Ageism In Nursing Care

In a society where racism seems to often take the media by storm, a lesser-known, yet somewhat similar concept also involving stereotypes and prejudices, may be equally present. This term is known as ageism. McMinn (1996) defines ageism as the “prejudice and negative description of older people who have been so categorized because they are old. Ageism involves the use of negative stereotypes of both the process of aging and of those who are seen as aged” (p. 27). Some ageist views may include that old people are grumpy, confused, a burden, or a lost cause. In today’s world, where the age group of those 85-99 years old is most rapidly increasing, ageism is about to become an even bigger problem. These individuals have different needs and are
not numb to what is being said about them. Stopping ageism can begin by opening the eyes of those in society to the concept of ageism, having nurses self-reflect on their own ageist views, and collaborating together to abandon these ageist stereotypes.
Literature Review
The authors covering ageism come to similar conclusions regarding this topic and would agree with Johnstone (2013) when she writes, ageism can be expressed in a variety of ways including: stereotypes about the recuperative abilities of elderly patients, value judgments about the quality or worth of elderly lives, or misconceptions about the desires of elderly people for certain forms of treatments. (p. 27)
Aging has come to be associated only with negative aspects. Often when people think about aging, they think about being disabled (McMinn, 1996 p. 18). Since ageism has such a negative connotation associated with it, the general population is afraid of what aging will do to them. According to McMinn (1996), “the most widely quoted explanation for ageist attitudes is the fear that younger people have of ageing themselves. This is reflected in the views of young people of what old age must be like” (p. 19). Because of a long-lasting cycle of ageism, younger generations see the elderly as different than themselves and “cease to identify with their elders as human beings” (Biggs & Haapala, 2013, p. 1302). Due to society’s general acceptance of these ageist views, few see the topic as an issue. Phelan (2008) writes: “ageism is in itself abusive to older people as it fails to acknowledge the diversity of older people in society” (p. 322). Phelan (2008) continues to say, “devaluing a particular social group covertly justifies certain discriminatory behaviors such as abusive activities” (p. 322). This tolerance of ageism has created an acceptance for behaviors that would not be allowed with other age groups.
Ageism in the medical field is also a large problem. Holroyd, Dahlke, Fehr, Jung, and Hunter (2009) report that “older adults occupy 50 percent of hospital beds, account for 85 percent of home care visits, and reside in 90 percent of nursing home beds” (p. 375). However, few nurses have specialized nursing knowledge needed for these older adults. According to Holroyd et al. (2009), “in North America, less than 10 percent of nursing students’ clinical hours occur in a gerontological setting and approximately half of all nursing programs lack certified gerontological courses” (p. 375). Without these courses, nurses are unaware of their patients’ needs and can develop bad attitudes towards these patients. According to McMinn (1996), “ageism in medical practice leads to low standards of care and loss of opportunities for rehabilitation,” (p. 19). As patients age, health care workers are not spending as much time with them and health problems are not being diagnosed.
The attitude towards the older individual plays a large role in how they are cared for. Holroyd et al. (2009) writes, “in a hectic work environment, nurses inadvertently may view older adults as no longer acutely ill and resort to the use of objectifying labels, such as alternative level of care or bed blockers” (p. 375). The nurses’ attitudes towards the elderly can have a substantial impact on the “quality of care and the recovery of older adults during an illness” (Holroyd et al., 2009 p. 375). Holroyd et al. (2009) continues on to say, “the more dependent older adults are on receiving nursing care, the more likely it is for nurses to project a negative attitude” (p. 375). Healthcare workers are viewing these patients in a burdensome manner. Ageist assumptions by healthcare workers can produce ethical implications. When a nurse or provider views the care for elderly as less important than that of younger generations, the elderly’s health may be at stake as well as this worker’s license and career. Holroyd et al. (2009) also describes “older adults [reporting] experiences of others making assumptions about their levels of illness and frailty based solely on their age, rather than on knowledge of them as individuals” (p. 374). This can be detrimental to their health. Every patient has different needs and will therefore need to be treated in different ways. Holroyd et al. (2009) also makes a point to say that “ageism is not limited to adult members of society; studies have documented ageism among young adults” (p. 374). Some of these generalizations include that all teenagers are irresponsible, have no manners, drive too fast, are addicted to technology, and spend all of their time partying on the weekends.
