The Power of Language to Change How We View Our Aging Selves

Education Spotlight | Ageism

The flight attendant on a commercial airliner made her way down the aisle during a recent trip from Baltimore to Atlanta. At each row, she paused and addressed the same question to every passenger. “Something to drink?” “Something to drink?” “Something to drink?” The robotic script took a sudden turn when the flight attendant eyed an older passenger in one row’s window seat. The 70-year-old woman happened to be sporting gray hair and glasses, and was working on a small needlework project. The attendant smiled and asked: “Something to drink, sweetie?”

By Geralyn Magan

The flight attendant on a commercial airliner made her way down the aisle during a recent trip from Baltimore to Atlanta. At each row, she paused and addressed the same question to every passenger.

“Something to drink?” 
“Something to drink?” 
“Something to drink?” 

The robotic script took a sudden turn when the flight attendant eyed an older passenger in one row’s window seat. The 70-year-old woman happened to be sporting gray hair and glasses, and was working on a small needlework project. The attendant smiled and asked:

“Something to drink, sweetie?”

Passengers within earshot probably thought the exchange was relatively harmless, if they noticed it at all. 

But those who pay attention to language—including Ashton Applewhite—would have been disturbed. 

Applewhite, author of This Chair Rocks: A Manifesto Against Ageism, views the word “sweetie” as an example of “elderspeak”—the “condescending and belittling” language we use when we talk to and about older people whom we subconsciously view as different from us, and not as competent as we are.

Ashton Applewhite

Describing someone as “75-years young” or using the term “young lady” to address an older woman is just as insulting, she says.

“Being called ‘young lady’ is not really a compliment,” explains Applewhite. “It is actually drawing attention to the fact that I am not young, but should aspire to be young.”

The Positive and Negative Power of Language

Is Applewhite being just a little bit oversensitive? 

Not really, say researchers like Dr. Becca Levy, a professor of epidemiology and psychology in the Yale University School of Public Health. Levy’s research suggests that ageism and the language associated with it can actually do serious damage to an  older adult.

For more than 20 years, Levy has been exploring how older people internalize stereotypes about aging, and how those stereotypes can negatively affect their health and well-being. 

Applewhite’s book describes a well-known experiment in which Levy flashed on a screen a series of words that were positively or negatively associated with aging. The words appeared too briefly for the subjects to be consciously aware of them. 

“The experiments demonstrated that older people exposed to the positive messages about late life showed better recall and more confidence in their abilities than those exposed to negative ones,” writes Applewhite. “The decline has nothing to do with physiology. It’s psychological.”

Applewhite continues: 

“Call it ‘stereotype threat,’ a term coined by social psychologist Claude Steele to describe apprehension about being seen through the lens of a negative stereotype … Call it subconscious self-handicapping. Whatever name it goes by, the phenomenon undercuts performance and well-being until the underlying assumptions are exposed and invalidated.”

Steele and Levy showed that stereotyping doesn’t need to be overt in order to be damaging, adds Dr. Judah Ronch, dean of The Erickson School at the University of Maryland, Baltimore County, and coauthor of The Power of Language to Create Culture.

Dr. Judah Ronch

“Basically, if you think people are stereotyping you, it affects the way you think and affects the way you are able to demonstrate how competent you are,” he says.

It’s alarming that negative stereotypes can have such negative effects on older people, says Ronch. But the fact that positive messages can improve confidence is “a very powerful thing,” he says. 

“If we changed our language, we could make people’s lives better,” says Ronch. “We   could promote more autonomy, better self-esteem, and maybe even cognitive function.”

Well-Intentioned Language Can Still Do Harm

Ronch’s belief that the right language could actually improve the aging experience encourages Dr. Tracey Gendron, director of community engagement and research in the Department of Gerontology at Virginia Commonwealth University (VCU) in Richmond. But Gendron has discovered that tapping into language’s power for good can be a complicated affair.

