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Posted: August 05, 2008

Baby Talk Infuriates Alzheimer's Patients; They Still Absorb It

The tendency of caregivers and others to use “baby talk” when speaking with Alzheimer’s patients is irritating to these individuals, who recognize the demeaning way they’re being spoken to and do not like being patronized or treated like children, researchers say.

Such baby talk – or “elderspeak,” as it is characterized by some seniors and observers – is understood and not appreciated by Alzheimer’s patients, even those who may seem deeply disoriented or cognitively impaired, said lead researcher Kristine Williams, an associate professor at the University of Kansas School of Nursing.

"People who have dementia are trying to maintain their sense of being a person. And if their concept of being a person is that they are a competent person, and someone is talking to them like they are an infant, that might be distressing," said Williams.

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Williams led a small study of communication and Alzheimer’s patients that offered a rare glimpse into the inner workings of these patients, who often seem too detached to absorb the message, let alone the way it is delivered. She presented her findings last week at the Alzheimer Association's International Conference on Alzheimer's Disease in Chicago.

Williams and colleagues videotaped 20 elderly men and women living in three nursing homes during the course of a day as professional caregivers helped them bathe, brush their teeth, dress, eat and take medications, along with other activities.

They then analyzed the tapes frame-by-frame, observing how the manner in which the nursing home staff interacted with patients influenced their behavior and the quality of care.

They discovered that Alzheimer’s patients were twice as likely to resist help when nurse’s aides communicated with them, using baby talk, or elderspeak, including high-pitched sing-song tones and comments like "good girl" and references like "honey." This pattern also was observed when these same caregivers used language that implied a state of dependency, such as, "Are we ready for our bath?"

In these situations, Williams’ team witnessed the elderly turning or looking away, grimacing, clenching their teeth, groaning, grabbing on to something stationary, crying or saying "no." All of these reactions can be interpreted as signs of distress at being patronized or treated like a very young child, said Williams.

Williams said this study suggests that a sense of adult identity remains intact in people with dementia, even when a person can’t remember how old they are, where they are, what day it is or which family members are in the room or even still alive.

Her study was all the more important, she said, because it opened a window on the world of how people experience Alzheimer's disease, especially in its latter stages -- long a mystery because those who suffer from the illness lose their ability to articulate thoughts and feelings.

Also, she emphasized, the study shows that "communication can really impact care.”

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