Elderspeak: The Language of Ageism

Elderspeak: The Language of Ageism

by | | Communication, End of Life, geriatric care management, Health & Wellness, Hospital Care, Medical

As a geriatric care manager, some days leave little time to prepare dinner. On those days I stop into my local deli. I am usually greeted by: “What will it be today young lady?” Yes, a lady, I hope, but young…not unless you think casting my first presidential vote in 1968 (Nixon-Humphrey) puts me in the young category. Yet, as this food emporium often puts food on the table, I don’t take issue with their choice of words. I will, however, not be as benevolent with a neurologist I recently brought a client to, who, as she exited the examining room, tapped Janet on the shoulder and said: “be a good girl.”

“Be a good girl,” this is the language of ageism or as it is known, “elderspeak.” The National Institute of Health defines elderspeak as “an inappropriate simplified speech register that sounds like baby talk”. Conversing with an older adult as one might talk to a four-year-old. But unlike the four-year-old who has years ahead to accrue his or her accomplishments, the older adult has amassed years of notable achievements, both in their personal and their professional worlds. For Janet, she had established a mortgage brokerage company and was also an instructor at a local adult education school where she taught a class on Victorian novelists. But yet, her neurologist, especially her neurologist chose these as her departing words.

Elderspeak presents itself in other ways as well. Often, it implies the older person is not competent to understand what is being asked or told to him or her. Words like, “honey,” “sweetie,” and “dear” are frequent. Pronoun choice can also present itself in a tactless way. “Are we ready for a bath?” Really? Is the caregiver, family member, or nursing home staff intending to hop in the bathtub with the senior adult? I doubt it. Instead, how about, “Are you ready for a bath?” Certainly, saves on towels and enhances self-esteem. The other pet peeve of pronoun choice is just that, the adult senior becomes invisible and is a generic “he” or “she.” No acknowledgement of their given name or their presence. Finally, another property of elderspeak is exaggerated slowness in speech with someone without hearing disabilities. For an elder with hearing challenges, slow speech in a low voice tone may well be appropriate.

In considering these faces of elderspeak consider the following suggestions: Talk in a normal tone. Make eye contact and pick up on any visual cues. Never be condescending, this may require taking a step back to look at the words we chose to use.

As an Aging Life Care Consultant®, the dignity of each of my clients takes uppermost priority. It becomes even more important when their current abilities and well-being are compromised. Words matter and voice intonation can be felt. Both contribute to how a person feels about themselves, and how others perceive that person. Let’s work to make elderspeak an extinct language.

As Rare as Venus Passing Across the Face of the Sun

As Rare as Venus Passing Across the Face of the Sun

by | | Aging in Place, Communication, End of Life, Family, geriatric care management, Health & Wellness, Medical, Westchester

On June 5th and 6th 2012, the world was able to witness planet Venus passing across the face of the sun for about 6 hours causing a small black dot to appear on the sun’s surface. This event will not reoccur until 2117. I didn’t see the passing in 2012, and I can confidently say I will not see it in 2117. Yet in my world of being a geriatric consultant, I did see something equally as extraordinary. A senior adult called this Aging Life Care® Consultant to inquire about my services and how I might, one day, help her. A senior adult inquiring about help for herself, as rare as Venus passing across the sun.

This call was a first for me. I was accustomed to counseling adult children in such matters as dementia, in-home and residential alternatives, and overcoming parental resistance. I asked Isabel (not her real name) what prompted her call. She explained that her adult children lived at a distance, and she wanted to prepare for whatever the future may hold. She was 84. There was nothing compelling going on at the time, so I described how I could potentially be of help. A year later, I heard back from Isabel. She asked that I come to her home so that she could meet me and vice versa. Two years passed before I heard from her again, this time she asked if I could help her find a companion for a couple of days a week. Because I had done what we call in the trade, “a meet and greet,” I had a good idea of what type of companion would work best with her. Luckily, she was available, and the match was a successful one.

