Understanding Ageism and Its Underlying Effects

Ageism or ageist attitudes represent a false myth or inaccurate stereotype about adulthood and aging. Some people may feel that it is a dull and unexiting time of life compared with childhood and adolescence. Many say it is depressing because it involves aging and society has taught us that aging is negative compared with the positiveness of youthhood. Others feel that infancy and early adulthood are important because certain situations or experiences at that time can influence the rest of their lives and mold their character. Comparatively, experiences in the elderly are seen not to have the same influency power. Sometimes people think that aging, senility and death are part and parcel with each other. That is, when you get one, you'll soon get the others. All these ideas are untrue, but society says they are and hence the treatment of psychological problems of the older adults is affected. Social roles and age norms are clearly influences on our behaviour. Those who deviate from the expected behaviour probably experience social pressures to conform or receive formal sanctions in varying degrees of severity.

Moreover, age and other social norms can be used to devalue the individuals and to discriminate against groups of people. Ageism, like sexism and racism is a form of bias. Palmore (1977) defines ageism as "moderately negative stereotypes about the aged, feelings of superiority among the non-aged and simple exclusion or avoidance of the aged." Since the mid-1960s, mental health policy has "deinstitutionalized" patients from mental hospitals. However, for many of the older patients, this has meant reinstitutionalizing them in adult homes, single room occupancy hotels or nursing homes (Kermis, 1986). Many of these older people do not receive mental health services because they are in institutions that do not routinely provide psychological or psychiatric care. It is estimated that 55 to 80 percent of the 1.4 million residents of nursing homes in the United States have diagnosable mental conditions.

Among the most common diagnosis and forms of behaviour in the nursing home are Alzheimer’s disease, confusion, depression, wandering, disorientation, agitation, withdrawal, lethargy, frustration, stress, reaction, dependency, apathy, guilt, irritability, rise and fall of self-esteem, persistent talk of a wish to die, and paranoid delusion. The treatment to these psychological problems are affected by ageist attitudes, mainly in the way that they are not treated. La Rue et al (1985) noted that depression is one of the most prevalent and most treatable of the mental disorders that affects the elderly. They reported that antidepressant medication responds well to the symptoms of depression in the elderly. However because of ageist attitudes, depression may not be diagnosed accurately because some of the symptoms could be thought of as "natural consequences" of aging. So it may be misdiagnosed or underdiagnosed as dementia. Isolation, retirement and relocation to new housing does not ordinarily produce depression. Factors ranging through the presence of social support, especially a confident are important in buffering the individual from this type of social loss. La rue et al (1985) concluded that only a small minority of older people were clinically depressed, and that adaptation rather than decompensation appears to be the modal reaction to any single loss such as bereavement or retirement. Suicides in old age result from severe depression. It occurs when the depression seems intolerable, and the person feels there is no chance of improvement, there is a decreased ability to function, or there is no chance to recover from a terminal illness. Suicide death rates increase steadily with age (not so obvious in Blacks) and Butler and Lewis (1977) speculated that the "explanation lies in the severe loss of status (ageism) that affects white men, who as a group have held the greatest power and influence in society. Black men and women have largely been accustomed to a lesser status (through racism and sexism) and ironically do not have to suffer such a drastic fall". Another treatment to a psychological problem that is affected by ageist attitudes is to that of Alzheimer’s disease.

In recent years, Alzheimer's disease has become more commonly referred to as "old-timer's disease". This implies that it is a condition caused by old age. Gatz and Pearson (1988) noted that Alzheimer's was distorted as an age bias. It has gained much publicity by the media, and thus its prevalence is greatly overestimated, and clinicians greatly over diagnose it. "Acting Senile" could be the result of depression , overmedication, lack of emotional stimulation, or be a withdrawal from an unpleasant environment, even in institutions such as nursing homes. Butler and Lewis (1977) noted that physician induced reversible and irreversible dementia can be caused by specific drugs (e.g. cortizone) or a prolonged use of tranquilizers, They also remarked that even small amounts of medication may have marked negative reactions in older people. Because many old people are not in institutions that provide mental health care, a product of ageist attitudes, their quality of life is minimised. In these institutions, the ageism is such a strong bias that ideal care treatment is not provided. With dementia, a progressive deterioration in a range of cognitive abilities and self-care skills, it is unlikely that psychological treatment completely reverses the effect. The aim of treatment should be to improve the quality of life. Interventions with the sufferer may entail attempts to change particular aspects of behaviour, rather than to reverse the whole process. Sufferers of dementia need to be treated by stimulation in a variety of ways. The sensory deprivation of sufferers of elderly people was attributed to a combination of loss of sensory acuity, the unstimulating environment of many old-age institutions, and the person's own withdrawal from their environment. Patients with dementia would suffer immensely from sensory deprivation as their impaired memory forces rely on external stimulation to maintain appropriate environmental contact. Attempts were made to provide mental stimulation, introduce care regimes and group work encouraging more independence, socialisation and activity.

However a range of studies have showed both the responsibility of patients with severe dementia to aspects of their environment and the detailed, careful observation needed to identify this response. The reason why treatments are scarce for the elderly is that there is a real risk of patients being "written off" as completely unresponsive because the response is not immediately apparent. Stress is another problem that the elderly suffer from and yet treatment is not the same for middle-aged people suffering from stress. Many old people are capable of leading active, useful lives. To them, forced inactivity is a cause of stress that can lead to physical and mental regression. Forced treatment for administrative reasons and prejudice against employing people in the older age groups are therefore damaging to some of these individuals, apart from being socially wasteful. Prejudice against employing older people can also be directed against individuals who are below pensionable age.

Sometimes unnecessary problems are created by compelling older employees to compete with younger ones. This is especially the case when emphasis is on physical strength or speed of working or speed of acquiring new skills. Certain steps could be taken by the public to avoid the stress induced on older adults caused by humiliation, isolation, and rendering helplessness. National and local authorities could provide the older people with employment, with greater emphasis on vocational guidance and staff welfare for the higher age groups. Arrangements could well be made within industry and government for transferring older employees to suitable jobs with which they can cope without stress. Occupational therapy along with cultural and social activity should be encouraged for retired people, who need the stimulation and companionship. Ageist attitudes prohibit the care that the elderly need to have. Care should be individualized and activities, games and music should be geared to individual tastes and preferences. Residents should have a sense a control over their environment. In any communal living arrangements, some control is lost. Residents should have independence. The environment should elicit and reinforce the resident's remaining abilities, and not differently reinforce inappropriate or dependent behaviour. Also the treatment of the resident should be a treatment of the person, not as an object, vegetable or doll. He/She has an experienced adulthood and although it might not be apparent, is attuned to the humiliation of public failure such as being talked over as if she can't hear.

However, it is not just the case of a lack of treatment because of ageist attitudes, but a lack of the appropriate treatment and sometimes over treatment as in some cases of depression where physicians act as if it were clinical depression.