CHP Conversations
Welcome to CHP Conversations, a podcast series produced by the VCU College of Health Professions. The College's mission is to create influential leaders in health care who embrace equity and model excellence through inclusive teaching and learning, thoughtful advancement of cross-cultural knowledge, meaningful service to others, innovative technologies, and scientific discoveries that promote health and health equity and eliminate health disparities. This series includes conversations with faculty, students and alumni who exemplify our mission.
CHP Conversations
The Challenge of Ageism in Our Families and Communities
Dr. Gendron, author of Ageism Unmasked, explains the concept of ageism, and discusses the impact that ageism has on our communities and families. She then outlines her thoughts on a healthy approach to aging
Welcome to CHP Conversations: a podcast series produced by the VCU College of Health Professions. This series includes conversations with faculty, students, and alumni who exemplify our mission to create influential leaders in healthcare. Hi, I'm Jared Schultz and I'm from the Department of Rehabilitation Counseling in the College of Health Professions here at Virginia Commonwealth University. I'm joined today by Dr. Tracy Gendron and who serves as the Chair of the Department of Gerontology and the Executive Director for the Virginia Center on Aging here at VCU. With over 25 years of experience as a gerontologist, Dr. Gendron, and is the author of the book, "Ageism Unmasked: Exploring age bias and how to end it". She's frequently quoted in popular media outlets including the New York Times, The Huffington Post, and US News and World Report. Dr. Gendron has spoken about ageism in forums across America and it can be seen and heard as a guest speaker on numerous podcasts and video productions. So thank you Tracy for joining me today. I am happy to be here, Jared. It's good to be talking with you. You've expended or, spent a lot of time in your career addressing the topic of ageism. And it's one of those words that is out there and you hear it. But just for our audience, would you mind just kind of backing up and explaining what it is and how we observe it in our communities. Absolutely, you have an hour or so? It might take me a few minutes. Multi-episode podcast. Exactly, multi episode podcast. But ageism is actually really ubiquitous. So it's everywhere and yet, because it's really has an awareness problem, it's also an invisible at the same time. So ageism is about how we see people of different ages. It's directed both at younger individuals and older individuals, but it's when we assume or judge or come at somebody in a negative way because we think they're in a different age group than we are, and therefore think that they are fundamentally different than we are. So ageism is other-directed. But ageism is also internally-directed and it's how we feel about ourselves is aging people. And that's one of the things that people don't talk about quite as much as this sense of internalized ageism and the consequences that it has. Ageism is also relational so it's how we communicate with each other formally and informally. The things that we say that perpetuate it, that keep us valuing youth over old age. And it's everywhere, meaning it's embedded in our culture from large messages- think anti-aging as a industry, all the way down to how we talk about ourselves when we disparage what it means to be old, or we self-deprecate what it means to be old. So it's actually really complicated because it's embedded in so many different ways and layers. Yeah, I mean, it sounds like there's, there's an element of attitudinal approach to things that mixed with my lived experience, you know, like, getting older, my body aches a little more than it used to and those sorts of things. So it's a lot of layers of who we are. It's a lot of layers of who we are and it's one of the forms of our identity that continues to change over time. Ability can do that as well, but it's not stable. How we relate to the world and how the world relates to us is different when we're 20 than when we're 40, than when we're 60, than when we're 80. So it's a form of our identity that we're constantly exploring, that's constantly changing. And that we really have to adjust to, because people do react differently to you when you're, again, 20 versus 80. It, it's something that's like ever present in our lives and constantly shifting and evolving. So earlier in your definition, you talked about ageism as being other-directed. You mentioned that they're a little bit of judgmental. Is that- am I accurate in that? Yes, yes. Is there a, is there a healthy opposite? There is a healthy opposite, and I think, you know, in gerontology we call it being person-centered. So, and I think, you know, understanding and biases is embedded in our brain. Right? You know that. I'm sure we've had multiple conversations about it. We can't help but being biased. So much information comes at us that we have to classify things very quickly. But if we focus instead on seeing the unique person in front of us with all of their identities, then we can kind of start to move away from that automatic judgment of somebody as older or younger and then a potential prejudice or discrimination that may follow. So it takes a little practice. But I think once we have the awareness of it, we realized that there's no blueprint for what it means to be of a certain age. And we can back away from making those automatic assumptions and start to ask questions instead, either internally or ask the person we're with, questions about who they are and what they prefer. So it's a very empowering thought that we can recreate. I mean, that its, we're not passively receiving that process, but that we can actually take initiative and create that for ourselves. Exactly. And then not only are you empowering others by really meeting them for who they are and where they are. But think about the power that has for yourself