Wednesday, May 24, 2006

Ageism, Elder Abuse and Social Justice

It’s not surprising that Paul Kleyman would take offense at a “Close to Home” cartoon that ran in a recent edition of the Washington Post. In it, an elderly bald man is reading a tabloid called Aging Today, which has a wrinkled, swimsuit-clad elderly woman on its cover under the banner "1st annual swimsuit edition.” The cartoon’s caption is “A dark day in publishing.”

Paul is editor of the real Aging Today, the bimonthly newspaper of the American Society on Aging and takes a firm stand against ageism. In a letter to the editor (from Paul to Paul)that appears in the latest issue, he points out that the term "ageism" first appeared in the Post in the early 1960s in a profile of Robert Butler, the founding director of the National Institute on Aging, written by the young reporter Carl Bernstein. Paul adds that the International Longevity Center USA (ILC-USA), which Butler directs, recently released a new report, “Ageism in America.”

Elder abuse is one of seven categories of ageism that the ILC-USA report addresses. It suggests that ageist attitudes are what compel some to rip off, neglect, or harm the elderly. It also gives examples of institutional ageism with respect to elder abuse, which includes the glaring inequities in public funding for protective services to children versus elders.

Butler and his colleagues make a convincing case. Still, there’s something troubling to me about blaming ageism for elder abuse, which, in essence, casts elder abuse as a social justice issue along with racism, sexism, anti-Semitism, heterosexism, classism, and all the other “isms” that are responsible for oppressing, discriminating against and marginalizing others. After all, the ranks of the elderly include society’s most privileged members.

If we’re going to embrace elder abuse as a social justice issue, we should start by taking an honest look at our field’s track record. Although our research consistently shows that communities of color are disproportionately affected by elder abuse, it’s an issue that’s rarely discussed. We know that African Americans and Hispanics are more likely than whites to experience financial abuse, and that elderly African-American and Hispanic women are more likely to experience intimate partner violence. Social and economic factors that heighten risk are also more prevalent in communities of color, includng poverty, which may contribute to or be mistaken for neglect and self neglect. In 2003, 8.8% of elderly whites lived in poverty, compared to 23.7% of elderly African-Americans and 19.5% of elderly Hispanics, and older women are much more likely to be poor than men (12.5% compared to 7.3%). Nearly 41% of elderly Hispanic women who lived alone were poor. Heightened demands on African-American and Indian caregivers, exacerbated by multigenerational caregiving, lack of resources, urban migration and other factors, also contribute to risk. Clearly, reducing poverty and offering adequate support to underserved groups can lower the risk of elder abuse and neglect.

The truth is that in this country at least, we’ve shied away from addressing elder abuse as a social justice issue. Late-life domestic violence programs have downplayed the fact that the domestic violence movement was driven by the women’s movement, which attributed domestic violence to discrimination and women’s subordinate status in society. In calling for an improved criminal justice system response, we’ve failed to acknowledge the historical injustices that make many minority elders wary of the system.

Destpite its title, the Elder Justice Act has little to say about justice. In sharp contrast, the World Assembly on Aging, in a 2002 report, cast the mistreatment of older persons within the broader landscape of “poverty, structural inequalities and human rights violations,” and further acknowledged that women were disproportionately affected.

If we’re going to frame elder abuse as a social justice issue, let’s be consistent and demand social justice and equal protection for all elders. Simply calling for parity with other age groups and more flattering media portrayals just isn't enough.

20 comments:

DawnJ said...

After reading the article on ageism I first have to say that the way society and media portrays the elderly is detrimental to everyone involved. I do agree that elder abuse affects every race and culture. The fact that it affects these groups disproportionately does not surprise me due to the way our society is disproportionate in everything else. It is hard for me to understand why ageism is so prominent. Every single person in the world has an equal opportunity of aging and being affected by ageism, as opposed to racism where certain races are discriminated against, so why is still such a problem when it will inevitable affect us all? Dawn J

Jessica Parent said...

First of all, there needs to be acknowledgement of the poor judgment that the Washington Post used in publishing that cartoon. Do they want to come across as an agency that supports ageism or do they just not care?

