Today is United Nations International Day of Older Persons, observed under the theme “Older Persons Driving Local and Global Action: Our Aspirations, Our Well-Being and Our Rights”. It’s a day to reflect on the way we think about ageing and older people, so I’ve teamed up with my former colleague Gerry Nosowska to share some thoughts about the language we use to communicate with and about older people, and how the words we read, hear and choose to use shape the way we all think and behave.

‘The elderly’, ‘the over 70s’ and ‘OAPs’

Blanket labels are rife in relation to older people. Terms like ‘the elderly’, ‘the over 70s’ (or ‘the over 50s’, ‘the over 60s, ‘the over 65s’ etc etc) and ‘OAPs’ imply a different, separate group, where everyone in the group is the same as each other, but different to us. Other. Lesser. Them.

There’s no sense of individual identity in this dehumanising language. 

No sense of people at all.

Our most vulnerable

Our most vulnerable. A ubiquitous, generic phrase that implies not just ownership, but a weak, helpless, anonymous group who require ‘caring for’, ‘protecting’ and ‘looking after’ – inviting and justifying a paternalistic response. The implication is that people are vulnerable due to their age – reinforced in dictionary definitions of ‘vulnerable’, like this one from Oxford Languages: “in need of special care, support, or protection because of age, disability, or risk of abuse or neglect” [1] – not that people are vulnerable due to ageist attitudes and environments.

Frail

‘Frail older people’. ‘Older people with frailty’. ‘Frailty’ is a clinical condition that has become an identity. Deterioration and decline trump dignity and dreams as frailty scales and pathways and plans define direction and destination.

EMI

‘EMI team’. ‘EMI home’. ‘EMI unit’. ‘EMI bed’. ‘EMI care’.

‘EMI individuals’.

EMI is an acronym for ‘Elderly Mentally Infirm’. 

Yes, we really are still using this term.

Super-agers

In contrast to the vulnerable frail elderly infirm identity, we have the “longevity champs over 80”. “Grandfluencers”. The “wellderly”(!) “Super Agers” who “defy age”, “keep the horrors of extreme old age at bay” and “prove that growing older doesn’t have to mean slowing down.” These “inspiring” folk hold the “secrets to ageing well” and are “debunking aging myths.” 

You’re either/or. 

‘Wellderly’ or ‘elderly’. 

‘Inspirational’ or ‘vulnerable’.

‘Incredible’ or expendable.

Ageing well

In our siloed approach to serviceland, we split populations at age 65. On one side of this divide we have the “Physical Disabilities Team”, “Learning Disabilities Team”, “Vulnerable Adults Team”, “Complex Needs Team”, “Complex Under 65 Team” (seriously!). And on the other side, the “Older Adults Team”. “Frail Elderly Team.” “Dementia Team.”

And while younger adults get information, advice and support to ‘live well’, older adults get information, advice and support to ‘age well’ – overlooking the fact that we’re all ageing (that’s life folks!) and implying that older people just age rather than live! Ageing Well services “manage functional decline and frailty” and are “aimed at the most frail and vulnerable of our current older generation” and “care home and house bound patients.”

Sigh.

The ‘silver tsunami’ and a ‘demographic timebomb’: the threat of the ‘ageing population’

 “The ageing population” is described as a “challenge”, a “problem” and a “burden on the working population”. Longer lives are presented as a threat, blamed for “increasing demand”, “rising health care costs” and “increasing pressure on the health and care system”. As well as overlooking the benefits of people living longer, as with other blaming language this frames people as the problem, deflecting attention from decades of limited investment and imagination.

[No more] wrinkly hands

A picture tells a thousand words, and if you pay attention to the images associated with older people and with social care, you’ll find bodies without heads, silhouetted figures gazing out of windows in sterile rooms or disappearing down empty, institutional corridors, and endless, endless images of hands. This prompted Sara Livadeas’ #NoMoreWrinklyHands campaign on social media – a campaign that began almost a decade ago and continues to this day, because these images are still the tedious, dehumanising and stereotypical default.

And…

And… so what? Why does all this matter? 

Maybe you think this is just being pedantic? Policing language? Being ‘woke’ or ‘politically correct’?

If so, maybe you don’t realise the impact of these words and their real human consequences. 

Maybe you’re fortunate enough not to have had them used about you, against you, to diminish your identity and potential. To overlook your passions and skills. Your knowledge and your humanity.

Maybe you’re not seeing the way our assessments focus on people’s needs for washing and dressing and toileting and mobilising and ignore people’s need for a life? For love and joy and purpose and adventure and hope? Maybe you’re ignoring the way we continue to warehouse older people in ‘retirement communities’ and ‘respite centres’ and ‘bedded care facilities’?

Maybe you’ve forgotten the Covid-19 response? The Clinical Frailty Scale? The blanket ‘do not resuscitate’ orders? The hospital discharge guidance? The care home visiting restrictions? The ‘who do we not save?”

All the people who died?

When we see people as vulnerable, not valuable – as needy, not needed – our perceptions justify our actions, and our inaction.

It’s time to flip the narrative and help each other create a future world “where older people, especially those of us who need a bit more help than we did, can continue living adventurous and fulfilled lives. Where we are valued for all we have experienced and learned. Where everything that we know and are good at can still be shared and useful. And where, when we do need help, we get it in the right way and at the right time so that we can carry on giving, living, and loving”. [2]

We can all act to adopt principles of age-positive language and question words and images that undermine dignity.

Age Without Limits have produced an Age Inclusive Writing Guide [3] with five principles that we can apply to how we talk and think about later life in social care.

1. Reject stereotypes

In the recent Social Work with Older People research project, [4] participants said that older people were ‘neither heroes nor victims’ but are often framed as one or the other. Instead, we should talk about people as, well, people.

2. Reflect diversity

Depending on how you think about it, older age can start from 50, from 60, from 70… These are all numbers. They don’t tell us anything about the person or their experiences or the diversity of later life. Avoid grouping people at any stage of life and using othering labels that deny individuality and humanity.

3. Be aware that words matter

Ageism is out there but it is also in here, internalised inside everyone. We can so easily diminish and dehumanise. People are people, not ‘demand’ or ‘cases’ or ‘throughput’.

4. Think carefully about imagery

#NoMoreWrinklyHands aims to banish images that deny the richness and humanity of later life. Age Without Limits have an amazing, free, age-positive image library [5] that we can use instead of the cliches. 

5. Avoid generational labels

Generations are pitted against each other, and this harms everyone. In contrast, the World Health Organisation identify that one of the main ways of challenging ageism is contact between different age groups that builds understanding, respect and mutual help. [6]

Today is United Nations International Day of Older Persons, observed under the theme “Older Persons Driving Local and Global Action: Our Aspirations, Our Well-Being and Our Rights”. Let’s recognise how language can damage well-being and undermine rights, recommit to seeing later life as a time for aspirations and choose to use words that avoid putting people in boxes whatever their age.

“You are part of a system that can disempower older people. You need to be reflexive: always thinking about the impact that you have and how you use your role. We need you to challenge ageism and other areas of discrimination, and to use your power as an ally.”

– Expert Advisory Group, Social Work with Older People research project

---

References

[1] Vulnerable, Oxford Languages 

[2] When I Get Old

[3] Make your comms and writing age-inclusive, Age Without Limits

[4] Social Work with Older People Research

[5] Age-positive image library, Age Without Limits

[6] Global report on ageism, World Health Organization, 18 March 2021