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Elderspeak And The Invisible Patient
Barbara Morris - Pharmacist - Writer - Aging Issues Barbara Morris - Pharmacist - Writer - Aging Issues
Escondido, CA
Friday, March 20, 2020

Yes, I have a younger sexy boyfriend. (Get over it!)

This past September (September 1st to be exact)  I was in a wheelchair in an emergency room with a  fractured knee cap that occurred in a moment of fully lucid but impaired equilibrium. But here's the good news: the bottle of beer I was carrying remained unscathed. No shattered glass or a drop of foamy goodness was lost. (That takes talent!) I should have known better than to imbibe in the second bottle of brew but as the saying goes, "What the heck. I was having a good time." Even better news: the white jeans I was wearing survived without a mark or tear.

Have I learned my lesson? Yes, of course I have. I'm not a dumb bunny. I no longer drink beer. I now drink white wine. Best of all, my sense of humor remains intact.

After a long wait in the emergency room, I was wheeled into a room and waited some more for a nurse (or anyone) to appear. My daughter and son-in-law were standing behind my chair when a nurse arrived. Then the fun began. As if I was not there, the nurse asked my daughter for details about how my injury occurred.

I was thinking, "Why isn't the nurse asking ME those questions. It's MY injury!" Irritation gnawed at me until I finally swung the bulky chair around to face the nurse, hitting a few cabinets in the process. In a calm, polite tone of voice, I said, "Excuse me, I can hear and understand everything you say and I can answer all your questions. You can speak to ME. I'm not senile." And I smiled. Granted, I should have turned the chair before she entered the room but the space was small.

The poor woman was taken aback. No one had probably spoken to her like that before. After all, she was just applying the accepted protocol for dealing with an old/older person -- it's a cultural thing, a "given".  In her eyes, she had done nothing wrong. I knew that and that's why I intentionally spoke to her in a calm, polite tone of voice.

Old people get used to and even expect (but don't like) to be treated as if they don't exist or are incompetent. It's a societal assumption that old people can't think clearly or remember much and they can't hear or understand if you speak too softly or too fast. After all,  most old people are senile or close to it so you have to be patronizing and deal with them as if they are children. Really? REALLY?

Not all old people are on the brink of senility -- most are not even close. Mature people function quite well if they are spoken to with respect and treated with the assumption they are competent. If they are mentally impaired, acknowledge their existence and treat them respectfully.

Then there is the "elderspeak" element of the "old people are invisible" syndrome.  It is beyond annoying and demeaning. Here is an example and just the tip of the elderspeak iceberg:

My sister and her husband were dedicated runners. On their daily run around the community and their neighborhood,  neighbors, sitting on their front lawn,  many with a glass of bubbly in their hand,  yelled to them as they flew by, "you guys are so cute!"  Was my sister angry? You bet. Please don't call mature persons "cute".  A six-year-old child is cute. To call an elder "cute" is as demeaning and infantilizing as it gets.

Here's more:  If you are a healthcare worker, a mature female patient you just met is not your "sweetie" or "honey". Terms of endearment are appropriate only when there is a romantic relationship. Egads! What a revelation! An old person in a romantic relationship? [gasp!] That's disgusting! Really? No, it's not.

If those in authority call you cute or utter another term of endearment,  it's tempting to want to haul off and smack them into reality, but don't give in to the temptation. Turn it around on them and tell them how cute they are,  and what a sweetie pie they are for telling you how cute you are. Be sure to smile as you do it. Take note of their flustered or confused reaction.

Becca R. Levy is Professor of Epidemiology at Yale School of Public Health and Professor of Psychology at Yale University. She is a leading researcher in the fields of social gerontology and psychology of aging. I have been following her work for a very long time. She has been at the forefront of issues that occur as a result of the way competent older adults are often treated and addressed.

Dr. Levy believes that many of those who use "elderspeak" -- including healthcare workers -- don't understand that it can be offensive and destructive. She says, "I've heard some people say they want to be able to use terms of endearment -- it's their way of expressing their affection for older people -- but I've heard older people say it can be belittling," and "In terms of healthcare settings, it's probably a good idea to ask people how they want to be addressed -- what is most comfortable for them  . . ."

I can get deep into the weeds on this subject but I think I've made my point.  Don't assume anyone with gray or white hair (or no hair)  is incompetent or cute, and don't call them sweetie or use another term of endearment. Acknowledge and respect their existence. Everyone gets old. Keep in mind that one day you will be where they are now and probably in a [gulp!] [gasp!] romantic relationship -- if you are lucky.  (Yeah, yeah. I know that's disgusting. Get used to it.)


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