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Minding our Elders: Preserve elder dignity with adult communication

Carol Bradley Bursack

DEAR CAROL: My wife tells me that I need to watch the words I use when I talk to or about her mother who has Alzheimer’s. Why does it matter? My mother-in-law often doesn’t respond to a lot of what we say, so I don’t get why the words we use matter that much.

While I don’t say bad things, it seems to me that calling a spade a spade makes more sense. Isn’t that more clear and understandable? – Chris

DEAR CHRIS: You are right if you’re thinking that talking about just one idea at a time is helpful. Presenting a lot of information does make understanding difficult for the person with dementia. That being said, the labels we use do matter.

Whether or not your mother-in-law seems to know the difference isn’t the issue. It’s a matter of respect. If she does understand, she may be more likely to respond well to respectful terms. However, even if she becomes non-responsive to what people say, your own words may affect how you treat her.

Put yourself into the place of someone with dementia. You’re attending adult day care every afternoon, but day care is a term traditionally associated with children. How much better would it be for you if you were told that you are going to the club? This kind of phrasing can allow people with dementia to save face as well as feel that they have a purpose, both of which are important to self-esteem.

Here’s another example. You are incontinent. Would you like to have are caregiver announce that it’s time to change your diaper? Diaper is a word associated with babies. Being discreet about time and place, plus using terms like pad or even underwear, comes across as much more respectful.

My overriding concern, however, is that caregivers understand that adults with dementia do not turn into children, and should not be treated as such. The words we use matter.

Phrases like “parenting our parents” and “role reversal” bother me. I understand why adult children who are caring for their parents often use them. Even some professionals use them because they are descriptive terms that make sense when interacting with adult children who have had to take over complete care of their parents. However, it’s well known that the words we speak can affect how we think and therefore act toward others.

Yes, some elders need incontinence protection, pureed food, careful monitoring and endless patience. However, the losses that have occurred do not erase the life they’ve lived and the dignity they’ve earned. They have the legacy behind them of a life lived and they should be treated with the respect due an elder.

The danger lies in that if we think what we are doing for them is “parenting,” we may start, well, parenting them. It will show in our attitude toward them, which then can become close to disrespect. Throughout my many years of elder care I never felt that I was changing roles with my parents. I was helping them. I was their primary caregiver. However, I was still their daughter and they were still my parents.

Keep in mind that words can direct actions and you’ll be fine. Sometimes it’s simply a matter of thinking things through.