as an aging person. So once we have that recognition that we are all aging, because ageism is not about older people, it's about all people. Then I think we start to make those connections of how do I really feel about myself as someone that's aging? Is this a negative that I carry around? Is it something that I'm dreading and that I fear? Is it something I'm looking forward to? And once we ask ourselves that question, I think we open up a whole new way of thinking about it. Because the truth is, many of us are taught that aging is something that is scary, that is negative, that is all about decay in decline. And we stopped really thinking of aging is living, and aging as being, and aging as becoming. So it makes it easy to, kind of, feed into that decline narrative instead of seeing the whole story. So talk about empowering, once that switch comes on for you. It's like you can envision your future in a whole new way. I love the positive approach and I want to come back to that a little bit later. The ageism element, kind of that negative side of this process. Any thoughts on where that originates? I mean, you talked a little bit about fear and misunderstanding and, where does it come from in us? Yeah, and that's a great question and it is the one of the questions that prompted me to write my book because I often got the comment, "Well, didn't we use to revere elders?" And I was like, "Well, yes and no". So in the book, I started from the very beginning, right? So really looking at what do we know from biblical texts, from ancient texts. And what I learned was that it's always been complicated. So while we do have references of revering elders and elders being the leaders of churches and elders being the keepers of knowledge. At the same time, you can find references to aging as a process of disease and decay and fighting wrinkles, right? Even ancient Egyptians had references to fighting wrinkles. So this has been something that's been around forever. So Cleopatra had her face cream and everythi-- Yes! Donkey milk! Yes, that's exactly what it was. Yes, that's really what it was. So we see that the complexity has always been there. And I think ageism is complicated that way because aging is complicated. Aging is a series of processes that are fundamentally in conflict with each other, right? We have decline and we have growth. It's multi-directional and it's multi-dimensional and you can't pick apart that aging does include biological decline. It does. It includes biological change. There's wear and tear. There's ways that we don't function as well as we used to. There's joints wear out. These things happen because we're mortal. So there's truth to that. I think when there's truth to that, it's easy to just give into that, right? That aging is all about decline. It's hard to hold two competing ideals at the same time. But aging is also just as much about growth. Psychological growth, emotional growth, growth within our social roles, growth in spirituality. So it's about seeing the whole picture. But to your original question, it's always been complicated. And that's one of the reasons why is because aging is complicated. Do you find that it is, is the dynamic of ageism related to how distance someone is for me? So for example, it, am I less prone towards ageism within my own nuclear family, or more prone to the further someone is distanced from me? Does that make sense? It does make sense. I think what I can say about that is one of the most protective factors against ageism is close relationships with older people when you're younger. So if you are in a family that you have a tight relationship with your grandparents or with older people in the community, you are much more likely to have positive associations with being older. However, on the other side, if you don't have any around you, then you're basically getting your knowledge about what it means to be old from popular culture and media. And that is not helpful. So that is more likely to feed the stereotypes of aging and that leads to ageism. So, yeah, it really does depend on the quality of the relationships that you have with older people when you're younger? Do you see differences among cultures that, where, you know, it's more likely that you have a closer multi-generational family connection in some cultures than others? Definitely. And that's a question I get all the time is "isn't this different in other cultures?" And the answer to that is also yes and no. So yes, there are certain cultures that, I think, do a couple of things. There are more that, I think, have a tendency for multi-generational families and households. And that definitely, you see more of this normative process of people caring for people of different generations. And that's just how you grow up, that's part of the culture. On the other hand, there is ageism research in every continent and country that shows that ageism exists and is on the rise. So, I think in part as capitalism rises and we tend to value efficiency and productivity and contribution, we tend to see an increase in ageism. Interesting. So that has happened globally. Interesting. Yeah. So we've kind of danced around a little bit the negative elements of ages. But let's kinda really specify what are, what's the negative impact? Yeah, that's a great question. So there's actually decades of research that shows that ageism is a public health problem because the impacts that it has on an individual level is profound. So people that hold those negative attitudes about aging who fear that they're going to have cognitive decline or lose their memory or have had physical decline, are actually more likely to manifest that cognitive and physical decline. It is related to higher rates biomarkers for Alzheimer's disease, it is related to higher rates of chronic illness. It is related to taking longer to recover from illness. And there's the seminal study by Becca Levy, who now has her book out, that shows that people who embrace their own aging, on average live