DR. DOHA RASHEEDY
LECTURER OF GERIATRIC MEDICINE
DEPARTMENT OF GERIATRIC AND
AIN SHAMS UNIVERSITY
• humans automatically categorize others in
social perception. Some categorizations—
race, gender, and age—are so automatic that
they are termed ―primitive categories‖.
• As we categorize, we often develop
stereotypes about the categories.
• As with race and gender, we rely on physical
cues for categorizing people based on age.
What physical characteristics do you associate
with older or elderly people?
gray or white hair
all assist rapid identification of people based
on their (old) age.
• The labels we give to these social categories
vary but include old
people, elders, seniors, senior citizens, and
Stereotyping based on age
• This stereotyping can be so prevalent in
society that it is almost invisible, but it can
perpetuate negative attitudes that influence
stereotyping, prejudicial attitudes and direct or
indirect discrimination against people because they
• Ageism, a term first used by Robert Butler in 1969, is an attitude of m
ind which may lead to age discrimination.
• Age discrimination, on the other hand, is a set of actions with outco
mes that may be measured, assessed and compared.
• ageism is used to describe stereotypes and prejudices held about old
er people on the grounds of their age.
• Age discrimination is used to describe behaviour where older people
are treated unequally (directly or indirectly) on grounds of their age.’
(Ray, Sharp and Abrams, 2006)
Ageism is a set of beliefs … relating to the ageing process.
• Ageism generates and reinforces a fear of the ageing process,
and stereotyping presumptions regarding competence and th
e need for protection.
• In particular, ageism legitimates the use of chronological age t
o mark out classes of people who are systematically denied re
sources and opportunities that others enjoy.
Butler (1969) proposed that ageism
has three components:
• a cognitive component (beliefs and
stereotypes about older people)
• an affective component (prejudicial
attitudes towards older people)
• a behavioural component (direct and
indirect discriminatory practices).
Emotional reactions to the elderly
• Pity and sympathy were the most common emotions felt
about the elderly.
• Old people also prompt a range of negative feelings in
others, and chief among those is anxiety.
– Researchers have found that anxiety is a common response to
older people among the young, and the main reasons seem
to be that old people remind us what may, or likely will, happen
to all of us eventually. The elderly remind us that youth and
beauty will fade; that illness and disability, along with the social
isolation they can cause, are likely; and that death is a certainty
– Another explanation for the anxiety and threat posed by the
elderly to younger people trades on the stereotypic beliefs that
old people are sick and feeble and therefore more likely to catch
and carry illnesses that can be caught by others.
• anxiety about older people predicted attitudes and behavior:
Participants who reported more anxiety also attributed more
negative characteristics to older people and reported less
willingness to help the elderly.
Manifestations of Ageism in Daily Life
• Two major types of negative communication
have been identified by researchers:
overaccommodation and baby talk.
• In overaccommodation, younger individuals become
overly polite, speak louder and slower, exaggerate
their intonation,have a higher pitch, and talk in
simple sentences with elders
(Giles, Fox, Harwood, & Williams, 1994).
• This is based on the stereotype that older people
have hearing problems, decreasing intellect, and
slower cognitive functioning (Kite & Wagner, 2002).
• Baby talk is a ―simplified speech register high
pitch and exaggerated intonation‖ (Caporael &
• As the term implies, people often use it to talk
to babies (termed primary baby talk) but such
intonation is used, also, when talking to
pets, inanimate objects, and adults (termed
secondary baby talk).
Examples of ageism in health care
loss, incontinence, and immobility: are often overlooked because
of a misconception that they are an unavoidable part of aging.
• An interim report in 2002, identified the following areas of explicit
negative discrimination in policy in secondary care.
Resuscitation , Hospital admission policies , Access to day
surgery , Gastroenterology screening , Osteoporosis screen
ing ,Adverse clinical incident reporting ,Transplant policy , P
rescribing , Colorectal cancer screening ,Anaesthesia guidel
ines , Breast screening ,Cervical cancer screening ,Coronar
y heart disease clinical guidelines , Immediate stroke care
(Department of Health, 2002, Policy document)
Impact of ageism
• Ageism promotes the idea that older people are a
burden and this can lead to neglect and social
• It can also reduce older people’s self-esteem, reduce
their participation in society and restrict the types and
quality of services available to them.
