How to Fight Against Internalized Ageism of Older Adults

By Maureen Colket, MA, CCC-SLP

Speech-Language Pathologist

When we speak of ageism — a term coined by gerontologist and psychiatrist Dr. Robert Butler in 1969 — we typically mean the negative attitude of society toward older adults. However, ageism is also perpetuated by older adults themselves. This is called internalized ageism.  I would argue we have all experienced this, even if we did not have a specific term to use.  Years ago, I toured a senior living facility with my grandmother, Joan. Naturally, she was reluctant to leave her home. As we walked through the large complex, I asked her, “Grandmom, what do you think?” Joan replied, “I don’t know. There are just so many old people here!”   While she did, in fact, make the move and enjoyed her new home, she disliked becoming one of the “old” people. As FOX clinicians, we see this in our patients often.

So the question we need to ask ourselves is: What can we, as clinicians, do to mitigate internalized ageism?

Older adults need and deserve the best care with the best outcomes. In order to get there, they must be motivated to achieve their goals. Older adults with a more positive self-perception of aging lived 7.5 years longer on average. This advantage remained after the study controlled for age, gender, socioeconomic status, loneliness, and functional health. That is astounding!

It makes sense that patients with more positive self-perception of aging will be more motivated to reach their goals. When we meet our patients, we have the obligation and the privilege to influence them in their rehabilitation journey.  This includes setting goals, providing encouragement, and educating patients and caregivers.  How can we enhance our practice with these things in mind?

Community

Older adults need to feel a sense of belonging, especially during this pandemic; they are an isolated population. And we can do better to expand their communities. A Cornell study has shown that education and intergenerational contact can reduce ageism significantly, including internalized ageism. Older adults tend to adopt the negative beliefs that society imposes upon them. As members of the community, clinicians can provide education to those within our communities to combat these negative beliefs.

Opportunities for clinicians to actively reduce ageism through education include:

• giving a talk at a senior living community
• providing written handouts to caregivers
• training students/mentees on the topic of reducing ageist behaviors and belief

Content for these educational opportunities would focus on how not to talk to older adults, i.e., do not use “elderspeak,” do not simplify your vocabulary, and do not speak louder than necessary, among others.  When those surrounding older adults reduce their ageist attitudes, older adults may be able to do the same in turn.

Contribution

Older adults, and all of us for that matter, require a sense of self-worth—a feeling of purpose. For some, physically feeling better is enough, but for many, it’s about producing or providing something meaningful.

As the aforementioned Cornell research noted, intergenerational connection reduces ageist attitudes and is key here. Clinicians spend lots of time in patients’ homes and in senior living communities. There are ample opportunities for us to help establish contact between our patients and younger adults: FaceTime calls with family, volunteer visits, book clubs, Bible studies, pen-pals, and making face masks to name a few. Virtual options might be necessary while the COVID-19 pandemic persists, but one can see that opportunities for in-person intergenerational contact abound.

In my role as a speech-language pathologist, I often educate caregivers (who are typically a generation or two younger) to ask for the patient’s opinion or advice. Any contribution to the youth of society, big or small, can provide happiness, confidence, and a sense of accomplishment.

It is worth noting that this is not a one-way street: Today’s youth truly needs the wisdom of older adults, just as every generation who came before them did, too.

Compassion

Just as we must demonstrate kind and sympathetic care toward older adults in their difficult moments, they must demonstrate self-compassion towards themselves. Self-compassion was associated with greater subjective well-being, even when participants in the study were in poor physical health. This study also showed that older adults who had self-compassion were more willing to accept assistance.

When providing care in the home setting, it is important to look for signs of depression, decreased motivation, and internalized ageism in our patients. We can offer encouraging words, educate and highlight progress made, and make appropriate referrals to other medical professionals, such as psychologists and psychiatrists, as needed. We will help older adults achieve greater success if we encourage them to reach the willingness to accept assistance.  In this way, we allow our patients to celebrate all of the wins in their course of treatment. It is not always helpful to read stories of centenarians running marathons because it could make the average older adult feel insignificant and unsuccessful by comparison. Let’s praise the older adult who uses the walker correctly every time she visits her favorite museum. Let’s celebrate the older adult who cares for and wears his hearing aids correctly in order to participate in an online course. For my grandmother, Joan, we cheered her on as she proudly strutted across a stage at her new SLC as a first-time model in a fashion show.

These are the everyday success stories that FOX clinicians make possible. Here at FOX, our mission statement reads, “believing in the strength of people—empowering our people to facilitate and provide clinically excellent care to our patients, allowing them to achieve what they once thought impossible: optimal function to live their lives.” We can be a part of restoring meaning to life, no matter the age of the individual.