Ageism and Abuse
Learning Outcomes
- Recognize ageist thinking and ageist attitudes in individuals and institutions
- Discuss elderly individuals’ risks of being mistreated and abused
Ageism
Driving to the grocery store, Peter, twenty-three years old, got stuck behind a car on a four-lane main artery through his city’s business district. The speed limit was thirty-five miles per hour, and while most drivers sped along at forty to forty-five mph, the driver in front of him was going the minimum speed. Peter tapped on his horn. He tailgated the driver. Finally, Peter had a chance to pass the car. He glanced over. Sure enough, Peter thought, a gray-haired old man guilty of “DWE,” driving while elderly.
At the grocery store, Peter waited in the checkout line behind an older woman. She paid for her groceries, lifted her bags of food into her cart, and toddled toward the exit. Peter, guessing her to be about eighty years old, was reminded of his grandmother. He paid for his groceries and caught up with her.
“Can I help you with your cart?” he asked.
“No, thank you. I can get it myself,” she said and marched off toward her car.
Peter’s responses to both older people, the driver and the shopper, were prejudiced. In both cases, he made unfair assumptions. He assumed the driver drove cautiously simply because the man was a senior citizen, and he assumed the shopper needed help carrying her groceries just because she was an older woman.
Responses like Peter’s toward older people are fairly common. He didn’t intend to treat people differently based on personal or cultural biases, but he did. Ageism is discrimination (when someone acts on a prejudice) based on age. Dr. Robert Butler coined the term in 1968, noting that ageism exists in all cultures (Brownell). Ageist attitudes and biases based on stereotypes reduce elderly people to inferior or limited positions and can reduce their quality of life as they internalize these false stereotypes.
Ageism can vary in severity. Peter’s attitudes are probably seen as fairly mild, but relating to the elderly in ways that are patronizing can be offensive. When ageism is reflected in the workplace, in healthcare, and in assisted-living facilities, the effects of discrimination can be more severe. Ageism can make older people fear losing a job, feel dismissed by a doctor, or feel a lack of power and control in their daily living situations.
In early societies, the elderly were respected and revered. Many preindustrial societies observed gerontocracy, a type of social structure wherein the power is held by a society’s oldest members. In some countries today, the elderly still have influence and power and their vast knowledge is respected. Reverence for the elderly is still a part of some cultures, but it has changed in many places because of social factors.
In many modern nations, however, industrialization contributed to the diminished social standing of the elderly. Today wealth, power, and prestige are also held by those in younger age brackets. The average age of corporate executives was fifty-nine years old in 1980. In 2008, the average age had lowered to fifty-four years old (Stuart 2008). Some older members of the workforce felt threatened by this trend and grew concerned that younger employees in higher level positions would push them out of the job market. Rapid advancements in technology and media have required new skill sets that older members of the workforce are less likely to have.
Changes happened not only in the workplace but also at home. In agrarian societies, a married couple cared for their aging parents. The oldest members of the family contributed to the household by doing chores, cooking, and helping with child care. As economies shifted from agrarian to industrial, younger generations moved to cities to work in factories. The elderly began to be seen as an expensive burden. They did not have the strength and stamina to work outside the home. What began during industrialization, a trend toward older people living apart from their grown children, has become commonplace.
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Mistreatment and Abuse
Mistreatment and abuse of the elderly is a major social problem. As expected, with the biology of aging, the elderly sometimes become physically frail. This frailty renders them dependent on others for care—sometimes for small needs like household tasks, and sometimes for assistance with basic functions like eating and toileting. Unlike a child, who also is dependent on another for care, an elder is an adult with a lifetime of experience, knowledge, and opinions—a more fully developed person. This makes the care-providing situation more complex.
Elder abuse occurs when a caretaker intentionally deprives an older person of care or harms the person in his or her charge. Caregivers may be family members, relatives, friends, health professionals, or employees of senior housing or nursing care. The elderly may be subject to many different types of abuse. In a 2009 study on the topic led by Dr. Ron Acierno, the team of researchers identified five major categories of elder abuse: 1) physical abuse, such as hitting or shaking, 2) sexual abuse, including rape and coerced nudity, 3) psychological or emotional abuse, such as verbal harassment or humiliation, 4) neglect or failure to provide adequate care, and 5) financial abuse or exploitation (Acierno 2010).
