Even when you've mastered the unusual spellings and bizarre pronunciations, meanings change and when you're not looking previously innocuous words become politically- charged insults.

The latest additions to the list of no-go terms are, at least according to the Nursing and Midwifery Council, "love" and "dearie".

A draft document due to be approved next week advises nursing staff the liberal use of terms of endearment is no longer acceptable and could be bad for the health of elderly patients.

The guidelines accept that in some areas, notably Yorkshire and its neighbour Lancashire, "love" is a part of everyday speech and therefore not patronising at all, proving just how tricky the whole linguistic business can be.

However, while the NMC was itself being accused of having lost the plot with the publication of what many saw as little more than an idiot's guide to bedside manners, it had clearly hit a very raw nerve.

While most right-minded people accept that only the very old can get away with calling somebody else "dearie", the use of "love" appears a far more contentious issue.

One online posting, from a man presumably few have ever had the misfortune to call "love", dismissed it as an "expression of the lower working classes" and called for it to be immediately taken out of use. Another claimed our "lax attitude to manners and civility" was the reason the country is in such a "pathetic mess". A third, more laid back contributor, controversially dared to suggest it was just a "nice word".

In truth, as with most turns of phrase, to love or not to love is a matter of context. However, even those who agree with the apparently sensible shadow health minister Anne Milton who described the guidance as evidence the of the "world having gone mad", may soon be forced to admit that "love" has had its day.

Before thrashing out the details of the document, part of the Government's drive for dignity in care, the NMC asked various groups of elderly patients their main concerns about the health service, and the use of terms of endearment was right up there with privacy on wards and long waiting lists.

There is also evidence that it does have a negative effect on health of vulnerable patients.

"Health care workers often think that using words like 'dear' or 'sweetie' convey that they care and make them easier to understand," says Kristine Williams, who studied the effects of so called "elderspeak" on a group of American patients
with mild to moderate dementia. "But they don't realise the implications. These words also give the message to adults that they are incompetent.

"We also found that when nurses used phrases like 'good girl' or 'how are we feeling' patients became more aggressive and were less receptive to care, while it made others refuse to do what staff members asked of them. There is a danger that patients who are viewed as difficult actually end up receiving less care, and elderspeak can also start a downward spiral with patients losing self-esteem and sinking into depression.

"The main task for someone with say Alzheimer's is to maintain their sense of self. If you know you are losing you cognitive abilities and someone talks to you like a baby, it's incredibly upsetting." However, the NMC report has left many wondering whether the time and money lavished on its new medical glossary might have been better spent.

"It's ridiculous that this kind of political correctness takes a higher priority than feeding patients properly and delivering good healthcare," says Mark Wallace of the Taxpayers Alliance.

"Elderly patients are more interested in getting appointments promptly and receiving the medication they need. Nursing and medical staff need practical support to their job and these kind of guidelines don't appear to help anyone.

"Until the very real problems with the health service are solved, this body should butt out of interfering in the language they use."

Unfortunately that is unlikely to be the last word on the matter.