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Running Head: What Goes Around Comes Around
What Goes Around Comes Around: An Analysis of the Effects of Age Stereotyping
Bethany F. Campbell & Hoi Kiu Tong
Brigham Young University
Health 466
April 18, 2015
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Abstract
Stereotyping of elders is common in society and results in a prejudiced attitude against them
known as ageism. As an individual ages, internalized ageist views are directed toward the self,
causing a cyclical pattern of belief that the aging process is essentially negative and to be
avoided at all costs. This paper examines the idea that continuation of this cycle imposes
unnecessary limitations on the aging population and impacts society in many negative ways.
Effects of positive stereotypes are also addressed and suggestions for remedial action within
society are set forth.
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What Goes Around, Comes Around: An Analysis of the Effects of Age Stereotyping
“It is natural for the culture to treat the old like the end of what was once good
material…The most flattering thing you can say to an older American is that he ‘doesn’t look his
age’ and ‘doesn’t act his age’ – as if it were the most damning thing in the world to look old…”
[Max Lerner’s, America as a Civilization, 1957]. The preceding quote is one of the first written
expressions of the phenomenon of ageism [Cohen, E., 2001].
Growing old is a necessary part of existence, yet it is one that our society refuses to
accept and actively tries to prevent. If you were to type “anti-aging products” into any online
search engine, over 18 million results would appear in less than a fifth of a second. You’ll find
everything from skin care products and miracle diets, to the best surgical procedures for reducing
wrinkles. In her book, The Denial of Aging, Muriel R.Gillick addresses this obsession and argues
against the desperate attempts of her fellow Baby Boomers to prolong life at any cost, stating
instead that quality of life ought to take precedence [Gillick, 2007].
Why such resistance? What is the reason that so many Americans, especially women,
fight so passionately against this natural process [Duncan, C., & Loretto, W., 2003]? The answer
lies in understanding the fundamental beliefs people subscribe to regarding the process of aging
and what stereotypes they employ.
In reality, the individual members that make up our nation’s elders are extremely varied.
They differ from one another in virtually every aspect, including race, living conditions,
educational background, religious beliefs, quality of health and political preference [Ferrini &
Ferrini, 2013, p. 7-24]. Even so, as is common with members of any cohort, they are often
stereotyped by outsiders, specifically by anyone younger than 65 years of age. While some of
these stereotypes may be harmless misconceptions, if not curbed and corrected, these
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misconceptions, perpetuated through the media, are adopted by ever increasing numbers of
people until they are accepted and even taught as fact. This results in the formation of a prejudice
toward the aged, and an active (though at times subconscious) discrimination against them. It’s
called ageism [Ferrini & Ferrini, 2013 p. 6] and no member of society is exempt from its
potential influence. Ageism shows up on the playground of the elementary school where children
scramble at recess to escape the imaginary “wicked old witch.” It exists in popular movies and
television shows where overbearing, senior mother-in-laws and grouchy next-door neighbors
provide so-called comic relief. Sadly, ageism even rears its ugly head in the medical profession.
Studies abound on the effects of cultural stereotyping on the health of elders. Yet, less
well-researched is the effect these negative stereotypes have on the elderly when they themselves
are the ones imposing them. This has been referred to as self-stereotyping and when studied
effectively, it may hold the key to understanding how much of the beliefs that incite ageism are
unfounded and what a truly accurate view on aging is. Of greatest significance is the hypothesis
proposed by researchers Korthase & Trenholme: “Perhaps these negative expectations about
aging will become self-fulfilling and impose unnecessary limitation on future generations of the
elderly” [Korthase & Trenholme, 1983, p. 890, as cited in Levy 2003]. The research also
suggests that positive stereotypes exist and can be a factor in extending life. Another area of
focus should then be how society can promote these positive stereotypes.
The purpose of this paper is to show that negative aging stereotypes are especially
harmful to the seniors who internalize them and that acceptance of positive aging self-
stereotypes have a measurable and beneficial effect on the physical and mental health of seniors.
It is the authors’ intent to examine an alternative approach: whether the debilitation traditionally
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associated with aging might at least in part result from the formation of aging self-stereotypes,
rather than solely from an inevitable biological process [Levy, B., 2003].
We propose that an elder’s internalized beliefs will have a significant effect on both their
physical and mental health and their longevity. If ageism is recognized and remedied in our
society at large, we will see not only an increase in length of life, but in the quality of life as
well. In the words of gerontologist, Roy E. Christensen, “It is time for society to change its views
on aging. Death can come to anyone, at any time. But old age comes as a blessing to only a few”
[Christensen, 2015].
Literature Review
The Reality of Ageism and its Manifestations in Society
The power and prevalence of our society’s negative aging stereotypes results in what
researchers call a “double-whammy” for seniors: ageism not only influences the way seniors are
treated in society, but also how seniors view themselves [Horton, S., Baker, J., & Deakin, J.,
2007]. Baby Boomer and former U.S. President, Bill Clinton is reported to have said, “When I
look at how old I am, and see my gray hair in the mirror, I can’t imagine that anybody’s
interested in life anymore!” [Horton, S., et al. 2007]. This statement should raise a lot of
concerns about our society’s views on aging, especially with the inflation of the elder population
as the Baby Boomers come of age.
In a 2003 study done by Ory, [Ory, m., Hoffman, M., Hawkins, M., & Scanner, B., 2003],
surveys found that 84% of Americans and 91% of Canadians reported experiencing at least one
incident of ageism. More than 50% reported encountering multiple incidents. Many of these
incidents were of a subtle and even humorous nature. For instance, some participants had
received birthday cards which poked fun at growing old. Many of the respondents didn’t even
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realize until participating in the study that they had encountered ageism. This illustrates the
pervasiveness of negatively stereotyping the elderly in our society. It is so commonplace that it is
oftentimes overlooked, even by those most adversely affected.
Ageism Exhibited among Children. These negative beliefs have even affected our
society’s youngest members. In a study where children ranging in age from preschool to sixth
grade were shown illustrations depicting a man throughout four stages of life, 67% of all the
children identified the oldest man as being “helpless, incapable of caring for himself, and
generally passive” [Levy, B., 2003].
Even when no ageist attitudes are detected in young children through survey questions,
often times their behavior still demonstrates discriminatory feelings for the aged. One project
compared the behavior of children working on a jigsaw puzzle with a middle-aged confederate as
opposed to working with and elderly confederate. Even though middle-aged and elderly
confederates alike were healthy, fashionably-dressed and each had professional experience
working with children, the children in the study “sat farther away from, made less eye contact
with, spoke fewer words to, initiated less conversation with, and asked for less help from aged
confederates” [Lott, B., 1995].
Ageism in the Media. Children’s development of these negative stereotypes can be
largely attributed to our society’s television and media. In a study done by Montepare and
Zebrowitz, they found that older adults were more likely to be portrayed in comical roles
reflecting the nation’s stereotypes of the physical and cognitive decline and even sexual
impotence of elders [Nelson, T., 2002]. How telling it is, that a hearing titled “Image of Aging in
Media and Marketing” was recently held by the U.S. Senate Special Committee in which twenty-
five witnesses testified of the negative portrayals of older persons, Older persons are continually
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characterized as ineffective, feeble, helpless and irrelevant, both in print and through television
[Ory, et al. 2003]. With good reason, there is growing concern and recognition that negative
views of the elderly are becoming pervasive in American Society.
Ageism in the Health and Medical Professions. Since stereotyping others is such a
deeply ingrained and fundamental component of social perception, researchers have termed the
act “automatic”, or “primitive” [Nelson, 2002]. It seems to be an instinct shared by all humans.
Accordingly, it should come as no surprise that negative age stereotypes are subscribed to by
medical and healthcare professionals.
