Catálogo de publicaciones - libros

Sexuality remains important throughout a person’s life, but sexual behavior does not receive the same levels of acceptance at all ages. Older people are challenged by ageist attitudes and perceptions that hinder their sexual expression. They are stereotyped as non-sexual beings who should not, cannot, and do not want to have sexual relationships. Expressing sexuality or engaging in sexual activity in later life is considered by many in society as immoral or perverted. False expectations for older people also stem from ideals of beauty, centralization of the biomedical perspective on sexuality of older adults, and the association of sex with reproduction. Unfortunately, older people internalize many ageist attitudes towards sexuality in later life and become less interested in sex and less sexually active. The following chapter explores attitudes towards sexuality in later life among the media, young people, older people themselves, and care providers. In order to enable older people to express their sexuality and sexual identity freely and fully, awareness of ageist perceptions must be raised and defeated.

Researchers have long used content analysis techniques to document the frequency of stereotypical representations in the media, but the interest in studying ageism in the media is relatively recent. We approach older people’s representation in the media by considering visual aspects—depictions in visual documents, such as photos and video materials—with a focus on television programs and print and television advertisements. We introduce the concept of “visual ageism”: the social practice of visually underrepresenting older people or misrepresenting them in a prejudiced way. According to previous studies, over time, media representations of older people have moved from visual under- and misrepresentation (negative images) to more positive depictions. Our review of empirical studies conducted since 1950 in Europe and North America reveals that print and television advertisements started the transition towards a more positive visual representation of older people during the last decade of the twentieth century; followed by television programs some years later. This is probably due to the increase in third age rhetoric in the media, picturing younger-old adults as healthy and as potential consumers. Our analysis also shows that the older-old (fourth age) group continues to be underrepresented in the visual media. Finally, we suggest ways of reducing visual ageism by adopting a design for dynamic diversity approach.

The population of older immigrants in Europe has grown in recent decades. This population consists of two main groups: individuals who migrated as labour migrants and aged in the host country and those who migrated in older age. Because of the double jeopardy of their migration status and older age, both groups are potentially at risk for experiencing ageism in the form of marginalization and social exclusion. As with other groups of older adults, ageism towards older immigrants takes place at different institutional, cultural, social, and individual levels, and in many different contexts. Most immigration studies have failed to recognize older immigrants’ jeopardies as practices of ageism. This chapter discusses policies regarding older immigrants in the context of ageism. The following question is investigated and discussed: Does migrant status constitute a situation of increased vulnerability to ageism? The chapter concludes with recommendations and implications in light of current immigration waves.

Older adults are major consumers of health care. Within the context of an ageing society, their presence in the health care system will continue to grow. Ageist stereotypes and discrimination against older adults have an impact on the health and well-being of older citizens and are potential barriers to health equality. This chapter addresses ageism at different levels of the health care setting with a review of empirical research and health care policy. At the micro (personal) level, manifestations of ageism include attitudes toward older adults among physicians, nurses, and other health care professionals. Ageist communication styles used with older patients, age-biased clinical decision-making regarding diagnostics and treatments, and self-directed ageism in older patients are also discussed. Macro-level (institutional or structural) aspects of ageism are then examined, as reflected in health care reimbursement structures, participation of older adults in clinical trials, institutional policies governing care, and the lack of emphasis on geriatric-specific training for health care professionals. The chapter closes with an integration of the findings and a discussion of the challenges in identifying and reducing ageism in this setting. Conclusions are drawn and recommendations for future research and practice are made.

Published studies have documented increased rates of adverse drug events, hospitalizations, mortality, and higher healthcare costs associated with inappropriate medication use among the population of older adults, in addition to various clinical, psycho-social, and economic risk factors. These risk factors are often directly or indirectly linked to ageism. In particular, inappropriate prescribing, polypharmacy/polyherbacy, and medication nonadherence substantially contribute to the rising prevalence of drug-related problems in older patients, such as cognitive impairment, impaired balance, risk of falls, and hospitalizations. These phenomena are closely connected. They present both risk factors and negative consequences of suboptimal prescribing and lead to a complicated net of multiple pharmacotherapeutic risks. This chapter examines inappropriate medication use (inappropriate prescribing, polypharmacy/polyherbacy, and medication nonadherence) among the older population and highlights their direct and indirect associations with ageism.

