Whatever Your Opinion of Him, Trump Is Not ‘Demented’

As boomers age, we’re more sensitive to the language used to describe us

By Jay Newton-Small and Patrick J. Doyle

On Tuesday night, after President Donald Trump’s rally in Phoenix, Maria Cardona, a Democratic strategist, was speculating about Trump’s erratic behavior: “I do think that after tonight, people won’t just think that he’s unfit to hold this office, but that he might be psychotically demented and ill of the mind.”

And just like that, millions of Americans living with Alzheimer’s disease and related dementias cringed. Setting aside the thorny question of if the president has some sort of cognitive impairment, using the word “demented” to describe such a diagnosis today causes a furor because for the one in five Americans either living with, or who have a loved one who has, the disease, it fails to account for the human behind the description.

As the boomers (the generation that invented the idea of political correctness) hit their mid-50s, 60s and beyond, they are redefining the language that describes the very process of aging. American society is firmly entrenched in the cult of youth, so most words to describe aging are derogatory. But as the boomers age, more and more words are becoming taboo or sensitive, sometimes for the good and sometimes for the bad.

Here’s a look at five such categories of words or phrases:

1. Old, Senior, Elderly → Elder → Older Adult

Unfortunately, there are virtually no words that are acceptable any more to describe older people. Old, senior and elderly are often used to describe persons over the age of 65, but let’s be honest, who really likes being called old, senior or elderly — even when the terms apply?

Folks do not want to be associated with the negative stereotypes attached to these terms — sick, frail, dependent. Some senior living companies have gone so far to advertise now simply as “community living,” detaching from all age-association in their names. If one must find a word to describe older Americans, elder is preferred because it connotes wisdom and has fewer negative associations than senior. But even that term is controversial: some people complain that makes them sound like tribal or religious leaders (think church “elders”), rather than simply what they are: older adults.

2. Retirees → Successful Aging/Active Adult → Engaged

Some older adults take offense at the term “retirement” when in the wake of the economic downturn, many are still working and are far from retired. Others reject the label “retired” as furthering the stereotype of older people as dependent economic leeches. Even AARP has disassociated itself from its former title, the American Association of Retired Persons, to move away from the idea of retirement and to emphasize staying active in the workforce as long as possible. Many boomers have adopted the moniker of “successful aging” or “active adults,” but that remains controversial. What defines success? If you’re frail and not very physically active, are you failing at aging? Success implies a degree of education, wealth and health, making the term inherently biased against disadvantaged Americans.

Like the American dream, should we view successful retirement as aspirational? Especially when both the words “successful” and “aging” are fraught with divisive interpretations. As of late, “engagement” is being used to capture the diversity of experience and success as people age.

3. Caregiver → Care Partner → Ally

Historically, we’ve called nurses, aides, orderlies, family and friends who help with care “caregivers.” Sorry, Florence Nightingale, but that’s no longer a title to which you should aspire in modern times.

Caregiver implies a unidirectional relationship in which one person renders care on another. Sometimes, that’s an accurate representation of a relationship. But oftentimes, that’s not true: people who require some care often partner with others to navigate the support they require. So, some organizations have coined new terms like care partners to reflect these dyadic relationships.

The fact is that no single term accurately describes the breadth of the care spectrum. To reflect this reality, sometimes the term “care” is even dropped. So, someone providing support to a person living with dementia is referred to as an “ally.”

4. Demented → Patient with Dementia → Person Living with Dementia

Dementia is also a controversial word. Some clinicians will call those living with the disease “demented,” a term that will draw gasps of horror from certain circles looking to destigmatize the disease. Maria Cardona, for example, got an eyeful on Twitter after using that word.

Likewise, calling someone a “patient” who isn’t in a medical setting is considered dehumanizing. A person diagnosed with dementia lives with this condition for many years and only gradually loses cognitive abilities. These people continue to engage to the best of their ability — some write books, advocate on Capitol Hill and even go back to school to further their education. So, the most politically correct and accurate term these days is: person living with dementia.

5. Suffering from → Living with → Living Well

Writers often describe disease by saying people are “suffering from” something: “suffering from Alzheimer’s,” “suffering from Parkinson’s,” or “suffering from multiple sclerosis.” Yes, those diseases can cause suffering, particularly in the end stages. But many people can lead full, productive lives for years with these chronic conditions, and they aren’t necessarily “suffering.”

To soften this, experts often replace “suffering from” with “living with,” or the more aspirational, “living well with dementia.” However, as with “successful aging,” not everyone with dementia can “live well” with the condition. All do, however, live their life to their fullest capacity.

Trump is the first person to decry the evils of political correctness. But words have meaning, and he’d be the first person to take exception to some of the bombastic language — and unconfirmed medical diagnosing — being applied to him.

This is one case where “both sides,” to quote Trump, got it wrong.

Jay Newton-Small is a contributor to TIME and founder of MemoryWell, a company that harnesses journalism to tell the life stories of those living with Alzheimer’s and dementia with the aim of improving their care.
Patrick J. Doyle, PhD, corporate director of dementia care at Brightview Senior Living and principal faculty member in the Center for Innovative Care in Aging at Johns Hopkins School of Nursing.
Note: This piece was first published on PBS’s Next Avenue’s website: http://www.nextavenue.org/why-trump-not-demented/

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