Speech-Language Pathologists’ Power to Fight Ageism

By Elizabeth Ferrizzi, MA, CCC-SLP

Speech-Language Pathologist

What does the word ageism mean to you? Have you ever experienced it? Do speech-language pathologists encounter ageism in their work setting?

Personally, as a new professional, I was unfamiliar with the term ageism despite having been a witness to it. We experience ageism regularly in movies, television shows, commercials, social media, and among family and friends. In our society, growing older is often viewed negatively — and seldom embraced. We are encouraged to dye our hair, wear make-up, dress in certain attire, and even use extreme means to alter our appearances to look younger, such as plastic surgery and Botox.

As defined by the World Health Organization, “ageism is the stereotyping, prejudice, and discrimination against people on the basis of their age. Ageism is widespread and an insidious practice which has harmful effects on the health of older adults.” Discriminating through ageism affects older adults daily.

In order to fight against ageism, we must educate ourselves and others regarding this prejudice and its negative impacts. As healthcare professionals, it is our duty to provide clinically excellent care and both patient and caregiver education. We must ensure that each and every patient feels validated and receives affirmation that they are capable of. We know despite one’s age, one can have a life full of quality and purpose through embracing this stage in their lives.

Approximately 50 million people worldwide are diagnosed with Alzheimer’s and other types of dementia. Nearly six million Americans are living with Alzheimer’s, and this number is projected to increase to 14 million by the year 2050. The role of the speech-language pathologist is imperative in the rehabilitation and treatment of all types of dementia (not just Alzheimer’s) through cognitive skills development, dysphagia management, and other skilled specialized services. Due to modern medicine, education, awareness, and therapy, average life expectancy is now approximately 79 years compared to 70 years in 1970. As our society continues to age and live longer, the increasing need for speech-language pathologists in settings with older adults is not only urgent — it’s crucial to expand our presence.

The American Speech-Language and Hearing Association (ASHA) reports that 10 percent of speech-language pathologists provide services in residential health care facilities (i.e., skilled nursing facilities, personal care, assisted living) and an additional 16 percent provide services in non-residential health care facilities (i.e., outpatient clinics, home care/house calls). With the boom in population and aging older adults, it is estimated that approximately 26 percent of speech-language pathologists are assessing and treating the older adult population while more than half (56 percent) are employed in educational settings and schools.

While needs in all populations and across all settings are equally important and highly valued, there is significant risk and concern for the underserved adult population in the coming years and decades.

SLPs: WHAT CAN WE DO TO FIGHT AGEISM?

Was working with older adults always my initial plan for my career path? No, it actually wasn’t what I had envisioned for my professional career, but in my 11 years as a practicing clinician, it has become my passion, calling and vocation in life.

SLPs who work with older adults, like myself, have likely encountered many people who ask you if you work with kids. Many associate speech-pathology with the pediatric population. This often even includes older adult patients who may feel ashamed, afraid, or in denial of their impairments when referred for speech therapy services.

Most SLPs in residential and non-residential settings have experienced stereotypes and have been on the receiving end of comments and remarks from patients and caregivers such as:

“There’s nothing wrong with my speech. I talk just fine.”

“Why aren’t you working with kids?”

“How can you make my loved one eat this awful baby food?”

“You’re insulting my intelligence!”

“There’s nothing wrong with my memory!”

“I cough sometimes, but my swallowing is just fine.”

Believe it or not, these are examples of ageism.

As SLPs, we ask ourselves, how can we fight ageism? How can we encourage more SLPs to explore roles and opportunities with older adults? How do we effectively communicate how rewarding services provided to assist our older adult population can be? The answers include:

• education early in our curriculum
• improved exposure to adult populations and treatment sessions
• increased opportunities for clinical practicums in adult settings, whether in acute hospitals, residential or non-residential settings

Personally, I did not experience nor interact with the older adult population until the spring semester of my junior year at college. Students were welcome to observe the aphasia group and assist as needed under the supervision and care of licensed SLPs at my university campus clinic. This included adults who had suffered recent cerebrovascular accidents, those with chronic side effects, and patients varying from mild-severe aphasia, including those with alternative augmentative communication devices.

This experience was eye-opening for me. It was rewarding, humbling, and motivating. After several observation sessions, I knew in my heart I wanted to change my career path to serving and working with older adults. Through that experience, I realized how undeserved the adult population can be and how rewarding it is to help those who have given so much to society through their experiences, wisdom, and knowledge. Assisting those in their time of need is at the very core of a profession in healthcare. Without the opportunity I was provided through this aphasia group, I may not have discovered my true passion.

EDUCATION IS KEY TO HEALTH CARE FIGHTING AGEISM

To fight ageism in a healthcare setting, we (no matter which specific profession) must educate and train students early in their curriculum and studies. Healthcare professionals must take all opportunities to recommend all avenues and settings in which SLPs work. Recently, a student observed me in my personal care setting, and I was given the chance to inquire about her curriculum and mandatory observation hours. ASHA requests 25 hours of guided clinical observation of SLP students in their undergraduate studies; however, there is no specific requirement for the populations in which these hours occur.

If ASHA and/or universities recommended a portion of these hours to be dedicated to observing treatment sessions with older adults, more clinicians would be exposed to alternative settings and opportunities that they may not have encountered. This would encourage students to reach out to healthcare professionals who treat adults and provide them with multiple opportunities and great learning experiences before they start a career

Health care is constantly changing, and our older adult population continues to grow and expand. The best way to fight ageism is through education. Revamping curriculum for SLPs, where students are exposed to adults early on in their schooling through coursework and curriculum, is imperative if current SLPs are to train our future SLPs to fight and advocate for our older adults. We must use our voices to educate physicians who may be prejudiced and feel cognitive therapy and diet modifications are unwarranted when a patient has a diagnosis of dementia. We must take the time and opportunities to educate caregivers and staff. We should continue to utilize in-services to demonstrate how SLPs can promote quality of life and how ageism hinders it. We must educate family and loved ones and provide compassionate and effective counseling and instruction.

You can be a part of this battle.

THE FIGHT AGAINST AGEISM WITH FOX REHABILITATION

Over the past five years as a clinician with FOX Rehabilitation, I have been able to join the fight against ageism. FOX has been advocating for older adults for more than 20 years in a private practice setting. Our clinicians are passionate. We are dedicated and we are motivated to be the voices for our older adult population. We as FOX clinicians believe in our patients, and despite chronic illnesses and diseases, through evidence-based research, we can provide clinically excellent care and treatment to all our patients throughout the stages of their progressive illness and disease.

As FOX Founder and CEO Dr. Tim Fox has eloquently stated, “I want to wipe out the stigma that a lack of function is part of getting old.”

Speech-language pathologists are a vital and indispensable tool in the fight against ageism. Through earlier exposure, education, and advocating for our profession, SLPs can and will reduce the stigma of ageism and replace it with helping our patients achieve their optimal abilities and quality of life!