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Best Practices

5 Ways Elderspeak is Ruining Mealtimes

Community mealtimes are an opportunity to nourish body and soul, but respect must be the main ingredient.

When you get together with friends for a meal, what do you expect from the occasion? Most of us probably anticipate good food, time to catch up on personal news, laughter, and camaraderie. We look forward to these meals because they refresh us and make us feel valued--a member of an inner circle of people we value in turn.

These good feelings can last long after the meal, enlivening an otherwise routine day, or creating cherished memories.

Mealtimes are so important culturally, they are often the setting for important life moments such as marriage proposals, announcing a new pregnancy or promotion, heartfelt talks with a loved one who needs extra emotional support.

But, if you have ever been required to show up at the table, knowing someone there will treat you poorly during dinner, it's a very different story. Have you ever had to attend a holiday meal where you predicted a certain relative would speak down to you? Made yourself go to a mandatory work event where you were sure to be insulted by a particular co-worker? Dreadful, isn't it? You probably felt stressed before, during, and after the meal. If you passively accepted the disrespect to keep the peace, you likely stewed with unhappy resentment for days. If you resisted, snapped back at your tormentor, or otherwise acted ungraciously, you probably contributed to everyone's indigestion and had to field criticism or judgment from the rest of the guests. It's understandable if you resolved never to go to dinner with that person again. Life is short; who needs that kind of heartburn? Nobody.

Which is why we all need to take a good, hard look at how we talk to residents in our dining rooms. Too many of us, inadvertently--intending to be kind, actually--fall into a pattern of communication called "elderspeak."

What is Elderspeak?

Elderspeak is condescending or infantilizing communication directed toward older adults. It might involve the words used or tone of voice. Examples of elderspeak include:

  • Calling people “sweetie” or “honey” instead of using their names, or saying “young man” to someone who clearly is not.
  • Using a syrupy tone, babytalk, or a sing-song voice
  • Speaking for the resident, "We're all finished with lunch now, aren't we?"

Basically, anytime we speak to an older adult in a way that assumes they are childlike or unable to speak for themselves, we are guilty of elderspeak.

How Does Elderspeak Affect Older Adults?

Studies [1-2] demonstrate elderspeak is ruining mealtimes in at least five ways:

  • Residents feel elderspeak is patronizing.
  • Elderspeak causes breakdowns in communication.
  • Residents subject to elderspeak tend to be more resistant to care.
  • Using elderspeak on people with dementia frequently precipitates aggression, withdrawal, vocal outbursts, and wandering.
  • Elderspeak contributes to disrupted care and increased cost of care.

Furthermore, research shows the consequences of elderspeak take a toll on staff, adding to their stress and increasing burnout and turnover.

Obviously, elderspeak is the opposite of hospitality. It prevents us from creating a sociable, nourishing atmosphere at the table. In short, it turns servers into the equivalent of that awful relative who wrecks holiday dinners. I don't believe any of us want to be that person, so we all need to take responsibility for how we talk to the residents we serve.

How Can We Banish Elderspeak from All Dining Rooms?

Whenever we start an initiative designed to change how people communicate, there is a danger of word-policing each other, which only results in increased conflict among staff. Take care of residents and each other by working as a team to:

  • Raise awareness through training: Encourage all staff to learn together what elderspeak is, how it affects residents, and more respectful ways to communicate. Consider asking residents to share their experiences and feelings about elderspeak during a staff meeting.
  • Stop, look, and listen as a team: Acknowledge elderspeak is common and often ingrained in our day-to-day interactions. Have everyone make it a point to start noticing how and when elderspeak is happening. Sometimes, simply being more mindful can create radical changes in behavior.
  • Encourage leadership rather than confrontation: Invite everyone on your team to be part of the solution. There is no need for anyone to start accosting co-workers. Instead, ask each staff member to be a culture change leader by modeling respectful communication during their own interactions with residents. Soon, using elderspeak will start to sound as strange and unsavory to staff as it does to residents.

Set a community-wide goal to make mealtimes happily anticipated events. You know, like gathering with your favorite friends and family around the table.
[1] Balsis, S., & Carpenter, B. (2006). Evaluations of elderspeak in a caregiving context. Clinical Gerontologist, 29(1).
[2] Herman, R., & Williams, K. (2009). Elderspeak's influence on resistiveness to care: focus on behavioral events. American Journal of Alzheimer's Disease and Other Dementias, 24(5), 417-423.

Did You Read the Genworth 2017 Cost of Care Survey?


