Tag: ageism

Ageism in medicine

“Studies show that one-third of Canadians admit to having been treated differently due to their age,” said Dr. Samir Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto.

Sinha, who is also a professor of medicine at the University of Toronto and the director of health policy research at the National Institute on Ageing, spoke on ageism in medicine and strategies for patients to combat this form of discrimination in a webinar presented by the National Council of Jewish Women of Canada (NCJWC) on June 6. He noted that the date of the webinar coincided with the start of Seniors Month in Canada, and shared that he was drawn to collaborate with NCJWC because Mount Sinai Hospital was founded 100 years ago “by a dedicated group of Jewish women.”

Sinha defined ageism, also known as age discrimination, as the act of imposing stereotypes, prejudice and discrimination on others or oneself based on age. He said the term was coined relatively recently, in the 1960s, even though it had existed in Canadian society long before then. He emphasized that “51% of Canadians agree that ageism is the most tolerated social prejudice, and 80% of Canadians agree that older adults (age 65+) are seen as less important than younger generations.”

This sense of diminished importance is commonly manifested in three forms: feeling ignored or invisible, being treated as devoid of value or contribution, and facing assumptions that seniors are always incompetent. Such experiences can have adverse psychological and emotional impacts, including social isolation, diminished trust in healthcare providers and negative self-perception. Sinha highlighted that although ageism may present itself universally, its impacts differ, and it “does not affect all older adults equally,” he said. Intersectionality, defined as the interconnected nature of social categories such as race, gender, age and more, can enhance the degree of ageism that a person faces, he said. In Canada, certain segments of the population are especially vulnerable, including immigrants or those born outside the country.

Narrowing in on Canada’s healthcare system, Sinha shared that healthcare professionals often hold ageist attitudes, perpetuating stereotypes that seniors lack agency and are frail, depressed or irritable. “This can ultimately manifest in undertreatment or overtreatment,” he said.

Undertreatment involves withholding resources or treatment options that would not be withheld from younger patients, while overtreatment refers to an exaggerated approach to patient care. Sinha said these issues were amplified during the COVID-19 pandemic, citing examples where older adults were denied access to ventilators due to assumptions about their life expectancies. This demonstrated the arbitrary use of age to determine life expectancy, he said, while other important health factors should also be considered.

Undertreatment is a key issue among patients with dementia – “many people in society consider dementia a normal part of ageing, but it is not,” said Sinha. He described the stigmatization faced by individuals living with dementia, which often leads to ageism in healthcare settings and subsequent undertreatment due to their condition. In cases like these, “labels can kill,” he said.

Referring to himself and his fellow geriatricians as a “rare and endangered species of physician,” as described by the New York Times, Sinha stressed the scarcity of geriatricians in Canada – only a few hundred among the country’s approximately 100,000 doctors. Nevertheless, he affirmed that “the few hundred of us have long advocated for older persons to be properly cared for in a health system that often does not adequately address their needs.” Further, he emphasized that “everyone has a role to play” in combatting ageism. This sentiment was echoed by Rochelle Garfinkel, manager of donor relations at NCJWC, who reminded the audience that “the tree planted today provides shade for future generations.”

“Eighty-five percent of the boomer generation wants their ageing experience to be different than their parent or grandparents,” added Sinha. He suggested strategies such as more comprehensive training for healthcare professionals and acknowledging the disproportionate impacts faced by marginalized groups.

In her introduction to the webinar, Linda Steinberg, NCJWC president, noted that defining the impacts of ageism will be central to NCJWC in the coming years. NCJWC is the oldest Jewish women’s organization in Canada, she said, and is currently comprised of five sections across the country’s major cities, including Vancouver.

Alisa Bressler is a fourth-year student at Queen’s University in Kingston, Ont. She is an avid reader and writer, and the online director of the arts and culture publication MUSE Magazine. Bressler is a member of the Vancouver Jewish community, and the inaugural Baila Lazarus Jewish Journalism Intern.

