I am not referring to Fido and Lassie. 

Honey, Dear, Cutie, Love…and the two that really make my skin crawl – Lady Bug and Sweet Pea – are some of the pet names, aka terms of endearment – that I heard used often through the years in caregiving situations.

Of course, at home, when you are providing care for a loved one, it is only natural to use endearing terms for someone close to you. Should different guidelines be followed in long term care, doctor’s offices, and hospitals?

As in most issues, there are two sides. Some people don’t mind, even take kindly to being called Honey Bunch or Sugar Pie. I cringe.

My mother did not like strangers (or people she knew, but not well, such as salespeople in stores) calling her by these cutsie-boopsie monikers. And she let them know. “My name is Mrs. Wright.”

Although my dad never verbally objected, I could see the discomfort on his face when the nurses at his doctor’s office called him Honey. It was just too familiar for this shy farmer, who reserved that term for his wife.

I have been a patient in the hospital a few times, and I do not like it at all when anyone on staff refers to me by a pet name. It seems impolite and impersonal. I always want to ask, “Don’t you know my name?” and depending on how I am feeling, I have done just that. One memorable experience was in a doctor’s office. I was feeling very sick. It was Halloween (a holiday we don’t celebrate and I try to ignore) but the office staff was observing it in what I considered an unprofessional way for a medical facility for adults – dressing up. A nurse in a “sexy cowgirl outfit” called me Sweet Cheeks. I almost barfed. “Please, call me Mrs. Johnson,” I requested in my best sweet cheeks voice. She appeared horrified and did not respond. I am sure she was asking herself what kind of old lady objected to being called Sweet Cheeks.

However, I have a lovely memory (which was hard to come by under the circumstances) of my granddaughter Talise and the young man she was then courting – Alex – who is now her husband, visiting me when I was at Duke Hospital, being treated for Guillain–Barré syndrome. Alex greeted me with, “Hello, Grammy.” 

That is my official grandparent title and it was the first time Alex had ever used it. It was endearing and I felt that since he had won Talise’s heart he had certainly earned the right. Titles are a bit different from pet names. On the other hand, I would not want just anyone calling me Grammy.

My most egregious memory relating to the use of these terms was a sad, very sad episode. It had just been decided that my sister Rodema, whose ovarian cancer had spread and was untreatable, should go to the Hospice Home for a few days so her family (husband and three children who had been caring for her at home) could get some rest. It was a sudden decision and Rodema was obviously distressed. I was alone with her in her bedroom, holding her hand, when a loud, animated EMT, entered the room exclaiming, “Hey, Lady Bug, you ready to go?”

Really? Really? It wasn’t like she had come to take her for a ride in the country. The pleading look on Rodema’s face said it all. 

I came so close to responding, “Just get out of here!” but controlled myself. Instead, as calmly as my emotions would allow, I replied, “Her name is Mrs. Stogner.”

Mrs. Stogner looked at me with approving eyes.

Like the cowgirl nurse at the doctor’s office, the EMT look flabbergasted. It is as if these health care workers – who should know better – have no empathy and can’t imagine why someone sick or in such solemn circumstances would not want to be called by a silly pet name. The tech did not say another word as she and her co-worker transferred Rodema to the stretcher. Rodema died at the Hospice Home three days later. I will always be glad I defended her right to dignity as she left home for the last time.

And I suppose that’s what this topic today is all about – the dignity of the patient. Here are some guidelines:

Patients get to decide what they want to be called. They may choose their surname, preceded by Miss, Mrs. or Mr. If they have earned a title such as doctor or professor, that may be their preference. Many people prefer to be called by their given name, sometimes with a Miss or Mr. preceding it such as Miss Sally or Mr. Joe. A dear elderly lady I took care of who never had children of her own  was Auntie to scores of kids in her family, neighborhood and church. She loved being called that named she had answered to all of her adult life. Military veterans may opt for a name that denotes their rank. “Are you ready for breakfast, Captain Martin?” you may ask, and even add, “Sir.” Others may have a long-standing and beloved nickname and choose to continue being identified by Lefty or Prissy.

Remember that some nicknames may be appropriate to be used by some but not others. My best friend’s very elegant and refined mother was known for her beautifully hand-written letters which she signed, “Affectionately, Toots.” Obviously, this was a sobriquet which her mother chose. When her daughter wrote a memoir about her, that was the fitting title she chose. Though I loved her dearly and was the recipient of many of those letters, I could never bring myself to address her in any way other than Mrs. Antonio.

Once the recipient decides his or her name of choice, in your role as advocate, you need to inform any health care professional who provides care of the preferred name. This is especially important if your loved one is in a nursing facility. It is a good idea to make this request in writing and ask that it be placed in the patient’s chart. If you observe anyone not fulfilling this desire, feel free to gently remind, such as, “Oh, my dad prefers to be called Mr. Wright.” By the way, both in nursing school and in the facilities where I worked, we were instructed not to use pet names, but those instructions were often disregarded

While some seniors do not object, others consider being called these names demeaning and disrespectful. It can make a patient wonder if the staff person actually knows his/her name. Already stripped of their health, patients may feel their identity is also being taken away.

Patients – who re already embarrassed at having others provide assistance with dressing and toileting – may consider this one more example that their life is out of control. Being called by your given name helps maintain dignity. Being called Poopsie can make you feel like a child. (This is as good a time as any to remind caregivers not to use “baby talk” when talking with or assisting their recipients.)

Research shows that people with dementia need to hear their given names. It helps to connect them with reality. A male patient with cognitive decline may be confused if a nurse calls him Darling. He may have only heard that term from his wife through the years, and there is a possibility he may think the nurse is his wife. Other findings include that when addressed with sweet or infantile talk (“Oh, aren’t you being a good girl today!”), patients respond by becoming more aggressive and less cooperative. Often, their stress levels increase.

Terms of endearment should be used only by those who have earned the right. Family, long-time friends, and health care professionals who have provided care for many years may make someone’s day by using a loving and appropriate name that the patient receives with pleasure. There is a time and a place for Sweetheart and Dearest.

The goal should always be to provide loving care in a dignified manner that makes the patient feel comfortable. Consider the relationship you have with the person; consider the circumstances. Be respectful. 

Understand, Dearie?