WEEK 10 DISC.

I A G E I S M A N D A D U L T I S M

L e g i s l a t i v e e r o s i o n a n d o r g a n i z e d o p p o s i t i o n to the J J D P m a n d a t e against i n c a r c e r a t i n g c h i l d r e n c h a r g e d w i t h status offenses has t a k e n m u l t i p l e f o r m s , r e s u l t i n g i n greater r e i n c a r - c e r a t i o n of y o u n g w o m e n . I n 1 9 8 0 , the d e f i n i t i o n o f status o f f e n d e r i n the f e d e r a l l a w w a s a m e n d e d to e x c l u d e c h i l d r e n " w h o v i o l a t e d a c o u r t o r d e r . " G i r l s i n foster care p l a c e m e n t s or g r o u p h o m e s , f o r e x a m p l e , w h o r u n a w a y , can be c l a s s i f i e d as d e l i n q u e n t s a n d i n c a r - c e r a t e d , r a t h e r t h a n c h a r a c t e r i z e d as status o f f e n d e r s w h o c o u l d be d i v e r t e d a w a y f r o m c o u r t a d j u d i c a t i o n i n t o s p e c i f i e d p r o g r a m s f o r y o u t h . T h i s s u b v e r s i o n o f the o r i g i n a l i n t e n t a n d p u r p o s e o f J J D P falls m o s t h e a v i l y o n f e m a l e d e l i n q u e n t s , w h e r e the gender d o u b l e s t a n d a r d results i n judges s e n t e n c i n g g i r l s to d e t e n t i o n f o r c o n t e m p t c i t a t i o n s ( v i o l a t i o n s of c o u r t o r d e r s ) i n f a r greater n u m b e r s t h a n b o y s — a p p a r e n t l y a t t e m p t i n g to c o n t r o l a n d c o n t a i n y o u n g w o m e n to p r o t e c t t h e m f r o m t h e m s e l v e s , i n a m a n n e r that w o u l d n o t o c c u r w i t h y o u n g m e n . T h e 4 . 3 % l i k e l i h o o d of i n c a r c e r a t i o n f o r g i r l s i n j u v e n i l e justice acceler- ates to 2 9 . 9 % w h e n t h e y are h e l d i n c o n t e m p t .

O n e c o n s e q u e n c e of the c o m b i n a t i o n of t r a d i t i o n a l a n d c o n t e m p o r a r y j u v e n i l e justice p r e s s u r e s o n y o u n g w o m e n is a r a c i a l , t w o - t r a c k s y s t e m of j u s t i c e , w h e r e W h i t e g i r l s are i n s t i t u t i o n a h z e d i n p r i v a t e f a c i l i t i e s a n d y o u n g w o m e n of c o l o r are d e t a i n e d i n p u b h c f a c i l i t i e s .

T h e n u m b e r s o f g i r l s h e l d i n p r i v a t e i n s t i t u t i o n s has d r a m a t i c a l l y i n c r e a s e d ; 6 2 % of i n c a r c e r a t e d g i r l s are being h e l d i n p r i v a t e f a c i l i t i e s , a n d 8 5 % o f those are d e t a i n e d f o r " n o n d e l i n q u e n t " offenses ( s u c h as v i o l a t i o n s of c o u r t o r d e r s , or status o f f e n s e s ) . T h e n u m b e t of y o u n g w o m e n d e t a i n e d i n p u b l i c d e t e n t i o n f a c i l i t i e s has r e m a i n e d steady. T r a n s l a t e d b l u n t l y , this m e a n s that W h i t e girls are r e c o m m e n d e d f o r " t r e a t m e n t " w h e r e a s A f r i c a n A m e r i c a n a n d L a t i n a g i r l s are d e t a i n e d .

P e n d i n g f e d e r a l l e g i s l a t i o n w o u l d e n c o u r a g e the uses of c o n t e m p t v i o l a t i o n s as a p a t h to d e t e n t i o n a n d once a g a i n w o u l d p e r m i t the h o l d i n g o f c h i l d r e n i n a d u l t j a i l s . I t is g i r l s , f r e q u e n t l y h e l d i n r u r a l a n d s m a l l - t o w n j a i l s f o r m i n o r i n f r a c t i o n s , w h o become m o s t subject to v i o l e n t abuse a n d s u i c i d e i n s u c h c o n f i n e m e n t .

W o m e n h a v e b e c o m e the fastest g r o w i n g sector o f people in p r i s o n i n the past d e c a d e ; s i m i l a t l y , d e t e n t i o n s of girls i n c r e a s e d 2 3 % b e t w e e n 1 9 8 9 a n d 1 9 9 3 . G i r l s r e m a i n i n d e t e n - t i o n l o n g e r a w a i t i n g p l a c e m e n t i n p r i v a t e f a c i l i t i e s or c o r r e c t i o n a l i n s t i t u t i o n s a n d are g e n e r a l l y d i s l i k e d by those w o r k i n g i n the o v e r w h e l m i n g l y m a l e s y s t e m of j u v e n i l e j u s t i c e . T h e f a i l u r e to take i n t o a c c o u n t past or c u r r e n t p h y s i c a l o r s e x u a l abuse a n d the l a c k o f a p p r o p r i a t e gender a n d c u l t u r a l p r o g r a m m i n g to address the needs of y o u n g w o m e n d e l i n q u e n t s is p e r v a s i v e .

T r a n s g r e s s i o n s by g i r l s h a v e h i s t o r i c a l l y been treated d i f f e r e n d y f r o m m a l e m i s b e h a v i o r . I t is p r o f o u n d l y d i s t u r b i n g that the c o m b i n e d i n v i s i b i h t y a n d d o u b l e s t a n d a r d paternaUsm/ h a r s h n e s s against y o u n g f e m a l e s result i n i n c r e a s i n g loss o f f r e e d o m f o r y o u n g w o m e n a n d i n e q u a l i t y of response i n p r o g r a m m i n g . T h e w o m e n o f H u l l H o u s e w o u l d be d i s m a y e d a n d e n r a g e d by this b a c k t r a c k i n g on f u n d a m e n t a l justice f o r c h i l d r e n .

C H I L D R E N I N A D U L T C R I M I N A L C O U R T S

C r u c i a l q ue s t i on s are g o i n g u n a s k e d as c h i l d r e n are i n c r e a s i n g l y a p p e a r i n g i n a d u l t c r i m i - n a l c o u r t s . C r i m i n a l c o u r t s operate o n g u i l t y p l e a s , a n d i n f o r m e d , c o m p e t e n t d e c i s i o n s to p l e a d g u i l t y m a y n o t be possible f o r m a n y c h i l d r e n . A d u l t c o u r t s f a i l to a c k n o w l e d g e the y o u t h of the c h i l d , to take i n t o a c c o u n t the c h i l d ' s age, d e v e l o p m e n t a l capacity, o r e x p e r i - ence w h e n assessing c u l p a b i l i t y . A d u l t c o u r t s i m p o s e a d u l t sentences, w h i c h d i f f e r f r o m d e U n q u e n c y sentences i n t w o c r i t i c a l w a y s : they are d e t e r m i n a t e , a n d they are s i g n i f i c a n t l y longer. D e t e r m i n a t e sentences result i n e x t e n d e d i n c a r c e r a t i o n of c h i l d r e n , b e y o n d a tim e w h e n they m a y be r e h a b i l i t a t e d . L o n g e r sentences m e a n that a c h i l d w i l l u l t i m a t e l y be

" L O O K O U T , K I D , I T ' S S O M E T H I N G Y O U D I D " i 5 5 7

i n c a r c e r a t e d i n a n a d u l t p r i s o n , w h e r e they m a y be subject to p h y s i c a l abuse, s u i c i d e , a n d a n e d u c a t i o n f r o m a d u l t o f f e n d e r s , r a t h e r t h a n r e h a b i l i t a t i o n f o r a f u t u r e p r o d u c t i v e l i f e . Y o u t h sent to the a d u l t c r i m i n a l s y s t e m are essentially cut o f f f r o m e d u c a t i o n a l a n d c o u n s e l i n g p r o g r a m s , f r o m j u v e n i l e p r o b a t i o n o f f i c e r s , a n d f r o m a p p r o p r i a t e m e d i c a l a n d m e n t a l h e a l t h s e r v i c e s . S e n d i n g c h i l d r e n to p r i s o n e n c o u r a g e s m o r e s o p h i s t i c a t e d c r i m i n a l b e h a v i o r . T h e r e is a m p l e e v i d e n c e t h a t c h i l d r e n r e s p o n d better to p o s i t i v e p r e v e n t i o n p r o g r a m s t h a n they do to p u n i t i v e legislative m e a s u r e s .

THE EROSION OF CIVIC RESPONSIBILITY FOR CHILDREN

A d d r e s s i n g the needs o f b o t h p u b l i c safety a n d p o s i t i v e y o u t h d e v e l o p m e n t r e q u i r e s a n a c t i v e a n d p a r t i c i p a t i n g p u b l i c . I f the o n l y p o p u l a r c r y is f o r s h o r t - t e r m f i x e s — " g e t t h e m o u t o f the n e i g h b o r h o o d , " " l o c k t h e m up a n d t h r o w a w a y the k e y , " a n d " s o m e t h i n g m u s t be d o n e " — s o c i e t y w i l l c o n t i n u e o n its c u r r e n t c o u r s e o f e s c a l a t i n g p u n i s h m e n t f o r c h i l - d r e n a n d i n c r e a s i n g a d u l t a b d i c a t i o n o f r e s p o n s i b i l i t ) ' . I f s c h o o l s are n o t f o r l e a r n i n g f r o m m i s t a k e s , i f c h i l d w e l f a r e is n o t f o r p r o t e c t i n g c h i l d r e n w h o h a v e been h a r m e d , i f h e a l t h systems are n o t geared to h e a l i n g y o u t h — f u r t h e r r e l i a n c e o n e x c l u s i o n , p u n i s h m e n t , a n d p r i s o n b e c om e s the l i k e l y o p t i o n . T e n s of t h o u s a n d s of p r o d u c t i v e adults w h o passed t h r o u g h the j u v e n i l e justice s y s t e m i n t h e i r y o u t h are w i t n e s s to the h e a l i n g a n d r e d e m p t i v e effect of getting a s e c o n d c h a n c e : the p r o g r a m , the j u d g e , the p r o b a t i o n o f f i c e r w h o m a d e a d i f f e r e n c e a n d a l l o w e d t h e m to t u r n t h e i r l i f e a r o u n d .

T h e r e a l a d u l t p r o b l e m is m a s k e d by o u r s o c i a l f o c u s o n the " y o u t h p r o b l e m . " I n scape- g o a t i n g k i d s , w e r e v e a l that as a society, w e d o n ' t l i k e adolescents v e r y m u c h . Y o u t h , b e i n g the i n t e l l i g e n t people they a r e , are v i v i d l y a w a r e o f the angry p o p u l a r a n d p o l i c y b a c k l a s h d i r e c t e d against t h e m . T h e y are k e e n l y a l e r t to issues o f f a i r n e s s ( w h i c h are at the h e a r t of j u s t i c e ) ; t h e y observe the a d u l t w o r l d a r o u n d t h e m w i t h a l a s e r l i k e a b i l i t y to i d e n t i f y h y p o c r i s y . T h e y see t h a t t h e i r v o i c e s , t h e i r o p i n i o n s , a n d t h e i r interests are l a r g e l y i g n o r e d , as are t h e i r r i g h t s as f u t u r e c i t i z e n s .

T h e use o f the l a w to e n f o r c e a l e g a l - e d u c a t i o n a l - p o l i t i c a l s y s t e m that h a r m s the a s p i r a - t i o n s a n d best i n t e n t i o n s of y o u t h c a n n o t be g o o d f o r society. H o l d i n g c h i l d r e n a c c o u n t - able f o r p r o t r a c t e d s o c i a l f a i l u r e s r e e k s of e x p e d i e n c y a n d r u n s c o u n t e r to d e v e l o p i n g i n t e r n a t i o n a l h u m a n rights s t a n d a r d s f o r c h i l d r e n a r o u n d the w o r l d . A d u l t c i t i z e n s are engaged i n the s o c i a l neglect a n d abuse o f c h i l d r e n , b o t h i n p u b l i c f i s c a l p o h c y a n d i n the absence of the c o m m i t m e n t o f o u r o w n p r e c i o u s t i m e a n d i m a g i n a t i o n .

C r i m i n a l i z i n g y o u t h b e h a v i o r s , p o l i c i n g s c h o o l s , p u n i s h i n g c h i l d r e n by d e p r i v i n g t h e m o f an e d u c a t i o n , c o n s t r i c t i n g s o c i a l p r o t e c t i o n s f o r abused a n d neglected y o u t h , a n d subjecting y o u t h to l a w e n f o r c e m e n t as a " s o c i a l s e r v i c e " — t h e s e t r e n d s s m a c k of s o c i a l i n j u s t i c e , r a c i a l i n e q u i t y , d e h u m a n i z a t i o n , a n d f e a r - f i l l e d d e m o n i z a t i o n o f y o u n g s t e r s , w h o are o u r p r o s p e c t i v e h o p e . A t stake here is the c i v i c w i l l to i n v e s t i n o u r c o m m o n f u t u r e by s e e i n g o t h e r p e o p l e ' s c h i l d r e n as o u r o w n .