The disproportionate nature of elder abuse and poverty is stunning. I was aware of the uneven levels but the statistics that were provided were helpful in showing just how disproportionate the issues really are.

I agree with the comment stating, "If we’re going to frame elder abuse as a social justice issue, let’s be consistent and demand social justice and equal protection for all elders." It is critical that we look at this issue through a fresh lens.

The women's movement has contributed greatly to the understanding of discrimination and women's subordinate status. It wasn't meant to be the template for all social justice issues. We need to develop a new model to address ageism and elder abuse because we know that one size does not fit all.

Jessica Parent

Anonymous said...

The author briefly highlights the lack of funding for elder abuse prevention. This is the most poignant part of the article for me as I believe that without the funding it will be impossible to assist abused elders. Without funding education can not take place and appropriate programs can not be tailored to the needs of the abused individuals. Just as we discussed in class Norman and Pat had needs that were unable to be met by previously established programs. In terms of culture playing a part in this process recognizing it is important to look at all aspects of the individuals life and sculpt the individuals support with guidance through what they state they need. This might include looking at how their culture views family and what supports are important to their culture. For example, through my work with elder's who live at home with their children with developmental disabilities I have found it is important to accept a beverage while meeting. Taking time to get to know the family through stories they would like to tell you is important as they are developing a relationship with you. Once they feel comfortable they will share more about their family life as they might believe that this aspect of their life is very private. In the position I am in giving the elder the freedom to direct the conversation makes for a better working relationship. They typically tell me more than if I sit down with them. Until we find the funding for support and prevention programs for those involved in elder abuse, developing relationships with elders is a good starting place for intervention.

Mandy G

MindyD said...

I offer my comments as a complete novice in this field. I guess I do think of elder abuse as a social justice issue, because we have lacked the political/social will to establish protections* for the elderly. Those who would do them harm (for whatever theoretical reason -- pathology, caregiver stress...), pretty much seem to have had carte blanche -- in the same ways as with other groups, such as women and racial minorities. I nipped over to the Ageism in America Report, since I have so little knowledge of the topic, and found the history of legislation around elder abuse interesting. In 1979, 15 years after the Civil Rights Act, was the First Congressional Hearing on Elder Abuse. The 1985 House Committee Report on elder abuse said that it was increasing; so did the 1990 Report, which also recommended immediate action by Congress and the states. Hmmm. 17 years later, we still have no comprehensive federal laws on elder abuse. It seems like the elderly as an oppressed, invisible group are not terribly important to politicians.
*And speaking of protections, it reminds me of how we noticed the perpetrators' behaviors in 2 of the film clips from class -- knowing that an external, government-backed authority was monitoring them caused them to either completely or mostly stop their abusive behaviors.

And what about us in the social services-- how much better are we doing? As we discussed in class regarding the elderly woman in the film looking for "peace and quiet", there were no shelter options designed for older women. It wasn't until 2005 that the nation's first elder abuse shelter opened -- and I wonder how many of them exist. Also, the dearth of research seems to indicate where priorities are, especially when held up against the wealth of literature on abuse against children and women.

I notice one more parallel with other social justice "isms", in this case, racism. While thinking about how society views aging and death, I couldn't help thinking about the popularity of cosmetic surgery, where the message seems to be "Don't get (or look) old". In a sense, people try to "pass" as being younger, much like when people of color used to try to "pass" as white, in order to get the privileges denied to their group.

Again, I don't think ageism is the be-all-and-end-all explanation for elder abuse, just that it seems like a valid way of looking at it; as long as, like the original author and Jessica said, we are consistent in demanding justice for ALL elders, and that we go much further than shaking our fingers at media portrayals of elders.
-- Mindy D.

Rebecca P said...

Although I found this reading interesting, I feel the last paragraph was very impactful. As the article states, if elder abuse is going to be framed as a social justice issue, then we must provide equal protection for all elders. I strongly agree with this statement and do feel that elder abuse is a serious issue. I feel concerned for the lack of protection and support services in communities across the nation for the aging population.

