“Sweetie,” my ass

The New York Times had a really interesting article up yesterday about the condescending language some use addressing older people, “In ‘Sweetie’ and ‘Dear,’ a Hurt for the Elderly.”

To study the effects of elderspeak on people with mild to moderate dementia, Dr. Williams and a team of researchers videotaped interactions in a nursing home between 20 residents and staff members. They found that when nurses used phrases like “good girl” or “How are we feeling?” patients were more aggressive and less cooperative or receptive to care. If addressed as infants, some showed their irritation by grimacing, screaming or refusing to do what staff members asked of them.
The researchers, who will publish their findings in The American Journal of Alzheimer’s Disease and Other Dementias, concluded that elderspeak sent a message that the patient was incompetent and “begins a negative downward spiral for older persons, who react with decreased self-esteem, depression, withdrawal and the assumption of dependent behaviors.”
Dr. Williams said health care workers often thought that using words like “dear” or “sweetie” conveyed that they cared and made them easier to understand. “But they don’t realize the implications,” she said, “that it’s also giving messages to older adults that they’re incompetent.”

I’m really glad that the NYT addressed this – and I think that an ageism/sexism combo probably really adds to the “sweetie” effect as well.
I like Ellen Kirschman’s response: “As I get older, I don’t want to be recognized for my age. I want to be recognized for my accomplishments, for my wisdom.”

To avoid stereotyping, Ms. Kirschman said, she often sprinkles her conversation with profanities when she is among people who do not know her. “That makes them think, This is someone to be reckoned with,” she said. “A little sharpness seems to help.”

Heh, nice. Before my grandmother (my Nanny Ann) passed away, when she was sick with dementia, she would often curse up a storm and get pissed when babied by her caretakers. An example: She was on the phone with my sister and the woman who was caring for her was making her mad. Vanessa sat there in horror as dear Nanny Ann screamed, “Leave me alone, you whoremaster!” and “Stick it up your hole!” The call ended when with my very frustrated Nanny saying “Ah fuck it,” and hanging up. Oh, Nanny, I miss you.

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29 Comments

  1. B
    Posted October 8, 2008 at 11:55 am | Permalink

    The other night when I advised an elderly woman to wear her sling (she has a broken arm), I was told to “shove it up my fucking ass and use it as a kotex.”
    It was all I could do to keep a straight face. I love old people. And no, I generally don’t use pet names with the patients.

  2. Kate
    Posted October 8, 2008 at 11:58 am | Permalink

    I see that some caretakers would consider talking that way to be soothing, but it really is talking down to them. Just as we posters have often discussed the infantalizing implication of words like “sweetie” or “doll,” I can’t imagine older people would enjoy it either!

  3. Posted October 8, 2008 at 12:01 pm | Permalink

    I wish my grandmother spoke that way.

  4. Miriam
    Posted October 8, 2008 at 12:01 pm | Permalink

    I hate these words in any phase in life–to me they are really demeaning. When someone in public, whether it be a waitress, or someone in a store, calls me “sweetie” I get so pissed! It’s kind of a problem since I grew up in the South, which is big on that kind of language.
    It’s also totally a gendered thing, and kind of replicates patriarchal ideas about women. Maybe I should write a longer post about this later…
    Thanks for pointing this article out Jess!

  5. MelissaRose
    Posted October 8, 2008 at 12:03 pm | Permalink

    Thanks for posting this. I see this all the freakin time working as a nurse in a large teaching hospital. Just the other day we had a combative, confused patient whom the doc just kept referring to as “dear (she wasn’t elderly either, but she was disabled…so ableism definitely plays a part here). I cringed every time he did it (I planned on correcting him as soon as he was out of earshot of the patient, but I ended up too busy before he left the floor…it’s the nature of the beast).
    It’s easily one of the most exasperating things I deal with, and now that I’ve got this information, it’ll be easier to speak up when I see it.
    I also noticed however, that this isn’t a phenomenon isolated in healthcare. I was out to dinner with the boyfriend, his parents and grandparents about a month ago. The waitress kept referring to his octogenarian grandfather as “young man.”Good lord.

  6. BROWN TRASH PUNK!
    Posted October 8, 2008 at 12:13 pm | Permalink

    NO SHIT, SHERLOCK!!!
    I always found it offensive whenever people do “baby talk” to anyone REGARDLESS of age.

  7. sdwryter
    Posted October 8, 2008 at 12:21 pm | Permalink

    I was so delighted to read the tip about using obscenity. I have been trying to stop cursing for years, and now I know that it not only isn’t necessary, but it can be helpful.
    BTW I learned all my curses from my mother.

