‘Ageism is as odious as racism and sexism’
Herr Levin von Schulenburg, a high official in Altmark, was travelling in about 1580 when he saw an old man being led away by several people. ‘Where are you going with the old man?’ he asked, and received the answer, ‘To God!’ They were going to sacrifice him because he was no longer able to earn his own living. When the official grasped what was happening, he forced them to turn the old man over to him. He took him home with him and hired him as a gatekeeper, a position that he held for 20 additional years.
Geronticide—the killing of the old when they are no longer of any use—features in the folk tales of many lands but has also been a historical reality. Even today some cultures do not encourage the survival of the old, much less suffer their continued burden. It is exceptional that in some primitive tribes the old are revered and cherished. The toughness of life, and scarcity of food, can render hearts impervious to soft sentiments with respect to the old. Particularly nasty examples have included claims of the killing of the old in several indigenous societies such as the Inuits, who live in the Arctic, the last example being in 1939. It is not clear how reliable these reports are.
The term ‘ageism’ was introduced in 1969 to refer to a combination of prejudicial attitudes towards older people, the promoting of negative stereotypes of old age, and discriminatory practices against older people. But as we have seen, it has a very long history. One of the comments about prejudice against the old before the term was in common use was by Max Lerner in 1957: ‘It is natural for the culture to treat the old like the fag end of what was once good material.’ The psychologist Dominic Abrams has claimed ‘Ageism is the most pervasive form of prejudice experienced in the UK population and that seems to be true pretty much across gender, ethnicity and religion—people of all types experience it.’ Ageism was described in 1975 by Robert Butler ‘as a process of systematic stereotyping of, and discriminating against, people just because they are old’; and by R. C. Atchley, as ‘a dislike of ageing and older people based on the belief that ageing makes people unattractive, unintelligent, asexual, unemployable, and senile’. He claims that research indicates that most Americans subscribe to at least a mild form of ageism.
A major example of ageism and age discrimination in everyday life in the UK is the mandatory retirement age set at, or after, the age of 65, though the mandatory retirement age for civil servants has been abolished. Early retirement is not necessarily a good thing for an individual. Over 100,000 people were recently forced to retire against their will and this has made life very difficult for many of them. With an estimated 120,000 older workers forced to retire in 2009, this policy is draining billions of pounds from the economy every year. Forcing over 100,000 employees out of the job market has opened up an estimated £3.5 billion gap in lost economic output, inclusive of £2 billion in lost earnings for the workers themselves. But the government has pledged to get rid of the mandatory retirement age.
A survey in the Economist of articles involving ageing over a recent 10-year period found that most showed a predominantly ageist view of older people as a burden on society, often portraying them as frail non-contributors. Costs of healthcare for old peope are regularly viewed unsustainable and pensions as a demographic ‘time bombs’. Over time small increases in average life expectancy can lead to very large increases in the size of a population, but have also resulted in large gains in economic welfare over the past century; these gains are consequences of improvements in life and health expectancy and are not restricted to a handful of old people.
Work in later life can contribute to older people’s health and wellbeing and can make a dramatic difference financially: ten more years of working life can double the value of a typical private pension. Magistrates and jurors are not allowed to serve past the age of 70, and older workers are rated consistently lower than younger workers, despite no significant differences in work achievements. In fact older workers are actually more reliable in terms of absenteeism than younger workers. The Employment Equality Act (Age) Regulations 2006 has made it unlawful to discriminate in a work or training context against someone because of their age. A worker should not be disadvantaged in any area of employment such as recruitment, employment benefits and dismissal. But there are still crucial exceptions, the main one being that this does not apply to those over 65.
If a task genuinely has to be done by someone who has a particular characteristic related to age, it is currently lawful to discriminate in order to achieve this. An example would be the case of an actor having to play a role of a young character—here there can be discrimination against old actors and a young one can be selected. But it is unlawful for an employer to discriminate against someone because he or she is over 50 unless they can justify their actions, or it is covered by one of the exemptions included in the law. An example of discrimination could be the case of a job applicant aged 60 who has evidence to show that she is better qualified than the person who got the job, who is aged 35, even though the job advert stated that the employer was looking for a ‘junior manager’. The application form had asked for her date of birth. Pay and benefits should be based on skills, and not age.
In the USA the Age Discrimination in Employment Act of 1967 protects individuals who are 40 years of age or older from employment discrimination based on age. It permits employers to favour older workers based on age even when doing so adversely affects a younger worker. An article in the Wall Street Journal claimed that as unemployment intensifies in the economic downturn, claims of age discrimination are soaring. Although mandatory retirement has been abolished in the USA, there are certain types of jobs that do have mandatory retirement laws. These are jobs that are too dangerous for older people or jobs that require particular physical and mental skills. Some of these jobs are those of military personnel, fire fighters, airline pilots and police officers. But retirement is not based on an actual physical evaluation of the person, and this is why many people consider mandatory retirement laws for these jobs to be a form of age discrimination.
