A Personal Question

Sunflower May

One of the recurring questions I heard at the Pioneer Network Conference earlier this year concerned how CNAs and other direct care workers refer to their residents/patients/clients.
I heard a variety of opinions, ranging from “Absolutely no pet names ever, it’s undignified and disrespectful” to “What does it matter?”
I don’t remember which individual it was who finally put forth the question: “Well, what does the resident think about this? Does the resident mind aides using terms of endearment?”
When I was asked for my opinion, I just shrugged and said: “I guess it depends.”

Having worked for years in Long-Term Care, this wasn’t the first time I’ve run into this issue and I doubt it will be the last. It’s one of those loaded topic, where everyone involved has surprisingly strong opinions. I think people lay bits of themselves on the line with this question…maybe it’s one of those questions that you can’t ask without thinking: “What do I want? What are my wishes and will they be respected if I can’t enforce them?”
My answer to the question is quite often met with confusion and occasionally disdain, but the truth is, I really do think it simply depends. You can’t answer this question with an absolute…it’s not that kind of question.

Some people like being called “buddy”, or “honey”, “sugar” or some other term of endearment. Some do not. Some go off the wall if person A calls them “sweetie”, but smile happily when person B calls them the same thing. (That’s me, by the way, squarely in category 3.) Residents are much the same way…being, you know, people. Individual human beings with unique preferences.

Here’s another big shocker: CNAs are also numbered among humanity. We’re people too. We each bring a different set of life experience and habits to the job. Some aides use pet names, some don’t. In my experience, good aides fall on both sides of the line. There doesn’t seem to be a one-to-one correlation.
As for me, it just slips out. It’s slightly odd, but I slip into a more Southern accent while at work (a benefit of living in multiple places is having multiple accents to switch between). “Honey”, “buddy” and “sweetie” just slide out with the Southern twang and none of my residents seem to mind…I’ve actually had residents complain if I call them only by their given names, with no endearments to follow. In front of State, no less.

Of course, I have to tailor my habits to my residents preferences. I’ve had residents ask me not to call them “honey” or “buddy” or “sweetie”––these residents are few and far between, but I’ve had them. Some prefer terms of endearment in private, one-on-one interactions and more formal modes of address in public settings like the dining room. I do my best to accommodate their wishes and preferences.
In fact, one of the very first things I’ll do when I have a new resident is to introduce myself and ask what they want me to call them. Do they want to be Mrs. P, or Mrs. Betty or just Betty? Then I play it by ear: after the initial unease, how formal is this resident in their interactions with others, with me? Do they respond better to jokes or serious discussion? How much humor on my part is tolerated? What do they call me?

In the end, this question of terms of endearment is one that I do not believe can be answered in a blanket policy. It’s a personal question needing a personal answer…and no one can supply except the resident. Even when the resident is so out of their head with dementia that they cannot remember the year or recognize their children, still they have the right to decide for themselves what they prefer. They may not be able to answer in words, but they always answer.
You just need to train yourself to hear the unspoken words hanging in the air. Don’t assume you know what another person wants. Listen before you speak for them.

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