Over the past ten years, my clients and I have had numerous encounters with healthcare professionals in which the professional uses terminology that is inappropriate. Most commonly, this involves calling the client “Hon,” “Dear,” or “Sweetie,” and/or commenting on how cute he or she looks (often several times).
It makes me uncomfortable. I just don’t appreciate seeing these wonderful and dignified older adults, who have a wealth of life experience, being treated in an infantilized way. And so I began asking my clients how they felt when someone talked to them this way. Over and over, they told me:
- I didn’t like it but I was afraid to say something.
- I just didn’t know what to say.
- I felt like a child and I know I’m not.
- I wondered if they thought I had dementia.
I began to seize the opportunity to change the status quo and Challenge the Process by speaking up. Here’s what I say when I encounter this type of behavior:
- Mr. T. prefers to be called “Mr. T.”
- Excuse me, Mr. T. prefers to be called “Sam.”
If this type of assertiveness makes you uncomfortable, I understand – I don’t find it easy either! Reactions range from heartfelt apologies to outright defensiveness, so you never know how your comments will be received. Sometimes, depending upon the response, I may add:
- I appreciate you were being kind, but I thought you’d want to know that it makes my client uncomfortable.
- Sometimes such terms lead an older adult to feel as if their being treated as a child. I thought you would want to know that for the future.
My clients, too, have begun to speak up for themselves, as a result of our conversations. They may say something like:
- I know you meant well by calling me honey, but I prefer to be called Sam.
I’ve also found myself sharing information about who Mr. T was as a younger man, as a way to demonstrate his accomplishments and preemptively curb the behavior. I say things like:
- Before retiring, Mr. T. ran a very successful accounting practice.
Older adults deserve our respect
Approximately 60% of my client base falls into the “older adult” category, defined as those who are over the age of 85. In our culture we use many different words to describe this demographic and I confess to having struggled with most of it until I settled upon “older adult.” It is my way of demonstrating respect for an individual’s age and the vast reservoir of experience they represent.
Words like “honey” or “cute” are often used to describe children. When they are similarly used for older adults, it can be perceived as condescending (whether or not that was the intention). As important, it can lead to attitudes that may ignore the older adult’s wishes or thoughts, again, as if they were babies.
I know that these terms of endearment are rarely spoken in a mean-spirited way. On the contrary, they are often intended to be kind and comforting. However, in healthcare settings – a place where healthcare consumers already tend to assume they have less power than those around them – this is problematic. My clients have often relayed how they felt patronized and offended, but just didn’t know how to handle these encounters.
Recommendations for interacting with older adults
In writing on this topic, I am hopeful that raising awareness about the issue will result in positive change. Here are a few ideas:
- Check yourself and see what your habits are when addressing older adults. Self-awareness is key to changing any behavior.
- Recognize that while endearing terminology may be fine with you, the other person may feel differently. They may be too polite to tell you how irritated it makes them.
- Recognize that such terminology, although well meaning, can be infantilizing and dismissive to what an older adult has to say.
- In first meetings with new people, err on the side of formality; address others as Mr./Mrs./Ms. if you know their last name. If the other person thinks it is too formal, they’ll let you know and will guide you as to what they should be called. If they accept such a greeting, use it until you’re told not to.
- If, as a manager, you notice an employee addressing people inappropriately, take the initiative to educate and coach them on the topic of appropriate greetings. Monitor improvement and hold others accountable for their actions.
- If you, like me, have people in your circle who refer to older adults in infantilizing ways, explore what they find admirable about that older person and encourage compliments on their own merits. Examples are:
- You’ve accomplished so much in your life.
- Your experience is amazing.
- You are a joy to interact with. I enjoy spending time with you.
- I admire your positive outlook on life.
- I admire your spirit.
- Model the way, leading by example. My preferred practice of exemplary leadership as outlined by my favorite researchers on the topic is to Model The Way. Kouzes and Posner say that leadership is not about personality; it’s about behavior – an observable set of skills and abilities. There is nothing more powerful than you demonstrating respectful behaviors toward others!
Communicating the difference between celebration of age and condescension takes time and skill; it is a fine balance. If we hope to get past the preconceptions that exist in our culture, we need to reflect on our own biases and openly discuss with others how their words make us feel.
I challenge you to speak up and proudly celebrate the experience and accomplishments that come with each day of living. Do this for your clients, your family and yourself.