5 5 8 A G E I S M A N D A D U L T I S M

1 1 6

Police Make Life Hell for Youth of Color

Kathy Durkin

G o i n g to the g r o c e r y store, v i s i t i n g a f r i e n d a n d w a l k i n g h o m e f r o m w o r k or s c h o o l are a l l o r d i n a r y , e v e r y d a y o c c u r r e n c e s . B u t n o t so f o r h u n d r e d s o f t h o u s a n d s of p e o p l e , m o s d y f r o m A f r i c a n - A m e r i c a n a n d L a t i n ® c o m m u n i t i e s , w h o are s t o p p e d , q u e s t i o n e d , a s k e d f o r t h e i r L D . , s e a r c h e d a n d o f t e n a r r e s t e d h e r e i n N e w Y o r k — a n d a r o u n d the c o u n t r y . I t h a p p e n s to m a n y y o u t h a n d e v e n to c h i l d r e n .

A t a t i m e w h e n m o r e w h i t e people appear to be r e j e c t i n g r a c i s m at the p o l l s , r a c i a l p r o f i l i n g by poUce d e p a r t m e n t s a n d other state agencies is o n the r i s e . I t is s y s t e m i c a n d d e e p l y e n t r e n c h e d i n the " c r i m i n a l justice s y s t e m " n a t i o n w i d e .

Statistics g i v e n i n n e w studies a n d r e p o r t s s t a r k l y bear t h i s o u t . B u t the statistics c a n n o t c o n v e y the i n t i m i d a t i o n , a n x i e t y a n d anger t h a t so m a n y p e o p l e , e s p e c i a l l y B l a c k a n d L a t i n ® y o u t h , m u s t l i v e w i t h o n a d a i l y basis, n o r the effect this c a n h a v e t h r o u g h o u t t h e i r l i v e s o n t h e m a n d t h e i r f a m i l i e s .

I n the f i r s t q u a r t e r of t h i s y e a r . N e w Y o r k C i t y p o l i c e , by t h e i r o w n r e p o r t , s t o p p e d , q u e s t i o n e d and/or s e a r c h e d 1 4 5 , 0 9 8 p e o p l e , m o r e t h a n h a l f o f t h e m A f r i c a n A m e r i c a n s . A t t h i s a l a r m i n g rate, a r e c o r d 6 0 0 , 0 0 0 p e o p l e w i l l be s t o p p e d t h i s y e a r .

I n the last t w o y e a r s , n e a r l y 1 m i l l i o n N e w Y o r k e r s w e r e h a r a s s e d by p o l i c e i n t h i s m a n n e r — 9 0 p e r c e n t o f t h e m people of c o l o r . T h a t ' s 1 , 3 0 0 a day. A n d i t ' s legally a l l o w e d .

T h e s e o p e r a t i o n s , just i n the past t w o y e a r s , h a v e put m o r e t h a n 1 m i U i o n i n n o c e n t p e o p l e , m o s t l y A f r i c a n - A m e r i c a n a n d L a t i n ® , i n t o the huge p o l i c e database; they are subject to f u t u r e c r i m i n a l i n v e s t i g a t i o n s m e r e l y by t h e i r i n c l u s i o n t h e r e .

T h e N e w Y o r k C i v i l L i b e r t i e s U n i o n ( N Y C L U ) is c h a l l e n g i n g the legality o f these p o t e n - t i a l l y d i s c r i m i n a t o r y p r a c t i c e s a n d d e m a n d i n g i n f o r m a t i o n o n the database k e p t by the N Y P D — w h i c h the d e p a r t m e n t refuses to t u r n over. I t c o n t a i n s p e r s o n a l i n f o r m a t i o n o n e v e r y o n e s t o p p e d by p o l i c e , t h o u g h the v a s t m a j o r i t y — 9 0 p e r c e n t — h a v e not been c h a r g e d w i t h a n y c r i m e s .

T h e N Y C L U is also d e m a n d i n g fuU disclosure f r o m the N Y P D about police shootings i n this city. T h e f u l l s t o r y o f this h o r r o r is not k n o w n . I n a d d i t i o n to the t e r r i b l e , tragic a n d totally u n j u s t i f i e d k i l l i n g s of u n a r m e d i n d i v i d u a l s l i k e Sean B e l l , A m a d o u D i a l l o , O u s m a n e Z o n g o a n d P a t r i c k D o r i s m u n d , countless other people of c o l o r have been shot. Yet the N Y P D refuses to r e v e a l w h a t p r o p o r t i o n of those shot over the last 10 years h a v e been m e m b e r s of oppressed nationaUties. I n the t w o years p r i o r to that, it w a s 9 0 percent ( n y c l u . o r g ) .

A n o t h e r aspect o f the N Y P D ' s r a c i a l p r o f i l i n g scheme is the c a m p a i g n o f t e r r o r t a r g e t i n g y o u t h f o r possessing m i n i s c u l e a m o u n t s o f m a r i j u a n a . T h i s , t o o , u s u a l l y h a p p e n s i n c o m - m u n i t i e s o f c o l o r , e v e n t h o u g h s o c i a l studies s h o w a h i g h e r rate o f m a r i j u a n a use a m o n g w h i t e y o u t h ( n y c l u . o r g ) . I n 2 0 0 7 a l o n e , p o l i c e a r r e s t e d m o r e t h a n 1 0 0 people per day, or 3 9 , 7 0 0 i n t o t a l , f o r this so-caUed c r i m e .

T h e N Y C L U has just i ssued a r e p o r t e n t i t l e d , " T h e M a r i j u a n a A r r e s t C r u s a d e i n N e w Y o r k C i t y : R a c i a l B i a s i n PoUce P o l i c y 1 9 9 7 - 2 0 0 7 , " by P r o f . H a r r y G . L e v i n a n d D e b o r a h P e t e r s o n S m a l l . I t describes the N Y P D ' s c a m p a i g n against oppressed y o u t h . O f the n e a r l y 4 0 0 , 0 0 0 p e o p l e a r r e s t e d i n that 1 0 - y e a r p e r i o d , 2 0 5 , 0 0 0 w e r e A f r i c a n A m e r i c a n s a n d 1 2 2 , 0 0 0 w e r e L a t i n ® s . T h i s r e p r e s e n t e d a t e n f o l d increase o v e r the p r e v i o u s 1 0 - y e a r p e r i o d .

4

A G E I S M I 5 5 9

S i n c e d e c r i m i n a l i z a t i o n i n 1 9 7 7 , the p o s s e s s i o n o f a s m a l l a m o u n t of m a r i j u a n a has n o t c o n s t i t u t e d a " c r i m e " i n N e w Y o r k C i t y — a s l o n g as it is n o t s h o w n i n p u b l i c . P o s s e s s i o n s i n c e t h e n has b e e n m e r e l y a " v i o l a t i o n , " s u c h as s p e e d i n g a n d o t h e r t r a f f i c i n f r a c t i o n s .

H o w e v e r , the p o h c e f r e q u e n d y stop B l a c k a n d L a t i n ® y o u t h a n d t h e n a r r e s t t h e m o n the charge o f m i s d e m e a n o r p o s s e s s i o n — w h e n , m o s t of the t i m e , t h i s is n o t the case. H i g h s c h o o l students are k e p t i n j a i l o v e r n i g h t u n t i l t h e y go to c o u r t . T h e n they are p r e s s u r e d i n t o a p l e a b a r g a i n , u s u a l l y w i t h an o v e r w o r k e d , c o u r t - a p p o i n t e d a t t o r n e y r e p r e s e n t i n g t h e m .

I n a c i t y w h e r e p o h c e c a n gun d o w n a y o u n g m a n l i k e S e a n B e l l just h o u r s before h i s w e d d i n g a n d get o f f w i t h n o t e v e n a slap o n the w r i s t , y o u t h s t o p p e d by cops n e v e r k n o w w h a t m i g h t h a p p e n to t h e m .

T h e s e y o u t h are t h e n l a b e l e d w i t h c r i m i n a l r e c o r d s , w h i c h w i l l f o l l o w t h e m f o r the rest o f t h e i r l i v e s a n d c a n create f u t u r e obstacles f o r t h e m i n h i g h e r e d u c a t i o n , e m p l o y m e n t a n d h o u s i n g . T h e y ' r e also d r i v e n i n t o the " c r i m i n a l j u s t i c e " s y s t e m — t h e i r f i n g e r p r i n t s a n d p h o t o g r a p h s go i n t o the N Y P D d a t a b a s e — w h e n t h e y ' v e d o n e n o t h i n g w r o n g .

I t is w e l l k n o w n t h a t there is s e r i o u s d r u g abuse i n m a n y h i g h - p r e s s u r e p r o f e s s i o n s i n t h i s city, y e t the poUce d o n ' t o c c u p y f i n a n c i a l centers or c a r r y out r a n d o m searches i n w e a l t h y n e i g h b o r h o o d s .

R a f a e l M u t i s , c o o r d i n a t o r o f 7 N e i g h b o r h o o d A c t i o n P a r t n e r s h i p N e t w o r k , w h i c h w o r k s to r e p e a l the d r a c o n i a n N e w Y o r k State R o c k e f e l l e r d r u g l a w s , e x p l a i n s t h a t " d r u g u s e " has b e c o m e a p r e t e x t f o r s t o p - a n d - f r i s k searches i n l o w - i n c o m e n e i g h b o r h o o d s . " T h e y d o n ' t go after p e o p l e o n W a l l S t r e e t , " he s a i d , " w h e r e t h e r e ' s a d a i l y s n o w s t o r m " of c o c a i n e use ( h i g h b r i d g e h o r i z o n . c o m ) .

I t is n o c o i n c i d e n c e that p o l i c e r e p r e s s i o n has i n c r e a s e d e v e n as b i l h o n a i r e M a y o r M i c h a e l B l o o m b e r g a n d his W a l l Street c r o n i e s are t r y i n g to m a k e N e w Y o r k C i t y a h a v e n f o r the s u p e r - r i c h , a n d the real-estate t y c o o n s are g e n t r i f y i n g w o r k i n g - c l a s s n e i g h b o r h o o d s as fast as they c a n . " L a w - e n f o r c e m e n t " agencies are h e l p i n g t h e m o u t by s t e p p i n g u p the i n t i m i d a t i o n of l o w - i n c o m e a n d oppressed people to suppress o p p o s i t i o n a n d t r y to d r i v e t h e m f u r t h e r out o f the city.

A l l p e o p l e need to s h o w s o H d a r i t y w i t h the o p p r e s s e d c o m m u n i t i e s , e s p e c i a l l y the y o u t h , i n t h i s struggle against p o l i c e r e p r e s s i o n .

1 1 7

Ageism

Another Form of Bigotry

Robert N. Butler

J u s t as r a c i s m a n d s e x i s m are based o n e t h n i c i t y a n d gender, ageism is a f o r m of s y s t e m a t i c s t e r e o t y p i n g a n d d i s c r i m i n a t i o n against p e o p l e s i m p l y because they are o l d . A s a g r o u p .

I A G E I S M A N D A D U L T I S M

o l d e r p e o p l e are c a t e g o r i z e d as r i g i d i n t h o u g h t a n d m a n n e r , o l d - f a s h i o n e d i n m o r a l i t y a n d s k i l l s . T h e y are b o r i n g , stingy, c r a n k y , d e m a n d i n g , a v a r i c i o u s , bossy, ugly, d i r t y , a n d useless.

A n ageist y o u n g e r g e n e r a t i o n sees o l d e t people as d i f f e r e n t f r o m itself; it s u b t l y ceases to i d e n t i f y w i t h its elders as h u m a n beings. O l d m e n b e c o m e geezers, o l d goats, g a f f e r s , fogies, coots, gerr i es, fossi l s, a n d c o d g e r s , a n d o l d w o m e n are gophers a n d geese. A c r o n e , h a g , or w i t c h is a w i t h e r e d o l d w o m a n .

A g e i s m takes shape i n stereotypes a n d m y t h s , o u t r i g h t d i s d a i n a n d d i s l i k e , s a r c a s m a n d s c o r n , subtle a v o i d a n c e , a n d d i s c r i m i n a t o r y p r a c t i c e s i n h o u s i n g , e m p l o y m e n t , p e n s i o n a r r a n g e m e n t s , h e a l t h c a r e , a n d other s e r v i c e s . O l d e r persons are subject to p h y s i c a l , e m o t i o n a l , s o c i a l , s e x u a l , a n d f i n a n c i a l abuse. T h e y are the focus of p r e j u d i c e r e g a r d i n g t h e i r c a p a c i t y f o r w o r k a n d s e x u a l i n t i m a c y , w h i c h F r e u d d e s c r i b e d as the t w o m o s t i m p o r t a n t h u m a n a c t i v i t i e s . T a k i n g a w a y the v a l i d a t i o n of w o r k or p u r p o s e f u l a c t i v i t i e s a n d d e m e a n i n g the c a p a c i t y f o r l o v e are s u r e l y the m o s t p r o f o u n d f o r m s o f age p r e j u d i c e .