Of course residents and families are very aware of the high cost of long term care. That's part of why they feel such deep dissatisfaction when they don't receive the level of service they expect from their senior care community. And that's understandable. Imagine how you would feel if you were paying nearly $97,500 a year but not receiving kind, hospitable service in your own home. This is an element of resident satisfaction and dissatisfaction to share with staff.Last year Genworth Financial reported the median annual cost of a private nursing home has risen to $97,455. Median annual cost of assisted living is now $45,000. You can see your state or regional median care cost on their interactive map: Cost of Long Term Care Across the Nation.

During Kind Dining® training we discuss the high cost of care and how it affects resident expectations. We also talk about how much it costs a senior care community every time a dissatisfied resident moves out. It is usually eye-opening for servers to learn how much it costs to replace a resident who moves out. This exercise helps servers understand how valuable they are to the community in real dollars and sense terms. Research shows mealtimes are so important to residents that if they enjoy eating in your community, they are more satisfied overall with living there. What satisfies residents most in the dining environment? According to a study by ProMatura Group: A place that feels like home and a place to make friends. In other words, a place where they feel like they belong.

Teach your servers to help residents socialize and bond at the table and your senior living community will set itself apart from the competition, which means you'll have an easier time retaining and attracting residents.

Not sure where to start? Let's talk. Send me an e-mail or call 503-913-1978.

Vintage Valentines

Sweeten mealtimes with a little nostalgia in February. Table tents featuring old-fashioned valentines make a fun, colorful centerpiece that can be used to inspire conversation. Decorate pre-cut templates or use plastic frames to hold the cards. Add a love poem or quote to the back.

You can find these old-timey cards at vintage shops or thrift stores, but if you don't have time to shop, the Internet is your friend. Check out:

While you're shopping, pick up a supply of valentine's you can give away--some modern ones will do just fine. On Valentine's Day, make sure every resident gets one.

Image source: Barbara Crews,

Thank you for choosing Higher Standards as your training partner.

Share a kindness today,




Available soon ~ the digital format of:

Hospitalty for Boomers: 

How to attract residents, retain staff, and maximize profitability!

For a limited time, you can access the first 2 chapters in the digital format: click here. Enjoy!



Pride in Foodservice Week 2018

February 5-9, 2018 is designated Pride in Foodservice Week by the Association of Nutrition & Foodservice Professionals (ANFP). This recognition week applauds nutrition and foodservice professionals and other members of the dining service team for their hard work and dedication on the job. Celebrating its 27th year, Pride in Foodservice Week will be celebrated in communities across the country in various inventive ways. Get ideas of ways to praise and celebrate staff. 


Save the Date

IDHCC Annual Spring Conference

Hilton Garden Inn,W. DesMoines,  April 6, 2018  

Speaker Highlights:

Cindy Heilman with Kind Dining
Dr. Diane Lamgeo / Skin Integrity and Failure
State Regulations & More

Contact the organizer,   Charlotte Kooima, RDN, LD, LN

Embracing What Matters Most in 2018

As you transition into 2018, let us help you transform your service team to deliver hospitality, without the common hassles often experienced around mealtimes.  Kind Dining Hospitality offers a unique training style that helps your team create achievable goals, improve performance, and deliver results.

Your staff learns competencies and skills to consistently demonstrate service that represents your values and raises standards. And as a bonus, reduces the stress of complying with updated CMS Food and Nutrition Service Regulations. When Kind Dining principles and lessons are consistently implemented, they help your staff,  better their own results and team performance, as they serve your residents and their families.

For more information about how Kind Dining works, click here, for additional insights about Cindy’s approach, see our 5 minute video about the 6 truths You Cannot Ignore for Success and read our article posted in the Nutrition & Foodservice Edge magazine about our 6 Truths.

In our own transformation this year we are launching our popular Hospitality for Boomers Book, as an ebook, ordered directly from our website. Price will be $ 9.95 when it is launched. Right now, you can receive the first two chapters in digital format here.
In the next few months, I will be introducing a platform in which I will be offering teaching sessions via computer, and video.

As words shared from an Oregon State Surveyor, “your training program fits very nicely into the current regulations for nursing facilities. CMS is giving equal weight to quality of life and quality of care and person-centered care is more than a concept – it is written into the regulation as a standard”.

And one last thought, here is a Tip Sheet shared from the Association of  Nutrition and Foodservice Professionals website, 10 Ways to Survive CMS Phase II. It’s  must have list of ideas, plus downloadable CMS pdf forms your team will need based on the New Survey Pathways.

Several of these forms can also be accessed from our Higher Standards Free Resources page.

If I can be of assistance as you work to meet the demanding service needs of your clientele, please call me or e-mail any time.

Share a kindness today,


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