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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

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