  8. Blitzgal
    Posted October 8, 2008 at 12:40 pm | Permalink

    Now if I can only get older men and women to stop calling ME “sweetie” and “hon” even when we are strangers in line at the grocery store…

  9. Katie
    Posted October 8, 2008 at 12:43 pm | Permalink

    Personally, I think using obscenity (especially with people you trying to get RESPECT from) is a bad tactic. Generally people do not like people who swear at them. Healthcare workers can be incredibly insensitive, but they don’t deserve to be cursed out.
    Ms. Kirschman’s statement was wonderful- why not say that, plus “by the way, please call me Ms. Kirschman”. My grandmother always says “If you call me Mrs. [LastName], I’ll call you Nurse/Doctor [LastName]“.
    Plus, if a fully-functioning older man told a young woman (even a condescending one) to “stick it up [her] hole”…
    I’ve called my grandmother a term of endearment as her first name since I could talk. As a teen I tried to call her “Grandmother” instead, but she refused to acknowledge me. I love her to pieces- she sends me about 3 musical cards a week and puts $5 bills in my coat pockets when I visit “for libations”.

  10. ShelbyWoo
    Posted October 8, 2008 at 12:51 pm | Permalink

    Melissa Rose made a good point that this isn’t isolated to elderly, it’s very common for health care workers to speak that way to the disabled as well.
    I work at a college in the health department, our instructors drilled into the students heads that they do not talk to patients/clients like that…ever. Even if they think they’re just being nice, it’s just not professional. I assumed that was part of every health care workers’ training, like HIPPA. I guess not, and, even if it were, for some people talking like that is almost reflexive and would take some introspection and self-determination to stop.

  11. ShelbyWoo
    Posted October 8, 2008 at 12:59 pm | Permalink

    Personally, I think using obscenity (especially with people you trying to get RESPECT from) is a bad tactic. Generally people do not like people who swear at them.
    I don’t believe she said she cursed at people. She simply said she uses obscenities in her conversatsions. There is a HUGE difference between generally swearing and swearing at someone.

  12. Tammy
    Posted October 8, 2008 at 1:12 pm | Permalink

    Working in a nursing home, I see this all the time and it irritates me to no end. Sometimes I don’t think the other aides are trying to be condescending, but they’re simply too lazy to learn the residents’ names, so they just call everyone “hon” or “sweetie”.
    I’m a student so I only work during summer and Christmas breaks. I try to look at the name on the door before I enter the room but sometimes I forget. I’ll quietly ask whoever I’m working with the name of a resident before I address them and often they don’t know the person’s name. Most of the aides take care of the same people every single day and still don’t know their names. It drives me crazy!

  13. Posted October 8, 2008 at 1:12 pm | Permalink

    Good point, ShelbyWoo. There is a big difference. It’s a pretty natural reaction to treat others the way that they are treating you. It IS offensive to be talked down to, and generally, the quickest way to make that point is to get verbally aggressive with the offender. Maybe not the most effective way of dealing with it, but it makes sense. Healthcare workers are trained to maintain professionalism at all times, no matter what, so a few obscenities hurled at them shouldn’t affect care given; if it does, that caregiver has no business being in healthcare.
    At any rate, thank you for pointing out this article. And I wish I had a Nanny Ann!

  14. AnatomyFightSong
    Posted October 8, 2008 at 1:28 pm | Permalink

    A bit off-topic, but… this made think of when my new gyno (soon to be ex-gyno) asked me if I was “having any problems with pooping or peeing.” Dude, I’m 30, not 5.

  15. Katie
    Posted October 8, 2008 at 1:30 pm | Permalink

    @ShelbyWoo
    I was just stating my personal opinion. I read the article and I know what the woman discussed said. You’re completely right that there’s a HUGE difference, but the effects are sometimes similar.
    I’ll amend it to “some, possibly even many, people do not like it when unfamiliar people use obscenities in casual conversation”. In my personal, unique, biased-towards-my-worldview opinion, people who ‘pepper’ casual conversations with obscenities come off as hostile/unpleasant/pushy (to ME).
    I just don’t swear much in general.

  16. ShelbyWoo
    Posted October 8, 2008 at 2:15 pm | Permalink

    I’ll amend it to “some, possibly even many, people do not like it when unfamiliar people use obscenities in casual conversation”.
    So? Asking people to change their speech because someone might be offended by it is not ok. If those words aren’t being used to attack or belittle someone, why should it matter if an unfamiliar person is offended? That’s an issue that person needs to deal with instead of assuming that everyone else they come in contact with will change speech patterns and vocabulary just to suit them.
    Indecent Idealist has a point, too. Health care workers are or should be trained to handle hearing random curse words in conversation as well as having those words leveled at them. When you work in health care, you come across a whole host of folks that say or do things that you may find personally offensive, it is up to you to remain professional at all times.

