The answer, in my opinion, is yes. Ageism may not be a fun subject, mostly because it is damaging to nearly everyone, no matter our age. But it is a serious issue and concern for older adults, especially those who are living in elder care communities.
The good thing about it is that since we all have the potential to experience it, we can all work to dismantle it.
What’s more, as someone who has been writing about, and for, elder care providers for more than 21 years, I believe that most everyone who works in this space has nothing but reverence for older people, and they certainly want to advocate for the residents and clients they serve.
So if we all love elders and want nothing but the best for people who need the assistance offered by aging services providers, then why should they address it purposefully within their own buildings and in their surrounding communities? There are several good answers to this question.
We Are All Ageist
It’s important to acknowledge up front that we, as older adults, are likely more ageist than people who are younger, simply because we have lived our lives internalizing media and marketing messages that advance damaging stereotypes about being older.
This makes us more likely to say ageist things (i.e. “I’m having a senior moment” or “I’m too old to do that.”), do ageist things, and even think ageist things about others. This is not meant as an indictment of the human race, but rather an acknowledgment that we are all, more or less, in this together.
Accepting this reality is an important step in recognizing how this affects the older people around us, especially those who live in nursing homes and assisted living communities. Recognition leads to awareness and awareness, ideally, leads to change.
Elderspeak is Harmful
People who work in aging services are also susceptible to internalizing ageist stereotypes. This can take the form of what can best be called elderspeak. According to research published in Innovation in Aging, “elderspeak is generally perceived as patronizing by older adults, and its speakers are perceived as less respectful. In persons living with dementia, elderspeak also increases the probability of resistiveness to care,” which can correlate with expressions of unmet needs, the study also found.
Another study, from the Journal of Gerontological Nursing, examined transcripts of 80 video recordings of staff and resident communication collected during nursing home care activities to identify specific elderspeak patterns, including diminutives, collective pronouns, tag questions, and reflectives. The results revealed that nursing home staff used elderspeak in 84 percent of the transcripts during bathing, dressing, oral care, and other activities.
Anyone who worked in a nursing home or assisted living community during the pandemic can likely attest to the frustration of feeling like the government left them behind in some way–either because they were not prioritized for testing or for PPE. What’s more, the lockdowns that left residents isolated and lonely were devastating for staff as well. In my opinion, the restrictions put in place for lockdowns were forms of ageism because they, in essence, marginalized and infantilized older people.
I presented a session on ageism during the recent annual conference of The Society for Post-Acute and Long-Term Care Medicine, where physicians recalled incidences of ageism during the past two years. In one example, a doctor said that when he attempted to transfer some residents to the hospital for COVID-19 treatment, they were told those residents would be, in essence, triaged for care because of their age and acuity level. He recognized this as being ageist and he ultimately realized those residents ended up with better care by staying in the nursing home.
When I posited during the session that the medical and institutionalized model of nursing home care is ageist, some agreed wholeheartedly, while others did not. I do believe that residents who are forced to live in rooms where space is shared among two, three, and sometimes four people, and where rigid dining and bathing schedules are applied to everyone, is ageist.
In fact, shared rooms and little access to the outdoors were among the key factors that led to the spread of the virus, thus contributing to the deaths of more than 200,000 people who live and work in long-term care (as of Jan. 30, 2022). I can think of few other things that should motivate our field, and society as whole, to contemplate how this happened and how it must be changed.
In addition, a key principle of person-centered care is honoring elders and their choices. That, to me, is also anti-ageist. Providers that incorporate such efforts into their culture are, ultimately, honoring choices, promoting independence, and contributing to high-quality care.
There are ways for elder care providers to tackle and confront ageism that entails creativity, fun, and something known as artistic activism. Artistic activism combines the creative power of the arts to move us emotionally with the strategic planning of activism necessary to bring about social change.
In short, it is about taking art and creativity and using it (in this case) to raise awareness of, and tackle, ageism. For providers, this can be anything from integrating it into activities programming to creating and placing an interactive art installation in the lobby.
Both of these things are now being done in senior living settings through Art Against Ageism, a nonprofit alliance of creatives and advocates that identifies, amplifies, and creates art that confronts and tackles ageism. Check out what we are doing with a Baltimore-based aging services provider, here.
We would love to work with other providers to help them incorporate art and creativity that raises awareness of ageism while advancing positive perceptions of aging and older adults.