It’s Time to Change the Way We Talk About Aging
According to the Merriam-Webster dictionary, the term “dementia” refers not only to progressive cognitive deterioration as seen in conditions like Alzheimer’s disease, but also to “madness” and “insanity.”
These latter two more colloquial uses of the term and their connotations quickly degenerate into a host of pejorative synonyms listed in the dictionary, including “batty, bonkers, deranged, unbalanced and unhinged” among others.
No one wants to be labeled as “demented” given these connotations—so why do we still use the term? We should no longer, according to the American Psychiatric Association, which has replaced “dementia” with the broader, more accurate and less pejorative term “neurocognitive disorder” in the latest diagnostic manual. With time, “dementia” may go the way of antiquated medical terms such as “imbecile” and “retarded.”
This new name is but one of many changes to the nomenclature of aging, driven in part by concerns about how the words we use to talk about our aging selves influence self-image. Call yourself a “grumpy old person” or an “old codger,” and then think about how badly these terms can make you feel. In contrast, positive labels and portrayals can empower us as we age.
This trend has some new legs. A task force from LeadingAge, a national organization of aging services, has recommended that the term “continuing care retirement community (CCRC)” be replaced by “life plan community.” The not-so-subtle message here is that we should define getting older by vitality, hope and the creation of life plans, and not by frailty, decline and needing continuous care.
Geriatric care managers now call themselves “aging life care professionals,” clearly emphasizing a future of positive expert planning over the implied struggle to manage old age.
A new model of smaller, homelike nursing homes uses the term “green house,” hitching onto the notion of improving one’s world through “green” efforts and tossing aside connotations of old age as a disease to be nursed.
All of these suggested terms have more positive connotations as they tap into how we define old age. They also reflect real trends toward more active, healthy and connected aging.
Despite good intentions, however, are these name changes simply public-relations gambits to make the reality of aging sound better? In the end, will they achieve anything more meaningful than selling more condos and services to unsuspecting elders?
My own observation as a geriatric psychiatrist is that many individuals face profound moments of change as they age, sometimes precipitated by an illness or injury, after which they begin defining themselves as less confident, capable and optimistic.
These age points typically occur in their 80s and 90s, and can lead individuals to imagine themselves outside of the realm of active aging celebrated by so many perspectives today. Being “old” becomes a four-letter word, and this denigration obscures the emergent strengths that come with age.
Too often, the focus at this stage is more on how to cushion the final slide rather than on elevating oneself from the rut. And yet, the findings of age researchers show how cultivating positive attitudes can bring greater function, form and even longevity.
In the end, changing the names of a geriatric disease, manager or community won’t immediately change the way we age. Nonetheless, the words we choose are powerful symbols along the road to shaping how we anticipate and perceive aging.
Marc E. Agronin is a geriatric psychiatrist at Miami Jewish Health Systems and the author of “How We Age” and the newly released “The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer’s Disease and Other Neurocognitive Disorders.”
Source: Marc Agronin, Wall Street Journal, November 30, 2015