Ageism is an attitude toward the aged in our midst that marks them out as a specific group demanding special recognition for their shortcomings and their demands. Old age is experienced individually; ageism removes that sense of individuality by insisting that the aged as a cohort are burdensome, costly, and politically awkward.
Ageism is a vogue word for a warm – rather than hot – topic.
Ageism refers to the concept that the old belong in a separate category to the rest of society, and it has definitely depreciative connotations. Somewhere in its multitude of implications are assertions that old people are different, high maintenance, costly and problematic. They need special consideration, demand extra resources and their costs outweigh their benefits. Ageists may not explicitly say these things, but their insistence that the old constitute a cohort leads easily to further judgements that old people are crappy, irrelevant, embarrassing, and – most disturbingly – less than fully human.
Old age is, of course, a problem that affects individuals who live long enough to experience its effects. But it is also a social phenomenon that is socially perceived and constructed. And therein is the central problem – age is socially conceived as a singular entity, as universal descriptor of a uniform state. Politically and socially we refer to the ‘problem of the aged’, whereas each person experiences something unique as they age.
Objectifying age leads to various conventions and claims about its physical and mental effects. At one (benign) end of a scale of responses, for example, we allege that age brings wisdom, experience, judgement and perspective; at the malign extremity we claim that the old are at best like Polonius, full of stale advice expressed as cliches, rooted in the past and no longer able to manage the changes of modernity or the progressive visions of youth. These tensions between respect and contempt are of ancient lineage. In the 1970s my contemporaries and I spoke of ‘geriatrocities’ with a kind of tolerant contempt for men and women of past achievement and current disability – at least as we perceived it. Perhaps the most extreme end of the scale of deprecation was expressed by the ‘duty to die’ movement examined by John Hardwig and others in the 1980s and 90s.
There is, of course, no arguing with facts. We decline physically and mentally as we age. We lose our mobility, our marbles, our capacity to multi-task to some extent. We are not what we were, however remarkable we may appear ‘despite our age’. The aged exist in our midst on a spectrum of dependency. At one extreme are the totally dependent who have to be fed, cleaned, turned and washed. Those at the other are generally fit, alert, independent members of society. All are deemed to be members of the cohort of the aged for economic, social and political purposes.
Along with these losses, we the aged and ageing encounter transparency. In our primes, we were noticed as people with ambitions, capabilities, physical and moral and intellectual presence. As we age these attributes fade and the young tend to pass us by. This transparency has always been worse for women, who have notoriously ‘disappeared in male company, metaphorically and actually either offered no place on the committee or reduced to mere formality in the minutes. Men who have been used to recognition, deference, influence, have to confront their own diminution as they age, have to listen as others take over their domains of expertise. A former colleague of mine died of muscular dystrophy. A few weeks before he died, inert and scarcely able to speak, he summoned the strength to say to a friend at his bedside: “I’m still here.” The desire to be seen is strong. Transparency is hard to bear.
Ageism is a product of the ways in which our society constructs old age. We are torn between extremes when we try to place age as a problem, trying to decide whether it is a burden to be carried by society, whether there is a real public obligation to care for the aged, whether our responses should be determined by some implicit set of values, or whether there should be legal and political measures to make explicit commitments to the aged.
Our current responses seem to sit uncomfortably between indifference and indignation. We need to ask whether the current response, sometimes angry, often anxious, sometimes indignant, can be improved by refining the discourse, publicly examining with equal care the case for keeping the issue at arms-length and maintaining distance from the emotional issues and the opposing claim that we should be more deeply involved in the theory and practice of aged care and care for the aged.
There is a long-standing case for diminishing the claims of the elderly. The ‘fair innings’ argument, for instance, suggests that the old have had their lives and should step aside to allow their successors to run the world. Contexts change and change should be managed by those with flexible minds and bodies that still have stamina. Evolution is still happening and the young supersede the old who are subject to entropy that robs them of relevance. Populations are increasing and the world belongs to younger generations who need space and time to mould the world to their hopes and expectations. The hand of conservatism is the hand of the old, and it should be lifted from the harness of governance.
And there is a familiar and equally long-standing counter-argument. Despite all the arguments for change, we are still human beings – we are “still here” like my former colleague, encountering one another, still dimly observing old maxims such as “Respect your elders”, “Do as you would be done by”, “One good turn deserves another” and so on. They may be cliches but they remain as human realities, entrenched as intuitions. The elderly remain repositories of history. Without their advice and example we continue to reproduce our mistakes – there is a case to be made for enlarging the scope for advice from the old in matters of public policy and governance. And it is wrong to consider the aged as a group without residual skills and capacities. They remain as an underused resource for education, training and advice. Australians have a rather charming habit of finding wisdom and worthwhile commentary from their ex-Prime Ministers as they age, however much they may have reviled them when they were in power. Dismissing the aged because they have reduced physical and mental capacities is wasteful.
It is furthermore dangerous morally and politically to define cohorts by their deviation from some questionable norm. Nazism defined disability as a marker of being less than human, enabling concentration camps and the T4 euthanasia program to be presented as legitimate solutions to unpalatable problems. ‘Life unworthy of life’ may appeal to racial purists and eugenicists as a valid concept, but it leads to measures that run counter to the evolutionary necessity of promoting human survival, security and flourishing in its manifold forms. A consequentialism that emphasises the social convenience of limiting aged care is balanced by a consequentialism that defends the valuable outcomes of expanding it.
The word ‘ageism’ may be relatively new, but the concept is ancient. All societies and communities have evolved ways to think about and to deal with their old. Geriatricide has a history that has relatively little documentation, but it has been practised in various cultures historically and may still persist in some parts of the world. Neglect, poor-houses, family care, state or ecclesiastical institutions, community care – all have their entrenched places in the social politics of most countries. Yet care of the aged remains a ‘wicked problem’ still searching for a solution that is affordable, compassionate, effective, quality controllable, socially acceptable and flexible enough to satisfy a majority of individuals and interests. If you are wealthy, you can buy care. If you are not, you and your family must find it from the aged care that your society provides – and as recent publicity has made clear, those public facilities may fall far short of fulfilling reasonable needs.
I suspect that we lack a common will to deal with the issues because age is irrelevant to many and distasteful to most. To acknowledge it as a social and political problem is to acknowledge that it awaits anyone who survives their productive years, the years when they are visible, identifiable and capable. For the influential young, it is far off. For the old, it is their life and their mode of being. For those caring for an aged family member, the problems are all too real; their challenge is to secure involvement and support from policy makers and administrators because carers need physical, emotional and financial resources to fulfil their roles. Politicians and business-people have different interests, and these differing interests “pass each other by”. Ageism needs to stay on the agenda, but we should not expect satisfactory outcomes while ever the interests of the many parties to aged care have so little common ground. Everyone involved in care of the aged looks for benefits and returns. Unfortunately, the currencies for these benefits and returns are not mutually transferable. Financial profits and costs, alleviation of suffering, social credit, feelings of security, votes, employment, values, beliefs – the currencies of transaction are multitude, but they aren’t fungible. Achievement measured in one currency may conceal failure in terms of another. Policy reform demands enlightened thinking and a broad appreciation of the relevant issues. And the aged should have their say!