Aged Care

Ageing: its stereotypes and its impact

Caroline Robinson

Associate Professor

Associate Professor Caroline Robinson is the Associate Head of School of Community Health (SCH) and Discipline Lead Podiatry at Charles Stuart University (CSU). She moved to Australia from the United Kingdom in 2005, where she completed her fellowship in Podiatric Surgery and Masters in Pharmacology. Caroline teaches across the podiatry program and has a particular interest in healthy ageing, the Indigenous curriculum, and pharmacology. She leads curriculum development in the SCH and is working to enable pathways into podiatry, particularly for Aboriginal students.

What role do podiatrists have in shaping the conversation around ageing and its stereotypes? Assoc Prof Caroline Robinson explores this issue.

A person’s chronological age represents the number of years they have lived, yet age may also be assessed by measuring age-related biomarkers such as grip strength.

The reality for many older people is that ageing is not a positive experience. Negative ageist attitudes are evident across different societies and social and ethnic groups around the world. It is suggested by the World Health Organisation that ‘ageism may now be even more pervasive than sexism and racism’. Negative stereotypes of ageing even have the potential to affect the holistic health of an older person, reducing quality and length of life.

 

Yet there is a positive to all of this. In fact, ageing may be considered in evolutionary terms as a valuable process for humans because it develops the character of a person. From this perspective, an older person is of unique value to a community group.

 

The perceived value of older people, however, is influenced by the cultural values and attitudes of all people living in a community.

 

The focus of this article

The second article in this series on the topic of aged care explores issues related to ageing stereotypes, ageism and the negative impact this has on older peoples’ functional ability, and their health and wellbeing.

 

In this article, I will focus on these areas and discuss the podiatrist’s potential role in relation to:

  • The three ageism predictors
  • The effect of negative stereotypes and ageism on older peoples’ health and wellbeing, and;
  • Changing the narrative about ageing.

Ageing may be considered in evolutionary terms as a valuable process for humans because it develops the character of a person. From this perspective, an older person is of unique value to a community group.

Actions for podiatrists

What do we stand to learn? These issues are relevant to all health practitioners who work with older people. As podiatrists, we have a unique opportunity to learn from the experience of older people and to understand how ageism is embedded in society. If we want to open up the conversation and change the narrative with our clients, colleagues, family and friends, then we can take the first step to develop an awareness of ageism and the impact of negative stereotypes.

 

In fact, this might be just the thing to liven up podiatry consults and shift the conversation from religious holidays and surgical procedures! If you consider yourself as a holistic practitioner, it’s relevant to think about the relatively hidden impact of ageism on the health and wellbeing of your older clients. Consider how empowering such a conversation might be.

 

 

How old do you feel?

A person’s chronological age represents the number of years they have lived, yet age may also be assessed by measuring age-related biomarkers such as grip strength. A person’s response to the question “How old do you feel, most of the time?”, is indicative of their subjective age.

 

A person’s experience of ageing, however, is far more complex. Age, and the expectations associated with being an older member of the community, has an element of social construction. That is to say, the shared meaning of ‘older’ is created through social interactions.

 

The three ageism predictors

What is ageism? According to the WHO, ‘Ageism is the stereotyping of and discrimination against individuals or groups based on their age. Ageism can take many forms, including prejudicial attitudes, discriminatory practices, or institutional policies and practices that perpetuate stereotypical beliefs.’

 

Research has shown that these three ageism predictors adversely affect health outcomes for older people:

 

  • Age discrimination: detrimental treatment of older persons
  • Negative age stereotypes: negative beliefs of older persons about older people in general, and;
  • Negative self-perceptions of ageing: negative beliefs of older persons about their own ageing.

 

It is also useful to note that ageism operates in two ways:

 

 

Consider for example, whether your referrals for older clients are managed by the doctor as efficiently or appropriately as you would expect for a younger person. It may be that you need to be the advocate for an older client to ensure that they receive a diagnostic investigation.

 

The effect of negative stereotypes

 

I clearly recall instances of sad frustration with my dear mother when she would give up trying to do a simple task because of her perception of being, ‘just a stupid old lady’. Mum was only 81 when she died several months after a serious fall but she had bought into the ‘ageing equals decline’ narrative, quite sometime earlier.

 

Studies show that ageism is significantly associated with physical illness; mental illness; cognitive impairment; poor quality of life and wellbeing; and reduced lifespan. Added to this, negative self-perceptions of ageing are reinforced by ageism in society. Older people often adopt negative self-perceptions and this is damaging not only to their self-esteem and self-confidence but also to their health and wellbeing.

A person’s experience of ageing, however, is far more complex. Age, and the expectations associated with being an older member of the community, has an element of social construction.

Actions for podiatrists

How can you make a difference? With an individual client who has very negative self-perceptions of ageing, there is an opportunity to assist them to cope and improve their quality of life by using the self-regulation strategies of selection, optimization, and compensation (SOC).  I go into these details a little later in this article.

 

Changing the narrative

In addition to the personal cost of perceived age discrimination and negative self-perceptions of ageing, the cost of ageism to society is vast. In the US, the annual cost of ageism is calculated as $63 billion: one of every seven dollars is spent on the treatment of eight chronic health conditions.

 

Yet the conversation needs to change. Negative attitudes towards older people are often based on outdated myths about ageing and despite this, negative stereotypes are deeply ingrained and reinforced by our language, media and popular culture.

 

 

Actions for podiatrists

Change the narrative. As podiatrists and primary healthcare practitioners, we have an opportunity to contribute to changing the narrative about ageing and participate in destigmatising the word ‘old’. It makes good sense to address these issues with your friends, family, colleagues and clients because ageism is ‘prejudice and discrimination against your future self’.

 

The end goal

We must be aware of the risk of stereotyping older people; particularly since greater time pressure in a busy podiatry practice will increase the likelihood of stereotyping clients. A greater self-awareness of our own attitudes and bias is the first step to addressing ageism at a structural level. It is important to remember that ‘ageing is many things for many people’.

 

Through partnering with clients to reduce negative age stereotypes and individual negative self-perceptions of ageing, we can work to enable productive, healthy and engaged lives for older people. Using ‘SOC’ for example, you could help a client to set a simple goal for daily exercise (selection); encourage them to download an app or keep a diary to log their daily exercise (optimisation); and provide appropriate insoles/orthoses to maximise foot function and comfort (compensation).

 

More information

If you are interested in any of the concepts raised here, I encourage you to take a look at:

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