had been made to sleep in soiled bedclothes. It was estimated that there had been up to a million such incidents in recent years. Though there may be surgeries or operations with high survival rates that might cure their condition, older patients are less likely than younger patients to receive all the necessary treatments. It has been suggested that this is because doctors fear their older patients are not physically strong enough to tolerate the curative treatments and are more likely to have complications during surgery that may end in mortality. The approach to the treatment of older people is often concentrated on managing the disease, rather than preventing or curing it. Thousands are discharged from hospital too early.
Some sources suggest that ageism in the healthcare system starts in the medical schools where young people—who, of course, will never themselves be old—begin their education. Only 10 per cent of medical schools in the United States require courses in geriatrics and less than 3 per cent of physicians ever take any courses in this area. In the UK there are some medical schools that do not teach geriatric medicine. When actually interacting with older patients on the job, doctors sometimes view them with disgust and describe them in negative ways, such as ‘depressing’ or ‘crazy’. For screening procedures, elderly people are a bit less likely than younger people to be screened for cancers and so less likely to be diagnosed at early stages of their conditions.
Outside the healthcare system, Help the Aged reported that older people routinely tell them that they feel ignored and undervalued by their local communities. There needs to be much more energy and determination to reach those who are seldom heard‚ for example isolated older people and those living in poverty. By contrast, fortunately, many very old people are sustained by love and care of family and friends.
Some forms of ageism are described as ‘benevolent prejudice’ because the tendency to pity is linked to seeing older people as ‘friendly’ but ‘incompetent’. This is similar to the prejudice most often directed against women and disabled people. Age Concern’s survey revealed strong evidence of ‘benevolent prejudice’. The warmth felt towards older people means there is often public acceptance that they are deserving of preferential treatment —for example, concessionary travel. But the perception of incompetence means older people can also be seen as ‘not up to the job’ or ‘a menace on the roads’ when there is no evidence to support this. Benevolent prejudice also leads to assumptions that it is ‘natural’ for older people to have lower expectations, reduced choice and control, and less account taken of their views.
When older people forget someone’s name, they are viewed as senile, but when a younger person fails to recall a name, we usually call that a faulty memory. A newspaper recently reported that the actress Keira Knightley was having something akin to a ‘senior moment’ as she came off a plane from London, due to the seven-hour flight and a five-hour time difference. She had just forgotten something, but this phrase is a mild example of ageism. Use of the term implies that she was suffering from one of the problems that afflict the elderly. I am all too well aware of them. But the young also forget things.
When an older person complains about life or a particular incident, they are called cranky and difficult, while a younger person may just be seen as being critical. It is quite widely assumed that older people might not want the sorts of life chances that younger people have and so it is ‘natural’ for older people to have lower expectations, and less account is taken of their views. Fortunately, as we have also seen, older people are further stereotyped as moral and admirable, and an overwhelming majority of people agree that they should be valued and cherished. But although most people think older people should definitely have equal access to health and care, this is often not the reality.
One way that implicit or explicit ageism may manifest itself is through the use of patronising language with older people. There are many ageist articles in the media, often presenting the elderly as a burden on younger people in families and society at large. Critical analyses have suggested that both negative and positive newspaper portrayals of old people may be ageist.
Negative stereotypes of older people range from the hostile image of a ‘cantankerous old codger’ to less explicit images. Not uncommon ageist terms inlude ‘old fogey’, ‘old fart’, ‘geezer’, and ‘old goat’; even the word ‘old’ itself is often used as an insult. Elderspeak refers to a way of communicating with the elderly—it is simplified language with exaggerated pitch and intonation. This can be based on beliefs about the elderly and personal experience.
The term ‘patronising language’ specifically describes two negative methods of communication: the person being unnecessarily courteous and speaking simple and short sentences loudly and slowly to an older person, with an exaggerated tone and high pitch; and baby talk, which involves the exaggerated pitch and tone that one uses when talking to a baby. Both these ways of talking have negative effects on the elderly. Anti-ageism activists in the US have strongly argued against the use by journalists of terms such as ‘elderly’, ‘fogey’ or ‘codger’—and even ‘senior’. They recommend the avoidance of phrases such as ‘of a certain age’, and ‘old ladies’ of both the ‘little’ and ‘sweet’ variety. The advice is included in a media guide on reporting issued by the International Longevity Center and Aging Services of California.
In this guide, the campaign attempts to help journalists and advertisers represent ‘older people’—its preferred term—in a ‘fair contemporary and unbiased’ manner. The authors state that 80 per cent of older Americans have been subjected to ageist stereotypes. While names and characterisations may vary, the message is the same: older men and women are incompetent and lack sufficiency. Journalists are advised: ‘If you need to identify individuals over the age of 50, “older adults” is preferred over “senior” and “elderly”, which can be discriminatory in nature as we do not refer to people under 50 as “junior citizens”. If relevant to the story, state the age.’ Out goes ‘golden years’ as a description of an individual’s period of life after being deemed to be an older adult.
Images as well as words may be ageist. Campaigns have been mounted in Denmark and some other countries to counter images of old people shown as overweight or sickly. In Australia money was given to promote the contribution of the old to social life: ‘Look past the wrinkles’ was on a billboard in Melbourne.
The stereotypes and infantilisation of older people by patronising language affects older people’s self-esteem and behaviour. Ageism, as distinct from discrimination, has significant effects. Exposure to ageist stereotypes has negative affects on physiology and mental abilities. After repeatedly hearing that older people are useless, older people may start to perceive themselves in the same way that others do, as dependent, non-contributing members of society. Studies have specifically shown that when older people hear about their supposed incompetence and uselessness, they perform worse on measures of competence and memory. These negative stereotypes thus become self-fulfilling prophecies. Then this behaviour in turn reinforces the present stereotypes and treatment of the elderly. Negative attitudes towards older adults and stereotypes about older people emerge early in a child’s life, even in such a simple ways as, for example, selecting a younger adult to partner them in a game rather than an older adult.
Ageism operates in high-profile professions no less than in others. In a recent interview, actor Pierce Brosnan, aged 57, cited ageism as one of the contributing factors as to why he was not asked to continue his role as James Bond in the Bond film
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In spite of its negative effect on the daily lives of older people, ageism is often unrecognised, ignored or even compounded in health and social care settings. And social exclusion has only recently been officially acknowledged as affecting older people as well as children and families.
