Ageism Archives - UW School of Nursing

Ageism Interview: Harriet Adhiambo

Harriet Adhiambo is a PhD Nursing Science student at the University of Washington with experience in clinical and implementation science research. Her work has mainly focused on improving maternal, child, and adolescent health outcomes using innovative strategies including mHealth and improving retention and viral load suppression among patients living with HIV/AIDs in Western Kenya. She is currently working at the Webel Research Lab as a Graduate Research Student Assistant in the High Intensity Exercise to Attenuate Limitations and Train Habits in Older Adults with HIV study (HEALTH).

This interview is a part of a series on ageism, completed by de Tornyay Center predoctoral scholar, Sarah McKiddy (sm256@uw.edu). Read her article on ageism here, and find more interviews on ageism here.

What are two to three action items that we could do on an individual, practical level to redirect ageist remarks by others?

We first need to speak with individuals who feel they are now old and cannot perform certain tasks and do not want to take the time to think through things because they feel or fear they’re too old for them. Some older adults feel like they can’t go out and dance. But who said that? Talking to individuals could help create a different mind shift. Everyone will grow old, but it does not mean being old you’re incapacitated – mentally, emotionally, or physically. Do what you can as a person. If you love dancing, dance. If you love music, listen to music or participate in music. Keep yourself active because idleness and not engaging yourself very much leads to thoughts of no longer being valuable. Talk to them and give them even examples. You could also form groups or clubs for people to meet and engage them in exciting activities and encourage them to do the work if they have the strength.

The fact that someone is incapacitated, or has some illnesses, should not push them down. They should still seek treatment but continue doing what they can. In Kenya, there is an expression we call “old age syndrome”, in which you start complaining of headaches, stomach aches, and all these symptoms. For the family, it is most helpful to be supportive.

I’ve observed in the U.S. that when people get older, they’re taken to adult family homes because they need someone to take care of them. Sometimes, the environment may not be as conducive because they’re going to an environment with people who are not familiar to them. You need a social support system. Those who are still working probably feel they don’t have the time to take care of their parents, so they move them to other community homes. What are the alternatives? Can a caregiver take care of a relative in their home environment?

Ageism is a global challenge, but there are unique variances in the ways that different countries, cultures, and communities discuss aging. How can we make this a collective global effort?

It will involve stakeholder engagement not just within the U.S. – globally. Engage all global leaders in this discussion. For example, In Kenya, if you want to engage in such, we can involve the people at the community level because, in Kenya, most people stay within the communities or the rural places. We need to engage as many community members who are considered older adults — or, as we say in Kenya, simply “old people” — as possible. Ask them what they want to see because if you get their opinion, you’ll be able to better advance in terms of the interventions you want to offer to them. And then these interventions will have a better chance of improving their lives so they can live fulfilling lives. With elders, global leaders, and stakeholders, you need their perspectives on aging and the particulars unique to each community. We need to bring all those ideas together and ask ourselves what our priorities are and what is achievable now – short-term, mid-term, and long-term.

Ageism Interview: Victor Yampolsky

Esteemed teacher, conductor and violinist Victor Yampolsky served as Carol F. and Arthur L. Rice Jr. University Professor in Music Performance at the Northwestern University Bienen School of Music; Music Director of the Peninsula Music Festival in Door County, Wisconsin; Music Director Emeritus of the Omaha Symphony, as well as the Honorary Director of the Scotia Festival of Music in Halifax, Nova Scotia, Canada.

Born in the Soviet Union in 1942, Victor Yampolsky – the son of the great pianist Vladimir Yampolsky – studied violin with renowned pedagogue Michail Garlitsky (1949-1961) at Central Music School in Moscow, the legendary David Oistrakh at the Moscow Conservatory (1961-1966) and conducting with Nikolai Rabinovich at the Leningrad Conservatory (1968-1973). He was a member of the Moscow Philharmonic as both violinist and assistant conductor, under the direction of the renowned Kirill Kondrashin.

Could you share a bit about your background and perhaps any differences in the cultures you have experienced regarding views on aging?