Ageism is more than simply having negative attitudes about old age. It can include the following: being refused interest-free credit‚ a new credit card or car insurance because of age; an organisation’s attitude to older people resulting in them receiving a lower quality of service; age limits on benefits such as Disability Living Allowance; a doctor deciding not to refer an old patient to a consultant; losing a job. Age discrimination can involve serious negative treatment that can affect how one lives.
A major biennial survey of over 2‚000 adults run by Age Concern since 2004 exposes the full extent of age discrimination in the UK. It reveals that more than three times more people have been the victims of ageism than any other form of discrimination. Direct discrimination occurs when an employer treats a worker less favourably than other workers on the grounds of age. Three fifths of people aged 65 and over believe older people suffer widespread age discrimination, including in the workplace.
Not surprisingly there was strong support for the Labour minister Harriet Harman’s attack on ageism in a new Equalities Bill which has not been made law, but which advocated ban on age discrimination in provision of goods, facilities, services and public functions. Such a measure could be a milestone in the battle for fairness in later life. But as Age Concern point out,
The Bill only gives ministers the power to ban age discrimination in services if they wish. We want to see an unbreakable legal commitment to introduce new rights, across the public and private sectors. Age discrimination in health and social care services can literally mean the difference between life and death. Because of their age, older people are being denied vital treatments with no legal protection. Each day older people are refused financial products like travel insurance for no better reason than the date on their birth certificate.
Research indicates that most Americans subscribe to at least a mild form of ageism. International Longevity Center-USA found that a majority of older adults reported that they’d been ignored or experienced insensitivity, impatience and condescension from others based solely on their age. The outcome can be more than just an embarrassing situation. Research shows that individuals receiving such treatment often end up with debilitating lowered self-esteem and self-confidence, as well as substandard healthcare. While nearly a third of those in the survey had experienced ageism in the last year, those over 65, and particularly those over 75, were less likely than the rest of the population to view age discrimination as serious.
The former deputy prime minister Lord Heseltine, aged 76, claimed that Britain is becoming an ageist society ‘worshipping at the altar of the young’, and blamed a 24-hour news culture for perpetuating stereotypes about young and old. He said:
To my mind, ‘old’ is first and foremost something mature, ripened and proven, something that has survived time’s test. But I appreciate that society as a whole, and the media especially, does not see it that way.
Rabbi Julia Neuberger believes that in the UK many older people are demeaned and made to feel worthless. It has been suggested that ageism is worse than racism or sexism because there is so little recognition that it is wrong. Discrimination on the basis of age is under-researched compared with racism or sexism; the most serious form of prejudice is considered to be racism, followed by prejudice based on disability.
Abuse of the elderly is the most serious problem of ageism. As many as half a million elderly people in the UK may be being abused, according to a House of Commons report in 2004. It found two thirds of the cases of abuse occur in people’s own homes, and take the form of sexual, physical and financial abuse, neglect and overmedication. Much abuse is not reported because many older people are unable, frightened or embarrassed to report its presence. Often care staff take no action because they lack training in identifying abuse, or are ignorant of the reporting procedures.
A UK Study of Abuse and Neglect of Older People in 2006 found that in the past year about 227,000 people aged 66 and over living in private households reported that they had experienced mistreatment involving a family member, close friend or care worker. Mistreatment by neighbours and acquaintances was reported in about one third of cases. Overall, half of mistreatment involved a partner or another family member. About 10 per cent involved a care worker, and 5 per cent a close friend. Most of those responsible for physical, psychological and sexual abuse were men, while financial abuse was spread more equally between the sexes. Three quarters of those asked said that the effect of the mistreatment was either serious or very serious, and left the person feeling upset and isolated. About one third told nobody but most told family, friends, or a social worker or health professional. Very few informed the local authority or the police.
In developing countries there is no systematic collection of statistics about abuse, but crime records, journalistic reports, social welfare records and small-scale studies contain evidence that abuse, neglect, and financial exploitation of elders are much more common than these societies admit. A hospital manager in Kenya was quoted as saying: ‘Older people are a big headache and a waste of resources. The biggest favour you could do as an older people’s organisation is to get them out of my hospital.’
In healthcare, ageism presents serious problems as the National Service Framework for Mental Health applies only to people below the age of 65. This seems to be a clear case of age discrimination, particularly as dementia affects large numbers of people over 65. Those over that age receive lower-cost and inferior services to younger people, even if they have the same condition. Patients older than 65 are being denied treatments offered to younger people, either because they are too expensive or because they were not referred on by their family doctor.
