​Understanding Terms of Endearment: The ‘Do’s’ and ‘Don’ts’ of calling the Older Adults in our Care “Sweetie” or “Honey.​”

Some people have a strong affiliation either for or against the use of terms of endearment. They either love it or hate it, and the middle area of when their use is appropriate is grey. When about older adults, there is a multitude of reasons why you should not exchange an individual’s name with a term of endearment. And only one reason for why it is okay.

The only time calling an older adult “Sweetie,” “Honey,” or any other term of endearment is if you ask them directly and they say yes. Or at best in the cases, that a person is no longer able to communicate an answer close family members and friends can confirm that these names are appropriate.

So why draw such a sharp line?  It’s not like these nick-names are deliberately offensive. And on the surface, there are many reasons why people use them. Some of the most popular reasons I’ve heard over the years are:  “I call everyone, Sweetie.”,”They call me, Honey all the time.”, “I was raised to call people that,” or “I am horrible at remembering names.”

However, when used to an older adult, particularly older adults who are in the care of someone else the use of terms of endearment can raise a dignity issue.

What’s in a Name? 

Something strange happens when you receive a diagnosis. Suddenly your name becomes that diagnosis, or if you are living in a long-term care facility, your name become’s a room number and diagnosis.  Too often, I’ve been told “room 204 with dementia” can’t go to activities today because they have a doctor’s appointment.

Side note: a Resident has the Right to choose their schedule.  So if they want to go to the day’s activity instead of their doctor’s appointment, it is their right to do so.  Of course, under the advisement that a doctor’s appointment is important. 

To then replace their name with “Sweetie” or “Honey” only further distances themselves from who they are.  A diagnosis of dementia or Alzheimer’s already ripped away pieces of their identity from them, as their caregiver we should try everything in our power to maintain their sense of self.  One of the best ways to do this is to call them by their preferred name.

Now, if they have spent their whole life being called “Baby” then yes, of course, that is what we should call them, but to know this requires us to ask for their preference and spend the time to learn more about them.

Right to Dignity

The Resident’s Rights don’t explicitly spell out that terms of endearment shouldn’t be used. However, a resident’s right to be treated with consideration, respect, and dignity does encompass a preference for their name.

As a society, we have learned the power of a name. Calling someone something other than their birth name or nick-name can have very serious connotations. There is no difference when discussing the dignity of an older adult. As harmless as it may seem, and no matter the reason for their use without knowing the older adults preference, calling them “sweetie” or “honey” can be offensive and even demeaning.

Have a Conversation

While this article has taken a bit of an earnest tone, there is an excellent opportunity to get to know the person in your care.  So often terms of endearment are used as a personal sign of respect. However, their use isn’t one size fits all and the quality of care really should be person-centered.

There is so much in a name and asking someone what they would prefer to be called can offer great insight into their personality and even a life story. Finding out how someone came about receiving a nick-name has brought on wild tales that I still think about today.  The older adults in our care deserve the respect of a name preference, and we should always offer that choice to them.

Celebrating Residents Rights Month: Awareness of dignity, respect and the value of every Nursing Home Resident

 

Portrait of a smiling elderly woman.
Quality of Care and Quality of Life for Every Resident
Photo Credit: http://rosenspearslaw.com/resident-rights-month/

October is Resident’s Rights Month!

Since 1981, Nursing homes across the country have dedicated a week in October to Resident Rights. The celebration was expanded to the whole month in 2011 by the National Consumer Voice.  And this year’s focus is My Vote Matters! 

Celebrating Resident Rights is an excellent way to empower and educate both residents and staff on such an important topic. But it also serves as a good reminder to us all that when we work in or visit a Long-term care unit, we are a visitor in someone’s home.

On many  long-term care units, a regular staff to resident ratio is 1 to 5.  In order to provide care for everyone, this ratio requires staff to be task and time oriented. Such limitation allows little time for engagement outside of the checklist and often discourages meaningful interactions with the residents in their care.