Humans in many ways are the same. All of us are born, live our life, and pass away – it doesn’t matter which language we speak. At some point we realize we use different amounts of energy to overcome obstacles as we get older; that’s a very normal thing in daily living. How we treat one another throughout the world differs, however. What is a norm here is not necessarily a norm somewhere else in the world. The United States of America is a very, very young country. As a society, it is less than 300 years old. I brought my country’s tradition, which was the Soviet Union.

My thinking has always been about tomorrow: what is tomorrow? There was always a full plate of activities for tomorrow: mental labor, physical labor, reflection, meditation, physical exercise, speaking on the phone, traveling. From my profession as a teacher, I met individuals from various cultures across the globe. I managed to see a kaleidoscope of human experiences.

When do we start feeling that something is different, that we are aging? The answer is: we don’t. I don’t feel it, and it’s something that has bothered me because in conversations we talk about people who are “old.” My wife and I recently heard the recital of a pianist and my sister-in-law said there were a lot of “old people” present. But I did not think that I was one of them, despite the fact that I am just one month away from being 80 years old.

Conducting as a field may be an anomaly in that conductors are commonly seen as being able to offer more insights, creativity, and knowledge and continue to actively conduct beyond the typical ages of retirement when compared with other professions. These are the very values and sources of growth that sometimes get lost in our narratives about aging. Would you agree with this observation? Or do you want to add anything?

Obviously, there are unmistakable changes in the body, but there were changes throughout my entire life. One of my old colleagues, whom I admire very much, was the world-famous cellist and conductor Mstislav Rostropovich. The last time I saw him was at the end of his life, when he was already close to 80 years old. Shortly after, he passed away, and I saw his burial stone across in a cemetery in Moscow. When I saw his grave, the last things he told me in Russian language were: (Translated) Old man, never slow down! Obviously, I remembered this almost daily since I have been a teacher until a month ago when I retired. I always remind my students: Never slow down!

In the profession of conducting, there are interesting ingredients: conductors work standing up, which has its health benefits; conductors are always using physical gestures with the upper body and involve a degree of cardio, which is related to longevity; conducting requires the constant work of your brain, which is like a constant exercise of the brain: directing the orchestra, adjusting to sounds, and remembering musical text. In these ways, conducting is conducive to living a longer life and staying mentally and physically active. Of course, I also want to recognize the privilege of these experiences I am sharing.

Generally speaking, aging is misinterpreted in a way because I think there is a big difference in looking at the number and internalizing it. We invented this word: aging. We invented another word: retirement. All these milestones are made by us for either economic or political reasons. They are not really “natural” reasons. Growing up in the Soviet Union, there was a retirement age of 60 for males and 65 for females, which had nothing to do with physical or mental abilities. It had something to do with the notion that the Soviet Union, as the most progressive country in the world, did not have any unemployment. By sending millions of men to retirement at 60, they provided jobs for younger men, and there was no unemployment. This sends a message that at a certain age, you are done. This can affect the way people view themselves, and they self-limit their activities. Psychologically, it has nothing to do with human nature, but rather self-perception. In the US, I remember learning from my colleagues that I would reach my retirement age of 65 in eight months: I guess I missed it by over ten years.

When I look at myself, I think of my mother: she lived every day like a duty. Going back now to the culture of Ashkenazi Jews, most practice Judaism as a religion. I was told a long time ago: Don’t try to save the world; try to save one person. The Jewish religion is built upon the idea of a ‘mitzvah,’ which means, “You must do good things every day.” Jewish people are to perform up to 600 mitzvahs throughout their lives. I was told by rabbis in my past that you don’t need to count 600 mitzvahs; just try to do one or two every day. And not for yourself, but for others. In the philosophy of the Jewish people, there is no room for ego. In music, we are largely not performing individually with our instruments or voices. We play music that was created for a group of people: choir, band, orchestra, or various combinations. We are servants of the composer, so there is no place for ego, only our shared human experience.

Ageism Interview: Mark Johnson

Mark Johnson is currently involved with the University of Washington Retirement Association. Mark graduated from Edmonds High School and retired in 2013 after working as a maintenance painter at the UWMC for 30 years.

Intergenerational activities are one way we can increase age diversity throughout the community. What do you think would be meaningful intergenerational activities?