As Mindy D. stated, there still are not extensive laws in place for appropriate and necessary protection for the elderly. Furthermore, as Robert Butler noted in the report “Ageism in America”, throughout the next two decades, 75 million baby boomers will reach retirement age, which also indicates an additional increased need in protection and support services for the elderly. Furthermore, established policies and laws need to be in place surrounding this serious issue.

I do feel that raising awareness regarding ageism and elder abuse can only strengthen support and increase the much needed services for the aging population.
Rebecca P

Stephanie said...

I agree with Jessica that the Washington Post used extremely poor judgment when they posted the cartoon. I think, though, it is a perfect example of how our society looks at aging.

People for some reason are not comfortable with the thought of aging and death; and I believe a way that they handle this is making "jokes".

I can see how ageism can be seen as a type of discrimination. I can also understand how many in this country have no idea that elder abuse is going on. These two problems show the work that we have cut out for us and the need to find ways to make the elderly less isolated.

There is also a definite need for awareness on issues that affect the elderly. It appears hopeful that this will happen, especially with the number of aging baby boomers.

The public needs to be made aware of ageism and elder abuse and this needs to be done at both a community level, as well as, a national level. Until we stop trying to pretend that the elderly do not exist then ageism and elderly abuse will probably continue.

Stephanie S.

Cindy W said...

As I understand reading this post "ageism" is an attitude by some that allows discrimination, neglect,and financial/physical/psychological harm to be carried out against the elderly population.
Also there are comments regarding the social injustice issue of ageism in relation to underfunding, poverty, and minorities.
I do agree that ageism cannot be the only blame for elderly abuse, but I feel that ageism has a significant responsibility in discriminating against an already socially marginalized group of individuals. There are social, economic, and financial risk factors surrounding the poverty stricken elderly women in our society. Just as in any other "ism" in our culture, the balance of risk factors and protective factors must be in place for an individual to be successful in his or her development.
When discussing Erikson's developemnt stage of elders, the development of generativity versus despair needs to be considered. Service practioners should be aware of what state-of-mind the elderly person is in and what can be done to minimize the consequences of long-term self-abuse or neglect(alcoholism), poverty, and societel human rights violations that have effected the elderly throughout that individual's life.
There are also historical social injustices the elderly have had to contend with that have changed over the past 20-30 years such as racism and classim.
I believe as more baby boomers enter their "golden years" with more options from being"privileged members of society" they will not tolerate the current level of oppression and inequality of public funding for protective services, now available to children and IPV victims.
This will create a stress on our current public funding system and only then will elder abuse come to the forefront as an important social justice issue.
I stated in my dialogue conerning gender and aging that service providers should remain gender neutral when investigating and trying to understand the extent of elder abuse.
But I feel aging and cultural background (African-American, Hispanic-American, Caucasian- Americans, etc) needs to be included when exploring the mistreatment of older people. The 2003 statistic reported, certainly indicates a large disparity in the poverty levels of older women and their increased risk of abuse or neglect factors. I agree there appears to be a correlation between poverty and abuse/neglect in the older female population, but I wonder if the statistic of 8.8% white elderly living in poverty compared to the 23.7% African-American elderly living in poverty, and the 19.5% elderly Hispanic women living in poverty ( all experiencing self-neglect or neglect) may be slightly skewed due to the high number of minority elders that remain in the multi-generational home. Some research indicates that more African-American and Hispanic elderly women are cared for in the homes of relatives then are white Americans. These white edlerly women are more apt to be "put" in institutional settings such as nursing homes. According to some research this is a cultural difference. Is this a realistic disparity or not?

Anonymous said...

The article on ageism provides some interesting details that I had not thought of before. I do believe that elder abuse is due to social injustice. With a lack of funding to assist the abused elderly this creates more social injustice. However, I do feel that with more education and with practitioners taking the time to get to know the elderly population it will assist in discovering the abuse in a timelier fashion.

In order to prevent the abuse it will not only take more funding, but society will need to look at the elderly in a different perspective than they currently do. Think of how many times people with disabilities or the elderly are given “special” treatment in stores and they are given the opportunity to come into a store early and are given a discount. Most people would find that acceptable, even a necessity, however I challenge us to see a different perspective. A perspective that this opportunity for the elderly actually is allowing society to stigmatize this group as needing a discount or needing a “special” time to shop as opposed to realizing that the elderly should not be categorized as a group that is not capable of being part of society.