H i s t o r i c a l l y , o l d e r p e r s o n s h a v e been v e n e r a t e d i n m o s t societies a n d c u l t u r e s in word, a l t h o u g h n o t a l w a y s i n d e e d . I n fact, to be o l d or d i s a b l e d w a s a l w a y s a l i a b i h t y f o r p r a c t i c a l r e a s o n s . N o m a d i c g r o u p s f r o m N o r t h A f r i c a to A l a s k a a b a n d o n e d t h e i r o l d w h e n the w e l f a r e of the entire tri be or g r o u p w a s at s t a k e .

T h e t e r m ageism, w h i c h I i n t r o d u c e d i n 1 9 6 8 , is n o w p a r t o f the E n g l i s h language. I t is i d e n t i c a l to a n y o t h e r p r e j u d i c e i n its c o n s e q u e n c e s . T h e o l d e r p e r s o n feels i g n o r e d o r is n o t t a k e n s e r i o u s l y a n d is p a t r o n i z e d . A n t h r o p o l o g i s t B a r b a r a M y e r h o f f s p e a k s a b o u t " d e a t h by i n v i s i b i l i t y " w h e n she describes a n o l d e r w o m a n w h o , " u n s e e n , " w a s " a c c i d e n - t a l l y " k i l l e d by a b i c y c l i s t .

T h i s i n v i s i b i l i t y e x t e n d s to e m e r g e n c i e s , s u c h as the t r a g i c case of S e p t e m b e r 1 1 , 2 0 0 1 , i n N e w Y o r k C i t y . A n i m a l a c t i v i s t s e v a c u a t e d dogs a n d cats w i t h i n t w e n t y - f o u r h o u r s after the W o r l d T r a d e C e n t e r w a s a t t a c k e d , w h i l e d i s a b l e d or o l d e r p e r s o n s w e r e a b a n d o n e d i n t h e i r a p a r t m e n t s f o r u p to s e v e n days b e f o r e a d h o c m e d i c a l teams a r r i v e d to rescue t h e m . O l d e r p e r s o n s w e r e al so i n v i s i b l e i n the d e v a s t a t i o n caused by H u r r i c a n e K a t r i n a i n N e w O r l e a n s .

R e m i n i s c e n t o f the great s o c i a l scientist G e o r g e M e a d ' s c o n c e p t of the " l o o k i n g glass s e l f , " o l d e r p e r s o n s m a y t u r n ageist p r e j u d i c e i n w a r d , a b s o r b i n g , a c c e p t i n g , a n d i d e n t i f y i n g w i t h the d i s c r i m i n a t i o n . S o m e e x a m p l e s :

• S i m o n e D e B e a u v o i r , a u t h o r o f The Coming of Age, d e s c r i b e d her disgust at g r o w i n g o l d , a l t h o u g h she w r o t e l o v i n g l y o f h e r o w n m o t h e r ' s aging i n A Very Easy Death.

• C o m e d i a n G e o r g e B u r n s n o t e d the u n f o r t u n a t e t e n d e n c y of o l d p e o p l e to c o n f o r m to t h e i r s t e r e o t y p e — w h a t he c a l l e d the o l d p e r s o n ' s " a c t " — b y l e a r n i n g to s h u f f l e a b o u t a n d d e c o n d i t i o n i n a k i n d of i d e n t i f i c a t i o n a n d c o l l a b o r a t i o n w i t h the ageist society that d e m e a n s t h e m .

• Y a l e p s y c h o l o g i s t B e c c a R . L e v y r e p o r t s t h a t c o n s t a n t b o m b a r d m e n t o f negative stereotypes increases b l o o d p r e s s u r e . Ageism can make an older person sick.

A d v e r t i s e m e n t s a n d greeti ng c a r d s d e p i c t o l d e r p e r s o n s as f o r g e t f u l , d e p e n d e n t , c h i l d - l i k e , a n d — p e r h a p s the u l t i m a t e i n s u l t i n o u r s o c i e t y — s e x l e s s . C o n v e r s e l y , o l d e r p e o p l e w h o c o n t i n u e to h a v e s e x u a l desires are d i r t y o l d m e n a n d r i d i c u l o u s o l d w o m e n .

W r i n k l e s , c r o w ' s feet, l i v e r spots, a n d d u l l s k i n are d i s p a r a g e d i n o u r y o u t h - d o m i n a t e d c u l t u r e a n d e x p l o i t e d by the c o s m e t i c s i n d u s t r y a n d p l a s t i c s u r g e o n s . W o m e n w h o h a v e r e l i e d u p o n t h e i r a p p e a r a n c e f o r s e l f - d e f i n i t i o n a n d m e n a n d w o m e n w h o h a v e d e p e n d e d u p o n a y o u t h f u l a p p e a r a n c e i n t h e i r w o r k are u p against o v e r w h e l m i n g o d d s . T h e c l o c k does n o t s t o p . W h e n does one cease to be b e a u t i f u l a n d start o n the j o u r n e y to b e i n g

A G E I S M I

o v e r - t h e - h i l l ? H o w m a n y w o m e n past f i f t y c a n l o o k l i k e m o d e l L a u r e n H u t t o n or S u s a n S a r a n d o n ? H o w m a n y m e n a n d w o m e n c a n o v e r c o m e d i s a b i l i t y w i t h elegance a n d style?

A study c o n d u c t e d by the A m e r i c a n A c a d e m y o f F a c i a l , P l a s t i c a n d R e c o n s t r u c t i v e S u r g e r y r e v e a l e d t h a t baby b o o m e r s h a v e r e c e i v e d n e a r l y a q u a r t e r o f a m i l l i o n f a c e - l i f t s a n d o t h e r c o s m e t i c surgeries. M o s t o f these patients w e r e o v e r fifty. T h e A s s o c i a t e d Press has q u o t e d K a r e n S e c c o m b e , a U n i v e r s i t y of F l o r i d a s o c i o l o g i s t , w h o s a i d , " T h e t h o u g h t o f saggy breasts, h a i r loss o r w r i n k l e s d o e s n ' t sit w e l l w i t h p e o p l e w h o h a v e g r o w n u p e m p h a s i z i n g fitness a n d y o u t h . "

T h e f i l m a n d t e l e v i s i o n i n d u s t r i e s h e l p to p e r p e t u a t e a g e i s m .

• L e s s t h a n 2 p e r c e n t of p r i m e - t i m e t e l e v i s i o n c h a r a c t e r s are s i x t y - f i v e o r o l d e r , a l t h o u g h this g r o u p is 1 2 . 7 p e r c e n t o f the p o p u l a t i o n .

• 1 1 p e r c e n t of m a l e c h a r a c t e r s b e t w e e n f i f t y a n d s i x t y - f o u r are c a t e g o r i z e d as o l d v e r s u s 2 2 p e r c e n t of f e m a l e c h a r a c t e r s .

• 7 5 p e r c e n t of m a l e c h a r a c t e r s s i x t y - f i v e a n d o l d e r are c h a r a c t e r i z e d as o l d v e r s u s 8 3 p e r c e n t o f f e m a l e c h a r a c t e r s o f the same age.

• O n l y o n e - t h i r d o f o l d e r c h a r a c t e r s are w o m e n . • M i d d l e - a g e d a n d o l d e r w h i t e males h a v e j o i n e d w o m e n a n d m i n o r i d e s o n the side-

l i n e s , as w h i t e m e n u n d e r f o r t y get m o s t o f the jobs w r i t i n g f o r t e l e v i s i o n a n d f i l m . E m p l o y m e n t a n d e a r n i n g p r o s p e c t s f o r o l d e r w r i t e r s h a v e d e c l i n e d r e l a t i v e to those f o r y o u n g e r w r i t e r s .

• A c c o r d i n g to one study, a p p r o x i m a t e l y 7 0 p e r c e n t o f o l d e r m e n a n d m o r e t h a n 8 0 p e r c e n t o f o l d e r w o m e n seen o n t e l e v i s i o n are p o r t r a y e d d i s r e s p e c t f u l l y , t r e a t e d w i t h l i t t l e i f a n y courtesy, a n d o f t e n l o o k e d at as " b a d . "

• A l t h o u g h A m e r i c a n s w h o are f o r t y a n d o v e r are 4 2 p e r c e n t o f the A m e r i c a n p o p u l a - t i o n , m o r e t h a n t w i c e as m a n y roles are cast w i t h a c t o r s w h o are u n d e r forty.

B u t there is s o m e g o o d n e w s , t o o . B y the 1 9 9 0 s , soap o p e r a s s u c h as The Guiding Light w e r e p r e s e n t i n g o l d e r c h a r a c t e r s h a v i n g m o r e l o v e a f f a i r s a n d n o t j u s t w o r r y i n g a b o u t t h e i r c h i l d r e n . I n 1 9 9 4 New York Magazine p u t P a u l N e w m a n o n the c o v e r , c a l l i n g h i m " T h e S e x i e s t ( 7 0 y e a r o l d ) M a n A l i v e , " a n d More m a g a z i n e o f f e r e d w o m e n o v e r f o r t y a n a l t e r n a t i v e to those that cater to w o m e n i n t h e i r t w e n t i e s . O l d e r m o d e l s began to m a k e t h e i r a p p e a r a n c e i n g e n e r a l w o m e n ' s m a g a z i n e s , too. O n e w i d e l y c i r c u l a t e d m a g a z i n e a d v e r t i s e m e n t i n 1 9 9 4 d e s c r i b e d " B e t t y M e t d e r , age 1 0 1 , N o x z e m a user since 1 9 2 5 . "

OUR CULTURE'S FEAR OF GROWING OLD

A s T o l s t o y n o t e d , "Old age is the most unexpected of all the things that happen to a man." T h e u n d e r l y i n g basis o f ageism is the d r e a d a n d fear o f g r o w i n g o l d e r , b e c o m i n g i l l

a n d d e p e n d e n t , a n d a p p r o a c h i n g d e a t h . People are a f r a i d , a n d t h a t leads to p r o f o u n d a m b i v a l e n c e . T h e y o u n g d r e a d a g i n g , a n d the o l d e n v y y o u t h . B e h i n d ageism is c o r r o s i v e n a r c i s s i s m , the i n a b i l i t y to a c c e p t o u r fate, f o r i n d e e d w e are a l l i n l o v e w i t h o u r y o u t h f u l selves, as is r e f l e c t e d i n the y e a r n i n g b e h i n d the e x p r e s s i o n " s a l a d d a y s . "

A l t h o u g h u n d o u b t e d l y u n i v e r s a l , a g e i s m i n the U n i t e d States is p r o b a b l y f u e l e d by the w o r s h i p of y o u t h i n a s t i l l - y o u n g c o u n t r y d o m i n a t e d by the m y t h of the u n e n d i n g f r o n - tier. I n 1 9 6 5 , the W h o , a B r i t i s h r o c k g r o u p , s a n g , " I h o p e I die before I get o l d , " w h i l e i n A m e r i c a " y o u n e v e r say d i e . " H o l l y w o o d v e i l s o l d e r actresses w i t h gauzy lens f i l t e r s . M o r e o v e r , age c a r r i e s less a u t h o r i t y .

5 6 2 I A G E I S M A N D A D U L T I S M

T h e p o w e r f u l i m a g e r y o f the b i r t h a n d a d o r a t i o n of the i n f a n t J e s u s , a n d the j o u r n e y of the M a g i to see the C h r i s t c h i l d , describes a b i r t h of h o p e . H o w this c o n t r a s t s w i t h the f i n a l years o f l i f e ! C h i l d r e n are seen as the f u t u r e ; o l d e r p e o p l e , the past. G r i m m ' s f a i r y tales d e p i c t g n a r l e d a n d e v i l o l d w o m e n c u r s i n g i n n o c e n t a n d b e a u t i f u l y o u t h s w i t h spells a n d a f f l i c t i o n s .

Denial is a close cousin of ageism; in effect, it eliminates aging from consciousness. O n e o f the s t r i k i n g facts o f h u m a n l i fe is the i n t e n s i t y w i t h w h i c h p e o p l e a v o i d a g i n g .

N a r c i s s i s t i c p r e o c c u p a t i o n w i t h o u r o w n a g i n g a n d dem ise a n d p e r h a p s , a c c o r d i n g to F r e u d , the i n a b i l i t y o f the u n c o n s c i o u s to accept d e a t h m a k e it d i f f i c u l t f o r society as a w h o l e to d e a l w i t h the c h a l l e n g e s of agi n g. N o t e o u r g a l l o w s h u m o r at b i r t h d a y s , the m o n e y w e s p e n d o n c o s m e t i c surgery, a n d the p o p u l a r i t y o f a n t i - a g i n g m e d i c i n e . T h i s w a s n o t a l w a y s the case. I n E u r o p e i n g e n e r a t i o n s past, y o u n g m e n i n h i g h p o s i t i o n s w o r e w i g s t h e y h a d p o w d e r e d w h i t e i n a n a t t e m p t to appear o l d e r a n d , by i m p h c a t i o n , w i s e r . T o d a y , m e n f l o c k to c o s m e t i c s u rgeon s a n d c o l o r i s t s to p r e s e r v e the i l l u s i o n of y o u t h .

