I recently viewed a TED talk that made me realize I am ageist. As a middle-aged geriatrician, and someone who spends a lot of energy trying to recognize the other “isms “ in myself, I am not proud. Ashton Applewhite, activist and author of This Chair Rocks, calls this the last acceptable prejudice because it is so insidious in our culture.
Applewhite makes several points that are particularly relevant to healthcare, and like all the other forms of internalized and cultural stereotyping, reminds us we must first start with ourselves. Do you have any notions about yourself that start, “I am too old for…?” Do you lump every person over 65 into the same category? Do you assume wrinkles are bad or condone plastic surgery to “fix” them? Does your doctor treat you differently now that you have Medicare? In medical school we perpetuated ageism by learning to document our histories beginning with the word “elderly” in front of anyone 65 or older – or in some cases – anyone who “looked old.” We characterized “little old ladies” as cute or pleasant (guilty on both charges) and made paternalistic assumptions about their care.
Let’s not be in denial because it leads to shame. Chronological aging is inevitable and should be celebrated, among other things, for the wisdom that comes from living. Science tells us that people are generally the happiest at the beginning and end of their lives – so we should stop acquiescing to the cultural messaging that tells us it is all over after menopause, retirement, or a few health issues. We can start by changing the way we talk. Instead of saying “you look good for your age,” say, “you look so healthy and happy!” Remove age as a descriptor at all, as we have (mostly) done with race. Speak of your dreams and ambitions more than the things you miss. Perhaps the most ridiculously ageist is “senior moment,” which as commonly understood these days applies more to my teenager than my mother!