By Kay Hawes

A researcher at KU School of Nursing has taught the world the right way to speak to our elders.

Kristi Williams, Ph.D., FAAN, a nurse gerontologist and professor at the University of Kansas School of Nursing, is an international-award winning researcher whose work focuses on the care of older adults, particularly focused on improving nurse-patient communication and supporting caregivers of people with dementia. She also oversees the Caregiver Cohort for research at the KU Alzheimer’s Disease Research Center.

“We need more humane options,” Williams said. “We need to be thinking about how we can prevent dementia. How we can improve people’s lives who have dementia and how can we, as a society, place more value on those who care for our elders?”

Williams’ research on “elderspeak,” a form of communication similar to baby talk used by many nurses and other providers to address older adults, has changed the world. Where it used to be common to hear nurses or nurses aides talking to the elderly like they were babies, it’s not as common now. Williams’ work has demonstrated how this infantilizing communication style negatively affects patient outcomes and behavior. The training program she developed, a program known as CHAT (Changing Talk), also available in an online version known as CHATO, teaches staff at nursing homes and other healthcare settings how to use person-centered communication instead. It’s a difference that patients and families can literally hear.

Williams’ work has been funded by the National Institutes of Health for more than 20 years, and its impact has been far-reaching. The CHAT intervention has been delivered to more than 200 nursing homes, and her findings have been included in staff education programs provided by the Alzheimer’s Association and in publications produced by the Gerontological Association of America. Additionally, her research has been highlighted at the Alzheimer’s Association International Conference and has been featured on the front page of The New York Times.

A prolific researcher, Williams was one of only 15 world-renowned nurse researchers inducted into the 2025 International Nurse Researcher Hall of Fame by the Sigma Theta Tau International Honor Society of Nursing (Sigma).

The award, now in its 16th year, recognizes nurse researchers who have achieved significant and sustained national or international recognition and whose research has improved the profession of nursing and the people it serves. The 2025 inductees joined a small group of only about 300 previously inducted nurse researchers from around the world.

“It is such an honor to be part of this elite group,” Williams said.

In her letter nominating Williams for the award, Barbara Polivka, Ph.D., FAAN, associate dean of research at KU School of Nursing, said, “Her program of research has had a significant and long-term impact on gerontological nursing research and practice. Williams’ research linking nursing communication with behaviors of persons with dementia has exerted a global impact on clinical dementia care.”

For Williams, the high point of her career has been “finding out that we could educate people to communicate better and kind of build up the art of nursing, and that this could really make a difference in care and in how people reacted and received care — even to the point that we could reduce psychoactive medication needs for people with dementia just through communication.”

Williams also cites as a career highlight an innovative study she conducted looking at an app that allowed family caregivers of people with dementia to upload challenging situations they were experiencing. A group of experts would then provide feedback and suggestions to the caregivers.

“That was an advance, using technology that could really help caregivers.”

Changing perspectives on aging and long-term care

It’s not enough to change how we speak to elders. Williams also is encouraging the world to think differently about aging and dementia.

“Societies need to come to grips with the fact that people are aging,” she said. “We need to do a better job of taking advantage of older people’s contributions, and we also need to figure out care.”

As more of the population ages, it’s an issue that will affect us all, Williams said.

“I think the focus needs to change from a custodial approach — just taking care or doing for people — to a rehabilitation or health promotion approach,” she said. “This will require a change in philosophy for long term care — from administrators to direct care staff — and will require adequate staff who are prepared in rehabilitation and health promotion, not just custodial care.”

As an example, Williams explains that patients who enter a nursing home or skilled-nursing care after being hospitalized for surgery or an illness often become long-stay nursing home residents, with many never returning to their homes as their health declines. Williams said that happens in part because there is not enough focus on rehabilitation.

“If enough effort is invested in rehabilitation to gain the person’s independence, instead of staff doing for them to meet their needs, more older adults will be able to return to living in their homes, even if they need some support,” she said.

Part of changing the emphasis from warehousing to rehabilitation will require society to re-examine how long-term nursing staff is paid.

“Nurses who work in long-term care get paid the worst, but that is where we need nurses with the most expertise to provide the most intensive care,” Williams said.

And who could lead the charge for a new way to do things? Williams thinks more nurses should pursue research.

“I think that nurses naturally raise research questions and engage in research to determine ways to improve care,” she said.  “I have found using research as a tool to be very rewarding, and I would encourage other nurses to actively participate in and even initiate research.”