ELDER ABUSE

E l d e r abuse is a w i d e s p r e a d p h e n o m e n o n that affects o l d e r a d u l t s w h o l i v e i n r i c h a n d p o o r n a t i o n s a l i k e . I n the U n i t e d States alone it is b e l i e v e d that as m a n y as 1.2 m i l l i o n o l d e r a d u l t s are p h y s i c a l l y abused or neglected e a c h year. E l d e r abuse takes m a n y f o r m s , i n c l u d i n g p h y s i c a l , e m o t i o n a l , f i n a n c i a l , a n d s e x u a l a b u s e — o f t e n by f a m i l y m e m b e r s . I t m a y i n v o l v e neglect, s u c h as the f a i l u r e to p r o v i d e f o o d , shelter, c l o t h i n g , m e d i c a l c a r e , a n d p e r s o n a l h y g i e n e , as w e l l as n a r c o t i c o v e r m e d i c a t i o n .

I n 2 0 0 4 , U N S e c r e t a r y G e n e r a l K o f i A n n a n r eleased a r e p o r t o n the abuse of o l d e r p e r s o n s t h a t m e n t i o n e d p r a c t i c e s s u c h as the o s t r a c i s m o f o l d e r w o m e n , w h i c h o c c u r s i n s o m e societies w h e n t h e y are u s ed as scapegoats f o r n a t u r a l d i s a s t e r s , e p i d e m i c s , o r o t h e r c a t a s t r o p h e s . T h e r e p o r t s t a t e d : " W o m e n h a v e been o s t r a c i z e d , t o r t u r e d , m a i m e d o r e v e n k i l l e d i f they f a i l e d to flee the c o m m u n i t y . "

T h e W o r l d H e a l t h O r g a n i z a t i o n ( W H O ) r e p o r t e d t h a t 3 6 p e r c e n t o f n u r s i n g h o m e staff i n the U . S . r e p o r t e d h a v i n g w i t n e s s e d at least one i n c i d e n t of p h y s i c a l abuse o f an o l d e r p a t i e n t i n the p r e v i o u s year, a n d 1 0 p e r c e n t a d m i t t e d h a v i n g c o m m i t t e d at least one act of p h y s i c a l abuse t h e m s e l v e s . T h i s r e p r e s e n t s s e x i s m as w e l l as a g e i s m , f o r about 75 p e r c e n t o f n u r s i n g h o m e r e s i d e n t s are w o m e n . O t h e r statistics are e q u a l l y a l a r m i n g :

• 1 m i l l i o n to 3 m i l l i o n A m e r i c a n s s i x t y - f i v e a n d o l d e r h a v e been i n j u r e d , e x p l o i t e d , o r o t h e r w i s e m i s t r e a t e d by s o m e o n e o n w h o m t h e y d e p e n d f o r care o r p r o t e c t i o n .

• E s t i m a t e s o f the f r e q u e n c y o f elder abuse r a n g e f r o m 2 p e r c e n t to 10 p e r c e n t . • O n l y one o u t o f s i x i n c i d e n t s o f e l d e r abuse, neglect, e x p l o i t a t i o n , a n d self-neglect is

b r o u g h t to the a t t e n t i o n o f a u t h o r i t i e s . • O n l y t w e n t y - o n e states r e p o r t that they m a i n t a i n a n elder abuse registry/database o n

p e r p e t r a t o r s o f s u b s t a n t i a t e d cases, a n d less t h a n h a l f o f states m a i n t a i n a c e n t r a l abuse registry.

• I t is e s t i m a t e d that e a c h year 5 m i l h o n o l d e r A m e r i c a n s are v i c t i m s of f i n a n c i a l e x p l o i t a t i o n , b u t o n l y 4 p e r c e n t of cases are r e p o r t e d . M a n y o f these cases i n v o l v e the u n a u t h o r i z e d use o f o l d e r p e r s o n ' s assets a n d the t r a n s f e r r i n g of p o w e r o f a t t o r n e y f o r a n o l d e r p e r s o n ' s assets w i t h o u t w r i t t e n c o n s e n t .

• O f the n e a r l y $ 1 b i l l i o n N a t i o n a l I n s t i t u t e o n A g i n g budget, o n l y $ 1 . 7 m i l l i o n goes to N I A e l d e r abuse a n d neglect r e s e a r c h f u n d i n g .

A G E I S M I

AGEISM IN HEALTH-CARE SEHINGS

A g e i s m c a n be i n v o k e d by aesthetic r e v u l s i o n . E s p e c i a l l y w h e n w e a k e n e d by disease, o l d e r p e r s o n s c a n be d i s h e v e l e d , u n w a s h e d , a n d appear ugly a n d d e c a y i n g . S o m e o l d e r p e r s o n s " l e t them sel ves g o " a n d u n w i t t i n g l y a d d f u e l to the f i r e . S p h i n c t e r s l o o s e n , d e p o s i t i n g stains a n d s m e l l s . E a r a n d nose h a i r s g r o w m o r e q u i c k l y i n o l d e r bodies, as does the car- tilage, c a u s i n g the nose a n d ears to e n l a r g e . S o m e p r o f o u n d a n d c o m m o n d i s o r d e r s o f o l d a g e — m o b i l i t y p r o b l e m s , d e m e n t i a , a n d i n c o n t i n e n c e — a r e u n a t t r a c t i v e a n d p r o v o k e a negative r e s p o n s e .

W h e n o l d e r m e n or w o m e n are m a l o d o r o u s , s c a b r o u s , or d i s t u r b i n g i n dress a n d l a n - guage, they c a n s c a r e , disgust, a n d d i s c o m f o r t y o u n g e r p e o p l e . S u c h o l d e r p e r s o n s b e c o m e u n t o u c h a b l e . ( T o u c h is p o w e r f u l a n d t h e r a p e u t i c . S o m e o l d e r p e r s o n s l i v i n g a l o n e h a v e n o t been t o u c h e d f o r y e a r s . )

M e d i c a l s c h o o l s u n w i t t i n g l y p r o m o t e the v i r u s of a g e i s m . F r e s h out o f college, y o u n g students are c o n f r o n t e d w i t h aging a n d death a n d t h e i r o w n p e r s o n a l a n x i e t i e s a b o u t b o t h . T h e y are l e f t to t h e i r o w n devices to i n s u l a t e t h e m s e l v e s f r o m a n x i e t y a n d p a i n a b o u t disease, d i s a b i l i t y , d i s f i g u r e m e n t , a n d d y i n g . A c a d a v e r t h a t r e q u i r e s d i s s e c t i o n is u s u a l l y the f i r s t o l d e r p e r s o n m e d i c a l students e n c o u n t e r , a n d they are n o t o r d i n a r i l y p r o v i d e d w i t h e f f e c t i v e g r o u p or i n d i v i d u a l c o u n s e l i n g , e i t h e r at the t i m e of d i s s e c t i o n or later, u p o n the death o f t h e i r f i r s t p a t i e n t .

D e f e n s e m e c h a n i s m s l i k e g a l l o w s h u m o r , c y n i c i s m , d e n i a l , the i n v e n t i o n of negative language, a n d facetiousness are c o m m o n . L o n g h o u r s i n m e d i c a l t r a i n i n g l e a d to a n g r y e x h a u s t i o n a n d feelings o f b e i n g " p u t u p o n . "

I t w a s i n m e d i c a l s c h o o l that I f i r s t b e c o m e c o n s c i o u s of the m e d i c a l p r o f e s s i o n ' s p r e j u - dice t o w a r d age. F o r the f i r s t rime I h e a r d s u c h i n s u l r i n g epithets as " c r o c k , " w h i c h w a s use d to describe m i d d l e - a g e d w o m e n a n d o l d e r patients w h o w e r e l a b e l e d h y p o c h o n d r i a - c a l because they h a d n o a p p a r e n t o r g a n i c basis f o r t h e i r c o m p l a i n t s , as w e l l as h a v i n g m a n y s y m p t o m s , a n d " G O M E R " ( G e t O u t of M y E m e r g e n c y R o o m ) .

T h e h i d d e n c u r r i c u l u m i n m e d i c a l s c h o o l s u n d e r m i n e s s t u d e n t ' s i d e a l i s m a n d c a n c o m p r o m i s e t h e i r e d u c a t i o n . F o r e x a m p l e , i n s o m e studies u p to 3 5 p e r c e n t o f d o c t o r s e r r o n e o u s l y c o n s i d e r a n i n c r e a s e i n b l o o d p r e s s u r e to be a n o r m a l process o f a g i n g . I n p h y s i c a l di agnosi s c o u r s e s , m e d i c a l students meet o l d e r p e o p l e w h o are s t r i p p e d of t h e i r i n d i v i d u a l i t y a n d seen as a r c h i v e s or m u s e u m s of pathology, r a t h e r t h a n as h u m a n beings. M e n a n d w o m e n i n t h e i r eighties are p a r t i c u l a r l y v a l u a b l e i n these sessions because they o f t e n h a v e a p l e t h o r a o f s y m p t o m s a n d c o n d i t i o n s about w h i c h the s t u d e n t m u s t l e a r n .

I n a d d i t i o n , f e w m e d i c a l s c h o o l g r a d u a t e s w i l l p r a c t i c e g e r i a t r i c s , a n d p r a c t i c i n g p h y s i - c i a n s o f t e n d o n o t i n v e s t the same a m o u n t o f t i m e d e a l i n g w i t h o l d e r p a t i e n t s . M e d i c a r e e x p e n d i t u r e s per c a p i t a steadily d e c l i n e as people g r o w o l d e r . I n f a c t , a U C L A study r e p o r t e d that, as people enter their f o r t i e s , p h y s i c i a n s s p e n d less t i m e w i t h t h e m per e n c o u n t e r . L o g i c a l l y , it s h o u l d be the r e v e r s e since m e d i c a l p r o b l e m s t e n d to i n c r e a s e as w e g r o w o l d e r , a n d the r a m i f i c a t i o n s are s o b e r i n g . S i x t y p e r c e n t o f a d u l t s o v e r s i x t y - f i v e d o n o t r e c e i v e r e c o m m e n d e d p r e v e n t i v e s e r v i c e s , a n d 4 0 p e r c e n t d o n o t r e c e i v e v a c c i n e s f o r f l u a n d p n e u m o n i a . T h e y r e c e i v e e v e n less p r e v e n t i v e care f o r h i g h b l o o d pressure a n d c h o l e s t e r o l .

S o m e d o c t o r s q u e s t i o n w h y they s h o u l d even b o t h e r t r e a r i n g c e r t a i n p r o b l e m s of the a g e d ; after a l l , the patients are o l d . I s it w o r t h t r e a t i n g t h e m ? T h e i r p r o b l e m s are i r r e v e r s - i b l e , u n e x c i t i n g , a n d u n p r o f i t a b l e . T h e i r l i v e s are over.

B e t w e e n 1 9 5 5 a n d 1 9 6 6 , M o r r i s R o c k l i n , a v o l u n t e e r i n the N I M H H u m a n A g i n g Study, w a s s t u d i e d u n t i l he t u r n e d 1 0 1 y e a r s of age. R o c k l i n c o m p l a i n e d a b o u t h i s p a i n f u l r i g h t k n e e to his p h y s i c i a n , w h o s a i d , " W h a t d o y o u e x p e c t at y o u r a g e ? " T o t h i s t y p i c a l

5 6 4 I A G E I S M A N D A D U L T I S M

Statement by a p h y s i c i a n , R o c k h n r e p h e d i n d i g n a n d y , " S o w h y d o e s n ' t m y left leg h u r t ? " T h e s y m m e t r y of the h u m a n body o f f e r s a g o o d test o f the r e a h t i e s of m e d i c a l a g e i s m . R o c k l i n ' s o f t - q u o t e d response has been used by m a n y g e r i a t r i c i a n s to educate m e d i c a l students o n the t o p i c of a g e i s m .

NURSING HOMES: AGEIST SCANDAL

N u r s i n g h o m e s are licensed by the states a n d m u s t meet f e d e r a l s t a n d a r d s to p a r t i c i p a t e i n M e d i c a i d or M e d i c a r e . A b o u t 9 5 p e r c e n t of the n a t i o n ' s s i x t e e n t h o u s a n d n u r s i n g h o m e s ( w h i c h h o u s e 1.5 m i l l i o n m e n a n d w o m e n ) p a r t i c i p a t e i n those p r o g r a m s . A c c o r d i n g to a g o v e r n m e n t s tud y c o n d u c t e d i n 2 0 0 2 , n i n e o f ten n u r s i n g h o m e s i n the U n i t e d States l a c k adequate staff, a n d n u r s e ' s aides p r o v i d e 9 0 p e r c e n t o f the c a r e . I n m o s t n u r s i n g h o m e s , the r e p o r t s a i d , a p a t i e n t needs an average of 4 . 1 h o u r s of care each d a y — 2 . 8 h o u r s f r o m n u r s e ' s aides a n d 1.3 h o u r s f r o m registered n u r s e s or l i c e n s e d p r a c t i c a l n u r s e s .