  17. ShifterCat
    Posted October 8, 2008 at 2:30 pm | Permalink

    I read an article about this fifteen or so years ago, it just wasn’t part of a study.
    One woman who was interviewed said that she always firmly corrects attendants who use diminutives on her: “No, you call me ‘ma’am’ or ‘Mrs. So-and-so’.”

  18. MimiX
    Posted October 8, 2008 at 2:31 pm | Permalink

    My career is with the elderly too, and I *hate* hearing those terms of endearment. People don’t become different creatures as they age — they’re the same people, like you and your friends, just older. I always, always referred to people as Mr. or Ms. So-and-So. Sometimes they asked me to use their first names; sometimes I used Mr/Ms. as long as we worked together. Besides being respectful, it maintains professional boundaries.

  19. Miles
    Posted October 8, 2008 at 2:31 pm | Permalink

    I am really glad this came out. It has long been our belief (my wife and I) that this kind of talk is often taken as demeaning.
    My wife’s work as a CMA/CRA, and our visits to so called retirement homes, have shown this to be true in many cases.
    The “so called” comment might deserve some explanation. After a number of years of observation, to say we don’t think highly of most nursing homes is an understatement. I won’t get into the details – that would take forever almost – but the elderly are often treated with a lot less respect than they deserve.
    We are not saying they are all bad. But there are a number of problems. They New York times reports: http://www.nytimes.com/2008/09/30/us/30nursing.html?_r=3&hp=&adxnnl=1&oref=slogin&adxnnlx=1222787350-owPdpTAj6eJX2gH0lueaPA&oref=slogin

    More than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes, federal investigators say…

  20. ShelbyWoo
    Posted October 8, 2008 at 2:38 pm | Permalink

    In my personal, unique, biased-towards-my-worldview opinion, people who ‘pepper’ casual conversations with obscenities come off as hostile/unpleasant/pushy (to ME).
    Personally, I find judging others because they do not act or speak the way I’d like is much worse than “’pepper[ing]‘ casual conversations with obscenities.” But, that’s just me.

  21. Posted October 8, 2008 at 2:49 pm | Permalink

    I have a co-worker who is constantly saying, when she wants ME to do something or to know if I know something, “Can we do (blank)?” or “Do we know if (blank)?”. It makes me want to rip her tongue out and slap her with it, and I’m only 34. I can only imagine how much it will infuriate me if I live to be in my 70s or 80s. And since a lot of the societal restraints that keep me from screaming in this woman’s face now will have fallen away (the need not to get fired, etc.), I can only imagine what my reaction will be. Hint: Not restrained.

  22. Katie
    Posted October 8, 2008 at 3:03 pm | Permalink

    @ShelbyWoo, you’ve lost sight of the forest through the trees.
    The whole point of this article is that words, even benign words, may deeply offend- and that people should change their speech patterns to avoid offense, rather than shrugging off a “deal with it” to others.
    I’m not sure why you’re taking such issue with my comment; it was not meant to offend. I think polite, honest explanation (whatever your age) of why someone’s use of “dearie/sweetheart/honey”is hurtful would be most effective in stopping this type of ageism.

  23. Posted October 8, 2008 at 3:04 pm | Permalink

    I never really considered calling someone “sweetie” as talking down to them. I call my friends “hon” and “sweetie” quite often. Maybe it’s just a Southern thing…
    However, I’m glad that I was made aware that people might take it the wrong way. I’ll try to refrain from now on. :)

  24. Posted October 8, 2008 at 3:26 pm | Permalink

    @Katie
    I think you’re the one missing the point.
    There’s a difference between me saying “fuck it” in conversation and addressing you as “Fuck Muffin” or “sweetie-honey-baby”.
    It’s one thing to be offended by the way someone is addressing you, and another to judge people’s self-expression. If you don’t like “curse” words, then don’t use them and surround yourself with only the people who don’t. But I’ll be damned if I’m going to stop just because someone might over hear it and be shocked.
    And if you think I’m hostile and unpleasant, well frankly, I don’t give two shits, because you don’t sound like the type of person I would want to befriend anyway, all judgy and condescending.
    For fuck’s sake.
    Did I mention that I learned to swear from BOTH my grandmothers? Lovely women, both of them.