A clear demonstration of this can be shown in the research regarding a phenomenon
known as elderspeak. Elderspeak, also referred to as “patronizing speech” or “secondary baby
talk”, is a form of speech accommodation used by younger adults when speaking with older
adults [Draper P., 2005]. It is characterized by exaggerated intonation, greater repetition, a
higher pitch and volume and a slower rate. It includes a simpler vocabulary and grammar than
that used in ordinary adult communication and is often marked by frequent use of terms of
endearment. This over-accommodation of speech implicitly questions the competence of its’
listener. The use of collective pronouns (as in a nurse cheerily telling her patient, “It’s time for
our bath!”), diminutives (“Did you see the birdie out your window?), and tag questions meant to
illicit a specific response (“You need your meds now, don’t you?”) can each have a
condescending nature which elders find offensive and disrespectful [William, K., Kemper, S., &
Hummert, M., 2003].
One study established the views of older persons concerning elderspeak by asking 186
seniors to read scripts of a dialogue between an older patient and a nurse. In one script, the nurse
used terms of endearment and diminutives common in elderspeak, such as “poor dear”, and
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“good girl”. The other script omitted these expressions. In comparison, participants rated the
patronizing nurse in the first script as less competent, less nurturant, less benevolent and
significantly less respectful than the nurse in the second script [Brown, A., & Draper, P., 2002].
In spite of elder’s dislike for it, overly-accommodative speech continues to be used frequently in
hospitals and other nursing facilities for the elderly. Ageist attitudes held by individual
practitioners do indeed appear to play a significant role in explaining why health workers
continue to use over-accommodating language when addressing older persons, since it was noted
in a particular study that those subjects “who preferred over-accommodation also tended to have
the most negative attitudes towards older people”[Brown, A., et al., 2002].
Despite the clear association between negative age self-stereotyping and detrimental
effects on the elder’s health, researchers have found that, these stereotypes are less likely to be
counted as legitimate causes of “cognitive, behavioral or health related outcomes” among
healthcare professionals [Levy, B., 2001]. It is evident that there exists a lack of accurate
understanding of the aging process in the healthcare field. The assumption made by healthcare
workers that all patients will experience inevitable cognitive and physical decline by a certain
age leads to misdiagnosis of disease and poor health care interventions [Grant, L., 2006].
Elders usually receive more medication for the same illness and symptoms of the younger
population, even when they’ve been shown to react to the medication in the same way as
younger individuals [Kane, M., 2010]. A study done by Bowling and Pettersen found that a
certain cardiologist made treatment decisions based solely on age. They also reported that older
adults are much more likely to receive only medication without any other alternative treatments
or therapy that might lengthen their lives [Kane, M., 2010].
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Although the physical effects of aging are generally more noticeable, psychological
problems among older adults should be a more pressing concern within our society’s health care
system today. However, difficulties arise in diagnosing emotional distress in seniors because
such symptoms can be masked by physical ailments which most healthcare professionals view as
a normal and expected part of aging. Often, elderly individuals themselves are reluctant to seek
assistance for psychological issues due to their own belief that cognitive decline in aging is
inevitable [Grant, L., 2006]. Even when they do seek professional help, the ageist views of
health professionals that seniors are set in their ways and unwilling to change, decrease the
likelihood that the elder will be treated as rigorously or as effectively as their younger
counterparts are [Dittmann, M., 2003].
These problems might explain the reason for why older person have not generally been
targeted as beneficiaries of most healthcare or public health programs. About 45% of U.S
community mental health centers have reported having little or no programs for the elderly
[Grant, L., 2006]. As long as older adults hold preconceived notions that it is too late for them to
change their ways, and those notions in turn match the general consensus of members of the
healthcare profession, then little progress can be made in providing programs to improve the
quality of life and quality of care for seniors.
Ageism is as real of a problem as racism or sexism. It is an actual form of prejudice. Not
only does it limit our elderly to mere objects, myths, and stereotypes, it also shapes the
perceptions of both the young and old who internalize ageist attitudes. Eventually, the elderly
accept these stereotypes as self-evident truths [Kelchner, E., 2008].
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Self-Stereotyping
A leading researcher in the field of the psychology of ageing is Becca R. Levy, an associate
professor of epidemiology and social psychology at Yale University. One crucial component of
her work is the understanding of how the effect of ageing stereotypes differs from that of
stereotyping aimed at other groups such as race or gender. Stereotype Threat Theory (STT) is
used to describe the potentially harmful effects on a member of a targeted group when they feel
at risk of confirming negative stereotypes about their social group [Schmander, T., 2011]. The
threat is situational and stems from external forces. For example, an African American taking a
college entrance exam would perform more poorly than other groups because of stereotypes that
their race is less intelligent than others [Steele, c., & Aronson, J., 1995]. But, in these cases, the
individual need not subscribe to the stereotype personally in order for it to impact their
performance. The threat only presents itself when individuals are in a relevant situation and it
can therefore be evaded by avoiding those situations. Stereotype Embodiment Theory (SET) on
the other hand, posits that ageing stereotypes differ in that they are internalized over one’s life-
span, eventually becoming “self-stereotypes” about oneself as an aging individual. These self-
stereotypes utilize multiple pathways, exerting their influence on individual health either
consciously or unconsciously [Levy, B., 2009].
Harmful Effects of Negative Self-Stereotyping. A study of note which illustrates the
physiological effect of self-stereotyping on elders was conducted by Levy and associates. It also
reflects the complexity of self-stereotyping. Participants were exposed to either negative or
positive aging stereotypes at a subliminal level and then confronted with verbal and
mathematical challenges. Since one likely path by which aging stereotypes might influence
physical functioning of the elderly is through the autonomic nervous system, participant’s
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physiological responses to these stressors were measured by means of systolic blood pressure,
diastolic blood pressure, heart rate, and skin conductance. “The autonomic nervous system can
be adaptive in mobilizing an individual to respond to an acute stressor. . . Chronic activation of
the autonomic nervous system may lead to the body's overreacting and producing too many
stress hormones.” This study examined whether one such chronic stressor could be negative
aging stereotypes. Not only was it found that exposure to the negative stereotypes reduced
memory performance, self-efficacy, and the will to live of older adults, but the positive age
stereotypes “helped protect participants from experiencing cardiovascular stress” [Levy, B.
Hausdorff, J., Hencxke, R., & Wei, J., 2000]. As evidence of these stereotypes greater effects on
the elderly, the study also found “these same stereotypes exerted no effect on the young
participants, for whom the stereotypes were not personally relevant” [Levy, B., et al. 2000].
Detrimental effects of negative aging self-stereotypes are not limited to cardiovascular
stress. Belief that the aging process is one of inevitable and continual decline may encroach on
elders opportunities in later life. As noted by L. L. Carstensen, “Negative stereotypes can have
harmful consequences for the quality of life of older adults and can also result in a major loss to
society” [Carstensen, L., 2006]. One researcher interviewed a number of inactive nurses to
determine why they were not working. Many respondents cited their age as the reason they were
not working without giving any other explanation. This troubled the researcher, as she observed
“they were using ‘age’ to disqualify themselves or otherwise limit their range of choices”
[Grant, L., 1996].
Another subliminal exposure to age-stereotypes study examined handwriting.
Handwriting is a motor system that is thought to operate unconsciously and to reflect personality
[Levy, B., 2012]. Analysis of this activity in the elderly may lend clues as to how self-
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stereotyping can influence behaviors below their level of awareness. In the study, individuals
produced handwriting samples before and after exposure to the negative age stereotype primes.
These samples were then rated by a panel of forty younger individuals (aged 16-36 years)
according to how much they were characterized by the following six attributes: accomplished,
confident, deteriorating, senile, shaky, and wise. As was hypothesized by the researchers, the
samples produced after negative stereotype exposure showed a significant increase in
deteriorating, senile, and shaky ratings. In contrast, handwriting samples from participants who
were primed with positive aging stereotypes were rated as younger and as showing a significant
increase in accomplished, confident, and wise ratings [Levy B., 2012].
