The language of aging, illness, and death
By Crystal Shelley, LCSW
During my social work practicum in hospice care, someone mentioned that a patient had passed away. My supervisor later told me how much he disliked that term. His explanation has stayed with me a decade later. “What does ‘passed away’ even mean? It’s sugarcoating a reality that happens to all of us. A person dies. That’s how we should refer to it.”
Even after years of working in hospice and memory care, his response still influences how I discuss death and dying, personally and professionally. Becoming an editor has also made me more aware of how our language affects the messages we send—something I’ve witnessed countless times in healthcare, especially when discussing aging, illness, and death. Here are a few of the most common issues I’ve encountered.
This is a bit exaggerated, but ageist language exists everywhere. Older adults are often stereotyped in harmful ways, written off because of their age, or perceived as burdens. Some of the funniest, liveliest, and kindest people in my life qualify for senior discounts. They are you and me, now or in the future, and how we choose to describe this group may be the difference between playing into ageist language and subverting it.
Militaristic language is frequently used in medicine. Warriors must fight to destroy the enemy, and so must patients destroy illness. These metaphors may be empowering for some, but we also send unspoken messages with these terms. When someone loses, were they not strong enough? Are they worthy of praise only if they soldier on? Instead of focusing on comfort and healing, we glorify the language of suffering and sacrifice. In terminal diseases, there is no victory, regardless of how hard someone fights. Electing hospice means choosing quality of life over quantity, but it’s often criticized as giving up—or surrendering.
There’s nothing inherently wrong with these words. In healthcare, we often say that someone’s declining, whether we’re referring to their health, mental state, or physical abilities. The issue occurs when providers use vague terms to soften the blow of tough news. It may seem cruel to tell someone the reality of a poor prognosis, but giving clear, accurate information is an act of compassion. When we obscure our message in an effort to be gentle with the truth, we are denying someone the chance to understand and prepare.
Few people want to talk openly about death, so we often use euphemisms out of sensitivity or discomfort. The ambiguity can lead to confusion, particularly with children who may not yet understand the concept of death. By avoiding accurate language when discussing death and dying, we perpetuate the fear and unease around an already difficult topic. This, in turn, limits our ability to have open conversations about end-of-life wishes, funeral preparations, and unresolved issues.
As editors, we’re tasked with ensuring that messages are clear. To be effective, we must examine the words we personally use and be conscious of how we may unintentionally feed stigma. The ways we describe aging, illness, and death are deeply ingrained in our society. While it may seem challenging to shift perceptions, we are the word specialists who can help lead that change. I don’t think my practicum supervisor meant to challenge my views on how we talk about death when he made that comment 10 years ago, but he did—and so can we.
The Language of Aging, Illness, and Death was originally published in Tracking Changes (Summer 2020 edition). Members receive a PDF of the quarterly Tracking Changes newsletter by email.
Header photo by Pierre Bamin on Unsplash