I think educating society can assist with the up in coming baby boomers who are going to become the elderly. I agree with Cindy’s comment regarding the tolerance of the baby boomers and elderly abuse. I hope that this will give society a push to stop elder abuse.
Adrienne H.

Anonymous said...

I think in this society the elderly are looked at as burden and are pushed to the side to make room for the younger generations.

In some societies the elders are looked at as the highest ranking figure in the family. The elders are looked to for advice and highly respected. But in our society we have become so individualistic that we no longer lean on our families. In many cases families are so spread out that they only see older family members once or twice a year.

In our culture if a person is different or does not contribute they considered less than human. I agree ageism is a serious problem in the United States and around the world; the only way to change the social injustices that occur is to educate the population and not tolerate the continued abuse of the elderly. I agree with Dawn, isn't it ironic that our culture discriminates against the very thing we thing we all will become?

Anonymous said...

Adrienne has a vaild point when discussing the idea of "special". I work with families who have children with developmental disabilities and there appears to be a split between families who want their children to be fully included while others feel it is important for their child to have seperate specialized time. A book that highlights these issues with chldren with disabilities is "Seeing the Charade: What we need to do and undo to make friendships happen" by Tashie, Shapiro-Barnard and Rossetti. Although I am just starting to read it, the book talks about how children begin to make distinctions between "us" and "them" when children are taken out of the class room for things like speech or PT. I feel these are important for children who need these services however this book depicts the same issues that elders experience. They are ostracized by the greater society and therefore seen as different. This separation continues to keep elders at a distance. Again this is not to discredit that these individuals could need extra help but to assume that they are unable to participate as valued memebers of their community is harmful personally as well as politically.

Mandy G

Noel said...

Cindy made several interesting points. While ageism should not be considered the sole reason for elder abuse, I think it is part of the reason our society has been reluctant to do anything about it. It is not uncommon for a person to avoid eye contact with an elderly woman in a store or to poke fun at an elderly driver. That is why cartoons like the one in the Washington Post are considered funny. Our society does not respect the elderly and consider them to be a valuable part our society. This attitude allows us to excuse elder abuse in many of its forms.

Of course, as Cindy mentioned, ageism cannot be the only risk factor for violence. The statistics have shown us that poverty seems to have an influence here. I have worked in long term care in the past, and the cost of care is staggering. A survey done by MetLife in 2006 put the average daily cost of a private room in a nursing home at $206(check it out to see differences across states http://ltc-usa.com/docs/2006NHHCSurvey.pdf). The price tag of these facilities is more than most families can handle. Thus, without prior planning, many elders need to be cared for in the homes of family members. Our readings for class have shown that most elder abuse takes place at the hands of family members. It is crucial that as a society we realize that not only do we need to end discrimination against the elderly, but we need to make long term care options more affordable.

I strongly believe that it will take many voices to end discrimination against the elderly, end elder abuse, and increase affordable long term care options. Law makers cannot ignore these problems any longer. The "baby boomers" may be the catalyst for these changes, but I think it is very unfortunate that we've had to wait for the impact of this group to realize the seriousness of the issues.

Marti B. said...

I agree with Dawn that it is ironic that ageism is such a problem in our society when it it has the potential to affect each and every individual later in their (our) lives. It is unfortunate the members of our society begin to view the elderly population as a burden, rather than treasuring their experience and the contributions they have made through their lives. As social workers, we need to begin to change the stereotypes people have towards the elderly. The cartoon in the Washington Post is just one example of the way in which the media portrays the elderly. There seems to be a barrier in this country between the elderly and the rest of the population. They truly are "invisible" in many ways, and that is so unfortunate and so wrong. I feel that community programs that bring together people of all ages are effective in breaking down these barriers, and in turn raising awareness of elder abuse.
Marti B.

Anonymous said...

