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Ageism in Healthcare: a Canadian Perspective (Part 1)

1/26/2021

 
In this extensive piece, beautifully written by our latest addition to the Education team, Olivia Earl discusses age-based discrimination. In the first part of this series, she introduces us to the definition of discrimination and stereotypes. Ageism has broad implications in various parts of society. At the end, she's sharing resources that can help you engage in learning about ageism. 

Written by Olivia Earl
Picture

What is Ageism?

“My area of expertise is grant-writing for NGOs. As the funding for NGOs in my country got squeezed, I lost my job. I quickly found that with being older, people don’t call me for an interview. When contacted personally or over the phone, a few recruiters have directly said: ‘We don’t call back old people.’”
 Sirajul Islam. 

“In my mid-60s I was forcibly retired by a London council – this was legal at the time. I had an excellent record both of attendance (no sick days for five years) and competence. I was assured by my union that a letter of support from my line manager was all that was required to win my appeal – but my manager refused. I was sacked and I have never really recovered from the sense of being thrown on the scrap heap” 
Anonymous teaching adviser
Such stories are common among people who experience ageism, the stereotyping and discrimination of older adults because of their age. Stereotypes used against older adults, as well as other forms of age based discrimination can be systemically developed and perpetuated in our society. One reason damaging stereotypes and age based discrimination has become consistently present in our society is because of the negative portrayal of aging and older adults that exist in media, medicine, and other aspects of living. This negative portrayal includes perpetuating the idea that older adults are less creative, flexible, adaptable, incompetent, and that older adults are likely to be dependent on others for survival. 

Think about what type of advertisements you see older adults in. What is the first thing that comes to mind? I see older adults in medication commercials, fall- risk commercials, or other commercials depicting older adults as medically fragile. Seeing older adults portrayed in this light supports the narrative that centers older adults with illness, disease and dependency. 

Another penny for your thoughts: how do you see older adults portrayed in the media relative to beauty standards? Immediately, I associate beauty products of “anti aging” properties, or that aging is bad, and signs of aging must be slowed so people can stay “youthful” and “beautiful”. 

Overall, society doesn't typically see older adults being portrayed as people living life independently, healthy, and simply enjoying life. It almost seems as if older adults seem to be used as a cautionary tale: take care of your health or you could be isolated and sick. However, it's time that our society recognizes that aging is something we should not fear. The fact is, aging is a privilege that many people are not fortunate to experience, and we should critically think about how the portrayal of aging impacts our perception of it. 

Most people can agree that ageism is present in Canadian society. However, many people are not aware of how negative portrayals of aging impact older adults experiences, or how else older adults are impacted by ageism. To help people understand more about ageism, we will provive information on some different types of ageism, different types of ageist stereotypes, a sex and gender based anaylsis of ageism, as well as how ageism exists in media and in workplaces.
Screenshot from L'Oreal's Beauty Magazine Post showing the title
A "Beauty Routine" by L'Oreal detailing numerous products to avoid wrinkles and other signs of natural aging.

What Are Some Types of Ageism?

While there are different types of ageism that exist in our society,  the two that will be discussed below are compassionate ageism and new ageism.

Compassionate ageism, despite the name, still has negative impacts on how society perceives older adults. Compassionate ageism depicts older adults as weak and vulnerable; a group of individuals who are dependent on others to survive. This perception of older adults may elicit feelings of compassion from the younger population, a feeling of needing to assist older adults because younger generations feel pity for them and believe they cannot function on their own. This is where it becomes ageism, and why it presents an issue.