• Research by Sargeant (1999) reported that victims of
discounted, ignored, treated with disdain and denied
the opportunity to be recognised as individuals with
civic rights and responsibilities.
• Older adults in the United States tend to be
responsibility, power, and, ultimately, their dignity
Co-occurrence of Ageism and Abuse:
• The negative attitudes that lead to ageist
behavior also make it easier for the
perceiver to regard the welfare and
humanity of older adults as less important
than that of younger adults.
• As such, ageism may indeed be a
contributing factor that leads some
younger adults to neglect, exploit, or
otherwise abuse older adults.
Why Ageism Occurs?
Many theories have been proposed as to
why ageism occurs at individual, societal
and organisational levels:
• According to Butler (1969) and Lewis
(1987), ageism allows the younger
generation to see older people as
different from themselves and thereby
reduce their own fear and dread of
• A second factor contributing to ageism is the
emphasis on youth culture in western society
(Traxler, 1980). The media places an emphasis on
youth, physical beauty and sexuality, while older
adults are primarily ignored or portrayed negatively
(Martel, 1968; Northcott, 1975).
– For example, a cornerstone of the birthday greeting card
industry is the message that it is unfortunate that one is
another year older. While couched in jokes and
humor, society is clearly saying one thing: getting old is
bad. A recent survey found that approximately 90 million
Americans each year purchase products or undergo
procedures that hide physical signs of aging (National
Consumer’s League, 2004).
• Thirdly, the emphasis in western culture on
productivity contributes to ageism, where
productivity is narrowly defined in terms of
economic potential (Traxler, 1980).
– The industrial revolution demanded great mobility in
families—to go where the jobs were. In light of this new
pressure to be mobile, the extended family structure (with
grandparents in the household) was less adaptive. Older
people were not as mobile as younger people. These jobs
tended to be oriented toward long, difficult, manual labor, and
the jobs were thus more suited to younger, stronger workers
– great advances in medicine, extending life expectancy
significantly. Society was not prepared to deal with this new
large population of older adults. Society began to associate
old age with negative qualities, and older adults were
regarded as non-contributing burdens on society
Levels of ageism
ideas, attitudes, beliefs, and practices of individuals that
are biased against persons or groups based on their older
age. Examples include exclusion or ignoring older
persons based on stereotypic assumptions, and
• Institutional ageism: is defined as missions, rules and
practices that discriminate against individuals and/or
groups because of their older age. Examples include
mandatory retirement, and devaluing of older persons in
cost-benefit analysis .(gerontocracy)
• Intentional ageism: is defined as ideas, attitudes, rules, or
practices that are carried out with the knowledge that they
are biased against persons or groups based on their older
age. Examples include marketing and media that use
stereotypes of older workers; targeting older workers in
financial scams; and denial of job training based on age.
Types of ageism
ideas, attitudes, rules, or practices that are
carried out without the perpetrator’s awareness
that they are biased against persons or groups
based on their older age.
This type of ageism is also known as
inadvertent ageism .
Examples include absence of procedures to
assist old and vulnerable persons, lack of builtenvironment
(ramps, elevators, handrails), and language
used in the media.
• Positive ageism: For example, Palmore ( 1990 )
de fined ageism as “any prejudice or
discrimination against or in favor of an age
group” (p. 4). As examples of positive
ageism, older persons might be seen as
wiser, more capable of grasping the big picture as
opposed to details of a specific problem or
situation, and happier than younger persons.
• negative/overtly harmful – direct discrimination.
Assumptions based on positive or negative
ageism may lead to responses that are
The way forward
Discrimination in old age must be made visible and tackled
at every level:
• As individuals we must challenge ageist attitudes and
behavior wherever they occur.
• Discrimination in old age should be prohibited in national
legislation and existing discriminatory laws revised.
• Universal prohibition of discrimination in old age in a
human rights instrument would provide a definitive, universal
position that age discrimination is morally and legally
Health care ageism:
Health education about normal ageing
Improve access to care
Improve quality of care
Clinical trials for the aged.