Older adults interacting with speech technologies may benefit from a range of communicative accommodations. Potential accommodations include volume, intonation, and sentence structure, to name a few. This paper reviews the literature on human communication with the elderly in search of recommendations for speech interface design. We conclude that spontaneous human behavior cannot easily be taken as a guide in designing communicative interactions for older adults. Due to substantial variability in the population, successful accommodations are largely dependent on the specifics of speaker and situation. Regrettably, humans are frequently not attuned to these specifics, and inappropriate accommodation is often perceived as patronizing. Speech technologies present an opportunity to offer accommodations appropriate to the specific communication needs and social values of individual users. Acknowledging the limitations of using research between human communicators to inform the design of speech interfaces, we offer considerations for further research on appropriate communication technologies for older adults.