I n 2 0 0 0 , o v e r 9 1 p e r c e n t of n u r s i n g h o m e s h a d n u r s e aide s t a f f i n g l e v e l s that f e l l b e l o w the t h r e s h o l d s i d e n t i f i e d as m i n i m a l l y necessary to p r o v i d e the n e e d e d c a r e . I n r e s p o n s e , the D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s c o n c l u d e d t h a t " i t is n o t c u r r e n t l y f e a s i b l e " f o r the f e d e r a l g o v e r n m e n t to r e q u i r e t h a t h o m e s a c h i e v e a m i n i m u m r a t i o o f n u r s i n g staff to p a t i e n t s . N u r s i n g h o m e s w o u l d h a v e to h i r e 7 7 , 0 0 0 to 1 3 7 , 0 0 0 r e g i s t e r e d n u r s e s , 2 2 , 0 0 0 to 2 7 , 0 0 0 h c e n s e d p r a c t i c a l n u r s e s , a n d 1 8 1 , 0 0 0 to 3 1 0 , 0 0 0 n u r s e ' s aides. T h i s w o u l d take $ 7 . 6 b i l l i o n a year, a n 8 p e r c e n t i n c r e a s e o v e r c u r r e n t s p e n d i n g . T h e s o l u t i o n g i v e n by the B u s h a d m i n i s t r a t i o n w a s to e n c o u r a g e n u r s i n g h o m e s to a d o p t better m a n a g e - m e n t t e c h n i q u e s so n u r s e ' s aides c a n a c h i e v e h i g h p r o d u c t i v i t y a n d , u l t i m a t e l y , to r e l y o n m a r k e t f o r c e s .

AGE-BASED HEALTH-CARE RATIONING

M e d i c a l a g e i s m is p r e v a l e n t i n p r e v e n t i v e tests f o r c a n c e r a n d t r e a t m e n t o f a v a r i e t y o f illnesses, s o m e o f t h e m l i f e - t h r e a t e n i n g . F o r e x a m p l e :

• O n l y 10 p e r c e n t o f people s i x t y - f i v e a n d o v e r r e c e i v e a p p r o p r i a t e s c r e e n i n g tests f o r bone density, c o l o r e c t a l a n d p r o s t a t e cancer, a n d g l a u c o m a . T h i s despite the fact that the average age of c o l o r e c t a l c a n c e r patients is seventy, that m o r e t h a n 7 0 p e r c e n t of prostate c a n c e r is d i a g n o s e d i n m e n o v e r s i x t y - f i v e , a n d that p e o p l e o v e r s i x t y are s i x t i m e s m o r e l i k e l y to s u f f e r f r o m g l a u c o m a .

• C h e m o t h e r a p y is u n d e r u s e d i n the t r e a t m e n t o f breast c a n c e r patients o v e r s i x t y - f i v e , e v e n t h o u g h f o r m a n y o f these patients it m a y i m p r o v e s u r v i v a l .

• I n a c o s t - c u t t i n g e f f o r t to reduce s u p p o s e d l y u n n e c e s s a r y m e d i c a l tests i n 1 9 9 8 , the A m e r i c a n C a n c e r Soci ety a n d g o v e r n m e n t h e a l t h agencies d e t e r m i n e d t h a t i f a n o l d e r w o m a n h a d n o a b n o r m a l i t i e s i n a Pap smear f o r three y e a r s i n a r o w , she c o u l d be tested less o f t e n . Y e t o v e r 2 5 p e r c e n t of cases of c e r v i c a l c a n c e r o c c u r i n w o m e n o v e r s i x t y - f i v e !

• T h e p e l v i c e x a m i n a t i o n is o f t e n d e f e r r e d because m a n y d o c t o r s , e s p e c i a l l y m e n , d o n o t l i k e to d o it. ( I n b o t h m e n a n d w o m e n , the r e c t a l e x a m i n a t i o n m a y meet a s i m i l a r f a t e . )

• A l t h o u g h deaths due to i s c h e m i c h e a r t disease d i s p r o p o r t i o n a t e l y affect p e r s o n s o v e r s i x t y - f i v e ( 8 5 p e r c e n t i n the U n i t e d States a n d 8 7 p e r c e n t i n F r a n c e ) , f e w n a t i o n a l

A G I N G W I T H D I S A B I L I T I E S | 5 6 5

c o m p a r i s o n s f o c u s o n o l d e r p e o p l e . F o r e x a m p l e , W H O ' s M O N I C A P r o j e c t — t h e i m p o r t a n t i n t e r n a t i o n a l l o n g i t u d i n a l study that m o n i t o r s c r o s s - n a t i o n a l t r e n d s i n car- d i o v a s c u l a r d i s e a s e — f o c u s e s o n d e a t h before s i x t y - f i v e .

• A p a t i e n t u n d e r the age o f s e v e n t y - f i v e w h o is a d m i t t e d w i t h a h e a r t a t t a c k is s i x t i m e s m o r e h k e l y to r e c e i v e b l o o d c l o t - d i s s o l v i n g d r u g s s u c h as s t r e p t o k i n a s e t h a n a p a t i e n t o v e r s e v e n t y - f i v e , e v e n t h o u g h data i n d i c a t e the v a l u e of s t r e p t o k i n a s e i n i m p r o v i n g the c h a n c e s f o r s u r v i v a l of o l d e r p a t i e n t s .

• A d v a n c e d s u r g e r y f o r P a r k i n s o n ' s disease is less a v a i l a b l e to o l d e r p e r s o n s .

U n l e s s o l d e r p e o p l e are k n o w l e d g e a b l e or h a v e s t r o n g a d v o c a t e s , e v e n the m o r e a f f l u e n t m e m b e r s o f o u r society e x p e r i e n c e a g e - d e t e r m i n e d l i m i t s i n m e d i c a l c a r e . P a r e n t h e t i c a l l y , w h e n m a l p r a c t i c e suits are w o n , o l d e r p e r s o n s u s u a l l y r e c e i v e l o w e r m o n e t a r y a w a r d s .

1 1 8

Aging with Disabilities

Ageism and More

Debra J. Sheets

People w h o are o l d a n d w h o also h a v e d i s a b i l i t i e s — a g r o w i n g p r o p o r t i o n o f the p o p u l a - t i o n — f i n d t h e m s e l v e s i n " d o u b l e j e o p a r d y " of e x p e r i e n c i n g p r e j u d i c e a n d d i s c r i m i n a t i o n , w h i c h o f t e n leads to d i f f i c u l t y g a i n i n g access to n e e d e d h e a l t h c a r e a n d s o c i a l s e r v i c e s . . . .

W i t h o l d e r A m e r i c a n s l i v i n g l o n g e r a n d h e a l t h i e r l i v e s , r e c e n t t r e n d s suggest t h a t d i s a b i l - i t y is d e c l i n i n g a n d p o s s i b l y b e c o m i n g less severe. S t i l l , the c o m b i n a t i o n o f large n u m b e r s o f baby b o o m e r s a n d the i n c r e a s e d p r e v a l e n c e o f d i s a b i h t y a c c o m p a n y i n g age m e a n s that the size o f the p o p u l a t i o n w i t h d i s a b i l i t y w i l l g r o w r a p i d l y i n the n e x t decade. C u r r e n t l y , 3 2 m i l h o n p e o p l e ( 1 2 . 5 p e r c e n t ) l i v i n g i n o u r c o m m u n i t i e s h a v e a sensory, m e n t a l , p h y s i - c a l , o r o t h e r d i s a b i h t y that i m p a i r s t h e i r a b i l i t y to take care of t h e m s e l v e s ; m o r e t h a n one i n three ( 3 8 p e r c e n t ) is age 6 5 or o l d e r . S e l f - c a r e d i s a b i l i t y affects 6 . 7 m i U i o n p e o p l e ; a d u l t s age 6 5 a n d o l d e r c o n s t i t u t e n e a r l y o n e - h a l f ( 3 . 1 m i U i o n ) o f this g r o u p .

W h U e p o p u l a t i o n a g i n g has r e c e i v e d c o n s i d e r a b l e a t t e n t i o n , the aging of the " d i s a b i l i t y p o p u l a t i o n " has gone largely w i t h o u t c o m m e n t . I n the past, p e o p l e w i t h d i s a b i l i t i e s o f t e n d i d not s u r v i v e e v e n i n t o m i d d l e age because of c o m p l i c a t i o n s r e l a t e d to t h e i r disability. N o w , f o r the f i r s t t i m e i n h i s t o r y , a n e s t i m a t e d one o f e v e r y 1 0 0 o l d e r A m e r i c a n s is a g i n g w i t h a l o n g - t e r m d i s a b i l i t y s u c h as s p i n a l c o r d i n j u r y , c e r e b r a l palsy, m u l t i p l e s c l e r o s i s , p o s t - p o U o , a n d i n t e l l e c t u a l or d e v e l o p m e n t a l d i s a b i l i t i e s . F i f t y years ago, the average h f e e x p e c t a n c y of a n i n d i v i d u a l w i t h s p i n a l c o r d i n j u r y w a s less t h a n three y e a r s after the a c c i d e n t o c c u r r e d . T o d a y 4 0 p e r c e n t of a l l s u r v i v o r s of s u c h i n j u r y are 4 5 years o f age a n d o l d e r , a n d m o r e t h a n o n e - h a l f o f the e s t i m a t e d 6 0 0 , 0 0 0 to one m U h o n p o l i o s u r v i v o r s are n o w age 5 5 a n d o l d e r . A p p r o x i m a t e l y 5 2 6 , 0 0 0 A m e r i c a n s age 6 0 or o l d e r are a g i n g w i t h i n t e U e c t u a l o r d e v e l o p m e n t a l d i s a b i l i t i e s . O t h e r g r o u p s a g i n g w i t h disabiUty i n c l u d e 2 0 0 , 0 0 0 people w i t h s p i n a l c o r d i n j u r i e s a n d 6 0 0 , 0 0 0 w i t h c e r e b r a l palsy.

5 6 6 I A G E I S M A N D A D U L T I S M

. . . M a n y of those w i t h l o n g - t e r m d i s a b i l i t i e s are e x p e r i e n c i n g u n a n n c i p a t e d h e a l t h p r o b l e m s (e.g., fatigue, p a i n ) a n d f u n c t i o n a l declines (e.g., m u s c l e w e a k n e s s , m o b i l i t y l i m i - t a t i o n s ) as they r e a c h m i d l i f e . T h e s e s e c o n d a r y h e a l t h c o n d i t i o n s are related to the effects o f a g i n g s u p e r i m p o s e d o n the p r i m a r y disability. T h e c o n d i t i o n s h a v e been d e s c r i b e d as " p r e m a t u r e a g i n g " because they o c c u r a b o u t f i f t e e n to t w e n t y y e a r s e a r l i e r t h a n w o u l d be the case w i t h n o r m a l aging. A related p r o b l e m is that p e o p l e aging w i t h d i s a b i l i t i e s m a y face e a r l y a n d f o r c e d r e t i r e m e n t as they become p h y s i c a l l y u n a b l e to c o n t i n u e w o r k i n g . I n s u c h cases, they o f t e n h a v e n o t h a d t i m e to p l a n f o r h o w they w i l l address t y p i c a l r e t i r e - m e n t issues s u c h as h o u s i n g , h e a l t h i n s u r a n c e , t r a n s p o r t a t i o n , i n c o m e , a n d c a r e g i v i n g . Y e t they r e m a i n too y o u n g to q u a l i f y f o r the age-based s e r v i c e s y s t e m as they s h i f t o u t o f the d i s a b i l i t y s e r v i c e s y s t e m , w i t h its s t r o n g v o c a t i o n a l f o c u s . T h e r e s u l t i n g gap i n s e r v i c e s poses a t h r e a t to i n d e p e n d e n c e a n d q u a l i t y of hfe f o r p e o p l e aging w i t h d i s a b i l i t y .