​Compassionate ageism stereotypes anyone, typically over the age of 60, into a cohort that “deserve” help because they are thought to be unable to take care of themselves. This stereotype is reinforced when society uses terms such as “elderly” or “the aged”, or depicts seniors as medically fragile in the media or in medicine. It is important to recognize how even though acts of “kindness” from younger generations, towards older individuals, can be harmful as they develop from compassionate ageism. For example, helping behaviours from younger generations can come across as patronizing to older adults. These helping behaviours may come from a place that immediately assumes older adults are incapable to perform certain actions, with little to no regard to if the older adult needs or even wants help. This is not the same as asking an older adult if they would like help with something- it’s assuming they need help, and proceeding to do it without their consent. These types of “helpful” acts in our society reinforce the higher social positions of youth when compared to older adults.  
​
Here is another thought: people typically reach the age where they are considered older adults or “seniors” around the age of 55 and above. Why do we, as a society, group together individuals who are 55 years old, to as old as 100 years? We do not find this done, to this degree, with any other age group. This grouping of  adults allows society to stereotype and dismiss a large proportion of people with multiple stereotypes such as being dependent and incompetent. Unfortunately, this stereotyping of such a large population contributes heavily to the compassionate ageism that older adults experience from younger generations. 

Another type of ageism that exists by stereotyping and discriminating against older adults is coined as new ageism. However, compared to compassionate ageism, new ageism has disguised itself as part of a healthy life for older adults. New ageism is thought to have developed because of the discourse that surrounds “healthy” and “positive aging” for older adults. “Positive Aging” has been defined as “successful aging”, or aging while still continuing to be “productive” and staying “healthy”. In this instance, being productive refers to the older adult's ability to contribute to their society's economy and their community. Being healthy, is then defined as being free of illnesses and disease, while also maintaining high functioning cognitive and physical capabilities. 

These ideals that new ageism, positive aging and healthy aging, propose for older adults in order to be seen as healthy, while not impossible, can create unattainable standards for individuals. The ideas of “positive” and “healthy” aging depict aging in one way, and aging that deviates from that immediately becomes unhealthy and negative. For example, New Ageism would suggest that to engage in  “positive aging”, older adults need to find an encore career, or volunteer in their community and continue to be “productive”. If older adults are not able to do those, or simply do not want to, they may be stereotyped as being unhealthy or negative for not reaching the standard of “health” that new ageism perpetuates. Furthermore, it suggests that as soon as older adults have any sort of injury or illness, they can no longer be living a positive or overall healthy life.

This contradicts research supported definitions of what it means to be healthy, such as the definition proposed by the World Health Organization: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Considering that a state of being healthy can be incredibly complex and that there are many factors that influence an individual being healthy, the discourse that surrounds new ageism has created harmful ideas for older adults that healthiness is achieved only one way. 

Compassionate and new ageism, while stemming from very different discourses, present two harmful ways that ageism exists to discriminate against and negatively impact older adults. Along with these types of discrimination, ageist stereotypes are used in Canadian society and negatively influence society’s perception of older adults. Below will discuss multiple ageist stereotypes that exist in today’s society that negatively impact the older adult population in Canada. ​
Older adult on wheelchair holding supporters hand on shoulder
Via Getty Images

What Are Some Stereotypes About Older Adults?

Research has demonstrated that there are multiple stereotypes that older adults face due to ageism. These stereotypes range in how they depict older adults: some depict older adults as depedent and incompetent, such as the ideas we see presented in compassionate ageism. Other stereotypes depict older adults as being unreasonably positive and healthy, which fits into the discourse of new ageism. Each of these seven identified stereotypes have their own associated traits that are the most prevalent in society. These stereotypes and their associated traits are: 
​
  1. Despondent: neglected, sad, afraid, lonely 
  2. Severely Impaired: feeble, slow thinking, senile 
  3. Shrew/ Curmudgeon: ill-tempered, complaining, prejudiced, stubborn, nosy 
  4. Recluse: quiet, timid, live in the past, set in their ways
  5. John Wayne Conservative: proud, patriotic, wealthy, conservative, religious 
  6. Perfect Grandparents: kind, generous, family oriented, wise
  7. Golden Ager: intelligent, productive, healthy, independent 