seven-and-a-half years longer than people that fear their aging. And this study was after accounting for socioeconomic status, loneliness, functional health, gender- it was on top of all of that. So it is a profound impact to our health, to our happiness, to our longevity, also social isolation, depression, all of it. And yet, we know that smoking is bad for us. We know that not exercising is bad for us. We don't know that how we feel about ourselves as an aging person has that level of an impact. I have to admit it's a fascinating thing. And as a counselor, my mind just went [mimicking explosion noise], right? Because I'm, I'm sitting here thinking, "Wow, I've never thought of- What's the counseling and intervention to help someone be comfortable with that process?" And. Absolutely, and when you think about it from a biological level, it makes sense. I mean, when we have fears that triggers the stress hormone cycle, right? (Mhm. Mhm.) So we have that rise in cortisol and that's not good for our body if you're walking around constantly in elevated level of stress or an elevated level of trauma, it's going to lead to bad outcomes. So this is yet another stress trigger, but one in which, like you said, we don't really talk about. So yeah, truly think of the implications if we started to just have some conversations and reframe aging for people. I was just listening to a podcast not too long ago where the host was making the differentiation between making the point that the neurological process for approaching a challenge versus a threat are two different neurological processes and have a different impact. But then the perception of this as whether it's a challenge, it's a challenge and I can embrace that versus this is a threat and this is a scary thing- that's all in your interpretation. Exactly. Jared, I'm seeing a research opportunity for us here. A paper in my head is forming. I'm sure there's a grant somewhere. Yes, oh I'm sure there is. Let's get on this after the podcast. So, so, talking a little bit, what are, what are some of the things that we can do, some kind of concrete things that they start to address some of those negatives? I think the first thing is, no matter what age you are, no matter what stage of life you're in, is to identify that you are aging. Aging is not about older people. Aging is about all people. So I think the first is just to recognize and embrace that. And then the second would be to start to ask yourself some serious questions. What do you think it means to be old? How do you feel about your aging? How is it that you talk about aging and growing older? What role models do you have? So, when you think about the older people in your life, are you thinking about opportunities? Are you thinking about people that have life satisfaction, that can find joy? Or are you thinking about some of the common tropes that are out there or the messages that are out there in the media that basically tell us we need products and services and supplements in order to maintain our vitality, which is youthfulness. So start to think about what you know about aging, where you learn about aging. And then I think you can really start to get down to some of those feelings that are inside, maybe even some of the anxieties that you might have. And then once you identify those anxieties, you can seek knowledge that helps you bust the myths that helps you re-frame what you think you know from what is in actuality. That's always something that's interesting. When you start to go down to the myths and stereotypes of aging, most people believe things that are completely incorrect because it's what we're taught. So most people don't know about the U-curve of happiness. Most people don't know that people in their earliest and latest stages of life are actually the happiest and go, "What?!" Most people don't know that most older people were will report that they are in good health, whether they are in good health or not. They don't know about positivity effect, that older people tend to see the positive in things, that choose relationships that are healthy for them because they have the lived experience to do it. That most people are not depressed, that is not a part of normal part of aging, nor is cognitive decline or impairment. So, I think it's the reframing piece but it starts with us, and it starts with examining how we feel about ourselves. The reframing process. In my own work I've been reading a lot about and thinking a lot about the process of empowerment and the role that choice and autonomy of choice plays in empowering. And one of the things, conclusions I've come to is that choice is one of the fundamental building blocks of empowerment. Yeah. And so I guess when you were talking about that re-framing, is, are we able to choose? Are we able to go, "Okay, this is how I was raised. But here's some examples. Here's this person or that person. Maybe I'm not related to them, but that's what I want. And that's the attitudinal approach I'm going to take". Yeah, absolutely. I think we all have that choice. (Yeah) You know, I think it's like you can't help what happens to you, but you can choose how you respond to it. (Yeah.) So same here. We can choose to make an active choice in how we think about aging. And I'm not saying this in terms of it is all positive. Look their challenges with every stage of life, some harder than others for different reasons. So I'm not saying to ignore the challenges, but I am saying that we can acknowledge the challenges and still recognize that there's opportunity for growth and development with those challenges. So. Or even possibly because of those challenges. Or even because of those challenges, exactly. Yeah, I mean, you think about that, the U-curve of happiness. Is that what they call-- the curve of happiness? Yeah, yeah. I learned a new term today. Why is it that those two ends of the spectrum demonstrate more happiness and, you know, maybe the younger people don't know that they shouldn't be happy? I don't know. You