It's time we had a good, hard look at ourselves and our attitudes to older people, say a group of experts. By Diana Clement.
As the third decade of the 21st century hits its stride, one consistent trend stands out. Discrimination has become a dirty word. Sexism, racism, a plethora of other "isms" and homophobia are now deeply uncool. But someone seems to have forgotten to add "ageism" to the memo.
Ageist attitudes cut right across the lives of older New Zealanders. Issues faced by job seekers once they hit their fifties are well documented. Likewise, elder abuse is rife. The New Zealand Longitudinal Study of Ageing found that one in 10 people aged over 65 had suffered elder abuse, which could be physical, financial or neglect.
The Covid pandemic has also highlighted how our society views older people's health. It's a sensitive subject, with many academic papers devoted to the ethics of rationing health services based on age.
The knee-jerk reaction in our society is that younger people have longer to live and therefore are more deserving of treatment, says Professor Stephen Neville, head of the nursing department at Auckland University of Technology (AUT). He cites a news item in early October that the health system might need to ration care if New Zealand had a major Covid outbreak.
"They're not saying how they're going to do it. But I guarantee you that there will be decisions based on age. What's the rationale behind that? Is it saying that an older adult's life is less worthy of treatment than a younger person's life?"
It goes without saying that all older adults were once young adults, says Neville. "They have spent their life contributing to this economy in terms of paying taxes. They might expect to be treated when they get to an age where they need it.
"It goes back to the argument that if you are younger, you are seen as having more economic potential. If you are an older adult, you are often seen as a burden on the taxpayer. We've had a whole flood of media over the years about the costs of an ageing population."
The language we use to describe such demographic trends – "grey tsunami", for example – betrays our prejudices, he says.
"A tsunami is this huge wall of water that's going to come and decimate. It's something to be feared. We kind of use that very loosely and indiscriminately to describe a group of people."
Ageism is the systematic stereotyping of and discrimination against people based solely on age. There is evidence of it everywhere – in workplaces, in public and private health provision, media and more. It's built into our everyday language, and most New Zealanders don't even realise it, says Stephanie Clare, chief executive of Age Concern.
Lumping the 15 per cent of New Zealanders aged over 65 into one cohort, "othering" them with terms such as "elderly", dehumanises them and sets the scene for discrimination in many areas of their lives, says Clare.
"The language sets the scene. We have assumptions attached to it."
Associate Professor Sharon Harvey, who is head of the School of Language and Culture at AUT, couldn't agree more. Although most people bridle if they hear racist or gendered language, ageist language doesn't seem to attract the same sort of response, she says.
"[Ageist language] is still a popular kind of discourse, and people don't think about it as carefully."
Grouping people together takes away their individuality and the need to treat them on their own terms, she says.
"When language lumps people into a group such as 'the elderly' or 'boomers', it becomes easier to dehumanise them and lose sight of who the real people involved are. Once we start talking about something in a particular way, it's really hard to think outside of that frame."
Clare and Harvey both cite "old fart", "grumpy old man", "little old lady", and "Karen" as examples of terms that barely result in raised eyebrows, let alone condemnation.
Even the word "elderly", a term implying frailty, conjures up an image of someone using a walker, yet is used indiscriminately to describe anyone aged over 65, says Clare.
"If you say, 'An older woman in her seventies jumps into the room', all of a sudden that person has vitality," she says. "We're not going to disrupt ageist attitudes until we change the language we use to describe older people."
Dr Diana Amundsen researches positive ageing at Waikato University. The trouble with ageist language is that it internalises stereotypes, she says. "We start thinking, 'I'm not of value any more', as we hit 65 and move into our retirement years. We might think, 'I'm not useful any more', 'I'm not contributing to society' or 'I'm being a burden on my family'."
It's not just insults and labels attached to older groups of New Zealanders that encourage discrimination. Backhanded compliments, such as telling someone they look young for their age, can be just as bad.
The implication is that "young" is good and "old" is bad. "If you talk about someone having a young spirit, as opposed to an energetic spirit, you are kind of saying young is good," says Harvey.
