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Psychological Assessment and Therapy with Older Adults: What to Expect in a First Session
Listen To My Latest Podcast Episode: Psychological Assessment and Therapy with Older Adults: What to Expect in a First Session
Coronavirus: Isolate the Elderly was the sign on the freeway that I would see twice a day as I drove to and from work at a busy medical center in a Geropsychiatry Outpatient Clinic to provide teletherapy to older adults and their families during COVID. I cringed every time I drove past this sign.
Since COVID started, I have received several emails from people who care about older adults expressing concern for them. Like, a college professor who reached out to me to express concern that her father, who is a physician, made the decision to leave retirement to return to work in a medical clinic during COVID. She shared with me that she was appalled and went so far as to call his medical practice and complain.
There have been countless ageist expressions since the coronavirus started. And the problem with ageism, even well-meaning ageism, is that it has the effect of harming older adults rather than helping them.
I’ll start with the sign on the freeway: Coronavirus: Isolate the Elderly. While this sign, like the college professor, is well-meaning to protect older adults from contracting COVID, it actually has the effect of putting them in harm’s way. Here’s how: The idea that older adults need to be isolated is in direct contrast to the American Psychological Association’s (APA) recommendation that we need to “encourage social distancing, not social isolation.” The APA reminds us that while physical distancing is vital to reducing the spread of COVID-19, social isolation among older adults increases the risk of early death, heart disease, and dementia. Older adults living in long-term care communities are also especially vulnerable to the toll of isolation.
The APA Committee on Aging (APA CONA) defines ageism as “stereotyping and discrimination against individuals or groups based on their age. It can include prejudicial attitudes, discriminatory practices, or institutional policies and practices that perpetuate stereotypical beliefs.”
I want to draw your attention to three strains of ageism described in a recent Columbia Mailman School of Public Health article:
Now that we can all agree that ageism is bad (don’t do it), what can we do about ageism? Here are APA CONA’s tips to help older people, their families, caregivers, and health professionals confront ageism during this pandemic… and a few strategies of my own:
Be self-aware. Ageism is pervasive and often difficult to detect. Developing awareness of your own ageist attitudes, language and behavior is a great place to start (doctor, heal thyself). Here are some of my favorite strategies for doing this:
Remember that older adults are diverse and have intersecting identities. As such, ageism interacts with other stigmatized identities like sex, race, gender, ability, and sexual orientation and can create a phenomenon of double jeopardy, triple jeopardy, and so on creating higher levels of risk and disenfranchisement and reduced levels of access to resources and care.
Naturally, this will influence their resources and ability to cope effectively during a crisis. When addressing and responding to the COVID-19 pandemic, use an individualized lifespan approach to meet the needs of and care for older adults, not just their chronological age.
Speak out against ageism by providing feedback when you see ageism showing up. Ageism is so ingrained in us and our culture that many people are not aware of ways their language and behaviors negatively portray older adults. Some ways that I speak out against ageism are in my Psychology of Aging podcast, in my blog posts, and when I present on older adults and their families.
Shift your focus — meaning, try to see things with a new lens. Shift away from the stereotype. For example:
Spread the facts. Sharing accurate information is vital to ensure the responses to COVID-19 benefit everyone. Make sure health workers, policymakers, and health care administrators are aware of diversity among older adults. Older adults experiencing double or triple jeopardy as a result of intersecting identities may be at particular risk for the negative consequences of ageism. If you work with these groups, you have an important role in advocating for their needs.
I am happy to say that in the past week, the sign on the freeway changed to Coronavirus: Protect the Vulnerable. Now, that is a statement I can get behind.
Dr. Regina Koepp is a Contributing Author for Psychology Today, where this article was originally published on 6/22/20
I'm a Stanford trained, Board Certified Clinical Psychologist specializing with older adults and families! I'm an Assistant Professor at Emory University School of Medicine Department of Psychiatry & Behavioral Sciences, and a staff Psychologist working with older adults and families at the Atlanta VA Health Care System. I'm a mom of two little kids and a daughter to aging parents.
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