Each stereotype presents its own issues for older adults: whether creating a narrative where they are incapable and incompetent, or presenting only one way to be a thriving older adult. When we fall victim to stereotyping older adults, it takes away from the identity of the older adult, and emphasizes their ability to function in society, contributing to the dehumanization of the older Canadian population. ​

How Does Ageism Impact Older Adults:  A Sex and Gender Based Analysis ​

When addressing ageism, it is important to recognize that all older adults may experience ageism regardless of their sex or gender identity: however, a cis gendered man may experience ageism differently than a trans man, non binary individual, trans woman or cis gendered woman. For example, older women tend to be faced with a “double jeopardy” situation as they age; many women already face sexism that impacts their ability to function in society, and ageism perpetuates the discrimination they face. In workplaces, thoughts may develop in women’s colleagues that older women are incompetent because of both their age and gender, and therefore will not contribute significantly to their work environment. Compared to other groups of people in workplaces, older women are more likely to be perceived less competent than older men and younger women in their workplace as a result of this double jeopardy.

​Furthermore, in work environments, older men may be appreciated and receive more prestige for their efforts more so than women who accomplish the same task. In addition, in different environments, women tend to be more admired for their physical appearance than the contributions they make (e.g. work environment, volunteer environment, within their community). While this is an issue on its own, it is worsened for older women as aging in our society is perceived poorly. Since so much pressure and value is placed on women’s attractiveness in all aspects of their lives, as women get older, they may experience shame towards their age and their physical appearance. Unfortunately, this can lead to older women believing they are less than compared to their male counterparts of the same age or those who are younger. 
​
It is apparent that older women face many disadvantages as they age both due to their gender identity, and their age. However, older men may actually benefit from aging and how their coworkers perceive them.  Older men may be perceived as sexy and desirable as they age, especially if they hold positions of power in their occupations or other areas of their life.

​Think of the idea of a “Silver Fox''. Merriam Webster Dictionary acknowledges that utilizing the term fox is important in this context. The word fox is associated with cleverness and attractiveness, and silver typically refers to having grey, silver or white hair- a typical sign of aging in individuals. Compare this term to the term that can be utilized to describe older women: cougar. The term cougar does not have the same positive connotation that silver fox does. But how are these terms related to ageism? As previously mentioned, women face more scrutiny and judgement than men do as they age, especially when regarding their competence and physical appearance. While the term ‘silver fox’ alludes to the fact that older men are attractive, desirable and intelligent, the term ‘cougar’ focuses on the sexual prowess of an older women and with whom she prefers to have a relationship or engage in sex with. The usage of these terms, and the connotations that come along with it, demonstrate how men and women are perceived differently because of their gender as they age. ​
Image shows an older couple embracing
Via Getty Images

Ageism in the Media ​

Negative perceptions of older adults are significantly perpetuated through the use of media in today's society. This media  representation of older adults appears to occur through multiple forms: such as movies, television, print media, and even advertisements. Media is used as a tool to demonstrate social norms, current trends and patterns in society among other topics, which is why it can be so influential with society beliefs and expectations for older adults.  Especially on such a broad scale, the media's portrayal of people becomes highly influential.
​ 
Marier and Revelli  (2016) found that when looking at the limited media portrayal that exists for older adults, it appears that the majority shows and movies with representation depict them as dependent and incompetent. This is supported by research from the University of Southern California Inclusion Initiative, which found that in the top 100 grossing movies of 2016, 57% had leading characters portrayed by those 60+. However, 44% of those films engaged in ageist concepts throughout the film: portraying older adults as grumpy, incompetent, despondent, as well as portraying them as constantly medically fragile and unhealthy. As people begin to consume media from such a young age, these stereotypes begin to impact their perceptions of older adults in their everyday life, and thus they live their life with an ageist point of view.