"If it's someone who's older, we might be saying, 'Well, you know, they are displaying qualities of being young', which in our society is equal to being positive."
Such language builds up a stereotype in younger age groups that they are society's winners, and older people are the losers. "That's just not right," says Amundsen. "It's not actually accurate, either."
Likewise, says Neville, when somebody dies at 75 or 80, people often say that person had a good life. "It might not be a great age [to die] for that person. My mother died at 81 just recently. She wasn't ready to die. She thought she had a lot longer to go."
The term "elderly" is considered particularly problematic by many people who work with older adults.
"The term does have a biomedical use where an older adult has been formally assessed using a validation tool that will identify somebody as being frail and needing further support," says Neville.
Instead, it's widely used for anyone who qualifies for New Zealand Superannuation, he says. That covers everyone from age 65 to over 100 – a diverse group encompassing more than one generation.
"We need to take a real strengths-based approach to celebrating, and recognising, the contribution that they make," says Neville. For example, he says, New Zealanders often forget that volunteer work by older adults is the glue that holds communities together.
The word "elderly" was the focus of Amundsen's most recent research, because, she says, it is used indiscriminately, evokes emotion and can trigger a strong reaction in those it stereotypes. Yet many people will insist it isn't intended that way, she says.
"You'll immediately get a lot of people who will jump to the defence of the term 'the elderly' and say, 'No, no, no, I'm using that in a respectful way'."
Amundsen doesn't buy the idea that we need a label for older people, especially a pejorative one. "What it's doing is it's othering older adults," she says. "It's putting them in an 'other' group that is not part of mainstream society."
Burden on society
The news media has tried hard in recent years to be less discriminatory. But ageism is still rife, says Neville. He has taken it upon himself to challenge the media on Twitter when he sees ageist language.
"I will remind the media about things such as referring to older adults as 'elderly'. It's stigmatising and ageist." He prefers the term 'older adults'.
"Challenging the way people think can be a real catalyst for change," he says. "I am quite polite on Twitter. I am not saying, 'Media, you are bad'. It's about changing socially ingrained practices and encouraging them to use more appropriate terms, which hopefully then infiltrates into general society psyche. It's a long game rather than a short game."
In her research, Amundsen tracked 6690 uses of the phrase "the elderly" in New Zealand online media before and during the Covid-19 pandemic. She says 74 per cent of those uses were predominantly negative, depicting the person as vulnerable, declining, inferior and a burden.
The "burden" was often in connection with financial implications for pensions, taxes and healthcare resources that could otherwise be available for the rest of society. "This is not a trivial finding," she says.
Amundsen cites a 2015 Utrecht University study by sociologist Dr Dorota Lepianka, which researched the behavioural outcomes of older adults who were subjected to age-based stereotypes. The stereotypes provoked emotional responses that pigeonholed older adults as weak or vulnerable, evoking pity, sympathy or even contempt and disgust. Lepianka found that it could result in harassment and abuse.
When the Listener called Carol Wham, professor of public health nutrition at Massey University, regarding an article about her research that appeared on stuff.co.nz, she said she'd lost count of the number of times the media had changed "older people" to "the elderly".
One of her recent studies looked at people aged 65 to 103, but all were lumped into the category "elderly" by Stuff. A report by RNZ of another of Wham's studies used the word "elderly" three times when introducing the work to its audience.
"'Elderly' is definitely not a word I use and does not feature in any of my academic publications," says Wham. "Many journals do not allow its use and I encourage students and staff not to use it."
It's not a new problem by any means. An NZ Herald style book, dating back to the 1980s, warns young reporters not to use the term. Back then, sub editors and other senior staff tried to prevent such language getting through, says former deputy editor Bruce Morris. "Today, with the lack of such newsroom hierarchical protection for young reporters, not so much," he notes.
Drain on resources
The Covid pandemic has highlighted other aspects of ageism, too. For example, says Neville, the death of a young person from Covid is seen in media articles as far more tragic than that of an older adult who has "had their day".
Neville's PhD research in the early 2000s found that a younger person who presents in an emergency department in New Zealand would be assigned the most experienced registered nurse. An older person was more likely to be given the least experienced. "If you are an older person, you are often seen as being a drain on things such as scarce health resources."
