How to ﬁght stereotypes about aging
What can be done about negative stereotypes that portray older adults as out of touch, useless, feeble, incompetent, pitiful and irrelevant?
With late-night TV comedy shows where supposedly clueless older people are the butt of jokes and with ads for anti-aging creams equating youth with beauty and wrinkles with decay, harsh and unflattering images shape assumptions about aging. Although people may hope for good health and happiness, they tend to believe that growing older involves deterioration and decline, according to reports from the Reframing Aging Initiative.
Dismal expectations can become self-fulfilling as people start experiencing changes associated with growing older - aching knees or problems with hearing, for instance. If a person has internalized negative stereotypes, his or her confidence may be eroded, stress responses activated, motivation diminished ("I'm old, and it's too late to change things") and sense of efficacy ("I can do that") impaired.
Health often suffers as a result, according to studies showing that older adults who hold negative stereotypes tend to walk slowly, experience memory problems and recover less fully from a fall or fracture, among other ramifications. By contrast, seniors whose view of aging is primarily positive live 7.5 years longer than other seniors.
Can positive images of aging be enhanced and the effects of negative stereotypes reduced? At a recent meeting of the National Academies of Sciences' Forum on Aging, Disability and Independence, experts embraced such steps and offered several suggestions for how they can be advanced:
Become aware of implicit biases, which are automatic, unexamined thoughts. An example: The sight of an older person using a cane might trigger associations with dependency and incompetence.
Forum attendee Charlotte Yeh, chief medical officer for AARP Services, spoke of her experience after being struck by a car and undergoing a lengthy, painful rehabilitation. Limping and using a cane, she routinely found strangers treating her as if she were helpless.
"I would come home feeling terrible about myself," she said. Decorating her cane with ribbons and flowers turned things around. "People were, like, 'Oh, my God, that's so cool,' " said Yeh, who noted that the decorations evoked the positivity associated with creativity instead of the negativity associated with disability.
Implicit biases can be difficult to discover because they coexist with thoughts that seem to clash with them. For example, someone may implicitly feel that "being old is terrible," while explicitly that person may think, "We need to do more, as a society, to value older people." Yet this kind of conflict may go unrecognized.
To identify implicit bias, pay attention to your automatic responses. If you find yourself flinching at the sight of wrinkles when you look in the bathroom mirror, for instance, acknowledge this reaction and then ask yourself, "Why is this upsetting?"
Use strategies to challenge biases. Patricia Devine, a professor of psychology at the University of Wisconsin at Madison who studies ways to reduce racial prejudice, calls this "tuning in" to habits of mind that usually go unexamined.
Resolving to change these habits isn't enough, she said at the NAS forum: "You need strategies." Her research shows that these strategies are effective:
- Replace stereotypes. This entails becoming aware of and then altering responses informed by stereotypes. Instead of assuming a senior with a cane needs your help, for instance, you might ask, "Would you like assistance?" - a question that respects an individual's autonomy.
- Embrace new images. This involves thinking about people who don't fit the stereotype you've acknowledged. This could be a group of people (older athletes), a famous person (TV producer Norman Lear, now 95, who just sold a show on aging to NBC) or someone you know (a cherished older friend).
- Individualize it. The more we know about people, the less we're likely to think of them as a group characterized by stereotypes. Delve into specifics. What unique challenges does an older person face? How does that person cope day-to-day?
- Switch perspectives. This involves imagining yourself as a member of the group you've been stereotyping. What would it be like if strangers patronized you and called you "sweetie" or "dear," for example?
- Make contact. Interact with the people you've been stereotyping. Visit and talk with that friend who's now living in a retirement community.
Another strategy - strengthening implicit positive stereotypes - comes from Becca Levy, a professor of epidemiology and psychology at Yale University and a leading researcher in this field.
In a 2016 study, she and several colleagues demonstrated that exposing older adults to subliminal positive messages about aging several times over a month improved their mobility and balance - crucial measures of physical function.
The messages were embedded in word blocks that flashed quickly across a computer screen, including descriptors such as "wise," "creative," "spry" and "fit." The weekly sessions were about 15 minutes long, proving that even a relatively short exposure to positive images of aging can make a difference.
At the forum, Levy noted that 196 countries have committed to support the World Health Organization's fledgling campaign to end discrimination against people because they are old. Bolstering positive images of aging and countering the effect of negative stereotypes need to be central parts of that endeavor, she remarked. It's also something older adults can do, individually, by choosing to focus on what's going well in their lives rather than on what's going wrong.
Claim a seat at the table. "Nothing about us without us" is a clarion call of disability activists, who have demanded that their right to participate fully in society be recognized and made possible by adequate accommodations such as wheelchair ramps. So far, however, seniors haven't similarly insisted on inclusion, making it easier to overlook the ways in which they're marginalized.
At the forum, Kathy Greenlee, vice president of aging and health policy at the Center for Practical Bioethics in Kansas City and a former assistant secretary for aging in the Department of Health and Human Services, called for a new wave of advocacy by and for seniors, saying, "We need more older people talking publicly about themselves and their lives."
"Everybody is battling aging by themselves, reinforcing the notion that how someone ages is that individual's responsibility" rather than a collective responsibility, she explained.
- - -
This column is produced by Kaiser Health News, an editorially independent news service and program of the Kaiser Family Foundation.