There is considerable evidence of discrimination against the elderly in healthcare, with staff disbelieving older people’s accounts of their medical or clinical symptoms, or with these being disregarded as a natural condition of their age. Older hospital patients can be seen as financial risks: they are viewed less as human beings with health needs than as costly and inanimate ‘bed-blockers’. Physicians themselves and other healthcare providers may hold attitudes, beliefs and behaviours that are associated with ageism against older patients. Studies have found that physicians often do not seem to show concern in treating the medical problems of older people. There is evidence that more than a third of physicians erroneously consider high blood pressure to be a normal part of ageing, and do not treat the condition in their older patients.
The average size of care home for older people in England is 34, compared to nine places in homes for younger adults. Many of the old themselves believe that doctors view them less favourably than younger patients. Fewer than 10 per cent of older people with clinical depression are referred to specialist mental health services compared with about 50 per cent of younger adults with mental and emotional problems. Elderly stroke patients treated in the NHS do not get the same level of care as younger patients, who are scanned more quickly and more often. Mental health wards for older patients are less clean, more noisy and more violent than average.
Rabbi Julia Neuberger and many others have argued for legislation against such age discrimination. Older patients are less likely to have their symptoms fully investigated. A study by the Patients Association reported that some NHS nurses had been shockingly cruel to the elderly; some had been left without food or drink while others had been made to sleep in soiled bedclothes. It was estimated that there had been up to a million such incidents in recent years. Though there may be surgeries or operations with high survival rates that might cure their condition, older patients are less likely than younger patients to receive all the necessary treatments. It has been suggested that this is because doctors fear their older patients are not physically strong enough to tolerate the curative treatments and are more likely to have complications during surgery that may end in mortality. The approach to the treatment of older people is often concentrated on managing the disease, rather than preventing or curing it. Thousands are discharged from hospital too early.
Some sources suggest that ageism in the healthcare system starts in the medical schools where young people—who, of course, will never themselves be old—begin their education. Only 10 per cent of medical schools in the United States require courses in geriatrics and less than 3 per cent of physicians ever take any courses in this area. In the UK there are some medical schools that do not teach geriatric medicine. When actually interacting with older patients on the job, doctors sometimes view them with disgust and describe them in negative ways, such as ‘depressing’ or ‘crazy’. For screening procedures, elderly people are a bit less likely than younger people to be screened for cancers and so less likely to be diagnosed at early stages of their conditions.
Outside the healthcare system, Help the Aged reported that older people routinely tell them that they feel ignored and undervalued by their local communities. There needs to be much more energy and determination to reach those who are seldom heard‚ for example isolated older people and those living in poverty. By contrast, fortunately, many very old people are sustained by love and care of family and friends.
Some forms of ageism are described as ‘benevolent prejudice’ because the tendency to pity is linked to seeing older people as ‘friendly’ but ‘incompetent’. This is similar to the prejudice most often directed against women and disabled people. Age Concern’s survey revealed strong evidence of ‘benevolent prejudice’. The warmth felt towards older people means there is often public acceptance that they are deserving of preferential treatment—for example, concessionary travel. But the perception of incompetence means older people can also be seen as ‘not up to the job’ or ‘a menace on the roads’ when there is no evidence to support this. Benevolent prejudice also leads to assumptions that it is ‘natural’ for older people to have lower expectations, reduced choice and control, and less account taken of their views.
When older people forget someone’s name, they are viewed as senile, but when a younger person fails to recall a name, we usually call that a faulty memory. A newspaper recently reported that the actress Keira Knightley was having something akin to a ‘senior moment’ as she came off a plane from London, due to the seven-hour flight and a five-hour time difference. She had just forgotten something, but this phrase is a mild example of ageism. Use of the term implies that she was suffering from one of the problems that afflict the elderly. I am all too well aware of them. But the young also forget things.
When an older person complains about life or a particular incident, they are called cranky and difficult, while a younger person may just be seen as being critical. It is quite widely assumed that older people might not want the sorts of life chances that younger people have and so it is ‘natural’ for older people to have lower expectations, and less account is taken of their views. Fortunately, as we have also seen, older people are further stereotyped as moral and admirable, and an overwhelming majority of people agree that they should be valued and cherished. But although most people think older people should definitely have equal access to health and care, this is often not the reality.
One way that implicit or explicit ageism may manifest itself is through the use of patronising language with older people. There are many ageist articles in the media, often presenting the elderly as a burden on younger people in families and society at large. Critical analyses have suggested that both negative and positive newspaper portrayals of old people may be ageist.
Negative stereotypes of older people range from the hostile image of a ‘cantankerous old codger’ to less explicit images. Not uncommon ageist terms inlude ‘old fogey’, ‘old fart’, ‘geezer’, and ‘old goat’; even the word ‘old’ itself is often used as an insult. Elderspeak refers to a way of communicating with the elderly—it is simplified language with exaggerated pitch and intonation. This can be based on beliefs about the elderly and personal experience.