In a study done by the Heart and Stroke Foundation of Canada, it was found that 52% of
Baby Boomers are sedentary, and that 30% are obese. These numbers have dramatically
increased in the last decade. Even more concerning is the fact that only 13% of senior women
and 22% of senior men are physically active on a daily basis [Horton, S., Baker, J., & Deakin, J.,
2007]. These results were especially confusing when an overwhelming 98% of these same
seniors acknowledged that physical exercise was important to staying healthy. When researchers
tried to determine the reason for this gap between seniors understanding of what is beneficial
healthwise and their actual practiced health behaviors, the answer pointed to psychological
reasons more than any physical factors. Society’s attitude seems to present an important barrier
to senior’s participation in physical activity. It appears that negative aging stereotypes have a
self-perpetuating effect. If old age is seen as synonymous with frailty and physical deterioration,
seniors may passively accept such decline instead of exerting efforts to combat it. Yet,
“considering that a lack of physical and cognitive activity is believed to be the principal cause of
functional decline in elderly populations, it begs the question as to how much of the deterioration
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associated with aging is due to inevitable biological decline and how much is simply the result of
disuse” [Horton, S., ect 2007]. It is likely that an elder’s expectations of the aging process are
influencing their decisions on whether or not to take any active measures of prevention with
regards to their health.
This indeed appears to be the case, as confirmed by a study examining the effects of
implicit self-stereotyping on the will-to-live of elders. In the study, seniors were asked to respond
to a series of hypothetical medical situations involving potentially fatal illnesses. Those seniors
previously primed with negative aging stereotypes were “less likely to accept life-prolonging
interventions, even if it meant that they would die within a month”, whereas subjects who
received positive primes were more likely to be accepting of offers of medical treatment, even
despite great costs [Levy, B., Ashman, O., & Dror, I., 2000].
Research confirms the reciprocal nature of negative aging self-stereotypes. As stated in
the Stereotype Embodiment Theory, stereotypes are introduced early in life and are readily
internalized. They can operate below awareness. Since aging is not a situation one can simply
opt out of, the negative beliefs one holds about the aging process are gradually directed inward
as the individual becomes a member of the in-group of seniors [Levy, B., 2009]. When the
individual encounters physical or mental limitations or discomforts, these negative beliefs are
validated. The individual may be less likely to pursue any medical help or even social support
since they view these challenges as inevitable components of the aging process. Their resulting
pessimism in turn confirms the stereotypes forming in the minds of the younger generation.
Benefits of Positive Self-Stereotyping. In society, there exists a mixture of negative and
positive aging stereotypes. While the negative tends to outweigh the positive [Kotter-Gruhn, D.,
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& Hess, T., 2012], there is still reassuring evidence of the beneficial effects that positive aging
stereotypes can have on an elder’s physical and mental health.
In order to test the ability of positive stereotypes to partially reverse age-associated
changes in physical function, one study measured gait speed and percent swing time of 47 elders.
Again, subjects were subconsciously exposed to either a positive or negative stereotype of aging,
this time under the premise of playing a computer game. Measurements were taken pre and post-
intervention. After controlling for age, gender, health status, and psychosocial status, researchers
observed significant increases in walking speed and for percent swing time only among elders
who had received reinforcement of positive aging stereotypes. With such improvements resulting
from a mere 30 minutes of exposure to positive stereotypes, these findings provide strong
evidence supporting the potential of prolonged and consistent reinforcement to prevent, or
partially reverse some of the changes in physical function that we normally attribute to
advancing age [Hausdorff, J.M., Levy, B.R., & Wei, J.Y., 1999].
Other health benefits have been associated with internalization of positive aging
stereotypes. One encouraging study examined the association between positive age perception
and an elder’s capacity to recover from disability. Subjects in this study were not primed with
either positive or negative age stereotypes. Instead, each subject’s personal beliefs of aging were
assessed by recording their response to the question “When you think of old persons, what are
the first 5 words or phrases that come to mind?” Recovery from disability was based on the
patient’s efficiency in completing 4 essential activities of daily living (ADLs): bathing, dressing,
transferring, and walking. These activities are strong indicators of an individual’s use of health
care services and their longevity. Those subjects holding positive age self-stereotypes were
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found to be 44% more likely to recover fully from severe disability than those with negative age
self-stereotypes. [Levy,, B., Slade, M., Murphy, T., & Grill, T., 2012]
Longitudinal studies have been performed in this area of research, providing convincing
evidence of how elder’s self-stereotypes influence life expectancy. Using the community-based
survey, the Ohio Longitudinal Study of Aging and Retirement (OLSAR), the self-perceptions of
aging were assessed for each member in a sample of 660 people, aged 50 years or more [Levy,
B., et al. 2000]. The subjects reported their agreement or disagreement with several statements
about aging. Sample statements included: "As you get older, you are less useful." Over a 23-year
span, those individuals with greater positive self-perceptions of aging lived 7.5 years longer than
those with less positive self-perceptions of aging. Even more impressive is to note that a gain of
seven and a half years is much greater than the longevity increase attributed to other healthy
behaviors that are encouraged by health professionals. “The effects of attitudes about aging had a
greater impact on survival than low blood pressure and cholesterol, each of which is associated
with a longer life span of about four years. The attitudes about aging also had a greater impact on
longevity than lower body mass index, not smoking and regular exercise - each of which extends
life by one to three years” [Yale, Thinking Positively, 2002]. Incredibly, this advantage remained
after controlling for such variants as age, gender, socioeconomic status, loneliness, and
functional health [Levy, B., et al. 2002].
Discussion
With the strength of evidence for the measurable effects of aging self-stereotypes on
senior’s health, one may be surprised to find that drastic changes remain to be made in society’s
understanding of the issue and the promotion of positive self-stereotyping. Yet, the beliefs upon
which ageism is constructed are reinforced through a variety of cognitive processes. People tend
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to draw on the stereotypes which allow for the quickest and most efficient means of processing
information. Therefore, aging stereotypes are given primacy over actual experience with older
individuals. Learned information about elders may even be selectively recalled so as to maintain
stereotype congruity. If an elder is encountered who does not fit these internalized stereotypes,
rather than challenging the individuals beliefs about aging, the elder may simply be considered a
rare exception to the rule. Furthermore, negative age stereotypes can be easily assimilated into
one’s belief system during their younger years when they feel no need to defend against them
since they are not yet relevant to them personally [Levy, B., 2003].
Combating Ageism
Given the depth and pervasiveness of ageism in our society, the eradication of this
phenomenon is a complex and difficult task. We have noted how negative perceptions of aging
begin to develop very early in life and can be extremely subtle. The solution therefore, needs to
change the very way people think. Re-programming of attitudes toward aging and the elderly
must take place at an intimate level, within homes and families. Grandparents must be revered
instead of endured. Yet, because of the intimate nature of such a transformation, perhaps little of
practical application can be suggested in terms of correcting it. To begin this process of change,
we must instead start with experts in the field of gerontology, health policy makers, health
practice individuals, and other medical workers. We can then hope for a trickle-down effect in
shifting the views of society as a whole. [Angus, J., 2006]. As stated by Lynda D. Grant, “Health
care professionals need to move away from using the term ‘age’ as an explanatory variable and
the assumption that after enough time certain ‘things’ will happen to people” [Grant, L., 1996].
The current consensus among medical practitioners is that interventions should only be
extended for those who are likely to recover and enjoy long lives. The supposition that all elders
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are frail and bound for death puts a stop to the medical interventions, funding, and programs that
could benefit our elderly population [Kane, M., 2010]. Effective and broad public health
programs should focus on the culture, history, and social environments of our elderly population
and the effects, either for good or for ill that they may have on the aging process [Angus, J.,
2006]. Decisions regarding elder care must never be based strictly on age, but rather on
determining which services and resources would contribute to the health of seniors, regardless of
how few years they may have left to enjoy them.
In addition to changing belief systems of those in the healthcare profession, there are four
areas of specialty which require improvement. Psychiatry, psychology, social work, and nursing
share the bulk of responsibility in managing mental health care. Concerns have been raised about
the lack of professionals with specialized training in the care of the elderly within these fields.
Education in geriatric mental health for APRN’s (advanced practice nurses) and other medical
professionals has been severely inadequate [Hartford, Mental Health, 2011]. Only a small
amount of graduate nursing programs even include the topic of aging in their mental health
curriculum. Furthermore, no certification examinations exist for a specialty in geriatric
psychiatric nursing. As a result, insufficient numbers of nurses are prepared in this field. A
critical shortage of geriatric social workers also presents a challenge. Limited funding in
previous years has redirected many social work scholars into other, more appealing fields. Even
though a research fellowship program in geriatric psychiatry has been available at UCSD for
over 20 years, no post residency psychiatrists could be recruited because salaries were so low.
