CASLPO News

Does Elder Ageism Impact Speech and Hearing Care?

Aging is a universal human experience. In Canada, by 2030, one in four people will be over the age of 65, meaning older adults represent a growing proportion of clients seen by audiologists (AUDs) and speech-language pathologists (SLPs). 

Ageism refers to stereotypes (how we think), prejudice (how we feel), and discrimination (how we act) toward others or oneself based on age. Because communication, cognition, and sensory function are often assumed to decline with age, ageism can quietly influence clinical judgments in speech and hearing care. This makes it important for AUDs and SLPs to recognize how elder ageism—both conscious and unconscious—can affect assessment, intervention, and patient engagement.

How Elder Ageism Can Affect Clinical Practice

Elder ageism can show up in audiology and speech-language pathology in several ways:

• Assumptions about capacity or learning: Clinicians may assume older adults are less able to benefit from therapy, auditory training, Augmentative and Alternative Communication (AAC), or new technology, leading to lower expectations and fewer options being offered. (Ayalon & Tesch-Römer, 2018)
• Attributing concerns to “normal aging”: Hearing, speech, or cognitive-linguistic changes may be dismissed as inevitable rather than assessed thoroughly, contributing to under-treatment and delayed referrals. (World Health Organization, 2021) 
• Communication style and “elderspeak”: Using overly simplified, patronizing, or exaggerated speech (“elderspeak”) can reduce autonomy, trust, and engagement, even when intentions are well-meaning. (ACASA, 2024)
• Speaking to caregivers instead of the client: Addressing family members while excluding the older adult can make clients feel invisible and undermine informed consent and shared decision-making. (Baylor University, 2023)

Why Elder Ageism Matters for Patient Outcomes

Ageism is not simply a social issue—it is a public health issue. Internalized ageism, commonly defined as the process by which individuals absorb societal age stereotypes and biases and apply them to themselves, is associated with:

• Increased depression and anxiety 
• Reduced help-seeking behavior 
• Poorer recovery from disability
• A reduction in life expectancy of up to 7.5 years 

Strategies for Audiologists and Speech-Language Pathologists 

• Reflect on assumptions about aging. Check whether clinical decisions are influenced by age-based expectations rather than individual presentation. CASLPO emphasizes addressing both conscious and unconscious bias as part of equitable care. (CASLPO Guide for Equitable and Inclusive Services)
• Adapt communication—not expectations. Speak clearly and at an appropriate pace, face the patient, and use plain language without being condescending. Difficulty responding may reflect hearing loss or fatigue, not reduced cognition. (Global Campaign to End Ageism, 2017)
• Address the older adult directly. Even when caregivers are present, speak to the patient first. This supports autonomy, dignity, and the creation of a therapeutic alliance. (Baylor University, 2023) 
• Allow time for meaningful interaction. Older adults frequently report feeling rushed during appointments. Allowing additional time supports disclosure, understanding, and trust. (Care&, 2025) 
• Create age-friendly practice environments. Use large-print materials, adequate lighting, clear signage, and staff support with forms. These adjustments reduce barriers without lowering clinical standards.

Why Addressing Elder Ageism Is Part of Ethical Practice

Respectful, age-inclusive practice improves clinical accuracy, strengthens therapeutic relationships, and supports better outcomes. Addressing elder ageism is not only good clinical practice—it is aligned with professional standards, human rights obligations, and commitments to equity and inclusion.

Resources for Clinicians

• EAPO Elder Abuse Response Guide 
• CASLPO Guide for Equitable and Inclusive Services
• Culturally Appropriate Intervention Standard – Guidance on acknowledging socio-cultural and linguistic factors in clinical care 
• DEI E-Forum Series – Ongoing professional development webinars on equity, diversity and inclusion