Here’s the problem: just like the flight attendant, we’re often unaware of how our language affects others. In fact, many of us think we’re sending positive messages to older adults when we’re actually using words that reveal our negative attitudes about aging.

Gendron learned this lesson while analyzing comments that VCU medical students posted on the social media site Twitter after participating in a mentoring program with older adults. Through the university-sponsored program, first-year medical students meet regularly with older adults to talk casually about their interests and hobbies and, hopefully, “transcend generational divides and break down age-related barriers,” according to VCU News.

At first, Gendron was excited to read the tweets, which she said illustrated just how much students had learned about aging during their mentoring experience. 

Dr. Tracey Gendron

But initial excitement soon turned to concern. Rereading the tweets, Gendron discovered to her dismay that even the most positive comments contained ageist language. 

Gendron’s subsequent analysis of 354 tweets, published in The Gerontologist, indicated that, despite their positive experiences with older adults, the medical students still:

  • Viewed older adults as inherently different.
  • Expressed surprise that older adults were participating in activities or ways of thinking not expected of someone their age.
  • Portrayed “old” as an undesirable state.
  • Attributed to older people childlike attributes that denied their maturity or level of experience.

Tweets in which students shared comments from their older counterparts suggested that older adults in the program also held ageist attitudes. Gendron found that these older adults:

  • Internalized negative assumptions and judgments about aging and being older.
  • Made hostile, insulting, or derogatory statements about older people.

Gendron was most surprised by the fact that medical students were unaware of how their use of language unintentionally gave voice to their hidden, but no less discriminatory, attitudes about older adults. Underneath that language was a clear message that older people are not relevant or competent, she says. Gendron knew that these messages, however unintentional, could still be dangerous.

“We know these messages can affect you long term,” says Gendron. “So even though they might seem kind of innocuous, they stay with you.”

No Need to Call the Language Police 

The language experts interviewed for this article were hesitant to dictate which words are acceptable and which ones should never be used when talking with or about older adults. 

“The language police will tell you ‘Don’t use that word, that’s a bad word,’ but what you end up with is another word that doesn’t change the experience of the person,” says Ronch. “If you simply change the word to something else, that doesn’t mean you changed anything about your relationship.”

A critical first step in examining your language—and your relationships—is identifying the experience you want the other person to have, says Ronch. Then, choose phrases that do the best job of helping you create that experience.

Here’s an overview of some of the words and phrases that might be included in such an examination.

“Young Spirit” and Other Age-Based Language

Do you think you’re praising an older adult when you say he or she has a “young spirit”? Think again, says Gendron, who is quick to share a list of age-based phrases that, while well intentioned, are far from complimentary.

“When you say someone has a young spirit, young is not what you mean,” she says. “You really mean that the person is engaged, lively, energetic, or healthy. But the message that comes across—and the message that the person internalizes—is that young is good and old is bad.” 

We’re sending the same messages when we complain about “senior moments” or suggest that our need for glasses is a sure sign of age, says Applewhite.

“When we blame things on age, it reflects the fact that we have internalized this notion that our older self is less valuable, less attractive, less active, than our younger self, and that is terribly self destructive,” she says. “Every time we say something deprecatory about ourselves or someone else on the basis of age, it undermines our self-esteem and our self-image. “

That self-image also takes a hit when media organizations and public relations departments go out of their way to emphasize the age of an older adult in news items about activities that are traditionally associated with youth, says Stuart Greenbaum, a public relations professional and former director of public relations at Aging Services of California (now LeadingAge California), and Eskaton, a LeadingAge member in Carmichael, CA. 

Stuart Greenbaum

“The story should be about what you’re doing, not about your age,” says Greenbaum. “So don’t write a story about how cool it is that Warren Buffet is 85 and he can still do things. It’s way more inspiring to write about how he is the most brilliant mind in investing probably in the world.”

Talking about Aging

Greenbaum suggests that it may be time to replace the most basic word in our age-related lexicon: “aging.”

He prefers “longevity.”