Only after receiving additional funding has the UCSD program acquired twenty-one psychiatrists
into its research fellowship program [Hartford, Mental Health, 2011]. If progression is to be
made in providing better healthcare for the elderly and modifying the ageist views held by
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professionals, greater funding must first be available in order to entice individuals into geriatric
fields.
Changing the way our health care professionals think about elders and the process of
aging may be the most significant step in combating ageism in our society [Carmel, S., Cwikel,
J., & Galinsky, D., 2006].
Conclusion
It is not the intention of this research to suggest that the aging process is without
difficulty. Gradual decline is an indisputable fact of advancing years. Yet, if seen as the only
option, this can taint society’s perception of aging. Indeed, the effects of many common diseases
can be modified and minimized through the proper intervention of both the senior individual and
their health care provider. Growing old need not be the traumatic experience that so many fear it
is.
Having reviewed the research, there is ample evidence that the aging process is
influenced by a number of psychological factors which produce a unique experience for the
aging individual. Aging may not be the cut and dry process of degeneration that many claim it to
be. Aging self-stereotypes can be modified so that elders no longer feel the restraint of ageism
preventing them from seeing old age as the blessing it truly is.
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[5] Carstensen, L. (2006). A Social Psychological Perspective on the Stigmatization of Older Adults. In
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[6] Christensen, Roy E. (2015). From the keynote lecture of the 25th Annual Russell B. Clark
Gerontology conference at Brigham Young University.
[7] Cohen, E. (2001). The Complex Nature of Ageism: What Is It? Who Does It? Who Perceives It? The
Gerontologist, 41(5), 576-577. Retrieved April 17, 2015, from
http://gerontologist.oxfordjournals.org/content/41/5/576.full.pdf html
[8] Dittmann, M. (2003). Fighting Ageism. Monitor on Psychology, 34(5), 50-50. Retrieved April 17,
2015, from http://www.apa.org/monitor/may03/fighting.aspx
[9] Draper, P. (2005). Patronizing speech to older patients: A literature review.Reviews in Clinical
Gerontology, 15(3), 273-273. Retrieved April 17, 2015, from
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countid=4488
[10] Duncan, C., & Loretto, W. (2003). Never The Right Age? Gender And Age-Based Discrimination In
Employment. Gender, Work and Organization,11(1), 95-115. From:
http://onlinelibrary.wiley.com.erl.lib.byu.edu/doi/10.1111/j.1468-0432.2004.00222.x/full
| 19P a g e
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[11] Ferrini, R. L., & Ferrini A. F. (2013). Health in the Later Years (5th ed.). New York, NY: McGraw-
Hill.
[12] Gillick, Muriel R. (2007). The Denial of Aging: Perpetual Youth, Eternal Life and Other Dangerous
Fantasies. Harvard University Press.
[13] Graham, J. (2012, December 19). Older People Become What They Think, Study Shows. Retrieved
April 17, 2015, from http://newoldage.blogs.nytimes.com/2012/12/19/older-people-are-what-they-think-
study-shows/?_r=1
[14] Grant, L. (1996). Effects of Ageism on Individual and Health Care Providers' Responses to Healthy
Aging. Health & Social Work, 21(1), 9-17. Retrieved April 17, 2015, from
http://web.a.ebscohost.com.erl.lib.byu.edu/ehost/detail/detail?sid=df628c68-dbcb-4050-b9c9-
4f5b32eb12ae%40sessionmgr4001&vid=0&hid=4109&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT
1zaXRl#db=f6h&AN=9602154224
[15] Hausdorff , J. M. , Levy , B. R. , & Wei , J. Y. ( 1999 ). The power of ageism on physical function of
older persons: Reversibility of age-related gait changes . Journal of the American Geriatrics Society , 47 ,
1346 – 1349
[16] Horton, S., Baker, J., & Deakin, J. (2007). Stereotypes of Aging: Their Effects on the Health of
Seniors in North American Society. Educational Gerontology, 33(12), 1021-1035. Retrieved April 17,
2015, from
http://www.tandfonline.com.erl.lib.byu.edu/doi/abs/10.1080/03601270701700235#.VTFsSDvF-fM
http://www.pubfacts.com/detail/10573445/The-power-of-ageism-on-physical-function-of-older-persons:-
reversibility-of-age-related-gait-changes
[17] Kane, M. (2010). Ageism And Intervention: What Social Work Students Believe About Treating
People Differently Because Of Age. Educational Gerontology, 30(9), 767-784. Retrieved April 19, 2015,
from http://www.tandfonline.com/doi/pdf/10.1080/03601270490498098
[18] Kelchner, E. (2008). Ageism's Impact and Effect on Society. Journal of Gerontological Social Work,
32(4), 85-100. Retrieved April 17, 2015, from
http://www.tandfonline.com/doi/abs/10.1300/J083v32n04_07?journalCode=wger20#preview
[19] Kotter-Gruhn, D., & Hess, T. (2012). The Impact of Age Stereotypes on Self-perceptions of Aging
Across the Adult Lifespan. The Journals of Gerontology Series B: Psychological Sciences and Social
Sciences, 67(5), 563-571. Retrieved April 19, 2015, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441190/
[20] Levy, B. (2001). Eradication of Ageism Requires Addressing the Enemy Within. The Gerontologist,
41(5), 578-579. Retrieved April 17, 2015, from http://gerontologist.oxfordjournals.org/content/41/5/578
| 20P a g e
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[21] Levy, B. (2003). Mind Matters: Cognitive and Physical Effects of Aging Self-Stereotypes. The
Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 58(4), P203-P211.
Retrieved April 17, 2015, from http://psychsocgerontology.oxfordjournals.org/content/58/4/P203.full
[22] Levy, B. (2009). Stereotype Embodiment: A Psychosocial Approach to Aging. Current Directions in
Psychological Science, 18(6), 332-336. Retrieved April 19, 2015, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927354/#R7
[23] Levy, B. (2012). Handwriting as a reflection of aging self-stereotypes. Journal of Geriatric
Psychiatry, 33(1), 81-94. Retrieved April 19, 2015, from http://psycnet.apa.org/psycinfo/2000-00674-005
[24] Levy, B., Ashman, O., & Dror, I. (2000). To be or Not to be: The Effects of Aging Stereotypes on
the Will to Live. OMEGA Journal of Death and Dying, 40(3), 409-420. Retrieved April 19, 2015, from
http://ome.sagepub.com/content/40/3/409
[25] Levy, B., Hausdorff, J., Hencke, R., & Wei, J. (2000). Reducing Cardiovascular Stress With Positive
Self-Stereotypes of Aging. The Journals of Gerontology Series B: Psychological Sciences and Social
Sciences, 55(4), P205-P213. Retrieved April 17, 2015, from
http://psychsocgerontology.oxfordjournals.org/content/55/4/P205.full
[26] Levy, B., Slade, M., Kunkel, S., & Kasl, S. (2002). Longevity Increased By Positive Self-perceptions
Of Aging. Journal of Personality and Social Psychology, 83(2), 261-270. Retrieved April 17, 2015, from
https://books.apa.org/pubs/journals/releases/psp-832261.pdf
[27] Levy, B., Slade, M., Murphy, T., & Gill, T. (2012). Association Between Positive Age Stereotypes
and Recovery From Disability in Older Persons. JAMA, 308(19), 1972-1972. Retrieved April 19, 2015,
from http://jama.jamanetwork.com/article.aspx?articleid=1392557
[28] Lott, B. (1995). Ageism in Interpersonal Setting. In The social psychology of interpersonal
discrimination. New York: Guilford Press.
