed the F.D.A. to reverse a 2023 ban and allow the use of a number of peptides, unproven compounds purported to offer anti-aging or muscle-recovery benefits.
Before leading the F.D.A., Dr. Makary was a cancer surgeon and health policy researcher at Johns Hopkins University School of Medicine. He was also the author of several books about the health care system.
Some of Dr. Makary’s more popular moves included encouraging broader use of hormone replacement products for women and lifting the F.D.A.’s warnings on them. He helped speed some promising drugs to market, including a pancreatic cancer therapy and the pill form of the popular GLP-1 weight loss drugs.
Some California residents were among the 147 passengers and staff aboard a luxury cruise ship stricken by a suspected outbreak of hantavirus that has left three people dead and several others severely ill, officials confirmed Thursday.
California public health officials say they are monitoring the situation after being notified by the U.S. Centers for Disease Control and Prevention that some state residents were passengers on the MV Hondius. The precise status of those individuals, however, remains murky.
Hantavirus is a rare but deadly disease that attacks the lungs and is typically contracted by humans through inhalation of particles contaminated with the urine, feces or saliva of a wild rodent.
However, Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, confirmed Thursday that the Andes virus — a form of hantavirus that can spread from person to person — was involved in the outbreak.
Here’s what we know:
The MV Hondius cruise ship anchored at a port in Praia, Cape Verde, on Wednesday.
(Misper Apawu / Associated Press)
As its name suggests, the Andes virus is typically found in South America. The Dutch-flagged MV Hondius was on a 46-day journey that traveled from Antarctica with stops in Argentina.
In the case of human-to-human transmission, a person would first be infected by a wild rodent’s contaminated particles and then pass the infection to someone else, said Dr. Gaby Frank, director of the Johns Hopkins Special Pathogens Center.
“In previous outbreaks of Andes virus, transmission between people has been associated with close and prolonged contact, particularly among household members, intimate partners and people providing medical care,” Ghebreyesus said. “That appears to be the case in the current situation.”
None of the remaining passengers or crew members on the ship are symptomatic, he said.
The ship was not permitted to allow passengers to disembark at its original destination, Cape Verde, and is sailing for Spain’s Canary Islands.
“I want to be unequivocal here: This is not SARS-CoV-2. This is not the start of a COVID pandemic. This is an outbreak that we see on a ship. There’s a confined area,” Dr. Maria Van Kerkhove, who leads the WHO’s epidemic and pandemic management, said at a briefing. “This is not the same situation we were in six years ago. It doesn’t spread the same way like coronaviruses do.”
California passengers on the cruise
On April 1, 114 guests boarded the cruise ship in Ushuaia, Argentina. Twenty-three days later, 30 passengers — including six people from the United States — disembarked on a stop in St. Helena, a remote island about 1,100 miles off the coast of Africa, according to the cruise operator Oceanwide Expeditions.
Public health agencies in California, Georgia and Arizona were notified by the CDC that some of their residents were among the passengers on the cruise. It’s unclear whether these individuals disembarked on April 24, however.
The CDC is assisting local health authorities with monitoring California residents who were aboard the cruise, according to a statement by the California Department of Public Health on Friday.
As of Friday, one passenger has returned to their California residence and is in contact with local public health officials, and at least one other remains aboard the ship, according to the state agency.
“We understand that news of an unusual outbreak can be concerning,” said Dr. Erica Pan, director of the California Department of Public Health. “Unlike influenza and COVID-19, years of experience in South America have shown that this Andes hantavirus rarely spreads between people.”
Officials said the current public health protocol is to do daily symptom monitoring and reporting.
“As there are no known cases of Andes hantavirus infection from people without symptoms, and any spread has usually been limited to people with prolonged close contact with an ill person with this virus, the risk to the general public in California is extremely low,” the agency said in a statement.
In a statement earlier this week, the CDC also said that the risk to the American public “is extremely low” at this time.
“We urge all Americans aboard the ship to follow the guidance of health officials as we work to bring you home safely,” the agency said.
