- Elliott M. Stein, M.D.
Older People, Ageism, and Language
The first known use of the word “Elderly” was in 1611 when it was used in a context meaning “rather old, being past middle age”. Elderly is derived from the word “Old”. One might think “old” would be a neutral or even positive term because the Latin roots, alere and alescere, mean to nourish or grow. However, most of the synonyms for old make it clear that the connotations are usually negative: antiquated, archaic, senile, worn, discarded, debilitated, infirm, frail, and so forth. When it comes to older adults, language matters.
Aging is something that affects everyone. In cultures and in past generations when it was more common for grandparents, parents, and children to dwell together in households and communities, more people were directly exposed to the positive and negative potentials of the aging process. We now live in a society where we no longer have as many multi-generational families living together (although this trend may be changing again). Now we have a society that still focuses on the youth-oriented aspects of culture, losing perspective on how the past is formative and still present in the continuum leading to later life.
Ageism Ageism is discrimination against older people due to negative and inaccurate stereotypes. Since all of us are aging, ageism is a prejudice that everyone, of every grouping, could be subjected to, and likely will if they live long enough and these attitudes persist.
The 2020-21 COVID-19 pandemic has differentially and adversely affected older people, particularly the vulnerable individuals living in congregate facilities, like retirement settings and nursing homes. When questions were raised by some people about the choices and values of preferentially treating the residents of these facilities, it highlighted the ease with which ageist language was employed and ageist stereotypes were used to characterize older adults. These attitudes are harmful and display an impressive lack of future thinking, as the younger and middle-aged adults who use this language and repeat these concepts also hope to live long lives.
Issues of aging and agism, both overt and covert, are an ongoing problem in society and will only increase with the further graying of the population. The myths of aging are only slowly being confronted.
Positive Aging The vulnerability of older people has been highlighted during the coronavirus pandemic. However, the contributions and positive attributes of older people are not as well known or even discussed. A more accurate picture would include discussion of their creativity, experience, and wisdom, as well as examples of successful aging. For example, Sophocles wrote Oedipus Rex at 71. Imogen Cunningham still published photographs and taught at the Art Institute of San Francisco in her 90’s. Einstein published “The Meaning of Relativity" at 74. John Muir wrote his book "My First Summer in the Sierra", when he was 73 years old. In 1972, at the age of 99, astrophysicist Charles Abbot designed a device for converting solar energy into power. Robert Frost published his volume of poetry, “In the Clearing”, at 88. Our last two presidents were both elected in their 70’s. George Burns won an Oscar at the age of 80, and his last film performance was at 98 years old. Warren Buffett, currently 90 years old, is still the perennially successful CEO of the Berkshire Hathaway investing firm.
In recent years we have begun to see more popular literature featuring older people as protagonists. More movies, television shows, TV commercials, podcasts, and other entertainments have been created with older casts, showing older actors and themes. This is not accidental. Older writers and filmmakers are producing works that reflect their lives, and can appeal to the aging population. However, additional positive portrayals in other settings, including the potential benefits of successful aging, are very much needed.
“Dialogue with Time” was a recent original Israeli interactive museum exhibit that aimed to change negative ageist attitudes by creating a meaningful and stereotype-breaking encounter between visitors and old age, and to reduce ageist attitudes among its visitors. Surveys taken before and after visiting the exhibit showed a positive beneficial effect.
Language and Aging Medical organizations, including the American Medical Association and the American Geriatrics Society, have instituted policies of awareness of the language to be used in their publications when referring to older people. This includes avoiding “seniors,” “elderly,” “aging dependents,” and similar “other‐ing” terms that stoke stereotypes, in favor of using more‐neutral (older people, Americans) and inclusive (“we” and “us”) terms. They want journal authors to use a term like “older adult” when describing individuals aged 65 and older. They recommend avoiding words like “struggle,” “battle,” “fight,” and similar conflict‐oriented words to describe aging experiences, or “tidal wave,” “tsunami,” “fading away”, “breaking down”, and similarly catastrophic terms for the growing population of older adults. They recommend talking affirmatively about changing demographics: “As Americans live longer and healthier lives...”
Older people are as vulnerable to ageist stereotypes as younger people are. Aging adults generally think of themselves as younger than their chronological age, in part due to the stigma associated with being “old”, as well as also having culturally based preconceptions about what it means to be “old”.
"How old do you feel?" Subjective age (also commonly called perceived age, self-perceived age, or self-perception of age) is a concept that captures personal perception of the aging process. Subjective age is a measure of self-perception of age including how old a person feels and thinks, as well as factors such as psychological well-being, life satisfaction, or overall health. Subjective age measures can encompass person-oriented measures or context-oriented measures. Person-oriented measures include feel age (the age a person feels), look age (the age a person thinks they look), do age (the age a person perceives themselves to act), or interest age (the age a person perceives to reflect their interests). Context-oriented measures involve a specific comparison with another individual or group. Interest in subjective age can be assessed in a variety of ways. These can include questions like, “How old do you feel?”, “How old do you feel when you look at yourself in the mirror?”, and “How old do you, yourself, feel inside?
My Experience One of the things I have always found fascinating in my work has been when I have asked older people to bring in pictures of themselves as younger people, and then discussed the connection of that younger individual who is embodied in the person in their later years. When I teach, I remind trainees to think of the older individual in front of them as someone who has had a life full of events, a person who was previously younger, someone who had been a child learning to ride a bicycle, a school student starting to read, a teenager who had a first kiss, a person who got a first job, got married, may have had a first child, military service, travelled the world and other experiences both good and bad.
Older People, Ageism, and Language
Aging needs to be redefined. Widespread negative assumptions about “getting old” have led the public to take a fatalistic stance that there is not much to be done about aging, and that older people, simply by virtue of their age, are no longer capable of doing things. Awareness of the words we use to describe older people is part of this. Such language has an impact. Developing and conveying equitable attitudes about aging obliges us to develop an understanding of the lifetime of experiences of each older person we encounter, and an awareness the words used to express that understanding.
Elliott M. Stein, M.D.
For attorneys, legal professional and individuals representing or involved in legal matters requiring forensic geriatric psychiatric matters as part of their case, please contact Dr. Stein to schedule a no-obligation 30-minute consultation: https://www.elliottsteinmd.com/request-consultation