Researchers across the map can agree that ageism is a problem, but they may have more of an issue trying to find a solution for this problem. Ward (2000) suggests, “a team approach is particularly important when working with older people because they have multiple problems with multiple causes” (p. 562). Having a wide range of specialists providing care will help provide optimal care. The aging body is complex and requires close attention to each system.
Discussion
A major part of the issue with ageism that I have noticed is that people think it is okay and normal to view older individuals in this negative light. It is simply a natural view to them. Some truly think that as people age, they become grumpier and confused. This is not a normal part of aging though, and certainly should not be a judgment passed on to everyone. Just because someone is older, does not mean he or she deserves to be treated with less care. I can agree with McMinn (1996) that nurses, along with everyone else in society should “extend to older people the basic principles of humane care, dignity, privacy and respect as provided to people of all other ages, no matter how physiologically or psychologically disabled an individual may be,” (McMinn, 1996 p. 20). These individuals are real people too and have feelings. They are not naïve to what is happening. Constantly being viewed in this negative light and being made fun of affects their mental wellness as well. When people begin to think about how they are treating the elderly, they should really consider if they want their loved ones that are older to be treated and viewed in that way or even themselves treated in a similar manner. Maybe part of the reason people are so afraid of aging is because they do not want to be treated or viewed in the same way that the elderly are now. They are failing to realize that the change needed to stop ageism can start with them.
McMinn (1996) also makes a good point saying, healthcare workers should make attempts to individualize and personalize care.
[They] should not assume that being elderly or sick means that there is no need for setting medium and long term health goals towards independent functioning. Temporary loss of function due to illness or disability should not be an overwhelming obstacle to that person's nursing care. (p. 20) In this day and age, there are so many options for treatment, so even if a client becomes ill, he or she has a very likely chance at recovery. Every patient should have a health care plan that has been personalized just for him or her. I think it is really important to recognize that the elderly population may require different care, as their bodies are experiencing different processes. They need extra attention because their bodies may not be able to handle illness as well as they might have
previously.
It is easy to realize that ageism is a problem; the hard part is finding a solution to it. How do you change someone’s views? I think the best way to start is by opening the eyes of everyone to the concept of ageism. Some people may actually not realize the problem with their actions and beliefs. Once people have an understanding of what ageism is, I think they will want to change it. They will begin to see the harshness of their comments and realize how unfair and untrue these statements are. No one deserves to be treated a certain way simply because of his or her age. People should also be educated about the aging process. This will help them realize that often these stereotypes they are putting on older people are most likely not true. People may say old people cannot hear and makes jokes about it, but is anything being done to help with this perceived hearing loss? Perhaps, the person is in need of a hearing aid, or maybe he or she has hearing aids but they are not on or they are out of batteries. This person could have a cerumen impaction. These are all fixable problems that will increase the person’s function and improve his or her quality of life. As nurses and members of the health care team, I think it is especially important to find the root cause of the problem. If the care team takes the time to really assess the client and determine his or her needs, many issues could be resolved. An accurate baseline can be gathered, which means abnormalities in that patient’s status can be recognized, and the patient’s current needs can be identified. The patients will also feel better about the care they are receiving, and ultimately themselves as human beings. I also think it is important that health care workers work together to treat the patients. This will ensure that patients are receiving ideal care. I have also found that geriatric courses for nursing students are very beneficial. They can help eliminate ageist views. I think this should become a requirement in more medical schools. Students will learn about the aging process, about the different types of care the aging population needs, and hopefully gain a greater respect for older individuals.
Conclusion
In a society with a rapidly growing older population, it is essential that steps be taken to educate the general public about aging and inform them that the older population deserves more respect.
People should recognize that changes do occur as people age, but these changes are not necessarily bad and certainly do not disable someone. The first step in fighting ageism is to make society aware of the abundance of ageist views that are present today. A lot of people may think their views are completely normal, but once they see how degrading these comments are and the effects they are having on these older individuals, they may think differently. Those who care for the older population also need to reflect on their own views of the elderly and identify any ageist views, so they can put a stop to them. Even with this education and self-reflection, ageism cannot be ended without a great deal of cooperation. Health care workers and the rest of society need to work together to help one another abandon these views and provide optimal care for the elderly population. This will make fighting ageism a much more manageable task. Eventually, our older generations will be given the respect and care they deserve, just as everyone else is. The age of the patient should not determine the quality of care given or be a reason to talk negatively of
someone.