Discrimination of the elderly or, ageism, is defined as a form of discrimination which is based on an individual’s age (Hitchings & Day, 2011). The advance in age, the reduction in independence and the limitations in social participation affect society’s views and approaches towards elderly individuals. Due to such attitudes, the elderly are frequently stereotyped and subjected to positive or negative prejudice (Cinar et al., 2018). Ageism and age discrimination may manifest themselves differently in various social, economic, work, health care and cultural contexts but remain widespread, often unrecognized and accepted by the public (Cinar et al., 2018).
Age is considered one of the principal social categories. Therefore, social categorizations based on age are quick and automatic (Brewer & Lui, 1989). Physical attributes such as grey or whitened hair, wrinkled skin, balding, dentures, movement variables and slouched posture all identify elderly people. They are often labelled as senior citizens, elders, seniors, old people, and the elderly (Karel et al., 2012).
As stated by Brewer et al. (1981), society holds stereotypes of subgroups of the elderly rather than a one-size-fits-all stereotype. Schmidt & Boland (1986) reveal that older individuals had more diverse and different stereotypes of elderly whilst younger people had relatively straightforward stereotypes of old people. A study by Hummert et al. (1994) showed that older individuals viewed the stereotypes as less representative of elderly adults than the young participants. However both age groups agreed on the stereotypical images seen in the elderly population. Results also showed that both older and juvenile respondents tended to link negative stereotypes with old age ranges. Combining the two studies by Schmidt and Boland (1986) and Hummert et al. (1994) together, seven typical stereotypes of elderly citizens have become evident.
Healthy, productive, independent, knowledgeable
Age stereotypes are social constructs that are set historically and culturally and also, perceived individually (Dionigi, 2015). Moreover, social and cultural factors such as media, advertisements and television contribute to the portrayal of negative stereotypes of elderly people. Various geriatric meta-analyses show that the elderly are viewed as weak, self-centred, unattractive, worthless, senile, unsuccessful, ill, lonely, depressed and demanding (Fraser et al., 2016). Harwood et al. (1995), revealed that out of 490 leading and supporting characters featured in the 40 most popular television programmes in 1995, only 29 (4%) were older adults. Such results conclude that elderly individuals are underrepresented on television, particularly on shows directed towards younger viewers. Moreover, the featured older characters were predicted to be presented with a disability, an injury or an illness and are portrayed as dependent, unpleasant people with physical and mental limitations. Some positive qualities of older people in television programs include being viewed as mentors, high-profit investors, cherished grandparents and active retired people (Miller et al., 2004).
Old Age Prejudice
Moreover, age discrimination entails prejudicial and emotional reactions to elderly individuals that consequently depicts the ambivalent stereotypes perceived by society (Karel et al., 2012). A study by Fiske et al. (2002) found that the most common emotion felt about elderly people was pity due to possible acknowledged complications they experience such as deterioration of health as well as loss of opportunities. Other negative feelings include anxiety among young people due to the fear and the reminder that becoming old will happen to them eventually and that their youth and beauty will fade away in the future (Greenberg et al., 2002). Younger people may also feel anxiety and threat by the elderly due to the stereotype that older individuals are ill and feeble and thus may carry illnesses which are contagious (Bugental & Hehman, 2007).
Types of ageism
There are different types of categories of ageism. These include personal, institutional, cultural, intentional and unintentional (Sporre, 2019). Personal ageism may be described as practices, prejudicial ideas and attitudes of people that are biased against older people. Examples of this may include gerontophobia and gerontophilia. Institutional ageism refers to rules, missions, practices and policies that discriminate against the elderly most frequently found in workforce or employment. Cultural ageism is defined as social norms and values favouring one sub culture at the expense of the other (Chonody & Teater, 2017). Intentional ageism refers to attitudes, practices and ideas that are executed consciously which are biased against old individuals and take advantage of their vulnerabilities. An example of this are scam artists who take advantage of elderly people and also employers who do not hire older individuals due to their age (Sporre, 2019). Unintentional ageism refers to attitudes, practices and ideas that are carried out without the perpetrator being aware that they are biased against older people. This includes humour, cards and black balloons in birthday parties.