Amanda C:
I totally believe that ageist attitudes can play into harm against elders, but I don't believe that it plays a huge part. I think the general public needs more knowledge and awareness of elder abuse, particularly people in the medical field who have the most access to the elderly population. I think that, more then ageism, caregiver stress and adult children with addictions or mental health issues trying to care for older relatives plays into elder abuse. I think that social workers and health professionals should try to do more to promote support groups for caregivers and respite programs to help give them a break from caring for their elders.

I also agree with other comments that we need to put some money where our mouths are and fund some research and programs for the issue of elder abuse. It is interesting to me to learn that elders require different types of programs and help that younger victims of abuse. Dynamics are different and their needs are not the same.

Abbey said...

Abbey P.
I agree with Mindy, I am a complete novice when it comes to elder abuse. I am a Child Protective Service Worker and thought that there were not enough federal laws that protect children from abuse. After reading this blog and realizing that it took nearly 17 years to realize that elder abuse is increasing and there are still no federal laws to help defend elders who are victims of abuse. It gives me more hope that children are on the right path of being protected, but gives me a false sense of hope for elders. There is still a lot to accomplish in order for there to be a federal law to stop abuse toward elders. Not only do children have better protection laws for them, but they have better resources. I just wish this was the same for elders.

Lisa Nerenberg, Consultant, Speaker, Trainer said...

I couldn't be more delighted by the candid and thoughtful responses I've been getting. You've focused on some of the most important issues in the field of elder abuse today. I really hope that some of you will decide to work in this field. We need your insights and passion!

Many of you mentioned the need for federal law and funding for elder abuse. There's actually a bill pending in Congress, the "Elder Justice Act," which, if passed, would provide the first comprehensive response to the problem. A main feature is funding for Adult Protective Services but it also provides for additional programs and grants to improve detection and the handling of cases. The bill was first introduced in 2003 but didn't pass because of lack of support in the House of Representatives. It was reintroduced in 2005 and 2007.

For more about the bill, see the website of the Elder Justice Coalition at: http://www.elderjusticecoalition.com/

If you want to contact Congress, go to: http://www.visi.com/juan/congress/

A few of you have voiced frustration about our field's preoccupation with definitions. I know it can get tedious, but when you're involved in social policy, definitions are critical. In light of the conversations we've been having, consider the implication of casting elder abuse as a crime versus domestic violence versus a "caregiving issue" within the EJA. How we "frame" the issue dictates how we respond. That's why, in a book I just finished writing on elder abuse, I devoted a whole chapter to definitions and made a pitch for why service providers should get involved in these "definitional debates." How we define and frame abuse will dictate who we serve, the demand for services, and the types of services clients need.

Just a few more random comments on this chain…

Cindy raised the issue of cultural differences and how they affect risk. This, to me, is one of our most important unmet research needs. We simply don't know how factors like living in multigenerational families affect risk. I would guess that it's pretty complex; that some factors both contribute to and reduce risk depending on the circumstances. Which of your classmates was it who said "Context, Context, Context!"

I really liked Dawn's point that ageism is an "equal opportunity" disease because we're all vulnerable to it. I wonder if and how older people's experiences with ageism affect their attitudes toward social justice and equality.

You've also talked about how tricky it is to recognize and address elders' special needs without stigmatizing elders or creating an "us versus them" mentality as Mandy warns against.

I suspect that your assignment is over by now, but I'll continue to post and read messages for awhile. I've really enjoyed them.
Thank you all!

traciew. said...

I guess that my previous submition did not go through...as I had feared. So, I shall try it again.

The issue of ageism is an interesting one...especially in our individualistic society. Dawn J. made such a great point on the equal opportunity for aging that exists for us all. If we would only keep this in mind in our cultural perspective, the elders in our society might not experience the discrimination that they do simply because of age.

WE ARE ALL GETTING OLDER, EVERY MINUTE OF EVERY DAY!!! This is so important to appreciating the process of aging that we all experience and helps us to better relate to our elders.

I don't really feel that ageism is neccessarily a form of abuse, so much as it affects attitudes that lead to discrimination against the elderly. However, with that said, the notion of ageism could very well be related so far as creating increased feelings of frustration, the perception of burden, or feelings of entitlement that may develop into elderly abuse.

