Guest post – Elders in the #hcsm community

This is the third in a series of regular guest posts from the fabulous members of the #hcsm community. Interested in writing a post for #hcsm? Email me. This week, Meredith Gould discusses the idea of elders in community – and challenges elders in #hcsm specifically.


I did not initially join the healthcare social media (#hcsm) community as a social scientist. At first, I simply viewed myself as a marketing communications  professional committed to enhancing health literacy.  This, by the way, is my cleaned-up version of saying I’m committed to slashing ridiculously confusing medical jargon out of healthcare materials.

But old habits of education and training run deep.  I’m a sociologist and within weeks of participating in #hcsm chats, I could see a social world emerging in real time.  Enthralling!

Soon, I was tweeting more about the social construction of healthcare than anything else, although a content analysis of cached data would reveal my enthusiasm for proper spelling, grammar, and syntax. Within months, I realized online communities generate social structure and then develop just like  communities do in real life (IRL).  One significant difference: community development  happens more quickly when it’s happening online via social media.

And so does the potential for community destruction from either outside or within, which is why I’m currently fixated on the role of elders. IRL elders are vested with and take on key responsibilities that are essential for community survival.

Everything I’ve observed so far persuades me this is also true for the #hcsm chat community.  While it may not be immediately obvious, I believe our growth and survival will depend, to some extent,  on the positive participation of community elders.

If you’re a long-time participant in #hcsm chats, I suggest that these are your three (interconnected) responsibilities:

  • Holding collective memory: Elders are those around long enough to remember the beginning. They can recall – often because they’ve recorded them – the events and conversations shaping community.  Effective elders reference this information about social structure to build community.   Ineffective elders stifle community development by referencing this information to insist, “we’ve always done it this way” when facing change.
  • Providing continuity: Because they remember the beginning, elders provide the continuity needed to continue conversations and develop new ones.  In social media terms, elders curate as well as create content.  Effective elders participate during hashtag chats by offering links to new information that enhances the conversations.  Ineffective elders shut down conversations by insisting, “we’ve already discussed that” when facing inevitable redundancies.
  • Guiding newcomers: Elders are those not only able but willing to be generous with newcomers.  Elders recognize that each new generation will go through the same, or very similar,  stages as the ones before it. Effective elders are welcoming, patient and good humored with new visitors. Ineffective elders quit participating, although I suppose you could argue that by removing opting out, cranky elders are, in fact, serving the greater good.

So, now let me ask you this: Are you an elder in the #hcsm community?  If so, how are you helping the community survive and thrive?


Meredith Gould is a sociologist by training and activist by temperament with a wide range of editorial and marketing experience. Since 1990, she has focused on health and wellness issues, especially how health is socially-constructed.  A passionate advocate for using technology to build communities, Meredith participates in healthcare social media (#hcsm), healthcare marketing (#hcmktg) and hospice/palliative medicine (#hpm) conversations on Twitter.  She is the author of seven books, blogs about daily errata at More Meredith Gould and serves in an elected leadership position for the Virtual Abbey.

  1. Meredith,
    This is a terrific post. In the cancer community we call the mentoring process “the obligation of the cured,” a phrase coined by Lance Armstrong.

    I was fortunate to attend the first SXSH unconference in Austin last March where leaders w/in the HCSM community were standing in front of me, generous with their time, advice, and ideas.

    Thanks for pointing out and defining our mutual responsibilities.

    You rock,

    • Thanks, Jody…I love mutual admiration societies!

      “Obligation of the cured” is a wonderful frame but, ever the editor, I would have put it as the “responsibility” of the cured, drawing upon Eric Fromm’s classic definition of responsibility being “the ability to respond.”

      My sociological hunch is that even atheists and agnostics would view this type of responsibility as “sacred,” even if that word isn’t used.

  2. Thanks for the thought-provoking post. The elder concept will provide new meaning to many chatters and chats. As I read your post, I think a lot about relationships. The elders serve to establish and enhance relationships in the chat community. They also serve to reaffirm other elders,a very meaningful role in personal, professional and community development.
    Elders’ presence is important to anchor the chat and to help to discover, create, and/ or unify the “heart” of the chat community. I believe that as the “heart” is developed, the chat “becomes” a community.
    I enjoy the #HCSM community because it has “Heart” and elders to nurture it. Thank you for being one of the #HCSM elders.

    • Glad my post prompted more thought about relationships. Social media are highly relational and require some level of commitment among participants. I believe the willingness and ability to stay in (and advance) the conversation(s) is an effective way to achieve “success” in this domain.

  3. Meredith,

    HCSM has been one of the most pleasant surprises about participating in Twitter. Thanks for being a mentor to me and many others by playing this elder role. I do believe that a tone is set by the elders in online communities which influences *who* hangs out in them and *how* they relate. With hcsm, that tone is democratic, relaxed, intelligent, and compassionate. You can take a little bit of credit for that if you like. ;D

  4. Thanks, Kelly and I’ve had the same experience with folks I consider to be elders in the HCSM community. I will be eternally grateful those who welcomed me when I started participating at (almost) the beginning. Most have become dear and delightful friends as well as valued colleagues.

    As I say elsewhere when given the opportunity: virtual community is real community.

    • Martha Carter
    • November 4th, 2010

    Thanks for your thought-provoking post. I like the broadening of the distinction of “elder.” I am particularly interested in the idea that we would consider someone an elder with all the characteristics you mention above, even though they may not be of advanced age, which is one of the traditional descriptors of an elder. In a virtual community, we get to know each other’s character and can ascribe roles solely based on the relationship. I am not sure that this would be possible in a real-life situation where the physical attributes of the person are what we take in first. We might use “mentor” or “role model” but “elder” conveys an historical presence that those other roles do not. Those of you in hcsm who have met each other in person: do you find the relationship the same in person? Would the role of “elder” carry through from the virtual to the in-person domain?

  5. As you note, Martha, in the virtual world “elder” refers to actual time in community rather than chronological age. This has a number of benefits, including what happens when people meet IRL.

    You raise an interesting point about how the physical attributes of chronological age either support or undermine the social status, “elder.”

    In my experience, online interaction with #hcsm community members has led to a relatively seamless shift from virtual to IRL interaction with elders who are, in fact, chronologically younger than I — significantly so, in some instances. I’m always relieved they don’t hold my advanced age against me!

  6. Fantastic article Meredith. I tend to use the term “mentor,” but appreciate the term “elder.” In your opinion, do they imply different roles or import?

    Colleen, who is nuturing the mentors of #hcsmca

  7. I specifically chose the word “elder” because it conveys a gravitas that “mentor” does not; swiped it from anthropologists! As I noted in my response to Martha, although “elder” is generally thought of as a chronological age thing, in this domain it has to do with length of time participating. Also, I tend to think of mentors as engaged in one-to-one relationships, whereas elders engage with and can be accessed by the entire community. Make sense?

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