When Dr Dilky Rasiah, who was at the time the deputy medical director of Pharmac, wrote a dissertation in 2009 on the subject of Pharmac's Exceptional Circumstances schemes, she found children aged up to four years old had a high approval rate (55 per cent) and 65- to 80-year-olds had the lowest approval rate (6 per cent).
By basing triage in healthcare solely on age, you limit older people's right to treatment, says Age Concern's Clare.
"The prevailing opinion in society is the younger you are, the more deserving you are of healthcare in a rationed world," she says. "We use our own prejudice to make a judgment call. That's valuing length of time you may have in life versus quality of life."
Ageism touches all corners of the health sector, and can be even more subtle than a "yes" or "no" for treatment, says Neville. He cites the example of the nursing shortage in residential aged care, which he believes is a result of lower rates of pay and the fact that nurses often want to work in more high-tech environments such as hospitals.
"In terms of its consequences, older people are not having the same access to a registered nurse workforce, for example, which is a set of skills and abilities to provide a particular level of care," he says. "It demonstrates how embedded within society notions of ageism are."
Ageism is also still evident in advertising. In the mid-2010s, much criticism was aimed at the twenty- and thirty-somethings working in advertising who wanted to sell products to people like them, not those aged 50-plus with considerably more disposable income.
Academics such as Ekant Veer, professor of marketing at the University of Canterbury, feel that casual ageism is still very much alive in advertising.
Better data has enabled the micro-segmentation of audiences, says Veer. Older people are still watching traditional TV, while younger people are watching YouTube, TikTok and other social-media platforms.
Grant Frear, who leads Deloitte New Zealand's digital team, believes the premise that more older people are being depicted in advertising is likely to be an element of the "yellow car problem". That's a frequency illusion: a well-documented cognitive bias where, after noticing something, there is a tendency for people to notice it more often.
"One could argue the very reason you're noticing the ads on TV or digital media is because you are a boomer," says Frear.
In fact, the real success story in advertising diversity over the past 10 years has turned out to be the explosion of Māori, Pasifika and Asian faces, says Lindsay Mouat, chief executive of the Association of New Zealand Advertisers.
There are, however, a few standout examples of older people becoming more visible on TV screens. A notable example is the Z Energy ad that starred 92-year-old actress June Wigley dressed in leathers riding a motorcycle.
The advertising industry is keen to point to examples such as Dove and L'Oréal, which have used diverse models for some campaigns. But those are the exceptions, not the rule.
AUT's Harvey supervised a thesis by master's student Yulia Zelenkova, which researched anti-ageing advertisements in women's magazines. The predominant metaphors in anti-ageing advertisements, says Harvey, were that something was broken that needed to be repaired, or military metaphors of fighting ageing and defence against ageing.
"This whole idea that the body stands as the principal marker around ageing is very, very difficult for women in particular," says Harvey. "The idea is that we can improve ourselves if we just make the effort."
Zelenkova concluded in her thesis that although the advertising industry had made small inroads, the fundamental premise that ageing is bad was still embedded in everyday advertising that Kiwis see on TV, in print, on YouTube and social media.
Part of our journey
The irony about ageism, of course, is that people are discriminating against their future selves.
"Older people are 'us', not 'them'," says Clare. "Ageing is part of our journey and of our story. Hopefully, it will be part of my life because, if I'm given the opportunity, I will age inappropriately, as I would like to, and will disrespect the society and the system that is set up to make me invisible."
Unless we value age and use appropriate terms and be powerful and stand up for our rights, we will be overlooked, she says.
Clare points out that there has never been a greater proportion of older people in society than there is now. And it's only going to grow. "So, there is a good opportunity to disrupt the past thinking. But to do that you have to value older people."
The calling out of ageism is something we're particularly bad at, she says. We also need to check our own attitudes. "We need to reject the stereotypes. I will call out women I know when they say, 'Does it make me look younger?' or 'I'm a silly old thing' or 'That's my grey moment'. We do it in our own language, and we certainly don't call it out in ourselves."