Careless talk costs lives – mind your language on ageing

This column tries to alternate a focus on ageing, the key social advance of the last century, with reflections on broader perspectives of medicine and society. Several events this month compelled me to merge the two aspects by exploring how we talk about and contextualise ageing.

On a positive note, the editors of the main geriatric medicine journals have finally come together to reframe their language on ageing. Just like charity, age-attuning begins at home. While covering many important advances in ageing research with rigour, up to now the journals had been sadly disrespectful of the wishes and insights of older people, with frequent references to “the elderly”, “seniors” and much terminology of decline and burden.

Rather than describing ageing in terms of struggle, we can describe ageing as a dynamic process that leads to new abilities

In a revelatory position paper, the Journal of the American Geriatrics Society outlines how the wonder of ageing has been allowed to be diminished to a negative characterisation of someone else's problem, undesirability, decline, isolation, fatalism and invisibility.

They then provide useful guidance to how on reframing the issues, drawing on an excellent US initiative from a coalition of ageing-focused organisations and the Frameworks Institute.

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This project recognised that language, even down to specific word choices, has been a significant obstacle to conveying to the general public and policymakers the marvel of the longevity dividend and the many advances made in understanding how to nurture and protect it.

So, instead of talking about tsunamis and demographic time-bombs, we should talk positively about the changing demographics and how Irish people are living longer and healthier lives. Rather than describing ageing in terms of struggle, we can describe ageing as a dynamic process that leads to new abilities and knowledge that we can share with our communities.

An important mind-shift is to graduate from talking about “doing something for older people” to stressing the lifespan and shared intergenerational aspects of ageing.

That Ireland badly needs to get in line was all too apparent on a number of fronts this month. As feared, the Citizens' Assembly succumbed to a miserabilist vision of ageing, taking long-term care rather than a broader re-think of whether we value and embrace ageing as the focus of the first of its two weekends.

While recognising the goodwill and time spent by those at the assembly as well as the undoubted expertise of the speakers, it was dispiriting that there was little sense of a lifespan and intergenerational approach to our ageing. The word “elderly” made several appearances, and many slides, describing older people failed to provide the denominator of what was being described – from living alone to internet access – across the whole population.

While huge sensitivity is taken with terminology relating to race and gender preference, it remains open season for attitudes and descriptors related to ageing

Countering the clear erosion of our citizenship as we age has to be the starting point of any discussion of services, and this applies in particular to those of us living with dementia or on nursing homes: justice is more powerful than sympathy.

This consideration also applies to gerontologists. Many were saddened by the exclusion of those with dementia or living in nursing homes from recruitment into the Tilda study: is their life not equally relevant and worth studying? That those of so affected can be included was shown by the visionary Mary McCarron in her leadership of the related IDS-Tilda study of ageing among those with intellectual disability.

And just as my focus as a geriatrician should be on gerontologists’ language in the first instance, I am also troubled as a columnist at the degree to which casual ageism is tolerated in newspapers and the media. While huge sensitivity is taken with terminology relating to race and gender preference, it remains open season for attitudes and descriptors related to ageing.

My other low point this month was an editorial in this paper which stated that “Brexit was a con perpetrated by the old on the young”. Ouch! Apart from the fact that age was shown to have a weak impact on the vote, this is a stunning and offensive simplification of what was a complex mix of xenophobia, populism, insecurity of the poorly educated, race, globalisation frustration and other factors.

As they used to say in second World War posters, careless talk costs lives: rampant casual ageism undermines our universal citizenship. Leaders in the media and civic society need to engage urgently with contemporary gerontology to understand their role and stake in not only rejecting ageism but more importantly, welcoming our collective journey into a longer later life.