The others who exited the ship on April 24 were individuals from Canada, Denmark, Germany, the Netherlands, New Zealand, Switzerland, Sweden, Singapore, St. Kitts and Nevis, Turkey and the United Kingdom.
Of the remaining passengers still aboard the ship headed for Spain’s Canary Islands, California Department of Public Health said none were ill as of Friday.
How many people have been infected?
The number of lab-confirmed hantavirus cases has risen to five, according to the WHO. There are three additional suspected cases.
A timeline of reported cases of hantavirus aboard the cruise ship can be found here.
The WHO is monitoring reports of other people with symptoms “who may have had contact with one of the passengers. In each case, we are in close contact with the relevant authorities,” Tedros said.
The first passenger to have been infected, a Dutchman, became sick aboard the cruise ship on April 6 and died on April 11.
No samples were taken, because his symptoms were similar to other respiratory diseases. His widow left the ship with his body on April 24 during the scheduled stop at St. Helena.
“She deteriorated during a flight to Johannesburg on the 25th of April and died the next day,” Tedros said.
Before boarding the cruise ship, the Dutch couple had traveled through Argentina, Chile and Uruguay on a bird-watching trip, “which included visits to sites where the species of rat that is known to carry Andes virus was present,” Tedros said.
After leaving the ship, the woman was briefly aboard a KLM aircraft in Johannesburg bound for Amsterdam but was barred from the flight due to her medical condition, the airline said in a statement.
Dutch news outlets reported that a flight attendant on a KLM airplane — who briefly had contact with the widow — started feeling sick and had mild symptoms and was in isolation at a hospital in Amsterdam.
The flight attendant has since tested negative for the Andes virus, Dr. Jeremy Faust, an emergency medicine physician, wrote on his Substack blog, Inside Medicine, citing a text message sent to him by Tedros.
“It is still possible that the flight attendant contracted the Andes virus. However, given our understanding of the virus, this information means that the flight attendant’s symptoms are not caused by the Andes hantavirus, but by some other medical illness,” Faust wrote.
More cases may be reported, because the incubation period — the time it takes between exposure to the virus and the onset of illness — for the Andes strain of the hantavirus is up to six weeks.
What we know about hantavirus
There are roughly 50 identified species of hantavirus. The virus that’s found in the Americas tends to cause a cardiopulmonary syndrome, a condition that affects the heart and the lungs, according to Frank.
There have been 890 laboratory-confirmed cases of hantavirus disease reported in the U.S. since surveillance began in 1993, according to the most recent data from the CDC.
From 1980 to 2025, 99 California residents have been diagnosed with a hantavirus infection, according to the California Department of Public Health.
CDC officials said 38% of people who develop respiratory symptoms may die from the disease.
Still, the data suggest that contracting hantavirus is rare, said Dr. Afif El-Hasan, member of the American Lung Assn.’s national board of directors.
There is no vaccine or specific antiviral medicine for hantavirius.
Intensive-care treatment may include intubation and oxygen therapy, fluid replacement and use of medications to lower blood pressure, according to the American Lung Assn.
The signs of hantavirus
Early symptoms of hantavirus are similar to the flu and include fatigue, fever and muscle aches, according to the CDC. Symptoms start to develop within one to eight weeks after contact with an infected rodent.
Half of those who contract the virus also experience headaches, dizziness, chills, nausea, vomiting, diarrhea and abdominal pain.
Four to 10 days after the initial phase of the illness, another round of symptoms can develop, which include coughing, shortness of breath and possible tightness in the chest as the lungs fill with fluid.
Even though contracting hantavirus in the U.S. continues to be a rare event, El-Hasan said, people should take these initial symptoms seriously and promptly seek medical care.
How to protect yourself
Hantavirus cases can occur year-round, but the peak seasons in the United States are the spring and summer, which coincide with the reproductive seasons for deer mice.
To lessen your risk of infection, keep wild rodents out of your home and other enclosed spaces by sealing any holes and placing snap traps.
If you find evidence of mice, wear personal protective equipment and disinfect the area. When you’re done, put everything, including cleaning materials, in a bag and toss it in your trash bin.
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