Residents are not a task, they are individuals, too often, a residents care becomes the focus, their name becomes their diagnosis, and their needs become second to time constraints.

Resident Rights month than serves as an opportunity for us all to refocus our efforts to care for the whole individual and reaffirms our commitment to providing a quality of life for the people that depend on us the most.

What are Resident Rights? 

In 1987, The Nursing Home Reform Law was signed and declared that each resident living in a Long Term Care home would receive both quality of care and quality of life.

The Nursing Home Reform Act established the following rights for nursing home residents:

  • The right to freedom from abuse, mistreatment, and neglect;
  • The right to freedom from physical restraints;
  • The right to privacy;
  • The right to accommodation of medical, physical, psychological, and social needs;
  • The right to participate in resident and family groups;
  • The right to be treated with dignity;
  • The right to exercise self-determination;
  • The right to communicate freely;
  • The right to participate in the review of one’s care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility; and
  • The right to voice grievances without discrimination or reprisal.

Residents’ Rights Month Activities

Activities are a great way to bring staff and residents together and allow relationships to build outside of the role of caregiver to care recipient. And there are so many different ways to incorporate both residents and staff in on Resident Rights activities.

Since we have the whole month, choose 2-3 Rights to focus on each week. For instance, this week we can take a closer look at the right to privacy, the right to be treated with dignity, and the right to exercise self-determination! Then at the end of the month, hold a Rally for residents, staff, and visitors where everyone can celebrate all that they have learned over the course of the month.

Focusing on Resident Rights during trivia games and arts and crafts projects throughout the month are a great way prepare for a Resident Rights Rally at the end of the month.

Resident Rights Trivia

Trivia is fun and a great way to get staff and residents involved.  Be sure to have candy on hand for everyone that gets the answers right!! Don’t hesitate to engage staff as they walk by either- they may be on the floor, but these activities are as much for them as they are the residents.

Below are just a few questions to get you started:

  1. True or False – Once a resident enters a nursing home they lose their rights.
  2. Residents’ rights in nursing homes in the USA are protected at which level? Federal and State
  3. If a diabetic in a nursing home wants to have a piece of cake against physician’s orders, what should the nurse do?
    allow them to have it
    call the family for advice
    give them something sugar-free
    call the doctor for advice
  4.  Yes or No- If a nursing home resident has food left on her face after a meal, is this a violation of her rights?
  5. True or False- Technically, calling a resident ‘sweetie’ or ‘honey’ is a violation of someone’s rights.

Resident Rights Rally Signs

What you will need: 1-yard stick, one posterboard, patriotic stickers, markers      

Turn Thursday afternoon Arts and Crafts, into a prep session for your Resident Right’s Rally.  Team up each resident with a different staff member and have them choose one of the rights that they would like to focus on.

Then with supplies ready, as a team, they will interpret what that right means to them and draw or write it out on the sign.  For example, I once had an aid and a resident choose a right to privacy. On their poster, they drew a depiction of the aid knocking on the resident’s door. For those of us who aren’t as artistically inclined, writing out the right and decorating the poster with stickers can be just as effective!

Once all the rights have been represented you can put them up on display at your Resident Rights Rally!

Resident Rights Rally 

Like any rally, a Resident Rights rally brings everyone together to promote and support the rights of our residents. It is an excellent way to celebrate all of the fun and education staff, and residents have participated in over the course of the month.

Take this opportunity to invite family, friends, and even your local ombudsman!  Everyone has a part in upholding federal regulations and showing your communities support can raise awareness and support for your communities commitment.

Food, music, games, and decorations are all a must! Play favorite patriotic songs so residents can sing along and display the signs everyone made in arts and crafts.  It will undoubtedly become a beautiful representation of your community’s enthusiasm and support of the residents who call it home.

Have Fun Celebrating!

For more activity ideas check out the list by the National Consumer Voice! Don’t work in a Long Term Care Setting?  Call your local Center to see what fun activities they are doing to celebrate and how you can get involved!

golden-rule