Stop using the word elderly

I am at the American Geriatrics Meeting this week in Washington, D.C. Normally I find hanging around with a bunch of geriatricians to be endlessly pleasant and lovely because they (we) are such a harmless, laid-back bunch. I had often heard that geriatricians have the highest levels of job satisfaction amongst physicians. Well, with some digging I have found the evidence!

There is one issue that really gets my goat, so to speak, and it is ironic that it has come up here. That is the use of the word “elderly.” I know we, as a medical society, have gotten away from really derogatory words like senile or demented to describe our older patients. But it has been my experience that even “elderly” or “old” are not appropriate descriptive terms for our patients. An editorial in the British Medical Journal agrees with me, noting the particularly common use of “elderly” amongst biomedical researchers. The authors state:

"Two main phenomena of aging in later life may be obscured by the use of terminology that is simultaneously pejorative and reductionist. The first is that the many positive aspects of aging in later life, such as wisdom, experience, enhanced creativity, strategic skills and maturity, are often overlooked in an ageist society, and such qualities are a critical component of successful aging. Are the late great works of Verdi, Matisse and Bellow the works of 'elderly' or 'older' artists? The second is the greater variability between individuals: populations of older people are more complex and heterogeneous than younger cohorts, and the corresponding complexity of their health care needs are ill served by negative collective phrases such as 'elderly' rather than the more dispassionate 'older.'"

And they are not the only ones to point out this linguistic predicament. The United Nations noted this back in 1995. One would think it would have caught on within medicine by now. But no. As I flip through the abstracts and posters being presented today, I would estimate at least 20% still use “elderly” or “old.” And this is amongst a group of people who are supposedly more in tune to the issues of the older patient!

Some have argued that “elderly” is OK to use when referring to the frail older patient. That very well may be true, but the problem is we don’t really know what being frail means, and so the application of the “elderly” label is left to be highly subjective. In the end I think it is better not to use it at all.