The sisters caring for cognitively impaired elderly nuns in a Midwestern convent spoke to their care recipients in a way that sounded strikingly different to linguistic anthropologist Anna Corwin.
The nuns rarely used "elderspeak" — a loud, slow, simple, patronizing and common form of baby talk for seniors.
Instead, Corwin reports, they told jokes, stories and blessed the sick nuns, all the while speaking to them like they were completely capable, even though their ability to communicate was significantly diminished.
"It is beautiful watching these nuns," Corwin, a professor at Saint Mary's College of California in Moraga, said in a phone interview. "They accept decline. They value a person in a sort of inherent way."
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Corwin observed the nuns caring for their infirm sisters from 2008 until 2013. Altogether, she spent 10 months watching and listening.
In a paper published in The Gerontologist, she dissects the verbal interactions of caregiving nuns ministering to their elders during 26 visits that she recorded. Three caregivers visited 12 sick nuns, between the ages of 81 and 92, in their rooms, where they were bedridden or confined to reclining chairs, for 10 to 25 minutes at a time.
The nuns in the infirmary suffered from dementia, Alzheimer's disease, aphasia, stroke and neurological deterioration, and all had limited or impaired communication abilities. Sometimes the caregiver nuns held the sick nuns' hands, and sometimes they massaged their legs, Corwin said.
During all her visits over seven years, only twice did she hear elderspeak in the convent, and both times the words came from the same caregiver.
Elderspeak, often punctuated with terms of endearment like sweetie and dear, can communicate a message of incompetence to patients and can lead to a downward spiral of social isolation and cognitive decline, previous studies have shown.
Kristine Williams, a professor at the University of Kansas School of Nursing in Kansas City, trains nursing home providers to use less elderspeak. Her studies found that communication training can reduce the number of diminutives, terms of endearments and collective pronouns senior caregivers use.
"It's easy to say, 'Don't use elderspeak,'" Williams said in a phone interview. "But what is more effective to use?"
Corwin's observations provide alternative ways of communicating, though the nuns may be uniquely skilled, said Williams, who was not involved with the new study.
"Specifically, the jokes and narratives could be helpful to providers in a lot of different settings," she said.
The caregiver nuns had long-established deep relationships with their elder charges, Williams noted. "They are in almost a family-like relationship, as opposed to someone who's a nursing assistant in a home," she said.
The lessons might apply to relatives talking to family members with dementia and other cognitive impairments.
A nun who Corwin calls Sister Irma provides an example of how the sisters used humour to diffuse memory lapses.
An elderly nun Corwin calls Sister Julette knew Sister Irma for more than 40 years, but Sister Julette could not remember her name.
"And I forgot your name," she says.
"Irma," Sister Irma responds.
"Irma," Sister Julette repeats.
"We used to play cards together," Sister Irma says.
"Irma?" Sister Julette asks.
Sister Irma offers her last name, and Sister Julette repeats it. Then Sister Irma adds: "Sister Irma. Sometimes some of them call me Fatty Irma or Ratty Irma or Bratty Irma. I get all kinds. But then I give 'em right back."
Instead of feeling bad about forgetting her friend's name, Sister Julette winds up laughing, and Sister Irma laughs along with her. "
"There's really something about the way the nuns see their older peers that I think is motivating these linguistic interactions," Corwin said. "They see these older adults, even when they're lying in bed moaning and can't move, as not being reduced by these chronic conditions but still as whole individuals."