As we enter the middle of the 21st century with this New Year, I personally would love to imagine that we nurses have made strides in dismantling ageism worldwide. Abolishing ageism is essential to ensuring health, function and well-being with and for today's and tomorrow's older people. But, as I survey the clinical and scientific landscapes around me, I am increasingly concerned that we are losing ground in the global battle with ageism rather than making progress. Gerontological nurses have been talking about ageism for decades. Famed American geriatrician Robert N. Butler coined the term ageism more than 50 years ago (Columbia University 2022). We nurses picked up the conversation a few years later. Many nurses were writing strongly about ageing then and projecting what the future might hold for older people. Their works shed much needed light on ageism in the 20th century. For example, noted nurse scholar Maria Phaneuf presciently pointed out what we now call negative age-related self-stereotyping and societal or structural ageism (Phaneuf 1981). In Phaneuf's landmark essay Reflections: the Aged Today and Tomorrow, she pointed up the value that nurses placed on health and—by my contemporary extension—on function and well-being. Phaneuf outlined the dialectical nature of health and illness in later life, saying in part ‘…the aged (sic) who are ill are in some measure healthy or they would not be alive, and the aged who are ostensibly well are not necessarily free of health-related problems’ (p. 276) as she called on nurses to specialise in caring for older people. Forty-five years on and too little about ageism has changed. Older people still possess the manifold strengths of health and well-being along with other resources while they may be contending with illnesses and injuries. We nurses still find it difficult to recruit students and colleagues to care for older people. And, concerningly, we continue to express ageist beliefs and stereotypes in our research and clinical practice. But now we often do so in ways that distort principles of good science and effective communication. Misuse of theories and concepts is often employed to convey ageism in science today. Self-neglect is the misapplied concept catching my attention most often these days. The number of concept analyses, commentary papers and research reports involving self-neglect is growing. The assumption that older people should for some intrinsic reason neglect themselves always stops me in my tracks. A prime example of ‘othering’ older people, self-neglect is quickly becoming paradigmatic of our current ageism. In today's commonplace use, the ageism of self-neglect is cloaked with this term borrowed from the study of abuse and mistreatment of older people. In ageist applications, self-neglect is incorporated into the study of a wide range of phenomena from loneliness to personal hygiene. These applications reach far beyond the intended scope of the original concept. Thus, the resulting science simply becomes a cover for everyday ageism. The assertions that older people are more likely than younger people to neglect themselves just because they are old is indefensible. I do not dispute that older people can and do neglect themselves in specific circumstances and for a variety of important reasons. But nothing about ageing and being older accounts for the likelihood of neglecting oneself. Many things about ageism, however, do account for why older people may be falsely viewed as being self-neglectful. Structural ageism, for example, limits the availability of and access to resources that support autonomy and facilitate older people caring for themselves. Hence, uncritical and overreaching application of self-neglect represents ageist views, associating chronological age with our disparaging perceptions of older people's lives and lifeways. Used in nursing today, critical examination of self-neglect must call us back to Phaneuf. Her reminder to us that people who are ill still possess some level of health and its attendant strengths is more important than ever. Self-neglect was popular in medicine before it rose to prominence in nursing, offering a potential explanation of how we have come to misuse it. Nursing has, in recent decades, become increasingly biomedical in many ways. We employ biomedical frameworks, phenomena and thinking more frequently than ever to guide nursing research, practice and education. Indeed, many nurses now fully endorse the biomedical understanding of health as a steady state wherein illness and injury only deflect that state downward until treatment restores homeostasis. Our nursing emphasis on health and well-being as expansive capacities across the lifespan including later life is fading from preeminence. But with the decline in our nursing perspective, those who are or will be in our care incur a great loss. Our capacity to provide nursing care that they are right to expect from us wanes as our disciplinary perspective diminishes while biomedicine prevails. Simply said, if we are all doing biomedicine then who is there to do nursing? Evidence of our movement toward biomedicine appears in many ways including through our romance with biomedical labels, used to refer to patients and people who participate in our research. Biomedical labels are everywhere—person with dementia, cancer patient, Parkinson's patient. Labelling patients and participants remains popular in nursing despite our emphases on personhood, holism and person-centred care. These labels underscore our misplaced biomedical focus, typecasting older people into categories that are often incommensurate with gerontological nursing's foundations of understanding ageing as a holistic and multidimensional life experience. Helpfully, recent shifts in nomenclature reflect states of living with a condition rather than being defined by a diagnosis. For example, referring to people diagnosed with dementia as people who are living with dementia offers the breadth necessary to understand that these individuals are not defined by their disease. But such terms of reference are not ubiquitous and biomedical labels persist. Even more worrying is the unthinking practice of shortening those labels to acronyms. Biomedical acronyms vary around the world. We read and adopt them with ease, as we all recognize familiar examples like OA (older adults) and PWD (person with dementia). We are enticed into using them in our research as well as in clinical practice. The healthcare community has long acknowledged that acronyms and abbreviations carry risks of confusion, clinical errors and reductive thinking (Berger et al. 2026; Kuhn 2007). Accepting these risks runs counter to principles of effective communication and the tenets of nursing and specifically gerontological nursing. Interestingly, when challenged about their use of acronyms, authors typically plead for lenience. Their pleas are anchored in frustrations with stringent word limits or desires to meet interprofessional audiences' interests. While editors can often offer small increases in word limits, authors should remember that clear, tight writing is the real key to meeting word counts. Using active voice and avoiding unnecessary modifiers are strategies that reduce word counts far better than using acronyms ever could. Readers from all disciplines appreciate vivid, well-structured writing no matter the topic. Word limits and interprofessional communication aside, we must do better to dismantle the ageism that we and others express through misapplied ideas, labels, and acronyms. These five points in the style brief anchor our guidance for and expectations of authors and reviewers alike, creating a foundation for what readers will experience when reading articles in IJOPN. We can all use this guidance beyond our engagement with the journal to underscore what we value and prioritise as gerontological nurses. Our words are the basis for all our actions and our leadership, leadership needed to dismantle ageism and all discrimination. Use the ideas behind our guidance in all that you do and join us as we speak together of our shared aim for an age-friendly world, breaking down explicit and implicit ageism along with attendant ableism. Please share your thoughts on ageism in the 21st century, what age-friendliness means to you and your reactions to our 2026 Style Brief via social media. Just use our signature hashtag #GeroNurses and tag IJOPN's social media via LinkedIn and Bluesky. The author declares no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analysed.
Sarah H. Kagan (Thu,) studied this question.