AGEISM, HEALTH CARE AND POLICY PERSPECTIVE: PRATICAL STEPS TO IMPROVE HEALTH CARE FOR OLD PEOPLE.
“A woman in her fifties was getting changed in the locker room of the local YMCA, when her friend’s 26-year-old daughter entered the changing area. “What are you doing here?” the younger woman asked with surprise. “Well, the same thing you are” was the reply” (Cousins 2005).
The field of gerontology has attracted series of research, various arguments have emerged in the course of this; arguments about the attitudes of proponents of ageism, ageism as a socio-cultural construct, ageism as a psychological construct, ageism as determined by health status, ageism as a tool of racism or gender marginalization.
Professional literatures have however depicted ageism as a dependent on attitudes and knowledge of health and social workers. (Kane 2002).
The concept of Ageism is therefore prone to prejudice, elderly people are victims of discrimination in the process of seeking health care, seeking for a job and many are forced to retire from service thereby creating stereotypes of mental acuity and competence. (Martens et al 2004). In fact some ageist have justified that the aged are not more deserving attention and useful to the society in comparison to the young at heart and body, such assumptions are put to practice when resources for treatments are scarce. (Kane 2002)
Perceptions of health and social practitioners towards ageism however depends on their idiosyncrasy, personal experiences, socio-cultural background, religious affiliation to mention bit a few factors.
The foregoing creates a mental picture of in- group and out –group schism in the society and the globe at large. Elders in the context of this paper are therefore perceived as out-group due to the stereotyping and prejudice meted to them by health and social care officials.
The paper therefore seeks to demystify the concept of ageism and adopt a theoretical framework to explain the prejudice and stereotyping associated with old age, the paper would also examine policy areas and practices of health care delivery to the aged. The paper would from the theoretical position argue for methods and ways of reducing the stigma attached to being old or aged; drawing from the wealth of empirical studies the paper therefore seeks to clarify and demystify the contending issues associated with ageism and submit crucial ways of reducing the tide in the globe.
Culled from The Anti-Ageism Taskforce at The International Longevity Center.
CONCEPTUAL CLARIFICATION AND THEORETICAL FRAMEWORK
Having disclosed the prejudice associated to ageism in the beginning of the research, it is worthwhile to demystify the concept itself. Ageism as a concept has undergone several literature submissions and research. Ageism was first used in the United States by Butler.(Bytheway & Johnson 1990) Ageism is enshrined within institutions with de facto discrimination in the workplace, health care, language and the mass media.(The Anti-Ageism Taskforce) Ageism is a social attitude, constructed in such a way to discriminate the elderly ones just as people of different races and nations are stereotyped for either been a cheat, smart, lazy or easy going. (Canada Network for the Prevention of Elder Abuse). Butler however gave an all encompassing meaning of the term when he submitted that “ageism can be perceived as a systematic stereotyping of and discrimination due to old age, just as racism and sexism makes use of skin colour and gender to define boundaries. Old people are categorized as rigid in thought and manner, fragile, old fashioned.” (Butler 1999, p139).
Ageism could also take the form of stereotyping older people as frail, disabled which might be enforced by myths and culture.
Bytheway and Johnson further opined that the most prevalent way of defining ageism is through expressions such as sexism and racism, the distinction is in terms of variables you identify with each of the terms, for instance sexism is associated with gender, racism is associated with ethnicity and ageism is associated to age.
Ageism is also the transformation of the human organism that makes the probability of survival reduced.
Flowing from the foregoing is a fact that ageism is a socio-cultural and psychological construct.
In order to deal with the complexity of the discussion, the paper therefore takes a theoretical step to explain the imminent stereotyping related to ageism; the in-group and out group feelings and the old age psyche.
The characteristics of ageism are more related to sexism, discrimination and prejudice. In the light of this it shows that a sense of identity is formed, in the process stigmatizing the members of the out-group. (Aged people) The question remains why then does this prejudice and discrimination persists. In view of the foregoing I would apply two theories that firmly explain the rationale behind the whole tide. The terror management theory and the Social Identity theory would be used in analysing the impact of ageism on the elderly ones.
The Terror management theory (TMT) posits that the inevitability of death acts as a terror to human value and existence and as such a construction of cultural worldview to convince that human beings are not vulnerable to complete annihilation is created to add meaning to life. (Martens et al 2004).
TMT and other researches on mortality submit that ageism exists due to the fact that elderly people are associated with imminent loss and death. Social exclusion and distancing behaviours therefore serve as a crucial product of ageism. (Dozois 2006)
Social Identity Theory however posits a person has not one self but several selves that correspond to elongating the circles of group membership. The theory however asserts that group membership creates in-group self –categorization which further favours the in-group at the expense of the out-group. After categorization individuals or groups seeks the supremacy of their in-group uniqueness through some valued dimension.(University of Twente,TCW) This can be likened to the distribution of public goods in a club mode. The out-group is always left out and discriminated against.
Group identity is used to maintain positive self identity which leads to in-group and out-group schism. The impact of identity formation and the division that flows from it would be the next subject of discussion.
THE EFFECTS OF THE OUT-GROUP PHENOMENON: AGEISM IN REVIEW
The human drive to the issue of mortality paves way for people to perceive elderly people threatening because they serve as reminders of the inevitability of death. Theorizing and researching has disclosed that distancing or disparage of the elderly is a consistent phenomenon due to the qualities of been old. (Martens et al 2004)
From the foregoing stems a need to reassess the effects of ageism on older people. The imminent use of stereotypes underlies the general scope of this section. Ageism is the composite of these generalizations which makes use of beliefs and attitudes mainly associated with age as the most important variable. The belief or attitudinal system however paves way for positive or negative stereotypes. ((Dozois 2006)
A division of the different impacts associated with ageism is divided into several factors such as, the Sociological factor, the physical factor, the emotional factors, Cognitive factors. (Grant 1996)
Dozois (2006) disclosed that negative stereotypes associated with elderly people are; illness, impotency, ugliness, mental decline, mental illness, uselessness, isolation, poverty, depression.
The aforementioned are mainly associated with older women than men. The first impact ageism has a concept and practice has established is the sociological perception which paves way for isolation of the elderly. A survey of 84 people within the age range of 60 and above disclosed that almost 80percent of the respondents experiencing ageism had memory or physical impairments due to their age. (Dittmann 2003)
The 2001 survey by Duke University’s Erdman Palmore further confirms the societal and print media construct, the most frequent type of ageism reported by 58 percent of respondents was a joke against the elderly. The survey however states that 31 percent were ignored or not taking serious due to their age. (ibid Dittmann)