​Another study that analyzed 1000 photos used by American brands and corporations to advertise their products found that only 15% of the photos included older adults. This is despite the fact that older adults (over the age of 50 in this instance), make up nearly half of America’s population. Even worse, when older adults were included in these photos, 28% of those photos were presented negatively. These negative photos included ones trying to evoke feelings of isolation and dependence, similar to how a majority of movies and tv shows present older adults. This portrayal of older adults in the media continues to present ageist beliefs to the consumers- and in the end, older adults are the ones who get harmed by these beliefs.
The fact is, aging is a privilege that many people are not fortunate to experience

Ageism in the Workforce

Ageism is prevalent not only in the media that we consume, but also in hiring and working practices in the workforce. Both obtaining and maintaining employment as an older adult can be complicated by ageist beliefs and practices, which can negatively impact an older adult's income, perceived sense of self, and health. Research has shown that work place discrimination against older adults occurs through hiring practicies, as well as the type of training and promotion they receive, and maintaining employment. Older adults are less likely to get hired after losing a job than compared to their younger counterparts, and this is thought to be because of ageist beliefs against older populations. 
​
Ageism also impacts society's perceptions of how capable older adults are, questioning their competency and abilities to perform tasks related to jobs. This can include believing that older adults are less competent than workers who are younger than them, that they aren’t as creative and won’t be as effective at problem solving.

What employers are worried about in this situation is an older adult's crystalized intelligence. Crystallized intelligence is the knowledge that humans develop throughout their life. Knowledge, such as facts and skills, are learned from the experiences we have, and we can pull from this information and apply it to situations we have in the present and the future. For example, this may be why someone older than you, like your grandparents, has an easier time doing a crossword puzzle. Research has shown that generally, adults who are older have higher levels of crystallized intelligence than their younger counterparts. This is thought to be because it is likely the older you are, the more variety of experiences you have had, and that you have learned from those experiences and can apply that knowledge to your present and future situations.

Interestingly, in a meta analysis study that utilized over 400 primary studies, crystallized intelligence measures actually better predicted performance in work and educational settings than fluid intelligence measures. This demonstrates how experience accumulated over time can be a powerful influence on how an individual performs in employment environments. Thus, when employers utilize fluid intelligence measures for selecting candidates for work, they may unintentionally be overlooking older adults who may not score as well on those tests. 
​
Despite the fact that crystallized intelligence can positively impact an individual's ability to perform in an employment setting, older adults are routinely looked over in the workforce. It is time that society acknowledges the points of view, skills and experiences that older adults have to present.

So, What Now?  

Older adults work, travel, love, and live fulfilling lives: and it shouldn’t be up to them to have to educate younger generations on this fact. We as a society need to continue to educate ourselves on the matter of ageism, and we need to support older adults in continuing to live beautiful lives. Aging is a privilege; and it's time that we start appreciating it, and older people, for what they have experienced and the wonderful people they are. 

If you would like to learn more, some resources have been provided below to help you continue your understanding of ageism, aging, and older populations! Some of these resources tackle similar issues discussed, others perhaps are open to your thoughts and evaluations. Be on the lookout for the second part in our ageism series- Ageism in Healthcare: A Canadian Perspective.
Resources: 
Understanding Age Stereotypes and Ageism [Book Chapter]

Aging Isn't A Curse. But Ageism Is A Serious Global Problem [Youtube ~ 4 min total]

Ageing and Ageism [Article by WHO]

Millennials Show Us What ‘Old’ Looks like: Disrupt Aging [Youtube - 4 min total]

Age and Aging: Crash Course Sociology #36 [Educational Video - 10 min total]

Life Lessons from 100 Year Olds [Youtube - 14 min]

I love life: Oldest Living Olympic Champion Turns 100 [Article]