know, not a whole lot of life experience, but at that other end, it's that life experience and getting through those challenges and those pieces, you know, those things in life that kind of beat you around a little bit- (Exactly) that allow you to take perspective on everything that's going on around you? Exactly. And through challenges, we build resilience. And we build coping. So the next time something happens, we go "Eh. I've been there, I've done that. I'm not going to let it shake me to my core". Whereas the first time, that's really scary. Yeah. So yeah. I had an experience with my, my, my wife's grandmother. There were some things happening, it was stressful and I was sitting next to her on the couch one day and I was deep in my thoughts and everything and she was just sitting next to me. And she reached over and she patted me on the knee. And she goes, "It's gonna be okay". And what was interesting because I was pretty young at the time, but I recognize that it wasn't someone just saying, "Oh, don't worry, it's gonna be okay". It was the voice of someone who had been through a lot. (Yeah.) And it was the voice of experience saying, "No, I know it's hard. But you can get through it". And it's one of those treasured moments that I have with my wife's grandma (that's beautiful), and uh, but very powerful for me, life-changing. Absolutely. Because, yeah, that was a voice of experience and it does, it kind of gives you some reassurance. Like, yeah. Okay. I can feel a little bit of comfort now. Yeah. That's lovely. Yeah. So we've talked around a little bit the positive elements of aging and how to approach it. Little bit more on that. What, what does a positive aging process look like? I think of positive aging process means being open to all the challenges, to all the possibilities that are ahead. So I think it means challenging some of the assumptions like, you can't teach an old dog, new tricks. False. Anybody can learn anything at anytime. I think it means I'm too old to pursue this. False. We're never too old to be able to pursue a dream. So I think, you know, being open to the possibilities and releasing the constraints that we put upon ourselves. We do, we limit ourselves because we think I'm too old to start a degree program. I'm too old to learn a new language. I'm too old to go hang out with this group of young people. I think we need to just really challenge that. And then the world kinda opens up. I think that ageism is a driver of social isolation. You know, I think when people feel excluded, when people feel that there's no room for them to contribute. Of course, they're gonna be isolated. And even a self-remanded isolation is lonely, if you feel like there's no place for you to belong. So we can do this for ourselves, but the other thing we can do is open opportunities for other people. So maybe think about having a friend group that contains people of all different ages, seeking out those kinds of relationships where you can learn from people that are different from you. So there's benefits for you and for others. Yeah. I'm just, in some of the work I do in the community and I interact with, with groups fairly frequently. And one of the things that themes that I've kind of hit on is the need that we have to create a culture of invitation (Yes.) Where we invite others in. (Yes.) And it's very easy for me to isolate myself or to be with a few people. But if I'm going to a museum, take someone along with you. (Yes.) I think that can apply in this situation as well, (Absolutely.) where we're reaching out and that's a hard thing to do sometimes. Oh, absolutely, it is. And I think there's barriers to that. I think that I see the generational rhetoric that we spew as a barrier to that. I think that when we label or categorized groups of people and assume that they have things in common and things that are different from us. That's a barrier to that. The way that we use terms like boomers and millennials are a barrier to that. Because again, it's feeding those assumptions and judgments if somebody based on a perceived age group. So I think we need to be mindful of that and then yeah, invite your neighbor or just have a conversation with someone or talk to somebody you normally wouldn't. That's a different age than you are. I think those are all like easy strategies. Talk to me a little bit more about the generational issue because that to me is one that gets a lot of hype and press a lot of attention. I can't pick up my phone and see my news feed without half the articles being "Gen Xers" this and y's and z's. I can't, I can't. I don't even know what they are anymore, to be honest with you, can't track them all. How- what are some of the challenges of that? I mean, I just- it's an intriguing kinf of a thing that we've created. It is a, actually, very detrimental thing that we have created. So this is one of my soap boxes, is that generational rhetoric is ageism and it leads to ageism. So the first thing I think we need to understand is these concepts of generations are made up. There is nothing to delineate when a generation starts and when a generation ends. This is something that we have created. This is something that marketers have created. And this actually isn't something that had legs until the later 19th century, 1980s, 1990s is when we really started thinking about generational theory. The second thing to recognize- and was it the boomers? I'm just kidding. Probably. It probably was, yeah, probably was those boomers-- I'm just kidding. The second thing to realize is there's actually no solid data that shows that it's generations that make a difference in the research because you can't pick apart age and cohort from generation. And most of the research has cross-sectional. So you're really just getting attitudes at one point in time. You're not looking at how those change over time. Right, so there's the lack of longitudinal data. Yes. Yeah. Doesn't reflect the changing nature of (Correct.) who we are and our attitudes and our