[29] Meltzer, H. (1948). Diagrams of the Unconscious, Handwriting and Personality in Measurement,
Experiment and Analysis. Journal of Educational Psychology, 445-447. Retrieved April 19, 2015, from
http://psycnet.apa.org/psycinfo/1949-02612-000
[30] MENTAL HEALTH AND THE OLDER ADULT. (2011, January 1). Retrieved April 21, 2015,
from http://www.jhartfound.org/ar2011/index.html
[31] Nelson, T. (2002). The Paradox of Well-Being, Identity Processes, and Stereotype Threat: Ageism
and Its Potential Relationships to the Self in Later Life. In Ageism stereotyping and prejudice against
older persons. Cambridge, Mass., Utah: MIT Press.
| 21P a g e
What Goes Around Comes Around
[32] Nelson, T. (2005). Ageism: Prejudice Against Our Feared Future Self.Journal of Social Issues, 61(2),
207-221. From: http://onlinelibrary.wiley.com.erl.lib.byu.edu/doi/10.1111/j.1540-
4560.2005.00402.x/abstract
[33] Ory, M., Hoffman, M., Hawkins, M., & Scanner, B. (2003). Challenging Aging Stereotypes,
Strategies for Creating a More Active Society. American Journal of Preventive Medicine, 25(3), 164-171.
Retrieved April 17, 2015, from
http://www.sciencedirect.com.erl.lib.byu.edu/science/article/pii/S0749379703001818#
[34] Schmader, T. (2011). Stereotype Threat Theory, Process, and Application.New York, New York:
Oxford Scholarship Online.
[35] Steele, C., & Aronson, J. (1995). Stereotype Threat And The Intellectual Test Performance Of
African Americans. Journal of Personality and Social Psychology, 69(5), 797-811. Retrieved April 19,
2015, from http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=c0d68ad2-3eb3-4462-93fc-
c0578d1e1455@sessionmgr112&vid=2&hid=128
[36] Thinking Positively About Aging Extends Life More than Exercise and Not Smoking. (2002, July
29). Retrieved April 19, 2015, from http://news.yale.edu/2002/07/29/thinking-positively-about-aging-
extends-life-more-exercise-and-not-smoking
[37] Williams, K., Kemper, S., & Hummert, M. (2003). Improving Nursing Home Communication: An
Intervention to Reduce Elderspeak. The Gerontologist, 43(2), 242-247. Retrieved April 20, 2015, from
http://gerontologist.oxfordjournals.org/content/43/2/242.full
| 22P a g e
What Goes Around Comes Around

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AgeismResearchpaper

  • 1. Running Head: What Goes Around Comes Around What Goes Around Comes Around: An Analysis of the Effects of Age Stereotyping Bethany F. Campbell & Hoi Kiu Tong Brigham Young University Health 466 April 18, 2015
  • 2. | 1P a g e What Goes Around Comes Around Abstract Stereotyping of elders is common in society and results in a prejudiced attitude against them known as ageism. As an individual ages, internalized ageist views are directed toward the self, causing a cyclical pattern of belief that the aging process is essentially negative and to be avoided at all costs. This paper examines the idea that continuation of this cycle imposes unnecessary limitations on the aging population and impacts society in many negative ways. Effects of positive stereotypes are also addressed and suggestions for remedial action within society are set forth.
  • 3. | 2P a g e What Goes Around Comes Around What Goes Around, Comes Around: An Analysis of the Effects of Age Stereotyping “It is natural for the culture to treat the old like the end of what was once good material…The most flattering thing you can say to an older American is that he ‘doesn’t look his age’ and ‘doesn’t act his age’ – as if it were the most damning thing in the world to look old…” [Max Lerner’s, America as a Civilization, 1957]. The preceding quote is one of the first written expressions of the phenomenon of ageism [Cohen, E., 2001]. Growing old is a necessary part of existence, yet it is one that our society refuses to accept and actively tries to prevent. If you were to type “anti-aging products” into any online search engine, over 18 million results would appear in less than a fifth of a second. You’ll find everything from skin care products and miracle diets, to the best surgical procedures for reducing wrinkles. In her book, The Denial of Aging, Muriel R.Gillick addresses this obsession and argues against the desperate attempts of her fellow Baby Boomers to prolong life at any cost, stating instead that quality of life ought to take precedence [Gillick, 2007]. Why such resistance? What is the reason that so many Americans, especially women, fight so passionately against this natural process [Duncan, C., & Loretto, W., 2003]? The answer lies in understanding the fundamental beliefs people subscribe to regarding the process of aging and what stereotypes they employ. In reality, the individual members that make up our nation’s elders are extremely varied. They differ from one another in virtually every aspect, including race, living conditions, educational background, religious beliefs, quality of health and political preference [Ferrini & Ferrini, 2013, p. 7-24]. Even so, as is common with members of any cohort, they are often stereotyped by outsiders, specifically by anyone younger than 65 years of age. While some of these stereotypes may be harmless misconceptions, if not curbed and corrected, these
  • 4. | 3P a g e What Goes Around Comes Around misconceptions, perpetuated through the media, are adopted by ever increasing numbers of people until they are accepted and even taught as fact. This results in the formation of a prejudice toward the aged, and an active (though at times subconscious) discrimination against them. It’s called ageism [Ferrini & Ferrini, 2013 p. 6] and no member of society is exempt from its potential influence. Ageism shows up on the playground of the elementary school where children scramble at recess to escape the imaginary “wicked old witch.” It exists in popular movies and television shows where overbearing, senior mother-in-laws and grouchy next-door neighbors provide so-called comic relief. Sadly, ageism even rears its ugly head in the medical profession. Studies abound on the effects of cultural stereotyping on the health of elders. Yet, less well-researched is the effect these negative stereotypes have on the elderly when they themselves are the ones imposing them. This has been referred to as self-stereotyping and when studied effectively, it may hold the key to understanding how much of the beliefs that incite ageism are unfounded and what a truly accurate view on aging is. Of greatest significance is the hypothesis proposed by researchers Korthase & Trenholme: “Perhaps these negative expectations about aging will become self-fulfilling and impose unnecessary limitation on future generations of the elderly” [Korthase & Trenholme, 1983, p. 890, as cited in Levy 2003]. The research also suggests that positive stereotypes exist and can be a factor in extending life. Another area of focus should then be how society can promote these positive stereotypes. The purpose of this paper is to show that negative aging stereotypes are especially harmful to the seniors who internalize them and that acceptance of positive aging self- stereotypes have a measurable and beneficial effect on the physical and mental health of seniors. It is the authors’ intent to examine an alternative approach: whether the debilitation traditionally
  • 5. | 4P a g e What Goes Around Comes Around associated with aging might at least in part result from the formation of aging self-stereotypes, rather than solely from an inevitable biological process [Levy, B., 2003]. We propose that an elder’s internalized beliefs will have a significant effect on both their physical and mental health and their longevity. If ageism is recognized and remedied in our society at large, we will see not only an increase in length of life, but in the quality of life as well. In the words of gerontologist, Roy E. Christensen, “It is time for society to change its views on aging. Death can come to anyone, at any time. But old age comes as a blessing to only a few” [Christensen, 2015]. Literature Review The Reality of Ageism and its Manifestations in Society The power and prevalence of our society’s negative aging stereotypes results in what researchers call a “double-whammy” for seniors: ageism not only influences the way seniors are treated in society, but also how seniors view themselves [Horton, S., Baker, J., & Deakin, J., 2007]. Baby Boomer and former U.S. President, Bill Clinton is reported to have said, “When I look at how old I am, and see my gray hair in the mirror, I can’t imagine that anybody’s interested in life anymore!” [Horton, S., et al. 2007]. This statement should raise a lot of concerns about our society’s views on aging, especially with the inflation of the elder population as the Baby Boomers come of age. In a 2003 study done by Ory, [Ory, m., Hoffman, M., Hawkins, M., & Scanner, B., 2003], surveys found that 84% of Americans and 91% of Canadians reported experiencing at least one incident of ageism. More than 50% reported encountering multiple incidents. Many of these incidents were of a subtle and even humorous nature. For instance, some participants had received birthday cards which poked fun at growing old. Many of the respondents didn’t even
