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All about attitude

The words we use around people with dementia are important, but so too is how we say them, writes Jane Verity

To say darling or not to say darling – that is the question. The three words darling, dearie or sweetie are often perceived as inappropriate ways to address elderly residents, clients or patients. While this belief may be based on a genuine desire to do the right thing by older people elders, condemning the use of these familiar words can have a devastating negative effect on the person with dementia, which is often not acknowledged.

Here is a real life example.

Georgie was a personal career in a residential care facility. She adored her residents and would regularly use the word darling with genuine regard. One day, a newly arrived resident came up to Georgie and said: “You have so many darlings, can I become one of your darlings too?” There can be no doubt that for this resident, the use of this endearing term was important.

A few weeks later, management enforced a new procedure that prevented staff members addressing residents with endearing terminology to avoid making residents feel belittled or infantilised. Georgie struggled to change her language, as darling had been a natural part of her vocabulary for years, but she did her best. The consequences were that her residents became upset, anxious and unsettled – constantly wanting to know what they had done to upset her. They asked questions such as: “Why am I no longer your darling? What have I done to hurt you?”

The question of whether or not to use endearing terminology is actually not a matter of words, but a matter of attitude. The Spark of Life approach focuses on the fact that it is not what we say but how we say it that makes the difference. Research has shown that the actual words we use make up only 7 per cent of our communication; our tone of voice contributes 38 per cent and our body language 55 per cent. This means that 93 per cent of our communication is non-verbal and this is where we communicate our likes and dislikes, power and authority, and respect or disrespect. Our attitude about the person is what we show in these non-verbal actions.

When endearing words such as darl, dear and sweetie are used with compassion, which is our inner desire to enrich another person’s life with love and respect, these words cannot harm.

However, when used in a detached manner, this terminology can result in an unpleasant and hurtful experience for the person with dementia. The result can be that the person on the receiving end will respond with an angry outburst or withdraw emotionally.

In our endeavour to do the right thing by our elders and eliminate unpleasant experiences we tend to regulate across the board and focus on the face value of the terminology we use. Instead, we need to look beyond the words to the underlying attitudes and address face-to-face those who undermine the self-esteem of people with dementia.

There is no doubt that Georgie’s attitude ignited the human spirit and rekindled the spark. The same words used by a carer with a negative attitude may bruise or break the human spirit, resulting in withdrawal or depression in residents. The question for carers to ask themselves is, if they use endearing terminology, are they using it in a genuine and sincere way?

Jane Verity is founder of Dementia Care Australia. Go to www.dementiacareaustralia.com 

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