In the retirement association, there was an organization called Encore.org about giving back and taking your expertise and getting involved with younger people with activities like tutoring and mentoring.

Classic involvement would involve grandparents acting in caregiver roles and passing on knowledge. The logistics of getting people together can be tough but finding things of common interest and including everybody would garner compassion, and we need to give and receive more compassion in this world.

One of the programs in the retirement association is called ‘Member to Member.’ We recently gathered a few people who are retired authors who just published a book. We also have a mediator and then they discuss the processes of writing and publication. We also had artists discuss their work and the art community. Everything is recorded on Zoom. In the past, it was live, but we have adjusted to hybrid events and are able to reach wider audiences now.

Ageism is considered one of the unchallenged isms and is defined as discrimination based on age. How would you define it? Where do you see it?

I’m involved in aging in another aspect in that my mother just turned 99 last week and she’s in assisted living now but I am pretty much the primary care person for her. That gives me quite a perspective of what my future could look like. What my mother needs most from me is my presence and reassuring touch.

Part of the issues surrounding ageism is cultural. On a societal level, we need to look at how the family and the community deal with and take care of older adults. I know in other cultures that older adults remain close to the family and at home, but that’s even rapidly changing in modern times. There’s a detachment there. There’s not this obvious obligation or commitment to older adults. I’m really my mom’s advocate, and I see all the other residents there, and I am by far the huge exception to the rest of the people. Staff and movers were blown away that our family was there to help move my mom in. So, it’s kind of the way our society has gotten, and it has become an out-of-mind, out-of-sight phenomenon.

Sometimes you feel like with increasing age, you are slipping off the radar. It used to be retirement at 65 and then the “golden years.” Dealing with stigmas is a major obstacle. We don’t want to talk about older age, and we don’t want to “see” the institutionalized systems for older adults. When I retired at 62, my mother was 92, so I thought about how I had a whole new career and life ahead of me. There’s a lot of aspects that I need to accomplish to make the most out of that, and it’s not how long I can live; it’s how well I can live.

Ageism Interview: Aaron Rosser

Aaron Rosser is a recent graduate from the University of Washington holding a dual degree in Psychology and Philosophy. During his time there, he worked with the School of Nursing DPEN Team to develop an evidence-based intervention for informal caregivers and volunteered his time on the board of the non-profit Circle of Friends for Mental Health. Now, he works at the Hendrickson Lab in the Seattle VA Hospital researching PTSD and its comorbid conditions.

This interview is a part of a series on ageism, completed by de Tornyay Center predoctoral scholar, Sarah McKiddy. Read her article on ageism here, and find more interviews on ageism here.

Despite the fact that we all age and share a cumulative experience with successive ages throughout the course of our lives, aging still seems to be viewed and experienced as a mechanism for division. What contributes toward this disconnect?

There are differences in values and beliefs between different age groups perhaps because every generation has certain expectations about how they think the world is and how the world should be, and these ideas are ultimately crafted by experiences and the historical context of that time. It’s only human nature to experience nostalgia and romanticize the “good old days.” Generations differ from one another and do not necessarily have the same frame of reference on which to build viewpoints. Additionally, the status, positions, and varying amounts of wealth that often come with age offer a certain privilege and sense of self.

Different generations who obviously have had very different experiences and possess diverging beliefs about the world may at times inevitably clash in terms of overgeneralizing traits like idealism and pragmaticism. There is a tendency for bias against older adults that they are set in their ways and unable to change when that’s not true at all. It might just be that in some cases, individuals choose not to change. The disconnect in expectations among generations is exacerbated by our biases, and it is easy to limit generational labels to a certain ideology.

In our Western culture, generational labels like baby boomer, millennial, and Gen Z are widely used and accepted. One problem with this categorization is that it attempts to represent a snapshot in time and characterize someone based on an archetype, thus assigning traits. What are your thoughts on the use of generational labels?

It is difficult not to use the term “generation” when describing different ages; however, when you think about how individuals are born every single second, it does not make sense to utilize such a definite term for a phenomenon that exists within a broad spectrum. Still, it can be a useful construct when defining groups of people who are defined by their common, usually historical, experiences, which shape their beliefs and concerns. Younger generations may sometimes build resentment about various issues, like inaction surrounding climate change, income inequality, employment opportunities, and housing. The varying structures of power and resulting economic disparities contrast from one generation to another, and this creates tension.

