Written by Jane Turner, September 2020.
I was thrilled to be invited to give an introductory talk in “Our Ageing Future-Overcoming Ageism” by Louise and Les Mace of New Way to Stay. This was at the Aged Care Professionals Networking Breakfast in the beautiful venue of Gunners Barracks at Mosman.
I turned 60 earlier this year, and I had a big party to celebrate, squeezed in between the bushfires, floods and Covid-19.
I have been working as a Clinical Psychologist in the field of ageing for the past 25 years. There have been two psychological phenomena that I have witnessed repeatedly with my clients in this time.
I will give you an example and then discuss them.
Fred was a 95 year old man who was recently admitted to a nursing home. He was referred to me because he had expressed suicidal ideation, specifically he had told the staff that he would swallow his hearing aid batteries. As I was assessing him, towards the end I asked him “What is it about this place that you really don’t like?” He looked at me with shock and with all seriousness said “Have you looked around here? They are all old people”! I asked him then how old he was, he said “95, but I don’t feel my age”.
This example captures the 2 related phenomena that I have pondered for many years.
1. “I don’t feel my age”. This is called Subjective age versus chronological age; and
2. “I’m not like the others here” ie. I don’t identify with old people.
It may or may not come as a surprise that these are both the product of ageism. Firstly we internalise the negative stereotype of old age, and then we go all out to distance ourselves from it. The prospect of being old or being like others who are old is so abhorrent that we master ways to try and avoid it. The research literature calls this “age-group dissociation”. Interestingly, research has found that during the Covid-19 Pandemic, people have felt younger than their chronological age. These findings support the hypothesis that subjective age partly reflects a coping process of psychological distancing from older age, the age group most vulnerable to COVID-19 (Terracciano, 2020).
Psychologist Erik Erickson argued that the Western fear of ageing keeps us from living full lives. He stated, “Lacking a culturally viable ideal of old age, our civilization does not really harbor a concept of the whole of life” (1997, p114).
So what is ageism? The World Health Organisation definition states:-
“Ageism is the stereotyping, prejudice, and discrimination against people on the basis of their age. Ageism is widespread and an insidious practice which has harmful effects on the health and wellbeing of older people. For older people, ageism is an everyday challenge. Overlooked for employment, restricted access to social services, and stereotyped in the media, ageism marginalises and excludes older people in their communities”.
Discrimination occurs in a variety of settings. The literature and experience both tell us it is particularly evident in the workplace and in health care. There are also increasing concerns about the extent of elder abuse in the Australian community, both in institutional and family settings.
Ageism is everywhere, yet it is the most socially “normalized” of any prejudice, and is not widely countered, like racism or sexism.
“According to social representations theory (Moscovici, 1984) the views of ageing held within a given culture are a form of shared cultural representation. They constitute systems of ideas, values, and customs related to ageing that are treated by members of the society as if they were established reality” (Lockenhoff et al 2009).
I would argue that the end result of systemic ageism in our society has led to the parlous state of our aged care system (especially residential aged care facilities). This state of affairs is currently under review by the Royal Commission. The privatisation of service delivery and the commodification of care, within a poorly regulated capitalist and ageist system, results in mass neglect and premature death of older people. The Covid 19 pandemic has shone a spotlight on our vulnerable older population and failing aged care system, with the over 70’s making up 93% of all Covid-19 deaths in Australia. Of the over 70’s that have died, 94% were in residential aged care.
For older people still living at home, the pandemic means they have become more socially isolated as they can no longer attend their usual social activities. For older people in residential aged care, they have lost access to their group activities, volunteer visitors and family visitors during the lockdown. This has led to an increase in mental health problems, particularly depressive disorders.
As discussed, ageism develops from our cultural and societal values; for us this means in the context of capitalism; and we all internalise these cultural and societal values. So, how do we know ageism is driven by society and culture?
“Historically, older people were valued and respected members of society across cultures for their vast knowledge of the culture… Scholars have noted a contemporary shift toward a general devaluing of older persons in modern societies, especially in Western cultures” (Levy & Macdonald, 2016 p. 18)
There are cross-cultural differences in ageing perceptions, and different cultures have different attitudes and practices around ageing and death. These cultural perspectives can have a huge effect on how we experience ageing. We just need to look at different traditional cultures, where the value and treatment of older people varies from ours, for example:-
1. The Tsimane (Chimane) people, an Amazonian indigenous tribe who live in the lowland regions of Bolivia. Research revealed that the Tsimane’ reported more positive aging perceptions than 2 other westernised societies (the U.S. and Poland), especially with regard to memory functioning (Sorokowski, 2017).
