prof. dr. vok1 gerontology prof.dr.veronika ospina-kammerer
TRANSCRIPT
Prof. Dr. VOK 1
Gerontology
Prof.Dr.Veronika Ospina-Kammerer
Prof. Dr. VOK 2
Vulnerability and a Lack of Empathy or Compassion add up to
AGEISM
Prof. Dr. VOK 3
Keine Sorge – keine Angst
Wir sprechen Deutsch!
Prof. Dr. VOK 4
Are you prejudiced?
Do you say “aaawww, isn’t she cute?” when you see an older woman doing something a younger person might do (e.g., having fun, kissing a man)?
Do you think older people aren’t appealing because of their physical appearance (e.g., loose skin, wrinkles, gray hair, weight around the middle)?
Prof. Dr. VOK 5
Are you prejudiced?
Do you think all old people are wise?
Are you uncomfortable talking to elders?
When you talk to older people do you look them in the eye?
Are elders all “old people” to you or can you see each as an individual?
Prof. Dr. VOK 6
Beliefs about Aging and Older People
The Social Construction of AgingYouth, speed, production ($) are American
idealsPhysical and mental weakness are stigmatized
feel ashamed or embarrassed when weak, ill, or need help
You have done something WRONG if you become ill or old or poorBlame the Victim
Prof. Dr. VOK 7
Beliefs about Aging and Older People
The Social Construction of AgingValues underlie attitudes and stigma
Survivor of the fittest • (I [behavior or attitude] and am alive/well and Mr. X didn’t so
he became old/ ill/died• Control, control, control
Do not believe that uncontrollable forces or chance has anything to do with becoming old or ill
Belief in simple cause and effect relationships• e.g., She got cancer because she did/did not [behavior or
attitude]
Prof. Dr. VOK 8
Robert Butler on Ageism
In the 1960s, Robert Butler coined the phrase ageism, which he defined as:
"A process of systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish this with skin color and gender. Old people are categorized as senile, rigid in thought and manner, old-fashioned in morality and skills . . . . Ageism allows the younger generations to see older people as different from themselves; thus they subtly cease to identify with their elders as human beings . . . ."
(See R. Butler, Why Survive? Being Old in America, 1975 - item no. 71 of this bibliography.)
Prof. Dr. VOK 9
Ageism
Ageism can be coupled with other forms of oppression
sexism, racism, beautyism… a powerful combination
It all adds up to the beliefs that –AGING is badAGING is uglyAGING is to be avoidedAGING is a social and economic crisisWe need to FIGHT AGING
Prof. Dr. VOK 10
Ageism
“A man's face is his autobiography. A woman's face is her work of fiction.”
Oscar Wilde
Prof. Dr. VOK 11
AGEISM & SEXISM The Double StandardThe men shown here are the plastic surgeons – note they haven’t been touched up.
Prof. Dr. VOK 12
What? We’re Prejudiced? Are you?
Lots and lots and lots of examples in daily life…
ConversationsJokesTelevisionBirthday cardsNewspaperMagazinesMusic lyrics
Prof. Dr. VOK 13
Ageism and the MediaSubtle? NOT!
Music http://music.msn.com/music/features/bandsofthelivingdead
Is music only for the young?Rockers and rappers who are in their
40s, 50s, and 60s are referred to as “living dead” -- Writer states they “refuse to die”
Old men rockers are one thing but old women?
Prof. Dr. VOK 14
Ageism and the MediaSubtle? NOT!
Prejudice and discrimination on TVLess than 2% of prime time television characters are
65% Majority of film and TV writers are white men under 40Only 1/3 of older characters on prime time TV are
women70% of older men and 80%+ of older women on TV are
portrayed disrespectfully, treated with little if any courtesy, and looked at as “bad”
Examples from Ageism in America: Status Reports of Ageism in America by The Anti-Ageism Taskforce at The International Longevity
Prof. Dr. VOK 15
The Truth About AgingThe truth is that most older people are more
vulnerable due to losses Physical losses
May not be able to walk, drive, grocery shop, clean house, talk on telephone, see instructions or watch television, etc.
Social lossesLoss of parents, spouse, siblings, friendsCoupled with physical, income, and cognitive, may lose ability to get to
and enjoy social activities Income losses
Retirement Cognitive losses
Some processing changes and memory loss are normal
And sadly enough, some people prey on older people’s vulnerability
Prof. Dr. VOK 16
Age Discrimination & Health Care 60% of adults aged 65+ do not receive
recommended preventive services40% do not receive flu and pneumonia vaccines
Only 10% of elders receive screening tests forBone densityColorectal and prostate cancerGlaucoma Despite the fact that the average age of colorectal cancer
patients is 70, more than 70% of prostate cancer is diagnosed in men 65+, and people over 60 are 6 times more likely to have glaucoma
Prof. Dr. VOK 17
Age Discrimination & Health CareChemotherapy is underused in the treatment of
breast cancer patients aged 65+ even though survival could improve with many
Older patients are significantly underrepresented in clinical trials for all types of cancer but notably in trials for breast cancer
Older persons are the biggest users of prescription drugs, yet 40% of clinical trials between 1991 and 2000 excluded older persons
Prof. Dr. VOK 18
Race and Gender Discrimination in Health Care
The Effect of Race and Sex on Physicians’ Recommendations for Cardiac Catheterization
Article in The New England Journal of Medicine, 2/25/99
By Schulman, Berlin, Harless, Kerner, Sistrunk, Gersh, Dube, Taleghani, Burke, Williams, Eisenberg, & Escarce
Prof. Dr. VOK 19
Background
There are sex and race differences in terms of the prevalence of heart disease, heart attack, and death from heart attack in mid and later life in particular. African Americans and women are more likely to
die from heart disease and heart attack and also have higher rates of hypertension.
