“What’s in a name”, Juliet asked Romeo in Shakespeare’s famous tragedy. We all know how that story turned out: names meant a lot to the Capulet and Montague families.
And if the heated debate that’s been raging in the Australian aged care system is any indicator, names also mean a lot to older Australians.
The introduction of the new aged care quality standards heralded the start of a new era that is intended to place older people at the centre of care delivery in Australia.
The shift in emphasis has prompted a change in language: no longer will those living in nursing homes be referred to as ‘residents’, they will be called ‘consumers’ to reflect a more ‘person-centered’ approach.
While the standards refer to consumers, The Aged Care Act continues to refer to ‘residents’ and ‘care recipients’.
But what do the people themselves prefer?
Overwhelming majority prefer ‘residents’
Here at HelloCare, we put a survey to our readers. The question was, “What would you prefer to be called if you lived in a nursing home?”
The overwhelming majority – 91 per cent – of the more than 1,600 respondents to the survey said they would prefer to be called ‘resident’.
Only 9 per cent said they would prefer to be called ‘consumer’.
More than 200 readers commented.
One wrote, “‘Consumer’ may be appropriate for recipients of home care, although still sounds little more than a retail transaction. Definitely ‘resident’ for those residing in aged care, it’s far more personal and lends itself toward instilling a culture that aged care workers are working in the resident’s home, not consumers residing in the aged care worker’s workplace.”
Another wrote, “We are being trained to see residents as customers or clients, and we always call them by their preferred name… At the end of the day, yes, it is their home but they are paying customers. They are paying for a service, and we need to uphold that service to its highest standards.”
The official line: we use a variety of terms
A spokesperson from the Aged Care Quality and Safety Commission, told HelloCare, “The Aged Care Quality and Safety Commission uses the terms ‘aged care consumer’ and ‘care recipient’ to describe people receiving Commonwealth funded aged care services (in any setting) in our official correspondence and policy documents.
“This terminology is consistent with definitions in the Aged Care Quality and Safety Commission Act 2018.
“The Commission respects the individual preferences of people receiving aged care services and may use other terminology in some circumstances.
“The Commission may, for example, refer to a person receiving care in a residential aged care service as a ‘resident’ during a site visit where appropriate.”
‘Consumer’ implies choice, which is limited in aged care
Craig Gear, chief executive officer of the Older Persons Advocacy Network, told HelloCare, “We have heard a lot recently about the challenge with the term consumer.”
“The use of the word ‘consumer’ is intended to convey legal consumer protections,” he said.
“It has been criticised as implying choice and a market, when often there isn’t one.”
Lack of choice in aged care was an issue raised recently at the royal commission.
Dr Lisa Trigg, who wrote a thesis on ‘Improving the Quality of Residential Care for Older People, a Study of Government Approaches in England and Australia’, told the royal commission that aged care consumers in Australia do not have choice.
“One of the issues with calling people consumers is, if you think about what a consumer really is, then these people aren’t consumers for a variety of reasons.
“Think about Shannon Ruddock yesterday who knew her father could get better care but I think the word she uses: ‘We were in a crisis situation, I couldn’t do anything about it.’”
“And that, for many people, is how they choose an aged care facility.”
“There are some really unhelpful features of aged care that mean that mean that it’s not really about being a consumer,” she said.
Language can perpetuate negative stereotypes
The royal commission also heard from Dr Kaye Patterson, the Commonwealth Aged Discrimination Commissioner, who said a lot of the language used to describe older people helps to reinforce negative stereotypes.
She said, “We use negative language, and we actually, in fact, not only influence the community in having negative effects, but older people themselves begin to feel that they’re worthless and useless.
“We may appreciate what they do as carers, for grandchildren and for their partners and for children with a disability.
“We value what they do as volunteers, but we underestimate and devalue their other contributions to the community,” Ms Patterson said.
It’s hard to keep everyone happy
Mr Gear said OPAN prefers the term ‘older person’, but said it’s almost impossible to find a term that will suit everyone.
“We are supportive of the term ‘older person’ as its more empowering and respectful,” he said.
“We recognise there will be different views, but should keep the older person at centre. Language is important in that it needs to be respectful, but there will probably not be one perfect term.”
Other terms considered include service user, resident, people with lived experience, older person, customer, elder, and senior.
Each of these terms have their own difficulties, Mr Gear said.
Terms now considered anachronisms, but used in the past, include ‘sufferer’ and ‘frail person’.
“Maybe it’s time… to go back to older people to see what works for them,” Mr Gear suggested.