approaches. Exactly. Interesting. So it's, it's dangerous the way that we think about it and it takes us away from that person centeredness. I mean, it really makes no sense when you think about it. To assume that people, in a 15 or 20 years span, have a blueprint for their behavior, have the same voting patterns, have the same likes and dislikes, have the same needs. I mean, I've been in a situation with someone right next to me. We've experienced the same thing and we see it completely differently. You can't group people like that. So what it ends up doing is creating this false tension that boomers think one way, Millennials think another way. Voting is the best example of that. People think that all older people are conservative and all younger people are liberal. Go look at how people vote. It's split with all age groups. Maybe a slight elevation for some, but no more than 60, 40. (Right.) Yet, this is what we think. So it keeps us in tension with each other. And it keeps us from seeing that we actually have more in common with each other than we do that's different. Is that facilitated by our challenge that we have with just the complexity, you know, the cognitive complexity it takes to process so much information, it's just easier to reduce down into those basic groups. Absolutely. And we've been programmed to think of these generations as valid. I mean, we've all grown up just thinking that there's, as you said, there's Gen X, Gen Y, there's Gen Z, there's the boomers, there's the-. We've just grown up thinking, "Well, this is just the thing. This has to be real". So nobody's ever really come and very loudly said, "No, it's not. We made this up. It doesn't have to be this way". Whoever made it up as sitting in a corner somewhere going "Yes, it worked." It worked. "My plan worked" It did, exactly. Well, just a final question here, Tracey, what suggestions do you have for us moving forward? Just for the listeners, what can they do? We've had some of that in this conversation. Yeah, I think summarizing it and wrapping it up. Again, realize this is about you. Find your why. I always think finding your why is a good place to start. Why should ageism matter to you? Why does this generational stuff matter to you? And I gave some reasons. It matters to your health, it matters to your happiness. Maybe you're driven by justice and equity and you want a just and equitable world. Well, it strips us of that. Maybe you want to invest in your own elderhood and you want to have a world where you feel like no matter what age and stage, you have a role that you can contribute. Maybe because you want that for your loved ones. Maybe there's a business motivation for you because actually ageism effects businesses, strips us of the ability to innovate in certain ways. It strips older people the opportunity to contribute. So find your why, figured out why this matters to you. And then, I think, start thinking about some of those questions. Start thinking about who you are as an aging person, how you feel about yourself. And then keep learning, keep reading, keep exploring. There's plenty of articles out there. There's more and more conversation. Raise awareness of ageism. I truly believe that we will get there once critical mass is reached, and that means each person makes a difference. And then finally, I would say, realize that everybody is a role model for what it means to age. So what we say and how we say it matters. So the next time you're talking about yourself as an aging person, think about talking about it in terms of growth. Thinking about talking about the things that you're looking forward to. Think about how you may disparage and then reframe that. Because we all have power. And I think that's what so empowering is that each person can make a difference. That's fantastic. Thank you, Tracey. I appreciate you being with me today. Thank you so much. Okay. I want to ask one more question. So Chris, I'm going to ask this question and we can just edit it in right before I started the last question. Okay. So Tracey, in our conversations, we've actually- with me, I come from a background working in disability. We've talked a little bit about the intersectionality of ageism and disability. Can you talk a little bit about how ageism intersects with a lot of different elements of our society and who we are? Absolutely. There's a very strong connection between ageism and ableism. And it goes back to what I was saying before about the complexity of aging. So with aging, while we have growth, we also have decline. So, as much as we live in a just society as you know, we live in an ableist society that is very much built for people of certain abilities over other abilities. So in many instances you'll find structural ageism and ableism, so environments that aren't accommodating to people that have any kind of impairments and are older. But because aging and this physical decline go hand in hand, ageism and ableism go hand in hand. You know in the book, I write about an example of if you've ever been to a restaurant that is really dimly lit, that has really small font on their menus, that has really loud music playing in the background, you've experienced structural ageism and ableism. Those environments are not built for people that have any kind of sensory impairment or decline. Then I said, instead of having bread put on the tables and appetizer, they should put flashlights and glasses so that everybody would have an equal chance of being able to see the menu well. So- And find the bread that's been put on the table. And find the bread that's been put on the table. So yeah, I think they, they do go hand in hand very often and sometimes what somebody thinks is ageist is actually ableist and vice versa. So I just think it's important that we recognize both of those exist and that we recognize that, while they go hand in hand, you can have a disability at any point in your life. So it doesn't necessarily follow suit with age. It's just more likely to happen as you get older.