  • 6. | 5P a g e What Goes Around Comes Around realize until participating in the study that they had encountered ageism. This illustrates the pervasiveness of negatively stereotyping the elderly in our society. It is so commonplace that it is oftentimes overlooked, even by those most adversely affected. Ageism Exhibited among Children. These negative beliefs have even affected our society’s youngest members. In a study where children ranging in age from preschool to sixth grade were shown illustrations depicting a man throughout four stages of life, 67% of all the children identified the oldest man as being “helpless, incapable of caring for himself, and generally passive” [Levy, B., 2003]. Even when no ageist attitudes are detected in young children through survey questions, often times their behavior still demonstrates discriminatory feelings for the aged. One project compared the behavior of children working on a jigsaw puzzle with a middle-aged confederate as opposed to working with and elderly confederate. Even though middle-aged and elderly confederates alike were healthy, fashionably-dressed and each had professional experience working with children, the children in the study “sat farther away from, made less eye contact with, spoke fewer words to, initiated less conversation with, and asked for less help from aged confederates” [Lott, B., 1995]. Ageism in the Media. Children’s development of these negative stereotypes can be largely attributed to our society’s television and media. In a study done by Montepare and Zebrowitz, they found that older adults were more likely to be portrayed in comical roles reflecting the nation’s stereotypes of the physical and cognitive decline and even sexual impotence of elders [Nelson, T., 2002]. How telling it is, that a hearing titled “Image of Aging in Media and Marketing” was recently held by the U.S. Senate Special Committee in which twenty- five witnesses testified of the negative portrayals of older persons, Older persons are continually
  • 7. | 6P a g e What Goes Around Comes Around characterized as ineffective, feeble, helpless and irrelevant, both in print and through television [Ory, et al. 2003]. With good reason, there is growing concern and recognition that negative views of the elderly are becoming pervasive in American Society. Ageism in the Health and Medical Professions. Since stereotyping others is such a deeply ingrained and fundamental component of social perception, researchers have termed the act “automatic”, or “primitive” [Nelson, 2002]. It seems to be an instinct shared by all humans. Accordingly, it should come as no surprise that negative age stereotypes are subscribed to by medical and healthcare professionals. A clear demonstration of this can be shown in the research regarding a phenomenon known as elderspeak. Elderspeak, also referred to as “patronizing speech” or “secondary baby talk”, is a form of speech accommodation used by younger adults when speaking with older adults [Draper P., 2005]. It is characterized by exaggerated intonation, greater repetition, a higher pitch and volume and a slower rate. It includes a simpler vocabulary and grammar than that used in ordinary adult communication and is often marked by frequent use of terms of endearment. This over-accommodation of speech implicitly questions the competence of its’ listener. The use of collective pronouns (as in a nurse cheerily telling her patient, “It’s time for our bath!”), diminutives (“Did you see the birdie out your window?), and tag questions meant to illicit a specific response (“You need your meds now, don’t you?”) can each have a condescending nature which elders find offensive and disrespectful [William, K., Kemper, S., & Hummert, M., 2003]. One study established the views of older persons concerning elderspeak by asking 186 seniors to read scripts of a dialogue between an older patient and a nurse. In one script, the nurse used terms of endearment and diminutives common in elderspeak, such as “poor dear”, and
  • 8. | 7P a g e What Goes Around Comes Around “good girl”. The other script omitted these expressions. In comparison, participants rated the patronizing nurse in the first script as less competent, less nurturant, less benevolent and significantly less respectful than the nurse in the second script [Brown, A., & Draper, P., 2002]. In spite of elder’s dislike for it, overly-accommodative speech continues to be used frequently in hospitals and other nursing facilities for the elderly. Ageist attitudes held by individual practitioners do indeed appear to play a significant role in explaining why health workers continue to use over-accommodating language when addressing older persons, since it was noted in a particular study that those subjects “who preferred over-accommodation also tended to have the most negative attitudes towards older people”[Brown, A., et al., 2002]. Despite the clear association between negative age self-stereotyping and detrimental effects on the elder’s health, researchers have found that, these stereotypes are less likely to be counted as legitimate causes of “cognitive, behavioral or health related outcomes” among healthcare professionals [Levy, B., 2001]. It is evident that there exists a lack of accurate understanding of the aging process in the healthcare field. The assumption made by healthcare workers that all patients will experience inevitable cognitive and physical decline by a certain age leads to misdiagnosis of disease and poor health care interventions [Grant, L., 2006]. Elders usually receive more medication for the same illness and symptoms of the younger population, even when they’ve been shown to react to the medication in the same way as younger individuals [Kane, M., 2010]. A study done by Bowling and Pettersen found that a certain cardiologist made treatment decisions based solely on age. They also reported that older adults are much more likely to receive only medication without any other alternative treatments or therapy that might lengthen their lives [Kane, M., 2010].
  • 9. | 8P a g e What Goes Around Comes Around Although the physical effects of aging are generally more noticeable, psychological problems among older adults should be a more pressing concern within our society’s health care system today. However, difficulties arise in diagnosing emotional distress in seniors because such symptoms can be masked by physical ailments which most healthcare professionals view as a normal and expected part of aging. Often, elderly individuals themselves are reluctant to seek assistance for psychological issues due to their own belief that cognitive decline in aging is inevitable [Grant, L., 2006]. Even when they do seek professional help, the ageist views of health professionals that seniors are set in their ways and unwilling to change, decrease the likelihood that the elder will be treated as rigorously or as effectively as their younger counterparts are [Dittmann, M., 2003]. These problems might explain the reason for why older person have not generally been targeted as beneficiaries of most healthcare or public health programs. About 45% of U.S community mental health centers have reported having little or no programs for the elderly [Grant, L., 2006]. As long as older adults hold preconceived notions that it is too late for them to change their ways, and those notions in turn match the general consensus of members of the healthcare profession, then little progress can be made in providing programs to improve the quality of life and quality of care for seniors. Ageism is as real of a problem as racism or sexism. It is an actual form of prejudice. Not only does it limit our elderly to mere objects, myths, and stereotypes, it also shapes the perceptions of both the young and old who internalize ageist attitudes. Eventually, the elderly accept these stereotypes as self-evident truths [Kelchner, E., 2008].
