It Ain’t Necessarily So – 11: Terms of endearment – what’s so wrong with calling residents ‘love’, ‘darling’, ‘duck’, ‘dear’, etc?
Caring Times, December 2013
with JOHN BURTON
For a long time now, it has been considered bad practice to call residents love or darling. Why? These are terms of endearment, aren’t they? There are regional variations. I know “duck” from the Potteries and Staffordshire where my father was brought up. “Darling” is more universal but typically London. In Devon we might say “m’dear” or “my lovely”.
When used between people who are close, who know and love each other, these terms of address express intimacy and familiarity. They are also used by the market stall holder who doesn’t know your name but knows you as a customer. If you find it offensive or over-familiar, you should probably shop where you’ll be addressed as madam or sir.
So why is using such terms of address in care homes poor practice? This is where we get hung up on rules because of course it all depends on the relationship and the understanding between those who are using the words. If there’s a member of staff who calls all residents “darling” irrespective of their own preferences or of how well she knows them, or because she can’t be bothered to know their names, that is obviously wrong, and it shows that this care worker or nurse doesn’t know her job, even though she may have been doing it for20 years. But if we make it a rule that terms of endearment may not be used at all – especially if there’s an inspection taking place – we are denying the familiarity and intimacy that should exist between some staff and some residents . . . sometimes.
It is easy for outsiders to a relationship to misinterpret what is going on between two people who know and trust each other, and between whom there is a bond of friendship and even love. We can tease each other and call each other all sorts of names. “You old rascal” can be words of great affection and admiration and are unlikely to be abusive. “Good morning darling” or “Sleep well duck; see you in the morning” answered by “Not if I see you first” are likely to be familiar and comforting words. They may not be, of course, and we should constantly question ourselves and each other about how we address residents.
Outsiders, such as inspectors or the contract compliance team from the local authority, do need to be alive to the subtleties of relationships in care homes. They should not overreact to the use of these terms of endearment and familiarity. They should understand that there is no “standard” relationship or form of address.
Some residents do want to be called by their title and surname – Mr/Mrs/Ms/Miss – and very close relationships can and do occur when such formality is maintained. Others wish for informality, and encourage and welcome what may appear to a stranger as cheeky and even rude.
Yes, it’s difficult! The life and culture of a care home are created from thousands of minute interactions. We can’t isolate an exchange between a member of staff and a resident and make a judgement about the whole home or even about that relationship.
We found a different way: Caring Times readers tell their stories
Mike Farmer, home manager, Cedar Court, Oxfordshire: “It Ain’t Necessarily So” has inspired great debate in my staff team. I don’t usually join in these discussions but thought I might comment on how we address residents as it regularly crops up. I get very worked up around political correctness (resident, patient or client).
For me it is not what we say but the values and principles which led us to say it in the first place, and the tone or nature of discussion which led us to say “dear” or “darling”. Knowing when it is or is not appropriate is far more important. As long as it is not the norm for everyone, I do use such words as love, darling, my dear.
Care home manager, Scotland: I get very upset by comments from inspectors about using “dear” and other familiar forms of address. They don’t seem to understand the difference between when it’s used in a fond and friendly way and when it’s meaningless and institutional.
We always ask residents how they would like to be addressed. Very few ask to be called by their title and surname, and most like their first name to be used. There are so many variations and it depends how close you are to the resident.
I might address a resident as Mrs Smith because I’m not that close to her and I have a more formal relationship. But her keyworker will call her Mary because they are real friends. It’s a job to get inspectors to understand this.
C.L. Nottinghamshire: It’s often wrong to call residents “dear”, “darling”, etc. When I took over this home, the staff hardly used people’s names, it was always dear, deary, darling, sweetie and so on. It was so demeaning. So, I did make it a rule that we would ask each resident how they would like to be addressed.
One problem was that residents had got so used to this lack of respect that they said they didn’t mind. This made it very difficult for me to change things because the staff were then able to say: “There you are – they don’t mind – you can’t force people to be called Mr and Mrs etc.”
I resorted to making it a rule that we must use title and surname or Christian name or given name, and that it must be recorded in the care plan.
After two years, we’ve got to the stage when we can at last relax the rule to allow a bit more flexibility, and I don’t jump on people when I hear “dear” because I know we’ve got the right level of respect back.