Women and African Americans tend to have greater functional disability due to angina before myocardial infarction as well.
Cardiovascular tests and procedures can help with quality of life and the extension of life.
Prof. Dr. VOK 20
Research Question & Methods
Research QuestionDoes the race and sex of a patient independently
influence how physicians manage chest pain?
MethodsActors portrayed male/female white/black older patients
(age 55 and 70) with particular characteristics in scripted interviews about their symptoms
Identical data given to physicians about patients (medical history, results of tests, etc.)
Sample of 720 physicians derived from attendees at two national medical conventions
Computerized survey asked physicians to make recommendations for managing the patient’s chest pain
Prof. Dr. VOK 21
Results
Physicians’ mean estimates of the probability of coronary artery disease were lower for women
A sophisticated logistic regression analysis indicated that the odds of women and African American patients being referred for cardiac catheterization was lower than for men or whites Looking at the effect of the double whammy (sexism and
racism), it was found that Black women were significantly less likely to be referred for cardiac catheterization than white men
Some believe that people are most sympathetic to people like themselves; hence, the finding (white male doctors tended to favor or refer white men) Along these lines, one could ask -- Were the female and Black
cardiologists more likely to refer women and African Americans for cardiac catheterization?
Prof. Dr. VOK 22
You might ask – but aren’t college-educated younger adults less likely to be prejudiced than others?
And finally, you might ask – aren’t nursing students less likely to be prejudiced?
Prof. Dr. VOK 23
Study of Standardized Patients
Nursing studentsWhich patient was ascribed the most
negative characteristics?Which patient was least preferred to work
with?Why?
Prof. Dr. VOK 24
Your Beliefs and How They Affect You and Your Treatment of Others
How much control over things do you feel you need to have to be okay, live life as you’d like, and avoid anxiety?
How much control do you think you have over aging and disease?
What impact do you think your notions have on your behavior?
What impact do you think your notions have on the way you view others’ behavior?
What impact to you think your notions have on the way you will treat others who are aging, dealing with health decline, disability, disease, pain and suffering, dying?
Prof. Dr. VOK 25
More Examples of Age-Related Vulnerability in Today’s World
Out of sight, out of mind?14,802 persons, mostly
elderly, died in France during a 2003 heat wave
20% of health care providers were gone, most French families were on vacation
Should government have provided? Should people have not vacationed?
Prof. Dr. VOK 26
What is Resilience?What is Resilience?
The Resilience of Elders of The Resilience of Elders of ColorColor
The Resilience of Older The Resilience of Older WomenWomen
Prof. Dr. VOK 27
Ethnic Minority Distribution of Older PopulationEthnic Minority Distribution of Older Population84.3% of total population 65+ is White and 15.7% 84.3% of total population 65+ is White and 15.7% are ethnic minorities are ethnic minorities (8.1% African American, 5.6% Latinos, (8.1% African American, 5.6% Latinos,
2.4% Asian/Pacific Islanders, 0.4% American Indians)2.4% Asian/Pacific Islanders, 0.4% American Indians)
0
2
4
6
8
10
12
14
16
18
% of ethnic minoritypop 65+
projected % 2050
African Americans
Asian/Pacific Isl
American Indians
Latinos
Prof. Dr. VOK 28
Ethnicity and CultureEthnicity and Culture
Know definitions of ethnicity and cultureKnow definitions of ethnicity and culture What is “resiliency?”What is “resiliency?” Why do we even talk about the Why do we even talk about the
resiliency of particular groups?resiliency of particular groups? What social forces impact minority What social forces impact minority
elders’ lives? women’s lives?elders’ lives? women’s lives? What interactions does the book say begin What interactions does the book say begin
to add up and cause stress? to add up and cause stress? Know what the double jeopardy hypothesis Know what the double jeopardy hypothesis
isis
Prof. Dr. VOK 29
Issues Common AcrossIssues Common AcrossElders of ColorElders of Color
Cumulative structural disadvantagesCumulative structural disadvantages Low paying jobs, higher poverty rates, Low paying jobs, higher poverty rates,
more single womenmore single women Lower rates of insurance coverageLower rates of insurance coverage Sociocultural (structural and family-Sociocultural (structural and family-
related) barriers to health care and related) barriers to health care and social service usesocial service use
Centrality of family/kinCentrality of family/kin Chronic illness patternsChronic illness patterns
Prof. Dr. VOK 30
Social ForcesSocial Forces
How do minority and women elders How do minority and women elders become “resilient?”become “resilient?”
Is the answer to force individuals to Is the answer to force individuals to become resilient or should we become resilient or should we change society?change society?