  • 10. | 9P a g e What Goes Around Comes Around Self-Stereotyping A leading researcher in the field of the psychology of ageing is Becca R. Levy, an associate professor of epidemiology and social psychology at Yale University. One crucial component of her work is the understanding of how the effect of ageing stereotypes differs from that of stereotyping aimed at other groups such as race or gender. Stereotype Threat Theory (STT) is used to describe the potentially harmful effects on a member of a targeted group when they feel at risk of confirming negative stereotypes about their social group [Schmander, T., 2011]. The threat is situational and stems from external forces. For example, an African American taking a college entrance exam would perform more poorly than other groups because of stereotypes that their race is less intelligent than others [Steele, c., & Aronson, J., 1995]. But, in these cases, the individual need not subscribe to the stereotype personally in order for it to impact their performance. The threat only presents itself when individuals are in a relevant situation and it can therefore be evaded by avoiding those situations. Stereotype Embodiment Theory (SET) on the other hand, posits that ageing stereotypes differ in that they are internalized over one’s life- span, eventually becoming “self-stereotypes” about oneself as an aging individual. These self- stereotypes utilize multiple pathways, exerting their influence on individual health either consciously or unconsciously [Levy, B., 2009]. Harmful Effects of Negative Self-Stereotyping. A study of note which illustrates the physiological effect of self-stereotyping on elders was conducted by Levy and associates. It also reflects the complexity of self-stereotyping. Participants were exposed to either negative or positive aging stereotypes at a subliminal level and then confronted with verbal and mathematical challenges. Since one likely path by which aging stereotypes might influence physical functioning of the elderly is through the autonomic nervous system, participant’s
  • 11. | 10P a g e What Goes Around Comes Around physiological responses to these stressors were measured by means of systolic blood pressure, diastolic blood pressure, heart rate, and skin conductance. “The autonomic nervous system can be adaptive in mobilizing an individual to respond to an acute stressor. . . Chronic activation of the autonomic nervous system may lead to the body's overreacting and producing too many stress hormones.” This study examined whether one such chronic stressor could be negative aging stereotypes. Not only was it found that exposure to the negative stereotypes reduced memory performance, self-efficacy, and the will to live of older adults, but the positive age stereotypes “helped protect participants from experiencing cardiovascular stress” [Levy, B. Hausdorff, J., Hencxke, R., & Wei, J., 2000]. As evidence of these stereotypes greater effects on the elderly, the study also found “these same stereotypes exerted no effect on the young participants, for whom the stereotypes were not personally relevant” [Levy, B., et al. 2000]. Detrimental effects of negative aging self-stereotypes are not limited to cardiovascular stress. Belief that the aging process is one of inevitable and continual decline may encroach on elders opportunities in later life. As noted by L. L. Carstensen, “Negative stereotypes can have harmful consequences for the quality of life of older adults and can also result in a major loss to society” [Carstensen, L., 2006]. One researcher interviewed a number of inactive nurses to determine why they were not working. Many respondents cited their age as the reason they were not working without giving any other explanation. This troubled the researcher, as she observed “they were using ‘age’ to disqualify themselves or otherwise limit their range of choices” [Grant, L., 1996]. Another subliminal exposure to age-stereotypes study examined handwriting. Handwriting is a motor system that is thought to operate unconsciously and to reflect personality [Levy, B., 2012]. Analysis of this activity in the elderly may lend clues as to how self-
  • 12. | 11P a g e What Goes Around Comes Around stereotyping can influence behaviors below their level of awareness. In the study, individuals produced handwriting samples before and after exposure to the negative age stereotype primes. These samples were then rated by a panel of forty younger individuals (aged 16-36 years) according to how much they were characterized by the following six attributes: accomplished, confident, deteriorating, senile, shaky, and wise. As was hypothesized by the researchers, the samples produced after negative stereotype exposure showed a significant increase in deteriorating, senile, and shaky ratings. In contrast, handwriting samples from participants who were primed with positive aging stereotypes were rated as younger and as showing a significant increase in accomplished, confident, and wise ratings [Levy B., 2012]. In a study done by the Heart and Stroke Foundation of Canada, it was found that 52% of Baby Boomers are sedentary, and that 30% are obese. These numbers have dramatically increased in the last decade. Even more concerning is the fact that only 13% of senior women and 22% of senior men are physically active on a daily basis [Horton, S., Baker, J., & Deakin, J., 2007]. These results were especially confusing when an overwhelming 98% of these same seniors acknowledged that physical exercise was important to staying healthy. When researchers tried to determine the reason for this gap between seniors understanding of what is beneficial healthwise and their actual practiced health behaviors, the answer pointed to psychological reasons more than any physical factors. Society’s attitude seems to present an important barrier to senior’s participation in physical activity. It appears that negative aging stereotypes have a self-perpetuating effect. If old age is seen as synonymous with frailty and physical deterioration, seniors may passively accept such decline instead of exerting efforts to combat it. Yet, “considering that a lack of physical and cognitive activity is believed to be the principal cause of functional decline in elderly populations, it begs the question as to how much of the deterioration
  • 13. | 12P a g e What Goes Around Comes Around associated with aging is due to inevitable biological decline and how much is simply the result of disuse” [Horton, S., ect 2007]. It is likely that an elder’s expectations of the aging process are influencing their decisions on whether or not to take any active measures of prevention with regards to their health. This indeed appears to be the case, as confirmed by a study examining the effects of implicit self-stereotyping on the will-to-live of elders. In the study, seniors were asked to respond to a series of hypothetical medical situations involving potentially fatal illnesses. Those seniors previously primed with negative aging stereotypes were “less likely to accept life-prolonging interventions, even if it meant that they would die within a month”, whereas subjects who received positive primes were more likely to be accepting of offers of medical treatment, even despite great costs [Levy, B., Ashman, O., & Dror, I., 2000]. Research confirms the reciprocal nature of negative aging self-stereotypes. As stated in the Stereotype Embodiment Theory, stereotypes are introduced early in life and are readily internalized. They can operate below awareness. Since aging is not a situation one can simply opt out of, the negative beliefs one holds about the aging process are gradually directed inward as the individual becomes a member of the in-group of seniors [Levy, B., 2009]. When the individual encounters physical or mental limitations or discomforts, these negative beliefs are validated. The individual may be less likely to pursue any medical help or even social support since they view these challenges as inevitable components of the aging process. Their resulting pessimism in turn confirms the stereotypes forming in the minds of the younger generation. Benefits of Positive Self-Stereotyping. In society, there exists a mixture of negative and positive aging stereotypes. While the negative tends to outweigh the positive [Kotter-Gruhn, D.,
  • 14. | 13P a g e What Goes Around Comes Around & Hess, T., 2012], there is still reassuring evidence of the beneficial effects that positive aging stereotypes can have on an elder’s physical and mental health. In order to test the ability of positive stereotypes to partially reverse age-associated changes in physical function, one study measured gait speed and percent swing time of 47 elders. Again, subjects were subconsciously exposed to either a positive or negative stereotype of aging, this time under the premise of playing a computer game. Measurements were taken pre and post- intervention. After controlling for age, gender, health status, and psychosocial status, researchers observed significant increases in walking speed and for percent swing time only among elders who had received reinforcement of positive aging stereotypes. With such improvements resulting from a mere 30 minutes of exposure to positive stereotypes, these findings provide strong evidence supporting the potential of prolonged and consistent reinforcement to prevent, or partially reverse some of the changes in physical function that we normally attribute to advancing age [Hausdorff, J.M., Levy, B.R., & Wei, J.Y., 1999]. Other health benefits have been associated with internalization of positive aging stereotypes. One encouraging study examined the association between positive age perception and an elder’s capacity to recover from disability. Subjects in this study were not primed with either positive or negative age stereotypes. Instead, each subject’s personal beliefs of aging were assessed by recording their response to the question “When you think of old persons, what are the first 5 words or phrases that come to mind?” Recovery from disability was based on the patient’s efficiency in completing 4 essential activities of daily living (ADLs): bathing, dressing, transferring, and walking. These activities are strong indicators of an individual’s use of health care services and their longevity. Those subjects holding positive age self-stereotypes were