“It is powerful and positive and it literally means ‘long life and endurance,’” he says. “How great is that compared to the word ‘aging’?” 

It’s not that aging is inherently a bad term, clarifies Gendron. It’s just too weighted down with stigma. She blames the “anti-aging” movement for much of that stigma.

“How we can be anti-aging is beyond me,” says Gendron. “Are we anti-growth? Are we anti-development? We are misusing the word aging. We are talking about biological aging. Sure, there is change in our bodies, there is decline, there is wear and tear. That’s life. What we don’t talk enough about is psychosocial aging. That is all growth. That is all evolution. That is better emotional regulation and more social connectedness.”

Other common terms associated with aging also need a revamp. Gendron is particularly fired up about “silver tsunami,” the term often used to describe the anticipated impact that an aging baby boom generation is expected to have on the nation.

“A tsunami is a natural disaster,” says Gendron. “I don’t know about you, but I don’t want to be equated with a natural disaster.” 

Describing Older Adults 

When you turn 65, do you automatically become a “senior” or a member of the “elderly” population? Language experts reject that notion for several reasons.

Both terms automatically label a person as “old” when that individual doesn’t necessarily feel frail, says Gendron. 

Applewhite doesn’t like the fact that “elderly” is often preceded by a “the” (as in “the elderly”). This word pairing implies a homogeneity that does not exist in the older population, she says. 

Greenbaum takes the discussion a step further by advising aging services providers not to assume that “over-65” is synonymous with “retiree.”  

Alternatives to all these terms are available. For example, the culture change movement refers to older adults as “elders” to emphasize the wisdom and experience that come with age. Greenbaum and many others use “older adult” as a substitute for “senior” and “elderly.” Applewhite refers to older adults simply as “olders.” 

“Most people don’t want to be old but they will happily concede that they are older than someone else,” she says. “When you use ‘olders’ and ‘youngers,’ it emphasizes that age is a spectrum.”

Greenbaum even has an alternative word for retirement. He prefers the word “re-purposement” because it emphasizes the opportunity to spend time and resources on meaningful projects after full-time work ends. 

So if “retirement” becomes “re-purposement,” what happens to retirement communities? Redefine them too, says Greenbaum, to describe places that he hopes will become centers of community engagement and social action.

“Older adult communities can become bases (from which) interesting people with a lot of great experience go out into the community to do exciting things that show the value of that experience,” he says.

The Language of Long-Term Services and Supports

Ronch advises providers of long-term services and supports (LTSS) to steer clear of words that objectify older people. Avoid using “feeder” to describe someone who needs assistance at meals, he says. Never refer to “the dementia patient in room 20,” “the wanderer,” or “the fall risk.” 

While you’re at it, says Ronch, try describing your community as a place where 120 people live, rather than a “120-bed community.” Culture Change Advocate Karen Schoeneman suggests that the word “facility” has got to go too. 

Karen Schoeneman

“A facility is not a place where people live,” says Schoeneman, the retired deputy director of the Division of Nursing Homes at the Centers for Medicare and Medicaid Services. “A facility is a big factory that makes airplanes, or a military installation or something. It is not a home.”

In addition to choosing words carefully, LTSS workers must also watch how they deliver those words, says Ronch. Making eye contact, using positive body language, and waiting for a response before asking the next question, are important habits to develop, he says. In addition, choose words that will encourage autonomy and emphasize ability.

“Instead of saying, ‘Oh honey, let me do that for you,’ say, ‘Let’s see how well you can do that. I’ll help you where you need help,’” says Ronch.

Words That Describe People Living with Dementia

Dr. Al Power has spent a lifetime trying to raise awareness about how language can impact the lives of people living with dementia. The board-certified internist and geriatrician, and author of Dementia Beyond Drugs and Dementia Beyond Disease, has four major pet peeves.

Dementia: “The word ‘dementia’ comes from the old Latin word that means basically ‘out of your mind,’” says Power. He prefers to use the term, “people living with changing cognitive abilities.”