Ageism is an unproductive divisor with undercurrents of blame when it comes to institutional-levied issues like wage gaps and diminishing labor protections, which ultimately play a much larger role than age in creating socioeconomic barriers. Casting blame on age distracts by saying that differences ultimately lie in age rather than excess wealth or individuals’ overdue amount of influence within institutions as the cause of these inequities while simultaneously overgeneralizing older generations.

In reflecting on your studies and experiences, are there any philosophers or researchers that come to mind who challenged the current concepts surrounding aging?

Much of philosophy is focused on existentialism and abstract ideas of death more than the progression of life itself. Marcus Aurelius, in Meditations, discusses aging and frames some of his discussions around the inevitability of aging and urges us to embrace the time and capabilities we have while we possess them. Notably, Simone de Beauvoir, a seminal figure in the philosophy of the 20th century in existentialism and second-wave feminism, wrote a compelling book, La vieillesse, translated in the US as The Coming of Age, about the growth and richness of experiences that accumulate with age and the distance humans seek from aging and death. Beauvoir also emphasized the need for recognizing other ways to communicate with individuals when traditional linguistics are no longer possible, like individuals living with advanced dementia or experiencing aphasia. Beauvoir reminds us of our shared humanity and cautions against neglecting the voices of elders, or as Beauvoir refers to as the “conspiracy of silence.”

Ageism Interview: Tracey Gendron

Dr. Tracey Gendron serves as Chair for the Virginia Commonwealth University Department of Gerontology, as Director for the Virginia Center on Aging and is the author of the book Ageism Unmasked: Exploring Age Bias and How to End It. With over 25 years of experience as a grant- funded researcher and nationally recognized speaker, Tracey is dedicated to raising awareness and ending ageism through education. Tracey has a Master’s degree in Gerontology, a Master’s degree in Psychology, and a Ph.D. in Developmental Psychology.

Since you started your work in ageism, how has your definition or concept of ageism changed?

I think we’re just starting to have these conversations on age. It’s starting to crack through more mainstream consciousness. There’s still a long way to go but there’s more movement than there ever has been. You can Google ‘ageism’ and see more articles about it — more studies and more information than there ever has been. I know my concept of ageism continues to evolve the more I dig into it.

I’ve been studying ageism now for over 10 years, and it started for a variety of reasons. It was a part of my dissertation in which I was looking at aging anxiety. When I was first examining and understanding ageism, I had more of a unidirectional framework with it and looked at it more exclusively towards older people. The vast majority of research is looking at those negative attitudes towards older people – towards our own aging – and the detrimental consequences of that.

In more recent years, I started to explore the omnidirectional nature of ageism and not only how it is directed towards older people but how it’s directed toward younger people.

Another area ageism evolved for me is the concept of generations and how generational labels and stereotypes perpetuate ageism. I see them as a form of ageism; labels are another layer because those have become so normalized that we just refer to people as boomers and millennials, which have now become catch-all terms.

Now there’s a push to disentangle ageism from ableism and figure out not only how they work together but how they also need to be pulled apart. For a long time, and I write about this in the book, when we talked about successful aging, we were really fighting ageism by saying, “No, not all older people are frail. In fact, only 4% live in long term care and the vast majority live in the community.” And that’s fine, but we did enter that slippery slope of then perpetuating ableism at the risk of fighting ageism. That’s a newer thought in my mind of how we talk about it but in a way that doesn’t stigmatize disability or frailty. Rather, we need to value people in all abilities, stages, and ages.

In thinking about the ‘OK, boomer’ trend, was this a contributing factor to the idea of age groups as monoliths? What is the benefit, if any, to sustaining generational labeling?

If you look at it from a demographer’s perspective, I understand the value of lumping groups of people together in order to understand behavior. The problem when we do that with generations is that it’s leading to this idea of a monolith and that everybody within this group has the same values – the same likes and dislikes and preferences – which isn’t true. It’s capturing what’s happening at this point in our history, but it’s not capturing the nuances of how people who were boomers felt when they were millennials’ ages.