Though it is generally acknowledged that older adults are underserved in the area of mental health services, the impact of ageist stereotypes on mental health diagnosis and access to care, and on the provision of psychotherapy to older adults, has not been extensively studied. This chapter reviews the sparse literature on ageism and mental health services with the goals of examining current practice related to the assessment of mental health problems and barriers to optimal therapy of older adults from the social perspective of ageism. The chapter begins with a review of literature pertaining to attitudes of mental health clinicians towards psychotherapy of older adults, and focuses on possible contributing factors to the development of ageist attitudes among clinicians. Subsequently, we discuss older adults’ negative attitudes toward ageing, psychiatric diagnosis and psychotherapy, which may affect patients’ interpersonal encounters with a psychotherapist. We also address challenges and problems in the assessment and diagnosis of older mental health patients, and raise the possibility that ageist attitudes may be responsible for some of these issues. Finally, we discuss common difficulties in providing therapy to older adults with mental health problems and review different therapy approaches with older adults. Here again, we discuss the possibility that ageist attitudes might play a role in difficulties with the adaptation of these therapeutic methods for older adults. The chapter concludes with a discussion of possible prevention strategies to address ageist attitudes in mental health settings and makes recommendations regarding future research in this understudied area.

This chapter explores the relationship between ageism and dementia. Although dementia is not an unavoidable consequence of ageing, increasing age is the biggest risk factor for having this disease. The prevalence of dementia increases exponentially with age and 95% of those with Alzheimer’s Disease, the most common form of dementia, are aged 65 or over. Dementia often has strong negative connotations, partly driven by alarmist media portrayals of the disease, which means that people living with the condition can experience the ‘double stigma’ of ageism and dementia-related discrimination. The stigma attached to dementia can have significant implications for quality of life through, for example, decreased social engagement, reduced self-esteem, increased carer burden and sub-standard healthcare, a situation that is exacerbated by low levels of diagnosis and inadequate training of medical professionals. Despite attempts by governments and not for profit organisations to tackle dementia-related stigma, there remains a strong need to raise awareness of the realities of living with dementia and to reduce the impact of discrimination. This chapter explores the inter-connections and overlaps between ageing and discrimination because someone has dementia. The relationship between dementia and age is discussed, followed by an exploration of the impacts of dementia-related stigma for the individual and society. The chapter continues by analysing the role of the media in fuelling stigma and how having dementia can impact on the receipt of health and social care services. The chapter explores the implications of dementia stigma for social engagement and ends by considering how perceptions of dementia are reflected in research funding.

The performance of older adults on neuropsychological (and cognitive) assessment tests can set the perspective on the capabilities of this population in general, hence contributing to ageism. These tests are administered with two implicit assumptions: (a) the tests are a valid gauge of performance in older adults and (b) cognitive abilities decline in older age. In the current chapter, we challenge these assumptions by discussing two potential sources of threat to test validity: the sensory and the social contexts. First, we review findings that age-related decline in performance may reflect, at least in part, a sensory (visual and auditory) rather than a purely cognitive decline. Next, we discuss the negative effect of age-based stereotype threat on older adults’ cognitive performance. Both contexts may be present in daily testing of older adults in the clinic or the lab. Thus, targeting the sensory and social context in neuropsychological assessment may assist in reducing age-bias (leading to ageism) in the scientific, medical and general community.

We know that ageism is bad. It has a negative impact on our lives as well as on society at large. We know less, however, on ways to intervene in order to reduce or eliminate ageism. This section outlines primarily legal-judicial attempts to address ageism, with a specific focus on the European scene. We also present an educational intervention that capitalize on intergenerational relations to reduce ageism. We conclude this section with a call for action, to identify new methods to fight ageism.

Social phenomena that have an impact on European societies, such as ageism, can be explored and better understood by looking at the ways in which the law incorporates, supports, or attempts to oppose them. This chapter – which is the first of three different contributions in this book concerned with the legal aspects of ageism in Europe – provides a descriptive overview of the inter-connections between European law and ageing. By describing and summarizing selected elements of, EU human rights and discrimination law, the chapter makes a contribution towards a better understanding of the relationships between law, ageing, and ageism.