  25. Alara Rogers
    Posted October 8, 2008 at 4:24 pm | Permalink

    The cursing thing goes both ways.
    I was the moderator for a mailing list that talked about Star Trek’s Q. There was a young man (at least I presume he was young) on there who was a Christian, who was constantly pestering the group (and doing such things as slamming a fanfic, which wasn’t posted to the group but linked there, because it had bad words and the writer refused to bowdlerize it for his enjoyment. it was about *drug dealers*. Yes, because drug dealers never say “fuck.”)
    Anyway, he started posting lengthy screeds about how much he hated the last Star Trek movie. when he went on about Troi being a whore who deserved to die because she was in a sex scene (with her HUSBAND), I said “What the hell does any of this have to do with Q?”
    He responded, “I didn’t curse at *you*, you witch.”
    I didn’t curse *at* him either. He obviously took my casual use of profanity as an intensifier to be a direct insult, and responded with a direct insult. However, since I had *not* insulted him — my use of “hell” was intended to convey very strong astonishment at what this rant was doing on a list about Q — and he *did* insult me, I booted him.
    The moral of the story:
    1. Sometimes people do take your casual use of profanity to be hostile or insulting.
    2. If you are one of those people, and the person you’re talking to has power over you — the moderator of a list, for instance — do *not* respond to their “hostility” by being explicitly insulting. If they didn’t say it to insult you, and then you insult them, you are not the one with the moral high ground.
    3. Being a misogynist Christian with a massive oversensitivity to swear words on a board moderated by an agnostic feminist from New York, where “fucking” is an adjective, is probably not a good idea in the first place.

  26. Cactus Wren
    Posted October 8, 2008 at 5:49 pm | Permalink

    This reminds me of a scene in Eileen Simpson’s book Orphans: Real and Imaginary, in which she describes her grandmother’s last illness. The grandmother has been hospitalized after a heart attack and severe influenza, but — “temporarily disoriented” from the fever (and from having her daughter-in-law move her from an apartment in New York City to a hospital in Poughkeepsie) — she was mistakenly placed in a ward with severely mentally ill patients. And, although she shouldn’t be there, there’s no place to move her to … so she’s still there. (There’s a chilling description of a woman standing at a window, singing in a trained operatic voice the first few bars of an Italian aria. Over and over and over and over … )

    The nurse complained to me that my grandmother was a rebellious, stubborn patient. She refused to get out of bed even though she was well enough to walk. Her daughter-in-law had had no luck in trying to get her up. Would I see what I could do?
    [ ... ]
    Shortly before leaving, I asked [my grandmother] why she refused to walk. She said placidly that since the nurse had taken her possessions — her nightgown, bed jacket, hairbrushes, comb, and mirror — she didn’t see why she should. I could take a message to the head nurse for her when I went out: “Tell her that a woman who isn’t well enough to have a mirror isn’t well enough to walk.”

    Doesn’t that just about capture it? “She’s perfectly sane, mentally balanced, but we’re going to leave her surrounded by insane people. We’re going to treat her like a not-very-bright child, not to be trusted with her own belongings. And then we’re going to be utterly baffled when she doesn’t co-operate with us!”

  27. puerdixit
    Posted October 9, 2008 at 1:22 am | Permalink

    I agree that the casual use of “affectionate” diminutives is inappropriate for any human past infancy.
    However, I think the (classed, gendered, and usually racialized) power dynamic between nursing home/home care attendants and their clients is more complex than this article allows. In NYC, many of those workers are women of color and immigrants doing the kind of caretaking gruntwork that used to happen within the family and come with endearments included. Now that some women have jobs that prevent them from being full time unpaid caretakers, the paid caretakers who step in have to navigate the (very gendered) emotionally exhausting cultural expectations of what it means to provide care. Especially when the people being cared for might a) resent having to be cared for by non-family or b) have seriously messed up class/race privileged attitudes towards “the help.”

  28. really?
    Posted October 9, 2008 at 1:41 am | Permalink

    This post reminded me of my Gramma (My Feminist influence, although she never knew it!). She had emphysema and was frail in body but not in mind. She hated being called Mrs. Green and would demand to be called Ellen. She was on a first name basis with all her nurses and they never attempted to call her any pet names. She was a force to be reckoned with and is infamous for her swearing. One of the last things she said to me before she died was “What the fuck did I to to make these two so crazy” (about my mom and uncle) And then she laughed. She knew her abilities and did not like it when people assumed she couldn’t do things on her own. When she knew she needed help she would ask for it; and in no way was that demeaning to her because it was on her own terms. Members of younger generations need to keep in mind that older people were once just like us. They need to retain their independence and be treated with the respect they deserve. You wouldn’t call you boss “sweetie” or someone you really respected.

  29. emmy
    Posted October 9, 2008 at 10:48 am | Permalink

    This is interesting to me. Working in the lab at a hospital, I don’t have much interaction with patients. (Just the occasional blood draw for outpatients, or observed urine collection for drug testing)
    But during orientation, they made sure to tell us the rules for addressing patients. Anyone over 18 is Mr or Ms (not Mrs unless they correct you) children and teenagers can be referred to by first name. It’s hard not to use terms like “sweetie” or “honey” when you’re trying to be soothing to a child, though! It’s been a hard habit to break. And I still tend to at least once during a draw, end up referring to an infant as “little baby.” I don’t think they mind, but their parents might.

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