Aging Advocate: An Open Letter About Ageism
A social worker speaks out to her colleagues who work with older adults. It’s a message geriatricians in all disciplines need to hear.
Dear Fellow Social Workers,
What a time it has been for our profession. Many concerns have captured our attention as a result of unimaginable and beyond unfortunate circumstances. While all of these concerns, or social problems, are important and can in no way be ranked, I am a gerontology-focused social worker, so I am biased in writing this letter to you.
Therefore, my intentions are obvious: When it comes to advocating with the older adult population, it’s time for our profession to take more action. I say “with” rather than “for” because of the common misconception that older people are unable to do so.
Occasionally, older people do need help with living their day-to-day lives, but I am here to tell you that more often, they are resilient, strong, and wise. Despite their strengths, like many other groups that are stereotyped and discriminated against, no matter how hard they fight, no matter how much they have already survived in their lives, older adults are existing in a broken system. A system that still operates from a deficit-based, ageist model.
As a gerontological social worker and educator, I have always been prepped to consider the myriad theories and interventions we learn about through a specific lens of older adulthood—even if my professors didn’t. I can recall easily how I was the only social work student in many of my graduate classes, raising my hand to ask, “what about older people?” and “how does this apply to them?”
Years later, I find myself less alone asking these questions because certainly I am not the only social worker dedicated to working with older people, but nonetheless still asking. Whether you have committed to a career in clinical work, policy work, or working with children, young adults, or families, I assure you that recognizing how the harmful impacts of the COVID-19 pandemic have affected older adults and our overall approach to working with older people are issues we all should commit to addressing. If not for your clients, then for your parents, grandparents, and future selves.
As the pandemic took hold in the United States, the bulk of reporting emphasized that the vulnerable were particularly at risk. Society regularly defines this population to comprise the sick, the old, women who are pregnant, and children.
Many early reports noted that older adults were most susceptible to COVID-19. I remember thinking, why? Perhaps because their older immune systems cannot handle this level of virus?
I quickly moved on like most of the world and lived relatively unaffected by the virus until March 2020. The media reports continued to swirl around me and, like many, I began to panic. However, as the number of cases and deaths continued to grow, the message stayed the same: Continue living our lives as younger, healthier people because this virus was just like any other flu—an inconvenience for healthy, young people but potentially deadly to older and sicker people.
My question then—and still now—is, why shouldn’t I worry? Why shouldn’t I worry about my clients and their communities? Why shouldn’t I worry about the older adults that are not my clients? Why shouldn’t I worry about my older family members? Why shouldn’t I worry about how the care of older adults is being addressed—or not being addressed? After all, if we are lucky, aren’t we all going to be older one day? Shouldn’t we all care about how the older adult population is being treated throughout this pandemic?
Social workers are being inundated right now. Our hearts are hurting and we still have to show up each day for work. There are other brutal tragedies being played out every day. Communities are in pain. Many social workers like direction, a step-based guide on how to approach emotionally difficult subjects, how we can be a part of change, how we can show our clients, our students, and ourselves that a shift in thinking is possible and vital to the greater good.
It starts here. The following informal list offers tips on how to better respond to the concerns of older people—during and after the pandemic.
Think Critically About How You Engage in Ageist Behavior
In addition to protesting this behavior, it is important for social workers to consider how ageism enters their clinical spaces. For example, if you are working with older clients, have you asked them about how they have been affected by COVID-19? Have you asked them about whether they have experienced any loss or change to their routine? Have you considered your approach, your own values, and the way you offer services to this population? Have you provided the space for older people to speak about their losses?
Be Mindful of the Dominant Narratives About Aging and Older Adults
This shift in thinking is not new, but it’s one that I rarely see as part of any intake form. Each time I have completed a bio-psycho-social or other type of assessment, questions about disabilities always start the conversation. I wonder what the conversation might be like if we started with questions about what an older person can do for themselves, rather than what they can’t? Would it create a better foundation for a therapeutic alliance? Would this allow social workers to be in a better position to navigate concerns about a client’s ability to be independent?
Locate Your Position About Aging
Aging-related anxiety is real. It blocks us from providing ethical, respectful, and purposeful support to older adults. Take a second to ask yourself how you see yourself aging. Think about what would make you happy as an older person. Realize the great privilege it is to grow older, and how life is not easy to live.
Take these thoughts, hold on to them, and try to be braver about growing older so that those who are already older can be afforded as many opportunities as possible for a good quality of life until the very end.
Challenge the dominant narratives about the aging experience. Are all parts of this narrative true for all older people? Consider the role of a social worker in an older client's life, especially in a post–COVID-19 world. How can you help? How can you avoid the need to “save” and instead advocate with the client for what they need?
Use a bio-psycho-social-spiritual approach to treat all aspects of an older client’s care. We know that ethnicity, gender, sexual orientation, and socioeconomic status are only several parts of a person’s identity that can influence human behavior. This is true of older adults as well. Think about, for example, the impact recent racist events have had on older adults who have already lived through the Civil Rights movement of the mid-1950s and 1960s. How are social workers bringing this into clinical spaces with clients? Are we providing the space for clients to reflect on these experiences?
To understand behaviors and help plan effective changes, incorporate relevant theories for clinical practice with an older client. Open the space for dialogue about what aging today is like. Some older adults may feel intimidated by sharing their concerns out of fear of judgment and ageism. Do your part to create a safe space for sharing.
Lastly, notice ageist practices. Ageism occurs through media, everyday speech, and other types of entertainment. Unfair portrayals of older people influence behavior, even among medical providers, thereby negatively influencing care delivery.
Help create social change by evaluating your own potential biases and others' in order to eliminate ageism.
— Lauren Snedeker, DSW, LSW, LMSW, is an assistant professor of teaching coordinator for the Aging and Health Certificate Program, School of Social Work at Rutgers, The State University of New Jersey.
McInnis-Dittrich K. Social work with elders: a biopsychosocial approach to assessment and intervention (4th ed.). Pearson; 2013.
Seegert L. Are older lives less worthy in a pandemic? https://healthjournalism.org/blog/2020/03/are-older-lives-less-worthy-in-a-pandemic/. Published March 27, 2020.