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Respect wishes of cognitively impaired when addressing them

Alzheimer’s and related dementias rob a person of many abilities but should not rob them of being treated with dignity and respect. While some Alzheimer’s behaviours may seem childlike, the disease does not turn adults into children.

We often affectionately greet children as “sweetie,” “cutie pie,” and “my lovely,” but these are not approriate names for adults, no matter what their mental capacity. It is disturbing to hear paid home caregivers and residence staff use such childish endearments for their patients. When introducing a client to the head nurse of a residence, she greeted my client with: “Aren’t you a cutie pie?” My client’s daughter looked horrified and I half expected her to grab her mother and run. The following week I overheard a nurse call her Alzheimer’s patient “lovey.” I was sitting in my doctor’s office patiently, or not so patiently, waiting for my name to be called. “Mrs.” was called in, then “Mr.” and after a few more people had their turn, the physician called out “Bonnie.” I do not have a personal relationship with this doctor but was not offended by his calling me by my first name. I am just not sure why he used my first name while he called the other patients “Mr.” or “Mrs.”

I call him Dr. X and even though I know his first name, it would never occur to me to use it. Could it be that I was the youngest person in the waiting room? Does age give a signal of what to call someone?

I believe that all senior citizens, including those with dementia, should be asked how they would like to be addressed.

Recently I helped move an 85-year-old woman from an autonomous residence to a care facility because of a decline in her cognitive functioning. The care manager respectfully asked her what she would like to be called. She replied “Mrs. White” and went on to explain that in her previous residence, everyone had called her by her first name and she had hated it; she had never been asked for her preference.

Alzheimer’s patients have a full life history that the disease cannot erase. The woman who taught school for 40 years and had her students call her Mrs. X may feel uneasy when caregivers, sometimes as young as her students, call her by her first name without her permission.

Alternatively, others may find comfort in the informal manner of being called by their first names.

Caregivers working in this field should know the life history of those they care for. They should begin their relationship with them by respectfully asking what name they would prefer to be called. It’s all about maintaining respect and dignity.

Questions and comments can be sent to b.sandler@sympatico.ca

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