Skip to main content

“Elders?” “Older Adults?” “Seniors?” Language Matters

In a recent paper, some colleagues and I held the position that clinicians should routinely offer to discuss prognosis with very elderly patients.

I was later interviewed about this paper by a reporter who revealed that she is in her 70’s. She asked, “what does ‘elderly’ mean? When does a person become ‘elderly’?” I bravely (read ‘foolishly’) replied, “We use the word elder as a term of respect for the older adult patients we care for. In the paper we refer to individuals over the age of 85 as the ‘very elderly.’ This is an accepted term in the geriatrics literature.”

“When does someone become an ‘older adult’?” she responded.

I finally sensed danger. Using my palliative care communication skills, I quickly flipped the question. “You write about issues for older adults and have been for some time. What term do you use?”

“I never use term ‘elderly,’” she responded. “My readers don’t respond to ‘older adult’ either. They don’t want to be ‘older.’ We prefer the term ‘senior.’ That’s the phrase I use in all my writing.”

Pick up any general medicine or geriatrics journal, and you’ll see the words “older adult” and “elderly” all over the place. People in my division are conflicted about the best of these terms to use. Some argue that “elder” is more respectful, others that “older adult” makes them less “other.”

But these are not the preferred terms in the lay press.  They generally use the word “senior.” I can’t recall a journal article that used the term “senior.”

So what’s it going to be? What term should we use in academia? When we’re communication with the public about our work? If we drop the terms “elderly” and “older adult,” are we capitulating to a culture that denies the realities of aging?

Here is my thinking, at an admittedly early and basic stage in thinking about this issue: as a general rule, we should use the term that people use to describe themselves.

For example, in academic journals, we should stop calling Latinos “Hispanics.” Hispanic is a term made up by the government; Latino is the term that persons of Latin-American ethnicity prefer to call themselves. Similarly, Americans of African ancestry should be called “African Americans” not “blacks.”

And, perhaps, in academics, persons in the second half of life should be called “seniors,” as they are in the lay press, not “elders” or “older adults.” It’s the term they prefer.

by: Alex Smith @alexsmithmd


Mike Gamble said…
Why is everyone so fixated on the need to label us? We're all just plain people, not seniors and not elders. We're also not in denial of our status. Just like you, each one of us has our own individual hopes, desires and lifestyles. But, when younger, less experienced people try to label us, it usually comes across as pejorative, implying that our group is somehow less capable cognitively and/or physically. Of course, if a business offers us a "senior" discount, then nearly every one of us will admit to being a senior. We're not dumb.
If there is one thing that may distinguish us from our younger, less experienced citizenry, it is the fact that we tend to focus more on what matters in life, less glitz and glamour, and more focused on meaningful experiences and deeper friendships.
Dan Matlock said…
Alex, I've struggled with this as well - particularly in grants.

Mike Gamble, with all do respect, while you argue that there shouldn't be lables, you just labled people like me as "less experienced" :)

Perhaps that's the answer, we should use the phrase "more experienced" when describing...more experienced?? adults.
When does one become a "senior"? When they qualify for an AARP card? For Medicare? Or... other age?

In my own writing, I generally specify the age in question along with a designation -- eg, "...the study included elders over age 70." You can substitute "seniors" or "elderly persons," but the reader still knows specifically who you are talking about. --SBL
Anonymous said…
As a "younger, less experienced" person, I don't feel this great need to dispense with the current "labeling" of people who are of advanced age, especially in the context of academia or research or journalism. How would you generally refer to this group if writing a paper or news article then? It depends on who's writing the paper/article and who'll be reading it. I feel that the term "elders" is used more in a global context and is more appreciated in older cultures from which the term was derived. In the U.S., not so much. It seems to elicit anger from those who are "elderly." "Elderly" seems to connote frailty and feebleness so that it can be viewed as pejorative. Then, there's the term "older adult," which is not well received either because of the "older" part. In cultures where youth is obsessively sought after, nobody wants to be known as an "older" anything. And, there's "senior," which seems to be somewhat more acceptable than the other alternatives, as it connotes a higher position in society. But then again, even that becomes associated with the undesirable aspects of aging. So, to appease the more experienced folks, if we use the term teenager to describe people in their teen years, perhaps we should refer to people of advanced age groups by their age decade...e.g. octogenarians, septuagenarians, and the like.
Mike is on target with his comment about labels, but probably erred in implying those that use them are less experienced. Still, the reality is they are simply not needed in most cases. For example, doesn't saying "people age 70" mean the same as elders age 70." The key is in the context. Grant seekers may need to use the language of the funding source; but marketers do not. Any term that can conjure up aging stereotypes should be avoided. Instead, use the language of inclusion with terms which are ageless.
Dee Wadsworth said…
As a gerontologist I use the phrase "older adult." Cohort words like Senior and Boomer refer to specific generations. Boomers will never respond to the term senior because that was their parent. I was taught to avoid ageism best to use older adult just like we use younger adult. It refers to the continuum of lifespan development.
Patrice Villars said…
For the short time I lived in Mexico, the first questions people (kids and adults alike) asked me were "What's your name?" and "How old are you?" There was no emotional charge around stating your age. Here we try to be so careful not to acknowledge or offend anyone by calling them "older, senior, elderly...." Asking someone their age is considered rude. It's hard to find a birthday card that doesn't "joke" that someone is one year older. It makes me wonder if our cultural (and personal) response is another indicator of our fear of the aging process and death. Me llamo Patricia y tengo 56 anos.
Helen Chen said…
Words do matter and ageism is culture bound. My mother is referred to in her Chinese community as "lao shi" and in the Japanese community as "sensei"-- both terms of great respect. Imbedded in both words is the concept of age conferring wisdom and requiring respect. It is only in the English speaking community that she is potentially marginalized as "elderly".
Anonymous said…
Elderly, older adult, senior, etc. The problem isn't with the label, it is with the condition the label is attached to. As long as aging is viewed negatively, the labels will continue to change because the negativity associated with aging will overwhelm whatever the new label is. Consider the word "special" - at one time it was preferred to the term handicapped. Now I hear people who rail against it as inappropriate labeling. There is a reason why there are pediatrician and geriatricians. People who fall into age categories at either end of the spectrum have medical issues that differ from those of "adults." (Of course, the baseline is usually interpreted as male, which is why there are female specific specialties.)
Anonymous said…
I am Black and prefer to be called Black, NOT African-American.