I don’t think we’re going to move away from it. I think it’s sticky, but I think the more we talk about the way it doesn’t make sense, the closer we will get to people questioning its validity. We’ve been building on the idea of generational labels since the book on generational theory came out in the ‘90s. We’ve even built a whole series of workforce trainings on how to manage generations in the workplace and how to change your culture so that ‘Generation Z will stay. We’ve built these bricks, and we’ve created this wall, and now it’s time to deconstruct that and take that apart.

I think a lot of people don’t really recognize that ‘OK, boomer’ came out of one millennial’s frustration with being dismissed for being young. This was an ageist response to ageism, but we shouldn’t dismiss the origin of ‘OK, boomer’ with a simple notion that it is wrong. We must look at what it represents, which is a pushback against ageism. That’s important because then people of all ages can come together and recognize that when you stereotype a so-called “millennial” and say, “You don’t know what you’re talking about because XYZ,” you’re contributing to ageism. Ageism is a distraction technique because blaming a generation distracts us from the real issue. It’s easy, lazy, and convenient.

Regarding generational labels or terms like dementia, are there any terms or phrases that you think we could continue to pursue alternative language or nomenclature for?

It’s interesting – everybody wants to know what to call older people. The issue is that there’s never going to be a term that fits until we destigmatize what it means to be old. Any term that we have is not going to cut it because we’re still dreading what it means to be old. We still don’t want to be identified as a member of that group.

The most innocuous is to use ’older people,’ but I hope one day we can embrace ‘elder,’ and the reason I like it is because when you think about it, we do have all these stages of development in life, and when someone is in childhood, we call them a child. When someone is in adulthood, we call them an adult. We don’t push back against that because there’s no stigma associated with it. Someone who is in elderhood referred to as an elder just makes sense, but people don’t like the label because they think it implies frailty or will be judged in some way. No labels can work when stigmas remain. We need to stop lifting up what it means to be young. Young should not have value judgment just like old should not have a value judgment; it just is. That’s the work that needs to be done first and then maybe the language can come next.

Dementia is the perfect example of the intersection between ageism and ableism. It’s a double whammy to talk about someone suffering from dementia or calling someone a demented person. This person is just living with dementia. Why does dementia have to be the thing that defines them? That also goes to other kinds of forms of mental illness, and now we use that as a label to describe someone instead of recognizing that this is a part of their life experience.

What can we do on an individual, daily, practical level to redirect or eradicate ageism?

Eradicating ageism starts with the self. The first step is breaking down the barriers and recognizing we are all aging. It is important to recognize that the actual real definition of aging is not a sole process of decline. Aging is a process of biopsychosocial, spiritual change over time. It’s multidimensional and multidirectional, meaning we experience some decline, but we also experience simultaneous growth. If we start to see aging for what it really is, then it becomes a lot easier to say that you’re aging and it’s not this ‘us versus them’ barrier. I truly think step one is shifting our mindset and embracing the fact that aging is life, aging is change. It has both good and bad aspects.

We also need to take the blinders off. It’s one of the reasons I called the book Ageism Unmasked since we are so blinded by the normalization of ageism. It’s everywhere. We no longer see it and we just accept it. Taking the blinders off means we finally start to see the shame-based, fear-based messages and marketing that teaches us to be afraid of aging and to disassociate from it. Once you see it and recognize yourself as someone who is aging, you can find your motivation for change.

The next step is asking yourself – why does this matter to me? It matters for your health, your longevity, your happiness. It also matters for businesses and for workplaces. We lose millions of dollars and many years of potential contribution and productivity of people. It causes inequity. Finding your ‘why’ matters, and then you can get down to the nitty gritty of paying attention to the language that you use. Then you can ask yourself why you think you’re too old to start something new or why you make a judgement against somebody that’s younger that they’re too young to understand something. We need to recognize just as we do when it comes to racism, sexism, homophobia, and other forms of discrimination. We’ve had to practice, work on, and really recognize that certain things are offensive and can really hurt someone.

It takes years to plant ideas. It’s important to meet people where they are, and if they’re not ready, then they’re not going to hear it. You could give one small thing for someone to think about. If someone says something ageist, it could be helpful to ask a question back: Why do you think that about aging or older people? Where did that come from? How did you learn about aging? Who are your role models?