The term ‘patronising language’ specifically describes two negative methods of communication: the person being unnecessarily courteous and speaking simple and short sentences loudly and slowly to an older person, with an exaggerated tone and high pitch; and baby talk, which involves the exaggerated pitch and tone that one uses when talking to a baby. Both these ways of talking have negative effects on the elderly. Anti-ageism activists in the US have strongly argued against the use by journalists of terms such as ‘elderly’, ‘fogey’ or ‘codger’—and even ‘senior’. They recommend the avoidance of phrases such as ‘of a certain age’, and ‘old ladies’ of both the ‘little’ and ‘sweet’ variety. The advice is included in a media guide on reporting issued by the International Longevity Center and Aging Services of California.
In this guide, the campaign attempts to help journalists and advertisers represent ‘older people’—its preferred term—in a ‘fair contemporary and unbiased’ manner. The authors state that 80 per cent of older Americans have been subjected to ageist stereotypes. While names and characterisations may vary, the message is the same: older men and women are incompetent and lack sufficiency. Journalists are advised: ‘If you need to identify individuals over the age of 50, “older adults” is preferred over “senior” and “elderly”, which can be discriminatory in nature as we do not refer to people under 50 as “junior citizens”. If relevant to the story, state the age.’ Out goes ‘golden years’ as a description of an individual’s period of life after being deemed to be an older adult.
Images as well as words may be ageist. Campaigns have been mounted in Denmark and some other countries to counter images of old people shown as overweight or sickly. In Australia money was given to promote the contribution of the old to social life: ‘Look past the wrinkles’ was on a billboard in Melbourne.
The stereotypes and infantilisation of older people by patronising language affects older people’s self-esteem and behaviour. Ageism, as distinct from discrimination, has significant effects. Exposure to ageist stereotypes has negative affects on physiology and mental abilities. After repeatedly hearing that older people are useless, older people may start to perceive themselves in the same way that others do, as dependent, non-contributing members of society. Studies have specifically shown that when older people hear about their supposed incompetence and uselessness, they perform worse on measures of competence and memory. These negative stereotypes thus become self-fulfilling prophecies. Then this behaviour in turn reinforces the present stereotypes and treatment of the elderly. Negative attitudes towards older adults and stereotypes about older people emerge early in a child’s life, even in such a simple ways as, for example, selecting a younger adult to partner them in a game rather than an older adult.
Ageism operates in high-profile professions no less than in others. In a recent interview, actor Pierce Brosnan, aged 57, cited ageism as one of the contributing factors as to why he was not asked to continue his role as James Bond in the Bond film Casino Royale, released in 2006. Successful singer and actress Madonna spoke out in her 50s about ageism and her fight to defy the norms of society. The actress Geena Davis, at 52, complained that she could not get a decent role because of her decrepitude. Joan Bakewell, who was appointed by the government as the ‘voice of older people’, has criticised the BBC for banishing female news presenters once they reach 50, and for the general lack of older female faces. Arlene Phillips was dropped from Strictly Come Dancing when she was 66. The journalist John Simpson has also complained about ageism in the BBC. Yet just how impressive older women can be was shown when the 89-year-old novelist Baroness P. D. James interviewed the director of the BBC on the Today programme about his executives’ pay packages and, according to press reports, reduced him to a stuttering wreck. But a very recent tribunal ruled against the BBC for dismissing a 53-year-old female presenter.
In the US version of The Weakest Link, contestants’ voting decisions were, on average, biased against older panellists. At the stage of the game where it is in participants’ interests to vote for poor performers, older people were likely to be chosen even when younger adults had performed worse. But when contestants would benefit by choosing top-performing rivals to eliminate them from the competition, they tended to choose lower-performing, older contestants. Subconsciously, the panellists simply did not want to be around older people.
In spite of its negative effect on the daily lives of older people, ageism is often unrecognised, ignored or even compounded in health and social care settings. And social exclusion has only recently been officially acknowledged as affecting older people as well as children and families.
Older consumers have grown into a market force to be reckoned with, says Age UK, as new figures reveal the amount of money spent annually by people over the age of 65 in the UK is set to hit the £100 billion mark. Yet despite seeing their weight in the consumer market grow as a group, older people are still at risk of being frozen out of a marketplace which is slow to adjust to the evolution of an ageing society. Research by the charities found that many older people think businesses and retailers have little interest in the consumer needs of older age groups, and many still face obstacles in accessing financial services which are tailored to the needs of younger customers.
There are other, more robust views. The actress Joanna Lumley proclaimed, ‘I am not being unkind but I am just saying millions of crones like me shouldn’t suddenly be given the lead in things just because we are damn old.’ But this laudable refusal to claim special privileges for the old should not blind us to the rights of the old to be treated fairly, or to the fact that ageism can lead to social exclusion, diminish the quality of life which older people may enjoy, and threaten their mental health.