The National Center on Elder Abuse (NCEA), a division of the U.S. Administration on Aging, also identifies abandonment and self-neglect as types of abuse. The table below shows some of the signs and symptoms that the NCEA encourages people to notice.
| Type of Abuse | Signs and Symptoms |
|---|---|
| Physical abuse | Bruises, untreated wounds, sprains, broken glasses, lab findings of medication overdosage |
| Sexual abuse | Bruises around breasts or genitals, torn or bloody underclothing, unexplained venereal disease |
| Emotional/psychological abuse | Being upset or withdrawn, unusual dementia-like behavior (rocking, sucking) |
| Neglect | Poor hygiene, untreated bed sores, dehydration, soiled bedding |
| Financial | Sudden changes in banking practices, inclusion of additional names on bank cards, abrupt changes to will |
| Self-neglect | Untreated medical conditions, unclean living area, lack of medical items like dentures or glasses |
How prevalent is elder abuse? Two recent U.S. studies found that roughly one in ten elderly people surveyed had suffered at least one form of elder abuse. Much like other types of abuse, some social researchers believe elder abuse is underreported and that the number may be higher. (The risk of abuse also increases in people with health issues such as dementia (Kohn and Verhoek-Oftedahl 2011). Similar to younger women, older women are more likely to be victims of verbal abuse than their male counterparts.
In Acierno’s study, which included a sample of 5,777 respondents age sixty and older, 5.2 percent of respondents reported financial abuse, 5.1 percent said they’d been neglected, and 4.6 endured emotional abuse (Acierno 2010). The prevalence of physical and sexual abuse was lower at 1.6 and 0.6 percent, respectively (Acierno 2010).
Other studies have focused on the caregivers to the elderly in an attempt to discover the causes of elder abuse. Researchers identified factors that increased the likelihood of caregivers perpetrating abuse against those in their care. Those factors include inexperience, having other demands such as jobs (for those who weren’t professionally employed as caregivers), caring for children, living full-time with the dependent elder, and experiencing high stress, isolation, and lack of support (Kohn and Verhoek-Oftedahl 2011).
A history of depression in the caregiver was also found to increase the likelihood of elder abuse. Neglect was more likely when care was provided by paid caregivers. Many of the caregivers who physically abused elders were themselves abused—in many cases, when they were children. Family members with some sort of dependency on the elder in their care were more likely to physically abuse that elder. For example, an adult child caring for an elderly parent while at the same time depending on some form of income from that parent, is considered more likely to perpetrate physical abuse (Kohn and Verhoek-Oftedahl 2011).
A survey in Florida found that 60.1 percent of caregivers reported verbal aggression as a style of conflict resolution. Paid caregivers in nursing homes were at a high risk of becoming abusive if they had low job satisfaction, treated the elderly like children, or felt burnt out (Kohn and Verhoek-Oftedahl 2011). Caregivers who tended to be verbally abusive were found to have had less training, lower education, and higher likelihood of depression or other psychiatric disorders. Based on the results of these studies, many housing facilities for seniors have increased their screening procedures for caregiver applicants.
Abuse in Nursing Homes
On December 29, 2018, a woman in a vegetative state at a nursing care facility in Arizona gave birth to a baby boy. The staff was surprised by both her pregnancy and birth, and investigation discovered that she had been raped by a nurse in the facility. This terrible case brought abuse in nursing and care facilities into the national limelight.
Institutional abuse refers to physical or psychological harms, as well as rights violations in settings where care and assistance is provided to dependent older adults or others, such as nursing homes. Recent studies of approximately 2,000 nursing home facility residents in the United States reported a growing abuse rate of 44% and neglect up to 95%, making elder abuse in nursing homes a growing danger. Exact statistics are rare due to elder abuse in general and specifically in nursing homes being a silent condition. Watch this TED talk, “Abuse Hurts at Any Age” by Catherine Aaronson to learn more about this type of abuse. You can also read more about elder abuse at the World Health Organization website.
Think It Over
- Make a list of all the biases, generalizations, and stereotypes about elderly people that you have seen or heard. Include everything, no matter how small or seemingly trivial. Try to rate the items on your list. Which statements can be considered myths? Which frequently turn into discrimination?
- Have you known any person who experienced prejudice or discrimination based on age? Think of someone who has been denied an experience or opportunity simply for being too old. Write the story as a case study.
- Older people suffer discrimination, and often, so do teenagers. Compare the discrimination of the elderly to that of teenagers. What do the groups share in common and how are they different?
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glossary
- ageism:
- discrimination based on age
- elder abuse:
- the act of a caretaker intentionally depriving an older person of care or harming the person in their charge
- gerontocracy:
- a type of social structure wherein the power is held by a society’s oldest members
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