TOWARD A SHARED AGENDA TO COMBAT PREJUDICE

T h e aging a n d d i s a b i l i t y s e r v i c e systems h a v e h i s t o r i c a l l y d e v e l o p e d i n p a r a l l e l b u t separate t r a c k s , p a r t i c u l a r l y because o f d i f f e r e n t f u n d i n g s o u r c e s , despite o f t e n o v e r l a p p i n g c o n c e r n s a b o u t issues s u c h as a f f o r d a b l e h o u s i n g , p u b l i c t r a n s p o r t a t i o n , access to h e a l t h c a r e , l o n g - t e r m - c a r e needs, a n d e c o n o m i c stability. I n the e a r l y 1 9 8 0 s , aging a n d d i s a b i h t y a d v o c a t e s began d i s c u s s i n g the need to w o r k together to p u r s u e a u n i f i e d p o l i c y agenda that w o u l d r e f l e c t s h a r e d c o n c e r n s about these issues. I n the 1 9 9 0 s s e v e r a l m o d e s t attempts to d e v e l o p a u n i f i e d agenda w e r e u n d e r t a k e n but to little effect. E f f o r t s b e t w e e n the a g i n g a n d d i s - a b i l i t y s e r v i c e s y s t e m s u l t i m a t e l y s t a l l e d o v e r d i s a g r e e m e n t s that r e f l e c t e d d i f f e r e n c e s i n p h i l o s o p h i c a l p e r s p e c t i v e s , the d e f i n i t i o n o f p r o b l e m s , a n d w h a t c o u n t e d as a s o l u t i o n .

R e c e n t l y , e c o n o m i c a n d p o h t i c a l pressures h a v e p r o m p t e d about r w o - t h i r d s o f a l l states to c o n s o l i d a t e a n d integrate a g i n g a n d d i s a b i l i t y services i n t o a single agency s e r v i n g b o t h g r o u p s — o l d e r a d u l t s a n d p e o p l e w i t h d i s a b i l i t i e s . R e g a r d l e s s , s o m e a d v o c a t e s r e m a i n pes- s i m i s t i c a b o u t o v e r c o m i n g the d i f f i c u l t i e s that k e e p the a g i n g a n d d i s a b i l i t y s y s t e m s f r o m m e a n i n g f u l c o l l a b o r a t i o n a r o u n d a s h a r e d a g e n d a . H o w e v e r , o t h e r s are m o r e o p t i m i s t i c a n d p o i n t to a n u m b e r of state- a n d l o c a l - l e v e l i n i t i a t i v e s t h a t i n v o l v e c r o s s - n e t w o r k c o l - l a b o r a t i o n s a n d m a y r e f l e c t a c o a l e s c i n g a r o u n d issues that i n c l u d e i m p r o v i n g c o n s u m e r c h o i c e a n d the q u a l i t y o f l o n g t e r m c a r e . H o w t h i s w i l l p l a y o u t r e m a i n s to be seen, b u t t h e r e are s o m e p r o m i s i n g f o r c e s f u r t h e r i n g e f f o r t s to b r i n g the t w o s e r v i c e s p h e r e s together.

I m p r o v e m e n t s i n the s e r v i c e systems w i l l d o m u c h to c o u n t e r the effects of ageism o n o l d e r p e o p l e aging w i t h d i s a b i h t i e s . A d v o c a c y e f f o r t s by these t w o g r o u p s w o r k i n g together m u s t c o u n t e r p r e j u d i c e against elders a n d those w i t h d i s a b i h t y by p r o v i d i n g those a g i n g w i t h d i s a b i l i t y o p p o r t u n i t i e s to m a i n t a i n t h e i r c o m p e t e n c e , image, a n d sense of w o r t h w i t h i n o u r society. A g e n c i e s m u s t r e p l a c e p r o b l e m - b a s e d a p p r o a c h e s w i t h a strengths-based p a r a d i g m t h a t focuses o n e n s u r i n g i n c l u s i o n a n d p a r t i c i p a t i o n i n the b r o a d e r society. I n a d d i t i o n , b o t h systems m u s t endorse the s e l f - d e t e r m i n a t i o n o f p e o p l e aging w i t h d i s a b i h t y b y a d o p t i n g a s h a r e d f o c u s o n c o n s u m e r c h o i c e a n d the e m p o w e r m e n t of i n d i v i d u a l s to r e a c h t h e i r p o t e n t i a l . N e i t h e r age n o r d i s a b i l i t y s h o u l d be v i e w e d as a s p e c i a l c o n c e r n ; t h e y s h o u l d be r e c o g n i z e d as issues t h a t are i n the interests o f o u r society as a w h o l e .

B L A C K E L D E R L Y | 5 6 7

1 1 9

Black Elderly

Center on Aging Studies, University of Missouri—Kansas City

In 1985 approximately 14% of the population, 65 and over, were people of color. B y 2 0 2 0 , 2 1 % are p r o j e c t e d to be p e o p l e of c o l o r , a n d by 2 0 5 0 this p e r c e n t is a n t i c i p a t e d to i n c r e a s e to 3 3 % . T h e s e n u m b e r s translate i n t o i n c r e a s i n g n u m b e r s of b l a c k e l d e r l y a d u l t s in o u r society. H o w e v e r , despite g r o w i n g n u m b e r s of b l a c k e l d e r l y a d u l t s , m o s t of the p r o g r a m s a n d services p r o v i d e d to elders of c o l o r c o n t i n u e to be based o n r e s e a r c h a n d p e r c e p t i o n s r e g a r d i n g the m a j o r i t y p o p u l a t i o n . T h e r e s u l t is a g e n e r a l l a c k o f e t h n i c - a n d c u l t u r e - s p e c i f i c k n o w l e d g e . Approximately 33% of black elderly live in poverty. B l a c k e l d e r l y m a l e s e x p e r i e n c e a d e c l i n e i n t h e i r longevit)^. M a n y b l a c k e l d e r l y r e g a r d themselves as " u n r e t i r e d - r e t i r e d , " since they g e n e r a l l y c o n t i n u e to w o r k after r e t i r e m e n t . B l a c k e l d e r l y r e t i r e m e n t is f r e - q u e n t l y r e l a t e d to subsequent p h y s i c a l or m e n t a l disability. B l a c k e l d e r l y f e m a l e s w h o h a v e d e c l i n i n g h e a l t h are f r e q u e n d y sole heads of h o u s e h o l d s , a n d thus r e s p o n s i b l e f o r c h i l d r e n or g r a n d c h i l d r e n . B l a c k e l d e r l y u n d e r u t i l i z e p u b h c h e a l t h s e r v i c e s a n d tend to use e m e r g e n c y r o o m s e r v i c e s . M a n y do n o t h a v e a r e g u l a r p e r s o n a l p h y s i c i a n , a n d g e n e r a l l y e x p e r i e n c e p r o b l e m s i n accessing a l l h e a l t h care s y s t e m s . I n r u r a l areas, n e a r l y o n e - h a l f o f b l a c k e l d e r l y l i v e at or b e l o w the p o v e r t y l e v e l . Black male elders generally have less personal post-retirement resources and are more dependent on Social Security and Supplemental Security Income. M o r e t h a n t w i c e as m a n y b l a c k males as w h i t e m a l e s , o v e r the age of 6 5 , are d i v o r c e d or s e p a r a t e d . I t is a l w a y s i m p o r t a n t to r e m e m b e r that there is c u l t u r a l d i v e r s i t y w i t h i n e a c h e t h n i c g r o u p , i n c l u d i n g d i f f e r e n c e s i n v a l u e s , t r a d i t i o n s , e d u c a t i o n a l l e v e l s , s o c i o e c o n o m i c status, a n d l i f e s t y l e s .

Due to life-long patterns of socioeconomic disadvantages (e.g., income, education, access to health care, etc.), and prejudicial treatment, many black elderly don't respond well to service providers of a different race. I n some cases, the elder p e r s o n m a y d e m o n s t r a t e a c o m p l e t e l a c k o f t r u s t i n the m e d i c a l and/or m e n t a l h e a l t h s y s t e m . T h i s c a n p o t e n t i a l l y r e s u l t i n f e w e r attempts to p r o c u r e c a r e , a n d l o w c o m p l i a n c e w i t h p r e s c r i b e d i n t e r v e n t i o n s . B l a c k s tend to be i n s t i t u t i o n a l i z e d f o r m e n t a l h e a l t h reasons m o r e o f t e n t h a n w h i t e s ; t h e i r a d m i s s i o n to p s y c h i a t r i c i n s t i t u t i o n s are also less h k e l y to be v o l u n t a r y . I n a d d i t i o n , r a c i a l a n d e t h n i c m i n o r i t i e s t e n d to r e c e i v e less m e n t a l h e a l t h t r e a t m e n t a n d are m o r e l i k e l y to r e c e i v e l o w e r q u a l i t y t r e a t m e n t . Health conditions: M o r e than h a l f of b l a c k e l d e r l y i n A m e r i c a are i n p o o r h e a l t h . T h e y also t e n d to e x p e r i e n c e h i g h e r rates of m u l t i p l e c h r o n i c illnesses t h a n the rest of the p o p u l a t i o n . H y p e r t e n s i o n , obesity, a n d diabetes, i n p a r t i c u l a r , s u r f a c e as three m a j o r diseases w h i c h are o f t e n f o u n d to be r e l a t e d to e a c h other. L e f t u n t r e a t e d , a n y one o f these diseases c a n p r o g r e s s i n t o m o r e severe h e a l t h c o m p h c a t i o n s s u c h as s t r o k e , b l i n d n e s s , loss of an e x t r e m i t y , i m p a i r e d m o b i l i t y , k i d n e y f a i l u r e , or h e a r t disease. T h e s e three diseases are o f t e n associated w i t h a l i f e t i m e of p o o r d i e t a r y h a b i t s , l i m - i t e d e x e r c i s e , b e h a v i o r a l responses to d i s c r i m i n a t i o n , s o c i o e c o n o m i c f a c t o r s ( s u c h as p e r s i s t e n t p o v e r t y ) , a n d p o o r c o p i n g or p r o b l e m - s o l v i n g s k i l l s — s o m e of w h i c h m a y i n c l u d e the use o f sugar, f o o d , a l c o h o l , or d r u g s , i n excess, as a m e a n s o f m i n i m i z i n g

5 6 8 A G E I S M A N D A D U L T I S M

e m o t i o n a l p a i n a n d e s c a p i n g the h a r s h r e a h t i e s o f l i f e . I n t u r n , d e c r e a s e d s e l f - i m a g e , s e l f - w o r t h , feelings o f hel pl essness, hopelessness, a n d f r u s t r a d o n o f t e n a c c o m p a n y these c o n d i t i o n s . A n o t h e r possible p r o b l e m is n o n c o m p l i a n c e w i t h m e d i c a t i o n i n s t r u c - t i o n s a n d s c h e d u l e s . T h i s p r o b l e m is o f t e n the r e s u l t of f i x e d i n c o m e s w h i c h m a y n o t a l w a y s c o v e r o n g o i n g m e d i c a t i o n costs. . . . Cancer is found to be a critical problem for black elderly Americans. F o r e x a m p l e , as c o m p a r e d to w h i t e A m e r i c a n s , b l a c k A m e r i c a n s e x p e r i e n c e s i g n i f i c a n t l y higher rates o f s e v e r a l types o f c a n c e r , w i t h d e a t h rates three t i m e s h i g h e r f o r esophageal c a n c e r a n d t w i c e the m o r t a l i t y rate f r o m s t o m a c h c a n c e r . I n a d d i t i o n , the d e a t h rate f r o m l u n g c a n c e r is 4 5 % h i g h e r i n b l a c k males c o m p a r e d to w h i t e m a l e s . B l a c k f e m a l e s are also t w o to three times m o r e h k e l y to die f r o m c e r v i c a l or u t e r i n e c a n c e r t h a n w h i t e f e m a l e s . Concerning dementia, research has shown that black females may be at increased risk of multi-infarct dementia due to a higher incidence of obesity and hyperten- sion. T h e p o t e n t i a l f o r b l a c k m a l e s to e x p e r i e n c e a l c o h o l i c d e m e n t i a before age 5 0 is a ls o i n c r e a s e d due to e a r l y age onset o f d r i n k i n g a n d h e a v i e r p a t t e r n s o f c o n s u m p - t i o n . A l t h o u g h the f r e q u e n c y o f d e m e n t i n g i l l n e s s is at least as f r e q u e n t i n the b l a c k A m e r i c a n c o m m u n i t y as it is i n the g e n e r a l p o p u l a t i o n , b l a c k e l d e r l y m a y h a v e l o w e r rates of the A l z h e i m e r ' s type of d e m e n t i a . B e c a u s e of a l a c k of r e s o u r c e s , i n e f f i c i e n t d o c t o r - p a t i e n t r e l a t i o n s h i p , and/or l a c k of r e s e a r c h data a p p l i c a b l e to d e m e n t i a s i n the b l a c k elderly, there is a n a b o v e - a v e r a g e p o t e n t i a l f o r m i s d i a g n o s e s . For black Americans, in particular, family is of primary importance. F a m i l y n e t w o r k s p r o v i d e the m a i n s o u r c e o f n e e d e d assistance later i n life f o r m a n y b l a c k elderly. I n f a c t , w h e n b l a c k e l d e r l y l i v e w i t h t h e i r c h i l d r e n , the p o s s i b i l i t y o f t h e m b e i n g i n s t i t u t i o n a l - i z e d f o r d i s a b i l i t i e s decreases. I n g e n e r a l , b l a c k e l d e r l y d o n o t p a r t i c i p a t e i n s o c i a l o r r e c r e a t i o n a l a c t i v i t i e s that are outsi de the r e a l m o f t h e i r i n d i v i d u a l c u l t u r a l t r a d i t i o n s , b a c k g r o u n d s , or e x p e r i e n c e s . H o w e v e r , they tend to u t i l i z e a m o r e d i v e r s e p o o l of h e l p e r s , i n c l u d i n g b o t h e x t e n d e d f a m i l y a n d f r i e n d s . T h i s n e t w o r k , a n d its i n f l u e n c e , m u s t , i n t u r n , be respected a n d u t i l i z e d by outside c a r e g i v e r s a n d s e r v i c e p r o v i d e r s . I n c r e a s e d s p i r i t u a l i t y , f a i t h i n G o d , a n d i n c r e a s e d p a r t i c i p a t i o n i n r e l i g i o u s a c t i v i t i e s a n d i n s t i t u t i o n s c a n al so p l a y an i m p o r t a n t r o l e i n p r o v i d i n g s u p p o r t f o r b l a c k e l d e r l y . R e h g i o u s beliefs p r o v i d e a r e s o u r c e f o r c o p i n g w i t h the u n e x p e c t e d or losses ( w h i c h n a t u r a l l y i n c r e a s e w i t h age). T h e c h u r c h m a y also serve as a f o c a l p o i n t o f s u p p o r t i v e n e t w o r k s f o r e m o t i o n a l a n d m a t e r i a l a i d .

