Q: I am a COTA working in several nursing homes. All day I hear nursing assistants, therapists and other personnel talking to older people like they are babies. Is this the proper way of talking to older people?

A: Let me ask you a question. Is this the way you want people speaking to your parents or grandparents?

"Elderspeak" is also known as baby talk. Joy Simpson of the University of Kansas defines elderspeak as adjustments a young person may make when addressing an elder, such as a singsong voice, changing pitch and tone, and exaggerating words. Many of us commonly see this in nursing homes, hospitals and other structured settings for older people.

In essence, it's the "baby, sweetie, dearie, honey, my little pudding." I hear it all the time, and it makes my stomach curl. It's that voice that speaks to older people like they are stupid. Those who speak this way may do it so much that it's a habit.

I will tell you this. As I age, hopefully I will be in my right mind enough to correct it on the spot. I can see myself saying, "Are you talking to me? I am not your honey, sweetie, baby or pudding. My name is Mrs. Smith, and I wish you would address me as such."

Now, I know some health care ­professionals say nothing is wrong with this kind of talk. In fact, I will probably get a ton of e-mails in outright debate. However, you should not make a habit of talking to older adults as if they are babies. They are not! They were once young, but now they are old and deserve to treated with dignity and respect. Just because one may like or accept that kind of language doesn't make it right.

As practicing health care professionals we have the opportunity to set the standard ethically and morally even if it contradicts the norm. Take a stand! When I see it happen, I whisper in the person's ear in a gentle way and address the issue privately, not in public. This approach works for me, and I have seen the problem improve in our facilities. Better yet, coordinate with a speech-language pathologist and hold an inservice. Make it fun and role play. Use empathy to expound upon your message or intent.

Here are other things to consider when communicating with older adults:

•One out of three older people have some degree of hearing loss.

•Cognitive or mental disorders can affect how older people receive and process information.

•Age-related visual changes, such as glaucoma, cataracts and diabetic retinopathy, often affect how older people communicate and interact with the environment.

•Other factors such as medications, sensory loss, challenged mobility and nutritional status may affect communication abilities.

•Culture, mood and psychosocial status are also important to consider.

Remember these simple rules of communication when you are speaking with an older adult:

•You don't have to repeat yourself unless it is really necessary.

•Don't assume that an older person can't hear.

•Use simple sentences; the average length of a sentence is 11-17 words.

•Be conversational with your words and tone.

•Remember that some older people lip read. Be conscientious about looking around or talking with your back turned.

•Most importantly, talk to him or her normally, not like a child.

As occupational therapists, all the fancy techniques, equipment and skills in the world do not replace good human interaction. Use all of your senses to reach out to your patient: eye-level communication, touch, head nods, facial gestures and even lots of smiles. If you have to communicate something negative, think twice and do it in such a way that it continues to encourage the patient. You want your patients coming to you, not backing away. You want staff modeling your respectful behavior, not emulating what you see others are doing as a common practice.

When you consistently treat others the same and with respect, you will find your work enriching, fulfilling and exciting! The University of Florida's Elder Management Program changed my life and perspectives about aging. It's a great certificate course you can take online, check it out at http://ecm.dce.ufl.edu/index.shtml. Keep learning and keep growing!

Clarissa Fells Smith, PhD, OTR/L, has a doctorate in health services administration with a specialty in gerontology/geriatrics. She has worked as a manager and clinical education specialist and is currently an independent contractor, trainer, consultant and workshop leader in geriatric rehabilitation. Readers may contact her at clarissafsmith@aol.com.

Elderspeak is:

• Speaking more s-l-o-w-l-y

• Changing your pitch or tone

• Dragging your words

• Using limited vocabulary

Negative effects of elderspeak include:

• It can be ageist in nature.

• It reinforces stereotypes about the aging process.

• It increases reports of confusion.

• It decreases patients' self-esteem and dignity.

•It can actually diminish patients' ability to retain information, which can be difficult for many already.

•Elderspeak for those with dementia can be an excuse to talk down to a patient.