The passage of time brought conditions that required more care and eventually the need for a fulltime companion. None of this lessened Isabel’s astuteness to her needs, especially her hearing loss which was impacting on the activities she enjoyed in the community and with friends and families.  I am accustomed to seniors finding less effective and more irritating hearing solutions telling others: “To just speak louder.” Not Isabel. In keeping with this proactive senior, she headed to an audiologist to be fitted for hearing aids. They have helped, but even with regular adjustments, not to the degree she hoped.

With her mood now wavering and her age passing 88, we spoke about how the diverse world she was accustomed to was receding. Her family suggested consulting with her doctor about an anti-depressant which Isabel thought might be helpful (Again, I am more familiar with the response: “who needs that, I’m not crazy”). Not surprisingly, Isabel also asked me to recommend books about getting older. I mean getting older…. the real McCoy. Step aside Nora Ephron. The vicissitudes of accepting that you have less days on this earth than more. And with some research I shared three books with Isabel that would support what she was feeling.

  • Still Here: Embracing Aging, Changing, and Dying 
  • Growing Old: Notes on Aging with Something Like Grace
  • Helping Yourself Grow Old: Things I Said to Myself When I Was Almost Ninety

 Currently, Isabel and I chat on a regularly irregular basis. Sometimes short because a Zoom is about to start, other times longer. She leads me. I always like to know what she is reading, and we exchange names of books we have enjoyed. Truth be told, some of her nonfiction book recommendations are beyond my comprehension.

As an eldercare consultant I have always felt in the giving, there is receiving. It is so much the case with Isabel. And when the opportunity presents itself, I always remind her that she is my role model. I am not waiting for Venus to pass across the sun.

Farewell Dear Voice

Farewell Dear Voice

by | | Aging in Place, Covid-19, End of Life, Family, Good Deed, Health & Wellness

In the early days of COVID, senior centers and adult day programs shuttered their doors abruptly. Nearby family members visited cautiously while geographically separated family members remained just that. Caregivers weighed risking their health to meet the daily needs of the elders they were assisting.

For this eldercare consultant, it was a telephone, and technology that were my methods of communicating with clients and their families. As spring and summer arrived, outdoor visits served as a means for re-connection.

And while the seasons gave me the opportunity to re-unite with current clients and meet new clients, there still existed a segment of the population that remained isolated. It was during this time that I received an email from a non-profit organization asking for volunteers to reach out to homebound seniors to “chat” as they called it, just chat. Within weeks, I was asked to call Rosemarie T. in Brooklyn, no last name given.

While less than an hour from New Rochelle, I only knew Brooklyn via the tales my husband had shared of his youth growing up there and my occasional visits to a great aunt who lived, well, somewhere in the boro. As for Rosemarie, I was not calling in my familiar role as a care consultant, but just plain “Micki,” as I am informally known. I was instructed to keep the weekly conversation at no more than thirty minutes and let Rosemarie take the lead.

And so, began the year and a half relationship between, Rosemarie T. and Micki Z. It didn’t take much encouragement to learn about her early life in Spain and then Portugal. Oh, how she longed to be back in happier and healthier times. She was frustrated and depressed by the infirmities that were besetting her. Talk of death was a familiar part of our conversations. But no matter how great her suffering, before we said our good-byes, Rosemarie would tell me how much she loved me and made me promise that I would take care of myself. Each time I assured I would.
Occasionally our weekly calls were interrupted by Rosemarie’s hospitalizations. With each return home, Rosemarie sounded weaker. Talk of death now became an impatient wish to die.

In December of 2021, Rosemarie got her wish. I was notified by the “chat” representative of her passing. They told me how much my calls meant to Rosemarie. But truth be known, the voice of this faceless woman had also become very endearing to me. Thank-you and farewell Rosemarie T. from Brooklyn.

A Good Life, a Good Obituary

A Good Life, a Good Obituary

by | | Aging in Place, Caregiving, Connected, End of Life, Family, Westchester

I like to read obituaries, in death, as in life, I find it interesting to learn about people. And so, while returning to New Rochelle from Upstate New York, I read the obituary for Donald Lincoln (his middle named bestowed upon him by his paternal grandfather in honor of our 16th President) Burgess. He died on August 25, 2021, at age 102 years in Pittsfield, Massachusetts.