  • 15. | 14P a g e What Goes Around Comes Around found to be 44% more likely to recover fully from severe disability than those with negative age self-stereotypes. [Levy,, B., Slade, M., Murphy, T., & Grill, T., 2012] Longitudinal studies have been performed in this area of research, providing convincing evidence of how elder’s self-stereotypes influence life expectancy. Using the community-based survey, the Ohio Longitudinal Study of Aging and Retirement (OLSAR), the self-perceptions of aging were assessed for each member in a sample of 660 people, aged 50 years or more [Levy, B., et al. 2000]. The subjects reported their agreement or disagreement with several statements about aging. Sample statements included: "As you get older, you are less useful." Over a 23-year span, those individuals with greater positive self-perceptions of aging lived 7.5 years longer than those with less positive self-perceptions of aging. Even more impressive is to note that a gain of seven and a half years is much greater than the longevity increase attributed to other healthy behaviors that are encouraged by health professionals. “The effects of attitudes about aging had a greater impact on survival than low blood pressure and cholesterol, each of which is associated with a longer life span of about four years. The attitudes about aging also had a greater impact on longevity than lower body mass index, not smoking and regular exercise - each of which extends life by one to three years” [Yale, Thinking Positively, 2002]. Incredibly, this advantage remained after controlling for such variants as age, gender, socioeconomic status, loneliness, and functional health [Levy, B., et al. 2002]. Discussion With the strength of evidence for the measurable effects of aging self-stereotypes on senior’s health, one may be surprised to find that drastic changes remain to be made in society’s understanding of the issue and the promotion of positive self-stereotyping. Yet, the beliefs upon which ageism is constructed are reinforced through a variety of cognitive processes. People tend
  • 16. | 15P a g e What Goes Around Comes Around to draw on the stereotypes which allow for the quickest and most efficient means of processing information. Therefore, aging stereotypes are given primacy over actual experience with older individuals. Learned information about elders may even be selectively recalled so as to maintain stereotype congruity. If an elder is encountered who does not fit these internalized stereotypes, rather than challenging the individuals beliefs about aging, the elder may simply be considered a rare exception to the rule. Furthermore, negative age stereotypes can be easily assimilated into one’s belief system during their younger years when they feel no need to defend against them since they are not yet relevant to them personally [Levy, B., 2003]. Combating Ageism Given the depth and pervasiveness of ageism in our society, the eradication of this phenomenon is a complex and difficult task. We have noted how negative perceptions of aging begin to develop very early in life and can be extremely subtle. The solution therefore, needs to change the very way people think. Re-programming of attitudes toward aging and the elderly must take place at an intimate level, within homes and families. Grandparents must be revered instead of endured. Yet, because of the intimate nature of such a transformation, perhaps little of practical application can be suggested in terms of correcting it. To begin this process of change, we must instead start with experts in the field of gerontology, health policy makers, health practice individuals, and other medical workers. We can then hope for a trickle-down effect in shifting the views of society as a whole. [Angus, J., 2006]. As stated by Lynda D. Grant, “Health care professionals need to move away from using the term ‘age’ as an explanatory variable and the assumption that after enough time certain ‘things’ will happen to people” [Grant, L., 1996]. The current consensus among medical practitioners is that interventions should only be extended for those who are likely to recover and enjoy long lives. The supposition that all elders
  • 17. | 16P a g e What Goes Around Comes Around are frail and bound for death puts a stop to the medical interventions, funding, and programs that could benefit our elderly population [Kane, M., 2010]. Effective and broad public health programs should focus on the culture, history, and social environments of our elderly population and the effects, either for good or for ill that they may have on the aging process [Angus, J., 2006]. Decisions regarding elder care must never be based strictly on age, but rather on determining which services and resources would contribute to the health of seniors, regardless of how few years they may have left to enjoy them. In addition to changing belief systems of those in the healthcare profession, there are four areas of specialty which require improvement. Psychiatry, psychology, social work, and nursing share the bulk of responsibility in managing mental health care. Concerns have been raised about the lack of professionals with specialized training in the care of the elderly within these fields. Education in geriatric mental health for APRN’s (advanced practice nurses) and other medical professionals has been severely inadequate [Hartford, Mental Health, 2011]. Only a small amount of graduate nursing programs even include the topic of aging in their mental health curriculum. Furthermore, no certification examinations exist for a specialty in geriatric psychiatric nursing. As a result, insufficient numbers of nurses are prepared in this field. A critical shortage of geriatric social workers also presents a challenge. Limited funding in previous years has redirected many social work scholars into other, more appealing fields. Even though a research fellowship program in geriatric psychiatry has been available at UCSD for over 20 years, no post residency psychiatrists could be recruited because salaries were so low. Only after receiving additional funding has the UCSD program acquired twenty-one psychiatrists into its research fellowship program [Hartford, Mental Health, 2011]. If progression is to be made in providing better healthcare for the elderly and modifying the ageist views held by
  • 18. | 17P a g e What Goes Around Comes Around professionals, greater funding must first be available in order to entice individuals into geriatric fields. Changing the way our health care professionals think about elders and the process of aging may be the most significant step in combating ageism in our society [Carmel, S., Cwikel, J., & Galinsky, D., 2006]. Conclusion It is not the intention of this research to suggest that the aging process is without difficulty. Gradual decline is an indisputable fact of advancing years. Yet, if seen as the only option, this can taint society’s perception of aging. Indeed, the effects of many common diseases can be modified and minimized through the proper intervention of both the senior individual and their health care provider. Growing old need not be the traumatic experience that so many fear it is. Having reviewed the research, there is ample evidence that the aging process is influenced by a number of psychological factors which produce a unique experience for the aging individual. Aging may not be the cut and dry process of degeneration that many claim it to be. Aging self-stereotypes can be modified so that elders no longer feel the restraint of ageism preventing them from seeing old age as the blessing it truly is.
  • 19. | 18P a g e What Goes Around Comes Around References [1] Angus, J. (2006). Ageism: A Threat To "Aging Well" In The 21st Century. Journal of Applied Gerontology, 25(2), 137-152. Retrieved April 19, 2015, from http://jag.sagepub.com/content/25/2/137.full.pdf html [2] Brown, A., & Draper, P. (2002). Accommodative Speech And Terms Of Endearment: Elements Of A Language Mode Often Experienced By Older Adults. Journal of Advanced Nursing, 41(1), 15-21. Retrieved April 20, 2015, from https://www.pioneernetwork.net/Data/Documents/ElderSpeak article1.pdf [3] Caporael, L., Lukaszewski, M., & Culbertson, G. (1983). Secondary baby talk: Judgments by institutionalized elderly and their caregivers. Journal of Personality and Social Psychology, 44(4), 746- 754. Retrieved April 17, 2015, from http://web.b.ebscohost.com.erl.lib.byu.edu/ehost/detail/detail?sid=64594b89-c9f3-4812-8dd7- 0fce9ddf39ae@sessionmgr111&vid=0&hid=105&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaX Rl#db=pdh&AN=1983-33354-001 [4] Carmel, S., Cwikel, J., & Galinsky, D. (2006). Changes In Knowledge, Attitudes, And Work Preferences Following Courses In Gerontology Among Medical, Nursing, And Social Work Students. Educational Gerontology, 18(4), 329-342. Retrieved April 19, 2015, from http://www.tandfonline.com/doi/abs/10.1080/0360127920180403#.VTQG_dLBzRZ [5] Carstensen, L. (2006). A Social Psychological Perspective on the Stigmatization of Older Adults. In When I'm 64. Washington, D.C.: National Academies Press. [6] Christensen, Roy E. (2015). From the keynote lecture of the 25th Annual Russell B. Clark Gerontology conference at Brigham Young University. [7] Cohen, E. (2001). The Complex Nature of Ageism: What Is It? Who Does It? Who Perceives It? The Gerontologist, 41(5), 576-577. Retrieved April 17, 2015, from http://gerontologist.oxfordjournals.org/content/41/5/576.full.pdf html [8] Dittmann, M. (2003). Fighting Ageism. Monitor on Psychology, 34(5), 50-50. Retrieved April 17, 2015, from http://www.apa.org/monitor/may03/fighting.aspx [9] Draper, P. (2005). Patronizing speech to older patients: A literature review.Reviews in Clinical Gerontology, 15(3), 273-273. Retrieved April 17, 2015, from http://search.proquest.com.erl.lib.byu.edu/docview/211574518/fulltextPDF/B4B8082F8554487CPQ/1?ac countid=4488 [10] Duncan, C., & Loretto, W. (2003). Never The Right Age? Gender And Age-Based Discrimination In Employment. Gender, Work and Organization,11(1), 95-115. From: http://onlinelibrary.wiley.com.erl.lib.byu.edu/doi/10.1111/j.1468-0432.2004.00222.x/full
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  • 22. | 21P a g e What Goes Around Comes Around [32] Nelson, T. (2005). Ageism: Prejudice Against Our Feared Future Self.Journal of Social Issues, 61(2), 207-221. From: http://onlinelibrary.wiley.com.erl.lib.byu.edu/doi/10.1111/j.1540- 4560.2005.00402.x/abstract [33] Ory, M., Hoffman, M., Hawkins, M., & Scanner, B. (2003). Challenging Aging Stereotypes, Strategies for Creating a More Active Society. American Journal of Preventive Medicine, 25(3), 164-171. Retrieved April 17, 2015, from http://www.sciencedirect.com.erl.lib.byu.edu/science/article/pii/S0749379703001818# [34] Schmader, T. (2011). Stereotype Threat Theory, Process, and Application.New York, New York: Oxford Scholarship Online. [35] Steele, C., & Aronson, J. (1995). Stereotype Threat And The Intellectual Test Performance Of African Americans. Journal of Personality and Social Psychology, 69(5), 797-811. Retrieved April 19, 2015, from http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=c0d68ad2-3eb3-4462-93fc- c0578d1e1455@sessionmgr112&vid=2&hid=128 [36] Thinking Positively About Aging Extends Life More than Exercise and Not Smoking. (2002, July 29). Retrieved April 19, 2015, from http://news.yale.edu/2002/07/29/thinking-positively-about-aging- extends-life-more-exercise-and-not-smoking [37] Williams, K., Kemper, S., & Hummert, M. (2003). Improving Nursing Home Communication: An Intervention to Reduce Elderspeak. The Gerontologist, 43(2), 242-247. Retrieved April 20, 2015, from http://gerontologist.oxfordjournals.org/content/43/2/242.full
  • 23. | 22P a g e What Goes Around Comes Around