Use of the Term “Elderly”

Avers, Dale DPT, PhD; Brown, Marybeth PT, PhD, FAPTA; Chui, Kevin K. PT, DPT, PhD, OCS, GCS; Wong, Rita A. PT, PhD; Lusardi, Michelle PT, DPT, PhD

The terms senile, demented, and aged are unfortunate terms once in common use among physical therapy personnel. While these terms have mostly disappeared, there is still a term in common use that needs to disappear, the term elderly.Terms tend to be convenient but suffer stereotyping through their generalization and lack of specificity. Thus, using the term elderly for a person who is robust and independent as well as for a person who is frail and dependent says little about the individual. Since older individuals become more heterogeneous with age, a specific descriptor such as elderly is inaccurate and misleading. For example, asked to describe an 82-year-old woman would provoke little agreement and much discussion based on personal experiences. Eighty-two-year-old women run marathons and 82-year-old women are bed ridden. Which is the accurate description?The term elderly is ageist. Ageist terms are those terms in which a stereotype is promulgated and treatment is delivered differently on the basis of age.1 Ageism, like racism and sexism, is a form of prejudice or prejudgment that shapes perceptions. Ageist terms tend to diminish older adults, yet ageism is rampant in health care, stereotyping older folks as sick, frail, and physically dependent. Ageism can result in less care, less robust care, and negatively affect outcomes.2None of us would demonstrate ageism by using patronizing speech when interacting with older adults or talking baby-talk. Yet, the use of the term elderly persists. In a survey of major medical journals from 1996 through 2006, all used the term elderly and 3 of the 4 major geriatric journals preferred the term elderly over older adults at a rate of 4:1 over general journals.3The term elderly lacks an equal and opposite term pederly; unlike geriatrics versus pediatrics that describes an area of medicine and health care. The term elderly is often used to describe frail individuals; without applying the well-known and valid criteria of frailty.4 Furthermore, older adults do not like the term elderly applied to themselves, even if they use the term to describe someone else! A European survey asking older individuals their preferred term indicated a preference for older or senior and strongly rejected terms aged, old, and most strongly elderly. In 1995, the United Nations Committee on Economic Social and Cultural Rights of Older Persons rejected the term elderly in preference for the term older persons.5 Additionally, a media guide issued by The International Longevity Center, headed then by Robert Butler, recommended the term older adults over senior and elderly. The report states, “After all, we don't refer to people under 50 as ‘junior citizens'.”6It is time our language use matures. Using terms that are precise, accurate, value-free and that older adults prefer makes a good sense. The term older adult or older person is respectful and should be the standard term in this journal.—Dale Avers, DPT, PhDMarybeth Brown, PT, PhD, FAPTAKevin K. Chui, PT, DPT, PhD, OCS, GCSRita A. Wong, PT, PhDMichelle Lusardi, PT, DPT, PhD

REFERENCES

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2. Nemmers TM. The influence of ageism and ageist stereotypes on the elderly. Phys Occup Ther Geriatr. 2004;22(4):11–20.

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3. Quinlan N, O'Neill D. “Older” or “elderly”—are medical journals sensitive to the wishes of older people? J Am Geriat Soc. 2008;56(10):1984.

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4. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci. 2001;56A(3):M146–M156.

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5. United Nations Committee on Economic Social and Cultural Rights. The Economic, Social and Cultural Rights of Older Persons. 1995.

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6. Dahmen NS, Cozma R eds. Media takes on aging. www.aging.org. Published 2009.

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Copyright © 2011 the Section on Geriatrics of the American Physical Therapy Association