And not all Latinos prefer to be considered Latino. Some prefer to be considered Hispanic.

As always, one should ask people what they prefer and not make assumptions.
B.D. said…
We have found the term "senior" fits most folks best, but "loved one" is good too. Really the only feedback that surprised me was a comment that the title of our blog post called "How to Senior-proof your home" was objectionable.

Our intent was to have a play on words with "baby-proof" and was really geared to eliminating areas in the home that could cause falls. Oh well!
Lish1936 said…
Words matter, or should I say the way we interpret words matter most.
Each of us adds our life experiences and biases to the interpretation of words In the final analysis, it really doesn't matter much about the label when there are so many "brands" to choose from. Take your pick. Like it or not, they all share a common theme - aging.
Anonymous said…
Simply use "a person" and add "age XX" if it is appropriate to the occasion.

I see articles in the paper and on TV - "An elderly man . . . " What does that tell us - that he is "elderly? How about "a 75 year-old person" if the age is appropriate to the article. Most of the time it is not.

Elderly is generally 10 to 20 years older than the person speaking or writing. Ask a 15 year old what "elderly" is.
Katie Buckley said…
I completely hear the need to consider people beyond the need to label. However, using terms to describe a particular group of people also allows us health professionals to recognise the unique needs and strengths of that group. I agree that a participatory, client based approach does strongly lean towards using the term a group adopts. If used in kindness and respect, labels are just indicators (not ways to demoralise or pigeon-hole someone). You aren't your label, it is just a signifier of part of your lived experience.

Popular posts from this blog

Lost in Translation: Google’s Translation of Palliative Care to ‘Do-Nothing Care’

by: Cynthia X. Pan, MD, FACP, AGSF (@Cxpan5X)

My colleagues often ask me: “Why are Chinese patients so resistant to hospice and palliative care?” “Why are they so unrealistic?” “Don’t they understand that death is part of life?” “Is it true that with Chinese patients you cannot discuss advance directives?”

As a Chinese speaking geriatrician and palliative care physician practicing in Flushing, NY, I have cared for countless Chinese patients with serious illnesses or at end of life.  Invariably, when Chinese patients or families see me, they ask me if I speak Chinese. When I reply “I do” in Mandarin, the relief and instant trust I see on their faces make my day meaningful and worthwhile.

At my hospital, the patient population is about 30% Asian, with the majority of these being Chinese. Most of these patients require language interpretation.  It becomes an interesting challenge and opportunity, as we often need to discuss advance directives, goals of care, and end of life care options…

Elderhood: Podcast with Louise Aronson

In this week's podcast we talk with Louise Aronson MD, MFA, Professor of Geriatrics at UCSF about her new book Elderhood, available for purchase now for delivery on the release date June 11th.

We are one of the first to interview Louise, as she has interviews scheduled with other lesser media outlets to follow (CBS This Morning and Fresh Air with Terry...somebody).

This book is tremendously rich, covering a history of aging/geriatrics, Louise's own journey as a geriatrician facing burnout, aging and death of family of Louise's members, insightful stories of patients, and more.

We focus therefore on the 3 main things we think our listeners and readers will be interested in.

First - why the word "Elder" and "Elderhood" when JAGS/AGS and others recently decided that the preferred terminology was "older adult"?

Second - Robert Butler coined the term ageism in 1969 - where do we see ageism in contemporary writing/thinking?  We focus on Louise's…

Psychedelics: Podcast with Ira Byock

In this week's podcast, we talk with Dr. Ira Byock, a leading palliative care physician, author, and public advocate for improving care through the end of life.

Ira Byock wrote a provocative and compelling paper in the Journal of Pain and Symptom Management titled, "Taking Psychedelics Seriously."

In this podcast we challenge Ira Byock about the use of psychedelics for patients with serious and life-limiting illness.   Guest host Josh Biddle (UCSF Palliative care fellow) asks, "Should clinicians who prescribe psychedelics try them first to understand what their patient's are going through?" The answer is "yes" -- read or listen on for more!

While you're reading, I'll just go over and lick this toad.


You can also find us on Youtube!

Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher
Eric: Welcome to the GeriPal Podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: Alex, I spy someone in our …