His family referred to him as “a scholar, musician, World War II veteran, business executive, gardener, friend and lover of the sea.” This care manager believes this description comes with certain characteristics which make for a good life. Among them, being a good person, courageous when the occasion calls, kind, helpful, loyal, trustworthy, selfless, generous and purposeful.

For Mr. Burgess courage and loyalty characterized his devotion to country. During World War II, on the U.S.S. Brough he made twenty-six North Atlantic Ocean crossings protecting convoys of troops and supplies. He continued another 18 years in the naval reserve, to his resignation at rank commander.

After forty-three years in the printing business where he worked his way up from office manager to president of Sutin-Burgess Printing Associates he retired. A life of purpose became most apparent. During this time and thru retirement, he was a gardener, taking pride in a backyard full of plantings he nurtured for many years. His generosity to community was highlighted by his love of music and using his piano skills to serve as the organist for his church. Perhaps most significantly he was the care-giver for Kathryn, his wife of sixty-four years. While I am not a fan of “single-handed” caregiving, the term used in the obituary, I can imagine his devotion to his wife, trumped all offers made to help him. He “surrendered his role to professional care-givers only as a last resort.”

And then came one of the hardest tasks older adults face, “letting go,” as his obituary read, of his home of over a half century. He entered Payn House in Chatham, New York. Its website describes it as “a sensible, affordable option for the independent retired person.” Here, Mr. Burgess drew on his strengths from times past. While adjusting to a new home and befriending residents, “he maintained ties with far-flung family” and dwindling friends. “Doug, found among new friends and activities respite from loss, and opportunities to give of his time and abilities.”

Besides his children, Mr. Burgess left behind ten grandchildren and nine great-grandchildren. Judging from his well written obituary, I think his family recognized all the pieces that made for a life well lived. Quoting the author, futurist and pastor Erwin McManus, “a life well lived is the most exquisite work of art.” Douglas Lincoln Burgess, you were a masterpiece.

End of Life Decisions: A Broken Promise

End of Life Decisions: A Broken Promise

by | | Caregiving, Cognitive Decline, Dementia, End of Life, Family, geriatric care management, Health & Wellness

As a geriatric care manager, in the early part of my journey with senior adults and their families, I ask about advanced directives: a living will, power of attorney and a health care proxy. There will be one of three responses: 1. No, my mother refuses to talk about these documents. 2. We are planning to go to an attorney or 3. Yes, there has been a designated POA and health care agent.

If you fall into the number three category, it may be with relief that you have these documents in place. As the health care agent, you have had the “discussion” and understand the wishes of the person you will represent. You are certain that you can march forward through the complexities of end of life decision making. Yet for some, when the time arrives, that confidence becomes clouded by doubt. It’s not unusual. Such was the case for Lorraine, Anne’s daughter.

Anne, my client of nearly five years, confided in me with weekly regularity that she wanted to die. She knew she was losing her memory and was humiliated by what was happening. Other indignities followed. An extremely anxious person, the only comfort she took was that Lorraine knew her wishes and would do right by her.

Lorraine did not visit her mother with any frequency despite living just over the Westchester County border in Connecticut, a thirty-minute trip. Watching these meager visits and equally few telephone calls, I was sure that when Anne’s doctor called Lorraine to suggest hospice care, she would readily agree. To my surprise, Lorraine would not acquiesce. She acknowledged to me that she knew what she was supposed to do as her mother’s agent. The problem was she could not bring herself to make those final decisions about stopping advanced medical treatment, nutrition, and hydration. “Who am I to make those decisions?” she said to me. I wondered, was it unspoken hope or unease?

Anne lingered with time becoming the final decision-maker. In the days before Anne’s death, I said to Lorraine, with no suggestion of judgment, that she would carry with her whatever decision she made. I recognized that those who generously take on the role of health care agent do so with a full heart. But sometimes, good intentions can be superseded by last-minute questioning. Doubt fogs the road we thought we could readily take.