From RDH

July 20, 2009

When children receive an insult, they sometimes respond with the old adage "sticks and stones may break my bones, but words will never hurt me." As it turns out, words actually do hurt. Seemingly nice words like "dear" and "sweetie" are not only be irritating to some, but also damaging to psychological, physical, and cognitive health.

Terms such as "dear," "sweetie," or "young lady" may be wrongly used by health-care professionals to show affection particularly to older and younger patients. Patients often interpret the words as being talked down to and feel they are being treated in an undignified manner. Because the words are not a clear assault, patients may not directly object. Patients may instead be belligerent and refuse to comply with recommendations, or simply not follow through with instructions in an attempt to regain status, autonomy, and self-determination.

Patients may be right to assert their independence. Those who don't demand to be treated with dignity and who give in to being treated like a child may internalize feelings of helplessness and feebleness, and succumb more quickly to deterioration.

Health-care providers need to treat all patients with dignity and empower them. The first step toward change is to recognize words that may be construed as demeaning, undignified, or overly familiar and to acknowledge them as disempowering and harmful. Second, providers should make it a goal to catch these words and eliminate them from their practice.