Developing a caregiving relationship: F o r s o m e o n e outside the f a m i l y to establish a n d d e v e l o p a c a r e g i v i n g r e l a t i o n s h i p w i t h a b l a c k elder m a y r e q u i r e s p e c i a l a t t e n t i o n a n d s e n s i t i v i t y to the e l d e r ' s u n i q u e e t h n i c a n d c u l t u r a l e x p e r i e n c e , h i s t o r y , a n d f a m i l y r e l a t i o n s h i p s . A t a m i n i m u m , the s e r v i c e p r o v i d e r m u s t m a k e e f f o r t s t o w a r d b u i l d i n g a t r u s t i n g r e l a t i o n s h i p — r e m e m b e r i n g that n o n - r e s p o n s i v e n e s s or resistance o n the p a r t o f the e l d e r m a y r e p r e s e n t a m e a n s o f e v a l u a t i n g p r o v i d e r s a n d t h e i r a b i l i t y to w o r k w i t h the elder effectively. A big step i n the r i g h t d i r e c t i o n is a c h i e v e d i f the p r o v i d e r can meet elders w h e r e they a r e — w h i c h means h e l p i n g the elder d e t e r m i n e w h a t w i l l w o r k best, r a t h e r t h a n w h a t the p r o v i d e r believes w i l l be best f o r the elder.

R E G A R D L E S S O F W H A T Y O U W E R E T A U G H T T O B E L I E V E

1 2 0

Regardless of What You Were Taught to Believe

There Is Nothing Wrong with You: For Teens

Chefi Huber

C H : W h a t d o y o u w i s h a d u h s u n d e r s t o o d about p e o p l e y o u r age? B : I t h i n k they u n d e r s t a n d , because they w e r e o u r age a n d they w a n t e d to do e x a c t l y

w h a t w e w a n t to d o . B u t f o r some r e a s o n they d o n ' t w a n t us to do w h a t they d i d . E v e n t h o u g h t h e i r l i v e s t u r n e d o u t f i n e , e v e n t h o u g h they h a v e p e r f e c t l y f i n e l i v e s , they d o n ' t w a n t us to f o l l o w t h e m .

C H : S o , d o y o u feel l i k e y o u k n o w w h a t h a p p e n e d w i t h y o u r p a r e n t s , a n d they j u s t w o n ' t c o p to it?

Q : S u r e . T h e y say, " I d i d that but y o u s h o u l d n ' t do it because i t ' s b a d . E v e n t h o u g h I d i d it, y o u s h o u l d n ' t do it. Y o u s h o u l d l e a r n f r o m m y e x p e r i e n c e . "

T : B u t w e d o n ' t w a n t to l e a r n f r o m s o m e o n e else's e x p e r i e n c e . W e w a n t to h a v e o u r o w n e x p e r i e n c e a n d l e a r n f r o m that. W h a t h a p p e n e d to t h e m d o e s n ' t m e a n a n y t h i n g to m e . I w a n t to f i n d o u t f o r m y s e l f .

F : T h e y t h i n k because they d i d s o m e t h i n g w e ' r e g o i n g to d o i t , t o o . C H : S o , adults keep b r i n g i n g up the same s t u f f o v e r a n d o v e r a n d m a y b e y o u w o u l d n ' t

e v e n be t h i n k i n g about it i f they d i d n ' t k e e p b r i n g i n g it u p . F : T h e y k e e p a c c u s i n g us o f p l a n n i n g things that w e ' r e n o t e v e n t h i n k i n g about. S : S o m e t i m e s they t e l l us too m u c h . M y p a r e n t s h a v e t o l d me s t u f f I d i d n ' t w a n t to h e a r

l i k e about w h e r e a n d w h e n I w a s c o n c e i v e d a n d t h i n g s t h e y d i d w h e n they w e r e y o u n g . I t ' s w e i r d .

B : T h e y d o n ' t let y o u t a l k b a c k . T h e i r i d e a of a c o n v e r s a t i o n is i n t e r r o g a t i o n . T h e y say s o m e t h i n g a n d y o u t r y to say s o m e t h i n g b a c k a n d t h e y d o n ' t w a n t to hear i t . T h e y say, " W e w a n t to t a l k to y o u a b o u t t h i s . " B u t they d o n ' t w a n t y o u to say a n y t h i n g to t h e m a b o u t i t .

V : T h e y w o n ' t let y o u q u e s t i o n t h e m a n d they w o n ' t e x p l a i n t h e i r r e a s o n s . T h e y w o n ' t ever t e l l y o u w h y .

C H : So do y o u often f i n d y o u r s e l f i n a place of not u n d e r s t a n d i n g w h y t h e y ' r e d o i n g w h a t t h e y ' r e d o i n g or d e m a n d i n g w h a t t h e y ' r e d e m a n d i n g ?

G r o u p : Y E S ! C H : S o w h a t y o u ' r e s a y i n g is t h a t a d u l t s , e v e n t h o u g h t h e y say t h e y w a n t to t a l k to y o u ,

a r e n ' t i n t e r e s t e d i n h a v i n g a c o n v e r s a t i o n . A d u l t s d o n ' t realize w h a t c o n v e r s a t i o n i s . T h e r e i s n ' t m u c h of the one p e r s o n says s o m e t h i n g then the other p e r s o n r e p l i e s .

V : Y e a h , they w a n t to p r e a c h . G : T h e y t h i n k a c o n v e r s a t i o n r e v o l v e s a r o u n d t h e i r o p i n i o n a n d n o t h i n g else. C H : A n d t h e y ' r e a s s u m i n g y o u u n d e r s t a n d a lot of things y o u r e a l l y d o n ' t u n d e r s t a n d ? G r o u p : Y e a h . V : L i k e w h e n m y m o m w a n t s to t a l k to m e , she n e v e r w a n t s to t a l k to m e o n a p e r s o n a l

l e v e l . She calls me out of m y r o o m a n d asks m e " w h o ate the p e a n u t b u t t e r ? " A n d she

5 7 0 [ A G E I S M A N D A D U L T I S M

yells at me l i k e i t ' s m y f a u l t . I d i d eat the peanut butter. I ' m the one i n the house w h o l i k e s p e a n u t butter. She a l w a y s y e l l s at me w h e n she t a l k s to me. I t ' s a l w a y s l i k e w h a t e v e r it is is m y f a u l t . I n e v e r k n o w if she's a c c u s i n g m e of s o m e t h i n g or i f that's just the w a y she t a l k s to me. B u t w h e n I w a n t to t a l k to her about s o m e t h i n g i m p o r t a n t s h e ' s , l i k e , okay, w h a t e v e r . B u t w h e n i t ' s n o t s e r i o u s a n d she w a n t s to t a l k to me, she gets m a d . I c a n ' t r e m e m b e r the last actual c o n v e r s a t i o n I h a d w i t h m y m o m .

C H : I s that w h a t it feels l i k e , that y o u ' r e r e a l l y d i f f e r e n t f r o m y o u r parents? G r o u p : N o t really. T : I ' m a p p a r e n d y just l i k e m y m o m . W e a l l t u r n into o u r p a r e n t s a n d its h o r r i b l e !

C H : S o , w h a t do y o u w a n t to tell adults? W h a t s h o u l d adults k n o w ? — L I S T E N . B a s i c a l l y that's i t . I t w o u l d be r e a l l y n i c e if people l i s t e n e d to y o u w h e n y o u

h a v e s o m e t h i n g to say. — W e n e e d s u p p o r t , s o m e p r a i s e , some a c k n o w l e d g m e n t of the good s t u f f w e d o . — B e o p e n to the s t u f f t h a t ' s i m p o r t a n t to us even i f its n o t i m p o r t a n t to t h e m — n o t

n e c e s s a r i l y c o n d o n e i t , but d o n ' t say d o n ' t do i t . L i k e w a n t i n g to be w i t h o u r f r i e n d s a l l the t i m e . M y p a r e n t s m a y t h i n k it's a w a s t e of t i m e , but i t ' s w h a t I w a n t to do a n d it beats s i t t i n g a r o u n d the house o n m y butt. S o , o k , y o u t h i n k it's a w a s t e of t i m e , but it's w h a t I w a n t to d o , so d o n ' t give m e a h a r d t i m e about i t .

— D o n ' t w o r r y so m u c h a b o u t w h o w e h a n g out w i t h . T h e y just assume that i f y o u ' r e w i t h c e r t a i n p e o p l e y o u ' r e g o i n g to be just l i k e those p e o p l e . T h e y t h i n k w e h a v e n o w i l l p o w e r , i f s o m e o n e suggests s o m e t h i n g or o f f e r s us s o m e t h i n g , w e ' r e g o i n g to go a l o n g w i t h i t a u t o m a t i c a l l y . T h e y d o n ' t see us as i n d i v i d u a l s , they see us as w h o w e ' r e w i t h .

— W e h a v e g o o d m o r a l s , w e c a n m a k e g o o d c h o i c e s . — W e d o n ' t m e a n any h a r m . W e just w a n t to h a v e f u n . W e ' r e t r y i n g to l e a r n n e w t h i n g s . — T r u s t us. T a l k to us. G e t to k n o w u s . A n d t r u s t us. —^You w a n t us to act l i k e a d u l t s , treat us w i t h the same respect y o u give to a d u l t s . — I f y o u w a n t us to respect y o u , r e s p e c t us. C H : I n other w o r d s , i f the t e a c h i n g is g o i n g to be s u c c e s s f u l , parents h a v e to m o d e l

w h a t they w a n t y o u to be. — T e a c h e r s too. T h e best teachers I ' v e h a d are the ones w h o treated us as a c t u a l p e o p l e .

I listened to t h e m a n d e x c e l l e d in t h e i r classes. B u t the teachers w h o hate us, the ones w h o are there f o r the s u m m e r s off, I w a s e x a c t l y the o p p o s i t e . W e w i l l be w h a t adults e x p e c t us to be.

—^You c a n ' t just t e l l us n o . G i v e us a r e a s o n . W e d o n ' t see w h a t y o u see. W e d o n ' t u n d e r s t a n d . Y o u n e e d to e x p l a i n things to us.

— D o n ' t say, " B e c a u s e I ' m the p a r e n t . " I f y o u d o n ' t have a g o o d r e a s o n , i f y o u c a n ' t e x p l a i n it to m e , I ' m n o t g o i n g to do w h a t y o u w a n t .

— A d u l t s w a n t to k n o w w h y . W e h a v e to give reasons. G i v e us the respect y o u w a n t f r o m us a n d e x p l a i n to us y o u r r e a s o n s . T e l l us w h y w e s h o u l d do w h a t y o u w a n t us to d o .

— " B e c a u s e I said s o , " is n o t g o o d e n o u g h . I t m a k e s m e have to do the o p p o s i t e ! — A d u l t s h a v e h a d a l o t of e x p e r i e n c e w e h a v e n ' t h a d . G i v e us the benefit of that e x p e r i -

ence by e x p l a i n i n g w h a t t h e y ' r e t h i n k i n g , h o w they see things. — G i v e us a l l the i n f o r m a d o n w e need a n d s u p p o r t us i n m a k i n g a d e c i s i o n . — G e t to k n o w w h o w e are as i n d i v i d u a l s a n d s u p p o r t us. — D o n ' t c o n s t a n t l y r e f e r to the past a n d h o l d the past against us. — W e ' r e n o t a l l a l i k e . W e ' r e s i m i l a r , but w e are i n d i v i d u a l s . — S u p p o r t but d o n ' t p u s h . — W e ' r e n o t a l w a y s g o i n g to be c h i l d r e n . — W e h a v e a l o t o f e m o t i o n s i n s i d e . S o m e t i m e s w e d o n ' t k n o w w h a t ' s best f o r us. — W e ' r e n o : as bad as y o u t h i n k . Y o u w e r e o u r age once. G i v e us a break.