“That way you don’t see it as the person has a terminal illness, or that the person is fading away,” he says. “Instead, you’re seeing the person as someone who is differently able than he or she was 10 years ago. In a sense, we all are.”

Suffering: Power also rejects language that refers to people who are “suffering from dementia” or are “victims of dementia.”

“It’s not like suffering doesn’t occur,” he admits. “But this label suggests that suffering is the only path available to the person. That leads to negative thinking.”

Behaviors: Power has worked hard to get caregivers to stop using the term “BPSD,” which stands for the “behavioral and psychological symptoms of dementia.” He rejects the assumption that dementia causes “bad behaviors.” Instead, he says, behaviors typically associated with dementia are actually perfectly understandable responses to unpleasant relational or environment factors that would affect anyone.

“The difference with dementia is that people may have a little less ability to cope with stress and to communicate their needs,” says Power. “But the things that make people with dementia sad or anxious or angry are the same things that would make you and me sad or anxious or angry.”

The problem with blaming the brain condition for “difficult behaviors” is that it leads to an overreliance on antipsychotic drugs to “fix” the problem, says Power. That approach prevents caregivers from finding other solutions to address the real causes of an individual’s distress, he says.

Dementia-friendly: Like most ageist language, the terms “dementia-friendly community” and “age-friendly community” are well intentioned, admits Power. But he believes the term “inclusive community” sends a better message to people interested in making their neighborhoods more accessible and welcoming to people of varying abilities.

Dr. Al Power

“The reality is that very few dementia-friendly or age-friendly community initiatives actually engage people with dementia or older people on their planning committees,” says Power. “So it becomes very paternalistic and almost patronizing. It is one thing to say that we like people with dementia, and it is another thing to say that they are at the table and really included in the process.”

5 Steps to Better Language

Holding meaningful conversations with older adults, while remaining cognizant of all the possible minefields associated with ageist language, can be overwhelming. The experts interviewed for this article recommend 5 steps that will help you become more aware of the words you use, and take steps to adopt language that is more positive and empowering.

Step #1: Explore bias in your own language. 

How do you correct biased language when you may not be aware you’re using it? That’s a big challenge, experts agree. They recommend a few strategies:

  • Substitution: Gendron and her team tested student tweets for bias by using language substitutions. If the phrase in question included the words ‘old,’ ‘young,’ or ‘age,’ researchers replaced those words with any ethnicity, race, religion, or sexual orientation. Gendron suggests that anyone can use this exercise to test language bias. “After the substitution, does the sentence seem biased to you? If it does, you are using ‘old’ in a biased way too,” she says.
  • Vision check: Take a look at your organization’s vision and values statements, suggests Ronch. Then ask yourself whether the language you use every day reflects the values for which your organization stands. If it doesn’t, select words that better reflect those values, he says.
  • Metacognition: Metacognition is a way of becoming more aware of your language—hopefully before you speak. It involves consciously recognizing “those automatic associations that we make in our brain” and then stepping back and examining them, says Gendron. “You catch yourself and say, ‘Wow, I just put this person in this particular category. I’m not going to make that assumption.’ This is not an easy task at all, but it can help us to be just a little bit more careful about our own language and our own thinking.”
  • Check the attitude: “The words that we use form attitudes in our brain and those attitudes, in turn, affect our body language,” says Power. “Even though you may be saying the right things, your body language, your tone of voice, your expressions may betray how you really feel about the person.” People with changing cognition are particularly sensitive to this type of non-verbal communication, he says.

Step #2: Make it personal

When we use ageist language, we draw an artificial dividing line between ourselves (“us”) and the older people we meet (“them”), says Applewhite. She’s coined the phrase “older people in training” to illustrate how important it is to recognize that everyone—at every age—will eventually grow old. 

“We are scared of getting old, and we are locked in this sort of dance of trying to keep oldness at a distance,” she says. “But if we can become older people in training, we can stop the us-versus-them tango and make a connection to our future self.”