I sincerely believe that our culture does not embrace the importance of elders, their life experiences, knowledge, and the endless contributions that older citizens make in our society. Generativity is expressed by the older citizens in our society who wish to impart knowledge and improve the lives of the generations to come...who else would or could provide such generous gifts of long-life lessons, but the elderly. This stage of life is highly underestimated and taken for granted by the younger "movers and shakers" in our country.

Ageism is a sad reality in American culture, where the vitality of youth is a national treasure. Individualism and consequential isolation of people is a prominent cultural phenomenon in the U.S. It is this combined set of cultural beliefs that contributes to the increased isolation of senior citizens and leads to the increased potential for abuse. If we do not honor the elderly and look after them, because we place a higher priority on youth than yes, I suppose ageism is a form of abuse, but I tend to see it more as a correlation or potential causation of elderly abuse in our society.

kimc said...

Sometimes, as a social worker and as a woman, I am in situations where I am with others who care a lot about social justice issues but, perhaps can only relate to one aspect...rather than the whole of what is going on. (I'm going to relate this to Ageism and Elder abuse, I promise.)

Let me give you an example. I work with refugee women and students. Recently, I accompanied a large group of these women and teens to a Minority women's Health Conference. Everyone was really glad the women were there, they recruited this group specifically... and they even provided simultaneous interpretation headsets so all the women could understand what was being said. However, so much of the day was about taking care of ourselves within a very middle class frame of reference with talks about massage, accupuncture, products, creams, how to have balance in your life, taking time for yourself, for creative pursuits...etc. The day to day lives of the women I brought are very different than many of the lives of the planners and the participants...Most work long hours at hotels and fast food restaurants, have few resources and choices and have experienced violence and broken social worlds as a result of being refugees...One of the speakers talked about balance and cutting back her hours when she had kids, getting some "me" time...which is all really important...but it is just a "piece" of a large pie which would, hopefully, encompass advocacy and appreciation for all of the women's world's who were at the conference...

To me, "Ageism" is a piece of many elder's worlds, and it's a piece that middle class Americans can latch onto and understand because it's a piece that can affect them...However, we can't just focus on this piece...If we don't really ever get "touched" by the culture that many elders must live within (poverty, abuse, isolation) then we might just keep focusing our lens with middle class values and just focus on things like the unflattering media portrayals, etc...

Just like the refugee women I refered to before...They would like help finding better work, transportation and childcare...At the very least we need to understand and advocate...the creams and talk of "balance" are good ways to be good to ourselves, but there are many others needs and solutions out there...With social justice for all elders we must be looking through many lenses...

kimc said...

I believe it was right for the editor of the magazine to bring attention to the subject of Ageism by criticizing the cartoon in The Washington Post depicting an older woman in a swimsuit (like a Sports Illustrated issue)...We need to talk more about age and beauty and society and what that all really means...By criticizing the cartoon, the editor makes us think about meaningful beautiful qualities, like wisdom, experience, maturity, strength, resiliency, connectedness, kindess, self knowledge and passion...many of which come to us as we move through life and age...Having said this, we must make that as we keep moving the conversation we, also, don't forget to talk about the more invisible aspects of aging, the things we don't seem to be talking about, like the dispropotionately affected communities of color, poverty and abuse...

Sarah M said...

It is an interesting realization that aging and ageism is something that everyone will experience at some point, and the despite it being inevitable, it's still not widely addressed as it should be.

When it is addressed, it does not get enough attention until it is in a negative forum, like the Washington Post's cartoon -- and that seems to be the catalyst which finally lit the spark of actually delving into the issue. That's pretty sad.

I enjoyed and agree with Kim's point that we tend to stay within our middle-class comfort level when discussing issues such as ageism, poverty, and Elder Abuse. In turn, the statistics are so staggering to us when we hear or read the actual numbers. It makes me realize that the problem is just not ageist attitudes, it's also a socioeconomic issue as well.

retirement communities new york said...

Social abuse is perhaps one of the main reasons why the elderly without guardians or relatives supporting him/her should go into retirement homes.