Books and Media to Check Out! 
The Silvering Screen: Old Age and Disability in Cinema [can purchase on Amazon] 
Vision of Aging: Images of the Elderly in Film [can purchase on Amazon]
Letterboard Collection 
This letterboard collection of movies was specifically created to showcase movie titles that have 55+ lead characters that are multidimensional 
  • Back When We Were Grownups (2004) 
  • Harry and Tonto (1974) 
  • Quartet (2012) 
Living In LGBT-Friendly Senior Housing: “We Live Like Neighbors. And That’s A Good Thing.” [Youtube - 6 min total]
LGBT Seniors Tell Their Stories- LA LGBT Center [Youtube - 11 min total]
Edited by Saloni Gupta

References

Binstock, R. (1985). The Oldest Old: A Fresh Perspective or Compassionate Ageism Revisited? Milbank Memorial Fund Quarterly. Health and Society, 63(2), 420–451. https://doi.org/10.2307/3349887

Cherry, K. (2019, December 07). What Are Fluid Intelligence and Crystallized Intelligence? Retrieved January 08, 2021, from
https://www.verywellmind.com/fluid-intelligence-vs-crystallized-intelligence-2795004

Collins, L. (2019, September 25). Ageism is costing this country billions. Here's how. Retrieved January 08, 2021, from https://www.deseret.com/indepth/2019/9/24/20880106/elderly-media-portrayal-ageism-us-economy-aarp

Deanna Vervaecke, BSc (Hons), Brad A Meisner, PhD, Caremongering and Assumptions of Need: The Spread of Compassionate Ageism During COVID-19, The Gerontologist, gnaa131, https://doi.org/10.1093/geront/gnaa131

Hurd-Clarke, K. (2016). “I know it exists … but I haven”t experienced it personally’: older Canadian men’s perceptions of ageism as a distant social problem. Ageing and Society, 36(8), 1757–1773. https://doi.org/10.1017/S0144686X15000689

Horn, J., Cattell, R. (1967). Age differences in fluid and crystallized intelligence. Acta Psychologica, 26(2), 107–129. https://doi.org/10.1016/0001-6918(67)90011-X

Krekula, C. (2007). The Intersection of Age and Gender: Reworking Gender Theory and Social Gerontology. Current Sociology, 55(2), 155–171. https://doi.org/10.1177/0011392107073299

Marier, P., & Revelli, M. (2016). Compassionate Canadians and conflictual Americans? Portrayals of ageism in liberal and conservative media. Ageing and Society, 37(8), 1632-1653. doi:10.1017/s0144686x16000544

Merriam- Webster. (n.d.). Cougar. Retrieved January 08, 2021, from https://www.merriam-webster.com/dictionary/cougar

Merriam-Webster. (n.d.). What's a 'Silver Fox'? Retrieved January 08, 2021, from https://www.merriam-webster.com/words-at-play/whats-a-silver-fox

North, M. S., & Fiske, S. T. (2012). An inconvenienced youth? Ageism and its potential intergenerational roots. Psychological Bulletin, 138(5), 982. http://dx.doi.org.proxy.bib.uottawa.ca/10.1037/a0027843
https://www.sagepub.com/sites/default/files/upm-binaries/50361_ch_9.pdf

Satter, M. (2018, January 25). Movies' ageism can actually cause harm. Retrieved January 17, 2021, from https://www.benefitspro.com/2018/01/25/movies-ageism-can-actually-cause-harm/?slreturn=20210014181024
Schmidt, D. F., & Boland, S. M. (1986). Structure of perceptions of older adults: Evidence for multiple stereotypes. Psychology and Aging, 1(3), 255–260.

Seagger, C. (2017, April 28). 'I kept thinking: What is wrong with me?' – your experiences of ageism. Retrieved January 08, 2021, from https://www.theguardian.com/careers/2017/apr/28/i-kept-thinking-what-is-wrong-with-me-your-experiences-of-ageism
​

World Health Organization. (n.d.). Constitution. Retrieved January 17, 2021, from https://www.who.int/about/who-we-are/constitution

https://ir.uiowa.edu/cgi/viewcontent.cgi?article=2639&context=etd

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