Making that connection will help younger people follow the golden rule: when describing or addressing an older person, don’t use words or phrases that you wouldn’t use to describe yourself.

“This isn’t just about you working with older people,” agrees Gendron. “This is about you being an older person.” 

Step #3: Involve everyone in the language discussion.

LTSS management teams can’t make executive decisions to establish a new language around aging. Asking staff to stop saying words like “facility” or “senior” won’t work for long. Instead, everyone—“youngers” and “olders”—must be involved in the discussions from the beginning so they understand the power of language, says Applewhite.

“I think a lot of it is simply having the conversations that we don’t usually have,” agrees Gendron. “How often, when someone starts working in the aging services field, do we actually sit and have a conversation, an orientation, about ageism and attitudes about your own aging? I don’t think very often.”

Step #4: Join the social movement.

Individual reflection and a willingness to change is key to reforming our language around aging. But personal action won’t be enough to bring about lasting change, says Gendron. In addition, we need individuals to come together in a social movement to reform how our society thinks about and talks about aging.

That social movement has already begun to take shape within VCU’s Department of Gerontology, which Gendron describes as “an academic department and a social movement all rolled up into one.” The department recently launched a #disruptageism initiative through which VCU staff offer presentations to local groups, sponsor awareness-raising events, and develop training materials to help younger people recognize their age biases and take steps to adjust their language and their attitudes.

Older adults also need help to recognize ageist language and respond to it appropriately, say Applewhite and Gendron. To that end, Applewhite writes a blog, called Yo, Is this Ageist?, which raises awareness about ageism in everyday life. Gendron’s department created message cards to help older adults confront ageist language in a positive and empowering way.

“For example,” says Gendron, “if someone tells you ‘You don’t look your age,’ the card prompts you to respond, ‘Interesting. What does my age look like?’”

Applewhite has come up with her own rejoinders to ageist quips that can provoke “age shame.”

“When someone says, ‘You look good for your age,’ I say, ‘You look good for your age too,’” says Applewhite. “What you want to do is provoke some reflection by that person. When someone makes an ageist comment, a good, all-purpose rejoinder is simply, ‘Why would you say that?’ And then just listen.”
 
Stuart Greenbaum took steps about seven years ago to enlist the help of media, entertainment, and advertising professionals in portraying older adults in a more positive light. The result was a guidebook called Media Takes on Aging, which was published by Aging Services of California in association with the International Longevity Center – USA. 

Authors, activists, actors, and advertisers have important roles to play in creating a successful social movement around ageism and ageist language, says Greenbaum. But that movement won’t succeed without the strong support and leadership of aging services organizations, he says.

“It’s unrealistic to think that the general public is going to start using a term like ‘older adult’ when 90% of the programs and services and communities still use the term ‘senior,’” says Greenbaum. 

Step #5: Be patient and flexible.

The history of the disability rights movement suggests that we’ll never be “done” changing our language, says Power. The term “mental retardation” replaced “idiocy” in the 1960s, and then was replaced by “intellectual disability” in recent years as people with disabilities gained a better understanding of the power of language, and a better idea of how they wanted to describe themselves. 

Older people and their advocates must be willing to take on the same kind of continuous reexamination and redefinition, says Power. 

“Our relationships change, and the social and political environment changes,” he says. “Language necessarily has to constantly evolve to keep up. The message of any kind of culture change is that you’re never there. You are never done with it. It is always a journey.”

From Gendron’s perspective, that journey is just beginning.

“I think we are still a little bit in the dark but I think we are moving in the right direction,” she says. 

The process is slow and sometimes frustrating, admits Gendron. For that reason, it requires patience and, above all, tolerance—of others as well as yourself.

“Be gentle with yourself,” Gendron advises. “Let’s realize that this is a process for everybody, and that good intentions really do count for something. We will get the language right and I think it is great that people are striving to get it right. I just don’t like people beating up on themselves about this.” 

Geralyn Magan is a writer who resides in Clarksville, MD.