This is all to get to a dialogue about what is underneath the beliefs while recognizing this is not just one conversation that will immediately cause change. I found a 1959 issue of Ladies’ Home Journal with the headline: Look 20 years younger. Older people have been socialized with this and it has gone largely unquestioned their entire lives, so it’s deep and invisible. One conversation isn’t going to change it, but every conversation helps, and you never know how a conversation you have today could sprout something years from now.

After you recognize ageism, you can think about developing skills for disrupting social situations. It’s hard because it is uncomfortable, and it depends on the situation you’re in and who you talk to. We shouldn’t blame or shame ourselves or others because you don’t know what you don’t know. The point is to do better once you know better and to be aware. How we take the conversation in a different direction and give someone feedback when they’ve said something offensive related to age – how we redirect – there’s no single answer for that. Nonetheless, I think these are the steps that we need to start to take because that will create social change. It’s going to take a movement, but a movement takes each one of us.

The Age of Ageism

by Sarah McKiddy, UW School of Nursing de Tornyay Center for Healthy Aging Predoctoral Scholar

This article is a part of a series on ageism, completed by de Tornyay Center predoctoral scholar, Sarah McKiddy. Find accompanying interviews on ageism here.

According to the World Health Organization, ageism decreases an individual’s lifespan by 7.5 years. Ageism involves stereotypes, prejudices, or discrimination based on age. Ageism can occur at different levels: self-directed (internalized), interpersonal (between individuals), and institutional (policies, laws, and protocols). From an early age, we pick up cues from those around us about stereotypes, which are reaffirmed through our culture’s norms.

Negative expectations of aging can cause individuals to not participate in exercise classes or do social activities because they think they are too old and might hurt themselves, or because they do not see examples of other older adults doing those activities. This can lead to worsened physical and mental health.

Ageism also happens between people, in comments, conversation, or actions. Telling a 70-year-old, “You look young for your age,” suggests that you should look a certain way at 70. “Let me help you with that, dear,” employs “Elderspeak”, a patronizing form of speaking, that can involve talking louder or slower, using pet names, or speaking to adults like they are a child. It might seem nice or helpful, but it is based on stereotypes. It assumes the older adult needs help or is not capable. Other times ageism is blunt: “Boomers are out of touch with my generation,”, or “They are just like every other millennial: entitled and coddled.” This mentality is also seen in narratives of increased healthcare use and associated burden.

Workplace ageism is one of many other forms of ageism. It is assuming someone is too old or young to fulfill their job duties and is very common. A recent 2022 AARP study revealed that approximately one-third of older adults in the labor force reported hearing negative comments in the workplace related to a co-worker’s age in the last two years. In a 2022 AARP interview, Jennifer Schramm, senior policy advisor at the AARP Public Policy Institute, said that age discrimination continues to be one of the leading drivers of long-term unemployment for individuals 50 years and greater.

Ageism can also affect the health of individuals because it determines age as the leading factor in someone’s choices. When clinicians neglect to ask about an older adult’s sexual life or substance use due to ageist notions, it can result in delayed care, missed treatment opportunities, and missed diagnoses. Focusing only on age can also cause people to overlook other crucial factors like stress and one’s environment that might better explain health issues.

Age discrimination can compound other barriers related to things like race/ethnicity, income, health status, sexual orientation, gender, and disability. An individual’s ability to age and maintain a high quality of life relies on access to healthcare, social support, housing, and financial security. A 2021 study published in the Lancet pointed to evidence that older adults from racial/ethnic minority groups frequently had a worse quality of life due to chronic conditions and stress from adapting to a new culture.

Ageism is complex, and it can be overwhelming to think about how to solve it. Here are three practical ways to address ageism: First, self-reflect on what words you choose. Are you selecting terms that feed into stereotypes? Next, when someone uses a word like “elderly” or a phrase like “past one’s prime,” ask why they chose to describe someone this way and discuss what the implications are. Lastly, seek opportunities to socialize and interact with people of different ages from your own. Aging is a collective and shared journey that can connect us all. We all have a stake in how we contribute to the messaging surrounding aging. It is time to outgrow ageism.