2. The Asian cultures of Korea, China and Japan; Where the Confucion principle of filial piety, a fundamental value dictates that one must respect one’s parents. It’s also customary in Korea to have a big celebration to mark an individual’s 60th and 70th birthdays. Interestingly Japan has a lower proportion of Covid-19 deaths (84%) for the over 70s, as compared to Australia.
So, how can we tackle ageism and improve the lives of older people?
- Tackling ageism in this pandemic requires finding the evidence that contravenes the negative stereotypes. We can look for examples that value both the wisdom and personal resilience that comes with old age. Leaders who are older are often deemed wise eg. the USA’s most respected voice in response to Covid-19—comes from Dr. Anthony Fauci, who is 79 years old (Colenda, 2020).
- Research has found that education regarding ageing, and positive contact experiences with older people have been successful in changing negative attitudes. These interventions could include intergenerational experiences with older people, and older people themselves providing education about old age (Levy, 2018). For example as seen in the ABC production “Old Peoples Home for 4 year olds”. Research has also found that greater accurate knowledge of ageing is associated with more positive attitudes towards older people (Levy, 2018).
- We need to help older people to feel useful. Being useful creates value, purpose and meaning. Roles such as child-minding achieve this. Emphasise the things that older people can do better than younger people eg. Find roles such as teaching, advising, supervising. These could be voluntary or paid roles.
- We can encourage older people to contribute their unique experiences of having lived through the great depression and World Wars. They have showed remarkable resilience that we could all learn from.
- Under Covid-19 conditions, tackling ageism is much more difficult, as our older people often struggle to both access and use digital resources, which have become necessary.
Finally, to end with a quote from the chief editor of the Gerontologist “Drawing upon the experience and resources across the life span will build resilience against despair. Our obligations are to steadfastly tackle ageism in all of its forms; and to offer hope, compassion and empathy to those for whom we are responsible”. (Colenda et al 2020).
Australian statistics https://www.health.gov.au/resources/covid-19-deaths-by-age-group-and-sex
Colenda, C., Reynolds, C., Applegate, W., Sloane, P., Zimmerman, S., et al (2020). COVID-19 Pandemic and Ageism: A Call for Humanitarian Care. The Gerontologist, 2020, Vol. 60, No. 6, 987–988.
Erikson, E. (1997). The Life Cycle Completed. Norton and Co, New York.
Levy, S. (2018). Toward reducing ageism: PEACE (Positive Education about Ageing and Contact Experiences) Model. The Gerontologist, Vol 58 (2), 226-232.
Lockenhoff, C. et al. (2009). Perceptions of Aging across 26 Cultures and their Culture-Level
Associates. Psychology of Ageing, Vol 24 (4), 941-954.
Levy, S. R., & Macdonald, J. L. (2016). Progress on Understanding Ageism. Journal of Social Issues, 72(1), 5-25.
Moscovici, S. (1984). The phenomenon of social representations. In: Farr, RM., & Moscovici, S. (editors), Social representations. Cambridge University Press; Cambridge.
Sorokowski, P., Sorokowska, A.,Frackowiak,T., and Löckenhoff, C. (2017). Aging Perceptions in Tsimane’ Amazonian Forager–Farmers Compared With Two Industrialized Societies. Journal of Gerontology: Psychological Sciences, Vol 72 (4), 561–570.
Terracciano, A., et al. (2020). Changes in Subjective Age During COVID-19. Published by Oxford University Press on behalf of The Gerontological Society of America.
Weiss, D. & Kornadt, A. (2018). Age-stereotype and dissociation: Contradictory processes or two sides of the same coin? Current Directions in Psychological Science, Vol 27 (6), 477-484.
World Health Organisation (2016). Ageing and Life-Course. https://www.who.int/ageing/en/
World Health Organisation Definition of Ageism. https://www.who.int/ageing/ageism/en/