Age Discrimination and Health
As stated by WHO (2016), pessimistic attitudes towards aging and towards the elderly have significant consequences on their physical as well as mental health. Holding negative perceptions of aging may cause poor mental health and elderly people who feel that they are burden perceives their life to be less valuable, and thus are more likely to be diagnosed with depression and become socially isolated. Furthermore, the effects of widespread negative views towards elderly people may ultimately lead to a higher mortality risk, a decrease in functional health and slower recovery rates from illnesses (Burnes et al., 2019). Results from the study carried out by WHO revealed that people who hold negative views about their own aging process live approximately 7.5 years less than those individuals with a more positive attitude. Anxiety and alcohol abuse may also be other psychological effects caused by age discrimination (Vogt Yuan, 2007).
Another way in which ageism may result in poor health outcomes is by engaging in risky behaviours such as consuming alcohol, poor diet smoking and physical inactivity (Jackson et al., 2019). These behaviours may act as coping mechanisms whenever elderly people experience discrimination and may provide short-term comfort or relief from the psychological distress caused by age discrimination. Elderly people may avoid going to gyms due to this stigma and therefore acts as an obstacle to a healthy lifestyle.
Ageism also promotes exclusion of the elderly in society from their meaningful roles, relationships and functional occupations (Jackson et al., 2019). Age-based prejudices results in institutional norms that are held on stereotypical beliefs, limiting the engagement and participation of the elderly. Furthermore, discriminatory attitudes inhibit the development of appropriate health policies that may be advantageous and beneficial for older adults.
Discrimination in health-care and employment
Ageist attitudes among health care practitioners and professionals may lead to discriminatory events that place elderly adults at a greater risk in their health (Jackson et al., 2019). Such age-related discriminatory actions can be observed in the way clinical workers communicate with elderly patients as well as in the quality of care the older patients receive when compared to younger and more juvenile patients. In a study by Greene et al. (1986), it was revealed that widespread negative attitudes towards old patients were evident among nurses, medical students and also physicians which may cause severe consequences such as creating false assumptions, misinformation and exclusion from clinical trials. Mental health practitioners also assumed that depression and other mental illnesses were considered as “normal” for their old age and restricted access to treatments.
Older patients diagnosed with cancer and other chronic conditions such as pulmonary disease or diabetes were also less likely to receive treatment when compared to younger patients with the exact same or similar illnesses and conditions (Jackson et al., 2019). This is due to the fact that health professionals highlight more importance to treating younger patients first. Studies have also proven that facilities designed for the elderly are more likely to be of basic standards and more likely to be understaffed (Levy et al., 2002). Younger patients are also predicted to be more inclined to receive aggressive treatment in ICU and screenings for cancers such as breast cancer are targeted more for younger individuals even though elderly women may also have the risk. Medication is also tested on younger individuals therefore may cause different side effects for senior citizens. Thus, discrimination of older people among health care professionals have a substantial impact on the quality of care that older patients receive which in turn may result to poor health outcomes (Wyman et al., 2018).
Ageism can also be difficult for elderly people in the workplace. Older workers are often believed to have a lack of mental capacities and physical skills (Karel et al., 2012). Many companies in fact have mandatory retirement ages so as to push people into retirement regardless of their capability to pursue their career. Even though older workers are often assumed to be difficult to train and being physically incapable, younger individuals despite their lack of experience are still given more preference when in need of hiring new employees (Morgeson et al., 2008). As a result of this, older people struggle to apply for jobs and spend much longer applying to get an interview.
In conclusion, discrimination of the elderly leads to many negative consequences for elderly people such as poor health, decrease in quality of life, unemployment, physical and psychological effects. Developing effective interventions to reduce ageism and discrimination should therefore be a priority when working in healthcare settings to promote positive health behaviours, wellbeing and ensure an increased quality of life for all patients.
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