Ageism unacceptable

Contrary to popular belief, life as an older person is neither dull nor uneventful. We have experienced many things but have yet to see or hear it all.

A few years ago, my husband and I visited New York. We were in the process of checking into the hotel when our daughter arrived to greet us. The hotel clerk immediately shifted his attention to her. He explained how the elevator worked, how we could access hotel amenities, gave her the room keys and wished her a pleasant stay. In less than five minutes, blatant ageism had rendered my husband and me invisible, mute and incapacitated by age. Although we have endured strangers calling us dear, darling and sweetie in loud voices, the hotel episode left us stunned.

In his article “Ageism: I hope I (don’t) die before I get old,” Dan Levitt, adjunct professor at Simon Fraser University, defines ageism as “the stereotyping and discriminating against individuals or groups based on their age.” Ageist attitudes result not only in individual discrimination but they can also be found at the core of the design and implementation of services, programs and facilities for the elderly.

Lillian Zimmerman, in her 2016 book Did You Just Call Me an Old Lady?, takes a two-pronged approach to aging. First, she examines how medical interventions, technology and social programs have improved the quality of life for older people. Second, she cleverly unmasks the difficulties faced by an aging population living in a youth-obsessed culture and how these obstacles are reinforced and perpetuated.

Currently, the over-65 age groups are the fastest-growing population segments in Canada. The press has dubbed this “the Grey Tsunami.” Although many components are involved in reinforcing ageism and ageist attitudes, Zimmerman identifies language as one of the main preservers.

“Words are among the most insidious communication devices contributing to ageist attitude formation – tsunamis are catastrophes that bring death and destruction,” she writes. “As a metaphor for aging, it is simply not acceptable. We are now responsive and sensitive to demeaning and derogatory language. We need to take ageism out from the closet and ‘out it’ for what it is: a general dislike of older people. The list of unacceptable social attitudes should now read racism, sexism and ageism.”

Having a keen sense of humour is a highly desired quality. Throughout history, we have employed humour as a coping mechanism, a stress reliever and a route to gain social advantages. It is also used as a tool to manufacture “others,” and for them to appear less worthy and less capable. These jokes, whether narratives, cartoons or greetings, can be extremely hurtful and insulting. If heard often enough, they will become “alternative facts” and have the capacity to further cement negative stereotypes. Zimmerman cites a study of more than 4,000 jokes that found many in which older people were depicted as incompetent, forgetful, sexually frustrated, impotent males and infirm. As previously mentioned, ageism has not until recently been openly examined, so it is possible that the “jokesters” are not aware of imbedded ageist content.

The Ontario Human Rights Commission, in its research document Ageism and Age Discrimination, states that the first step to combat this derogatory ism is to “raise public awareness about its existence and to dispel common stereotypes and misperceptions about aging.”

Levitt concurs and goes a step further by citing a Slovenian project that has already been operationalized: “The Simbioza project’s goal is to improve e-literacy in seniors by young people volunteering to teach computer skills. Such a program is a win-win situation, as it puts technology in the hands of the elderly and instils social responsibility in the millennials.”

To quote Bob Dylan, “but times are a-changin’.” There is hope for the future. Through raising awareness of ageism and refusing to accept ageist discourse, the grips are loosened. The Ontario Human Rights research paper states, “The Supreme Court of Canada has made it clear that it is no longer acceptable to structure systems in a way that assumes that everyone is young and then try to accommodate those who do not fit this assumption. Rather, age diversity that exists in society should be reflected in design stages for policies, programs, services, facilities so that physical, attitudinal and systemic barriers are not created.”

Rita Roling is an executive of Jewish Seniors Alliance and a member of JSA’s Senior Line editorial committee. This article was originally published, as “We will not go quietly into the night,” in Senior Line, vol. 24 (2), which can be downloaded at jsalliance.org.