It's no secret. COVID-19 has hit older adults the hardest. So far, more than 80% of related deaths in Canada have occurred in facilities for older adults. And almost 80% of deaths linked to COVID-19 in Europe have been in people over 75 years.
Why haven't we better protected this population? Some say the culprit is ageism, pointing out that we protect our pets better than our older adults. There are even those who've proposed that we sacrifice our older population on the altar of the economy. Their thinking follows the line that we can afford to lose our unproductive elders who are costing us money, but we can't afford lock-down.
The terrain is now changing. We've recently seen spikes in cases among young adults. The question is: when will attitudes towards older adults change?
What is ageism?
WHO defines ageism as the stereotyping, prejudice, and discrimination against people on the basis of their age. It ranges from subtle to blatant. Because ageism is so prevalent in daily lives and youth-obsessed society, identifying it can be difficult. It may manifest as the occasional joke or cartoon that pokes fun at older adults. Or it may show up as ignoring or not taking them seriously.
Some of the most blatant examples of ageism occur in senior living settings. As an architect, I worked with many organizations in developing various facilities--from independent living to long-term care. Some clients were comfortable with mixing people of differing care needs in the same building. Others not so much.
I saw a glaring example some years ago when I visited a large CCRC (Continuing Care Retirement Community, now commonly referred to as a Life Plan Community) in Florida. With great pride, the marketing person toured me through the luxurious independent living facility. It was designed according to the hospitality model and felt like a 5-star hotel. I sensed something superficial and even false about it.
At the end of the tour, I inquired about the absence of walkers and wheelchairs. The marketing person responded: "They're not allowed in here. We keep them out of sight. Once a resident needs one, they have to move to a different building." This ploy is quite common, so I've learned, although discrimination-related lawsuits are now underway. It's also common to hear residents complaining about all the old people in their facility.
It seems that ageism is a form of prejudice against ourselves, against our feared future self. Perhaps it's a case of out of sight, out of mind.
Compared to other forms of prejudice and discrimination, ageism is still socially acceptable, strongly institutionalized, largely undetected, and remains unchallenged. Is it any wonder that we fear aging and that older adults develop negative self-views?
The true costs of ageism
Negative self-views among older adults affect their health and well-being. Such views may even shorten their lives. A recent study in the Journal of Personality and Society Psychology suggests that people with positive self-perceptions of aging live 7.5 years longer, and that positive beliefs about and attitudes towards older adults appear to boost their mental health. On the other hand, those with negative self-perceptions are slower to develop dementia and are less likely to recover from a debilitating accident.
A review of studies on ageism involving health care professionals, care workers, and administrators in long-term care facilities is chilling. I was shocked last summer, when a couple of staff told me that, although they liked working in their facility, they would never want to live there. They considered their facility like a palliative hospital where older adults come to die, not to live.
Evidence suggests that if we could change society's views on aging, people would live longer and healthier lives, and likely reduce medical costs to society.
Yet ageism in health care continues. It finds expression in the attitude that patients who are younger and healthier, and can more to society should receive priority. It's a practical response to limited resources. In the bigger scheme of things, older people are considered disposable.
This attitude impacts old adults in major ways. They receive less medical information and fewer services and treatment options. They are excluded from clinical trials. Because the focus is on acute care, they are not given chronic care. They are subject to paternalism and age-based decision-making. They are given less treatment for mental health issues, they are over-medicated. This results in significantly more negative health outcomes.
A personal confession
Today, I am celebrating my 78th birthday. And although I personally haven't faced ageism yet, I wonder if I am perpetuating it. I am often told that I don't look my age, and I enjoy hearing this, maybe a little too much.
Last December, while in Palm Desert, I joined a hiking group. The trail was easy to navigate until we reached the last stretch that required climbing over large rocks to reach a palm oasis at a higher elevation. Most of our group chose not to continue. But one young couple, their teenage daughter, and I proceeded. Clambering over big rocks while carrying my camera was not easy. And while I lagged behind, I made it.
When the couple and their daughter learned my age, they couldn't stop lavishing me with comments like: you're such an inspiration, you must be taking really good care of yourself. I enjoyed this, although I felt a touch guilty about the care part.
Is feeling so good about appearing younger than I really am a form of ageism?
I think it is if I regard adults who look and act older with a sense of superiority and treat them with a lack of compassion. Undoubtedly, I will be in their shoes some day.
We will all experience aging if we live long enough and perhaps ageism as well. As our aging population grows in numbers, ageism threatens to become a global crisis.
How can we change ageism?
We have to start with ourselves. We need to look at our own deep-seated beliefs and fears about aging. We need to identify our own prejudices towards older adults. Then, at a societal level, we need to challenge policies and re-write laws that discriminate against older adults. We also need to educate the public and professionals who care for older adults about the personal and societal cost of ageism.
Most importantly, we need to create multi-care and intergenerational communities that respect people of all ages and abilities.
One of these days, we're all going to grow old and die. Let's embrace aging with courage and recapture our dignity as human beings. To do that, we need to first become aware of ageism--in ourselves, in our institutions, and in our culture. Then we need to disrupt the status quo, to stand against ageism, become ant-ageist, and correct it wherever we find it. At the same time, we need to become pro-active in creating the kinds of communities we want to age in.