Social Work: Ageism and Us — More to Consider
The COVID-19 pandemic has caused an impressive number of researchers to focus on the presence of ageism in a variety of settings. How might this be internalized by older adults?
As a licensed social worker specializing in practice with older adults and as a faculty member at a social work program, I (like many colleagues) am committed to educating social work students on ageism and its presence in policies and direct clinical practice.
It is my hope that this will help encourage more students to consider and be prepared for this field of practice. In each course I teach, I begin the semester with a discussion and experiential activity focused on ageism. These activities can include identifying ads that are ageist, identifying policies that are ageist, and reflecting on experiences of ageism in class. A discussion that came up this semester is the impact of internalized ageism. One student asked, “How can we help older clients that may have internalized historic ageist attitudes and thus believe these attitudes are true?”
The answer, like the question, is complex and will be unique for each person and each scenario. A good place to start is infusing definitions of ageism for a deeper understanding of its impact.
This article explores definitions of ageism, how ageism can be internalized, and questions to ask ourselves as we continue to work clinically with older adult clients amid the pandemic.
For my work in and outside of the classroom, I immerse myself in a variety of resources to help me continue learning about the pervasiveness of ageism, how its definition continues to evolve while we continue to observe and partake in it, and how we can respond to it.
In “Gerontological Social Work in Action: An Anti-Oppressive Practice With Older Adults, Their Families, and Communities,” Hulko and colleagues discuss how age is “a category of difference” like race and gender, but that, unlike race and gender, society often can use age as a category that “positions older adults as a homogenous group with similar needs.”2
A practice lens can help debunk this assumption. For example, consider medical social workers, whose clients largely include older adults.3 There are vast differences between clients and their needs—even more so in the subpopulation of older clients managing health concerns, which can also be full of differences. Some discharges are simple—a client returning home to recover. However, others are complex. For example, a client may be required to transfer to a nursing home to live indefinitely. Differences in resources, cultural and ethnic background, and other aspects of social identity also matter. Like all clients, older adults are uniquely different from one another with different needs.
Cary and colleagues added to our understanding of ageism through research and the development of the ambivalent ageism scale to measure benevolent ageism as opposed to hostile ageism.4 Hostile ageism is easy to recognize; for example, dubbing COVID-19 as the “boomer remover” is considered hostile.
Benevolent ageism is not as easy to identify, perhaps because it has good intentions but results in negative outcomes. Benevolent ageism can occur when an older person’s opinions and decisions are disregarded, such as when someone insists an older adult receive homecare despite this being against the client’s wishes. This scenario is an ethical dilemma for care providers, family members, and friends. Although it can be difficult for clients to accept and understand the benefits of having more help at home and the need for providers to ensure no harm, we also must respect an individual’s right to self-determination. Despite an older client’s refusal of this type of intervention, there is a point when we must question how we interpret risk, our client’s wishes, and the goals of our profession.
On the other hand, meeting with clients every several months to ensure their memory is intact may create a feeling similar to test anxiety and lead to lower assessment scores.5 Although we know age is a risk factor for developing memory loss, it does not mean that each person will have significant memory changes as they age.
Self-perceptions of aging vary, influenced by lived experiences, social identity, and societal attitudes. In her seminal research on the internalization of ageism and development of age-stereotype embodiment theory, Levy stated children can internalize ageist stereotypes that are maintained across the lifespan and become harmful in later life.6 Furthermore, people often are unprepared to respond to negative ageist stereotypes when they become older.
For example, an 85-year-old client expressed how she no longer felt beautiful. I felt concerned about her sense of self, my response being patronizing, and the length of time it took for me to respond. I explored how she defined beauty and from where her feelings emanated. We discussed new definitions of beauty that she could accept and internalize and explored society’s ageist definitions of beauty and their impact on her perceptions.
More Steps to Consider
Another step we can take is to help clients understand the potential connection between their concerns and the ageist stereotypes that they may have internalized throughout their life.
Social work practice, like other related interdisciplinary fields, includes career-long learning as part of the profession and licensure. Whether or not social workers are practicing with older adults, they should explore continuing education workshops on ageism. Continue to explore ageism in direct practice and on different levels of policy. Remember the power imbalance that can exist between social workers and their clients and identify how you can engage in antioppressive practices with older adult clients and their communities.
Question your views on aging and how they are influencing your approach and recommendations to clients—especially the well-intentioned recommendations. Lastly, consider your own lived experiences. How might these impact your future? What might you need someone else to know when you become older?
— Lauren Snedeker, DSW, LSW, LMSW, is an assistant professor of teaching and coordinator for the Aging and Health Certificate Program at the School of Social Work at Rutgers, The State University of New Jersey.
2. Hulko, W., Brotman, S., Stern, L., & Ferrer, I. Gerontological Social Work in Action: Anti-Oppressive Practice With Older Adults, Their Families, and Communities. New York, NY: Routledge; 2019.
3. Aronson L. U.S. hospitals ignore improving elder care. That’s a mistake. STAT website. https://www.statnews.com/2018/11/16/hospitals-downplay-elder-care/. Published November 16, 2018.
4. Cary LA, Chasteen AL, Remedios J. The ambivalent ageism scale: developing and validating a scale to measure benevolent and hostile ageism. Gerontologist. 2017;57(2):e27-e36.
5. Lamont RA, Swift HJ, Abrams D. A review and meta-analysis of age-based stereotype threat: negative stereotypes, not facts, do the damage. Psychol Aging. 2015;30(1):180-193.
6. Levy B. Stereotype embodiment: a psychosocial approach to aging. Curr Dir Psychol Sci. 2009;18(6):332-336.