E L D E R L I B E R A T I O N D R A F T P O L I C Y S T A T E M E N T I 5 7 5

t h e n (either p o s i t i v e or n e g a t i v e ) . T h e s e f e e h n g responses, i n t u r n , affect h o w w e see the changes i n o u r o w n b o d i e s .

MOVING OUT OF THE OPPRESSION

B e g i n to act. C r e a t e g o o d d i r e c t i o n s a n d c o m m i t m e n t s f o r y o u r s e l f . B u i l d s u p p o r t g r o u p s a r o u n d y o u . P u t y o u r p l a n s int o a c t i o n .

STEPS

• E l d e r s a n d n o n - e l d e r s need to have c o n f i d e n t , h i g h e x p e c t a t i o n s of e l d e r s . R e c o g n i z e that w e are a l w a y s l e a r n i n g , g r o w i n g , a n d d e v e l o p i n g , that w e have n o t c o m p l e t e d o u r l i v e s , o u r c o n t r i b u t i o n s , o u r a c c o m p l i s h m e n t s . See elders as able to m a k e changes, to l i v e t h r o u g h m a n y m o r e b e g i n n i n g s . R e m e m b e r that there are f e e l i n g s , griefs, fears to be w o r k e d t h r o u g h at any age. I t is i n c o r r e c t to assume that e l d e r s ' distresses are m o r e i n t r a c t a b l e because w e have Uved longer.

• E l d e r s , let's do w h a t ' s u n p o r t a n t i n o u r l i v e s , l i v e w h a t e v e r w a y w e need to l i v e , a n d n o t neglect this because w e are older.

• L e t ' s l i v e a " n o l i m i t s " l i f e , be i n c r e a s i n g l y m i n d f u l that w e are in c h a r g e of o u r s e l v e s p h y s i c a l l y a n d e m o t i o n a l l y . L e t ' s t ake as a basic a s s u m p t i o n that a p e r s o n w i t h n o distress w o u l d age s l o w l y , i f at a l l .

• R e m e m b e r that w e are o u r o w n best alhes.

E n l i s t the s u p p o r t of n o n - e l d e r s as a l l i e s ; d e v e l o p a l o n g list a n d c a l l o n t h e m f r e - q u e n d y . O t h e r age g r o u p s , e s p e c i a l l y y o u n g p e r s o n s , have challenges i n c o m m o n w i t h e l d e r s .

• F i n d w a y s to celebrate a n d call a t t e n t i o n to s u c c e s s f u l aging. D e l i g h t i n a n d m a k e fes- t i v e e v e r y birthday. T a k e it as an o p p o r t u n i t y to shar e w h a t is good a n d p o s i t i v e about aging.

• T a k e i n i t i a t i v e a n d l e a d e r s h i p to challe nge . . . a g e i s m . • I n w h a t e v e r g r o u p y o u are a p a r t of, f i n d w a y s to h o n o r a n d s h o w respect f o r o l d e r

p e r s o n s , c a l l f o r t h their abilit ie s a n d talents, a n d i n t e r r u p t a n y ageist p r a c t i c e s a n d b e h a v i o r s .

• M a k e y o u r s e l f a v a i l a b l e as a spe ake r o n l i b e r a t i o n f r o m . . . a g e i s m . • D e v e l o p a n d take r e s p o n s i b i l i t y f o r a p e r s o n a l h e a l t h p l a n . • W h e n s o m e t h i n g goes w r o n g p h y s i c a l l y , d o n ' t assume i t ' s because o f age. • C o n f r o n t . . . fears about a g i n g , sickness a n d d e a t h .

• E n r i c h y o u r l i f e a n d t h e i r s by s h a r i n g it w i t h people of s e v e r a l d i f f e r e n t g e n e r a t i o n s .

• K n o w the l a w s p e r t a i n i n g to o l d e r p e r s o n s a n d lobby to estabUsh n o n - a g e i s t p o l i c i e s o n e m p l o y m e n t , h o u s i n g , h e a l t h c a r e , etc.

• F o c u s o n f r i e n d s h i p s w i t h o l d e r persons across race, gender, class d i f f e r e n c e s . • E n c o u r a g e a l l o l d e r p e r s o n s to be f u l l y p r o u d of t h e m s e l v e s , i n c l u d i n g b e i n g p r o u d o f

their age.

5 7 6 I A G E I S M A N D A D U L T I S M

• W o r k c o o p e r a t i v e l y to r i d o u r s e l v e s o f a l l o p p r e s s i o n s , i n c l u d i n g o l d - a g e i s m . N o n e of us is free u n t i l w e a l l are f r e e .

• D e v e l o p y o u r o w n strategies for e n d i n g o l d - a g e i s m , a n d share t h e m ! • O r g a n i z e w i t h other elders to take l e a d e r s h i p for o u r l i b e r a t i o n a n d the l i b e r a t i o n o f

a l l o t h e r sections o f the p o p u l a t i o n . W e c a n lead e v e r y t h i n g , a n d f r o m s u c h a p o s i t i o n o u r interests c a n r e c e i v e the a t t e n d o n a n d e m p h a s i s they d e s e r v e .

• F o r m a l l i a n c e s w i t h a l l o t h e r oppressed g r o u p s , . . . to s u p p o r t e a c h o t h e r s ' p r o g r a m s . T o o f f e r a l l i a n c e s to o t h e r l i b e r a t i o n g r o u p s a n d r e q u e s t t h e i r s u p p o r t is to m u l t i p l y o u r effectiveness a n d o u r c o n f i d e n c e i m m e d i a t e l y .

A g i n g has less s t i g m a i n c o m m u n i t i e s o f col or. T h e r e is m o r e respect f o r age a n d e x p e r i - ence. A l o t of the respect f o r elders is left o v e r f r o m o u r t r a d i t i o n a l c u l t u r e s .

T h o u g h g r a n d p a r e n t s a n d other o l d e r adul ts are respected a n d l o v e d w i t h i n t h e i r f a m i - h e s , they s u f f e r m o r e f r o m the i n h u m a n t r e a t m e n t of s o c i e t y t o w a r d s elder c i t i z e n s t h a n m e m b e r s o f the d o m i n a n t c u l t u r e . B e c a u s e o f the t r a d i t i o n o f segregation a n d r e d u c e d access to o p p o r t u n i t i e s , o l d e r p e o p l e o f c o l o r are less l i k e l y to h a v e g o o d h e a l t h c a r e , adequate h o u s i n g a n d g o o d n u t r i t i o n . C o n s e q u e n t l y o l d e r p e o p l e h a v e a l o w e r q u a h t y o f l i f e a n d a s h o r t e n e d l i f e s p a n .

B e c a u s e of the p o v e r t y a n d v i o l e n c e i n i n n e r c i t i e s , o l d e r w o m e n i n o u r c o m m u n i t i e s are often t a k i n g care o f g r a n d c h i l d r e n or other y o u n g p e o p l e left by the d e a t h of the y o u n g p e o p l e ' s p a r e n t s . T h e e x t e n d e d f a m i l y c o n c e p t is a g o o d o n e , but there is v e r y r a r e l y e n o u g h m o n e y to take care of these c h i l d r e n p r o p e r l y . A l o t of times the o l d e r p e o p l e are o n p u b l i c assistance f o r the e l d e r l y w h i l e at the same t i m e r e c e i v i n g a i d f o r d e p e n d e n t c h i l d r e n .

. . . M o s t of the d m e , just as w i t h e v e r y o t h e r issue w i t h people o f c o l o r , the aging issue is b u r i e d u n d e r the issues c o n n e c t e d w i t h r a c i s m , so if there is some d i f f i c u l t y , o l d - a g e i s m is n o t l o o k e d at. W e need f o r o t h e r elders to step outside t h e i r fear a n d e n c o u r a g e o l d e r p e o p l e o f c o l o r to . . . w o r k o n this v e r y i m p o r t a n t issue. W e need y o u n g e r p e o p l e to act as o u r a l l i e s a n d . . . [ t a l k w i t h us a b o u t ] o u r i n t e r n a l i z e d o p p r e s s i o n (the i n t e r n a l i z e d r a c i s m a n d the i n t e r n a l i z e d a g e i s m ) .

W e n e e d f o r p e o p l e . . . to u n d e r s t a n d that the p r o b l e m s f a c i n g a l l p e o p l e , a n d e s p e c i a l l y p e o p l e of c o l o r , are m u l t i p l i e d w h e n w e become e l d e r s . T h i s is e s p e c i a l l y true i n s u c h cities as A u s t i n , T e x a s a n d A t l a n t a , G e o r g i a , w h e r e the m e d i a n age is t w e n t y - f i v e . S i n c e people o f c o l o r h a v e been t r a d i d o n a l l y d e n i e d s o m e jobs (they are c u r r e n d y p h a s i n g p e o p l e o v e r f o r t y o u t o f c e r t a i n j o b s ) , the e m p l o y m e n t s i t u a t i o n f o r p e o p l e of c o l o r o v e r f i f t y is pretty g r i m .

O l d e r p e o p l e o f c o l o r h a v e a l o t to o f f e r : w e are an asset to any g r o u p . O u r c o n t r i b u t i o n to the h i s t o r y of this c o u n t r y is i m m e n s e . W e n e e d a c h a n c e to share t h i s w i t h the . . . w o r l d .

I 1 2 2 People of Color Over Fifty DoWe Cuffy

A L L I E S T O Y O U N G P E O P L E 5 8 3

• T h o u g h t f u l l y but f i r m l y i n t e r r u p t c o m p e t i t i o n a n d p u t - d o w n s . S o c i e t y has t o l d y o u n g p e o p l e that they are n o t yet f u l l h u m a n s a n d that t h e i r t h i n k i n g is n o t v a l u a b l e . T h e y i n t e r n a l i z e these messages a n d t hen take t h e m out o n each other.

• D o g r o u p f e e d b a c k . A s k p e o p l e to give s p e c i f i c p o s i t i v e as w e l l as g r o w t h / i m p r o v e - m e n t i n f o r m a t i o n to a n o t h e r m e m b e r of the g r o u p , i n c l u d i n g y o u . T h e y w i l l l e a r n the m o s t f r o m e a c h other.

E x p e c t to m a k e lots of p h o n e c a l l s a n d p e r s o n a l c o n t a c t .

• Because y o u n g p e o p l e are so o f t e n t o l d by s o c i e t y that they are n o t i m p o r t a n t , a d u l t allies n e e d to m a k e lots of p h o n e calls to p e r s o n a l l y r e m i n d people that meetings are i m p o r t a n t a n d that they are w a n t e d .

• T h e y m a y n o t c a l l y o u back. D o n ' t t ake it p e r s o n a l l y . K e e p c a l l m g . A s s u m e y o u are w a n t e d .

• R e m e m b e r that in m o s t s i t u a t i o n s , y o u n g p e o p l e are n o t t a k e n seriously, a n d they are t o l d that their struggles d o n ' t matter. W h e n y o u c a l l , y o u are t a l k i n g to s o m e o n e w h o p r o b a b l y d o e s n ' t feel v a l u a b l e , a n d thus d o e s n ' t r e m e m b e r that the w o r k that she does is v a l u a b l e . Y o u n e e d to k e e p r e m i n d i n g her h o w i m p o r t a n t she is.

D o n ' t c a n c e l meetings o r eve nt s.

• I t ' s o k a y i f o n l y a f e w p e o p l e s h o w up f o r things y o u h a v e p l a n n e d . G o ahead w i t h t h e m a n y w a y . I f y o u c a n eve n get t w o o r three people to get clo se r to e a c h other or w o r k together o n a p r o j e c t , y o u ' v e c o m e that m u c h clo ser to the goals of y o u r g r o u p .

• Y o u n g p e o p l e h a v e a l o t o f i n c o n s i s t e n c y in t h e i r l i v e s . I t m e a n s a l o t to t h e m i f y o u c a n s h o w t h e m that y o u w i l l f o l l o w t h r o u g h w i t h w h a t y o u say.

Y o u n g people s h o u l d be a c e n t r a l p a r t o f a n y o r g a n i z a t i o n , m o v e m e n t , c h u r c h g r o u p , etc.

• I t ' s n e c e s s a r y f o r the total h e a l t h of a n y m o v e m e n t or o r g a n i z a t i o n f o r y o u n g people to be a c e n t r a l p a r t of a l l facets of the o r g a n i z a t i o n . I t ' s great to h a v e a y o u n g p e r s o n c h a i r a y o u t h c o m m i t t e e , but also have her c h a i r the o u t r e a c h c o m m i t t e e , or be i n c h a r g e of the budget. I f y o u n g p e o p l e do n o t h a v e the s k i l l s to take o n these r o l e s t h e n t r a i n t h e m . A y o u n g p e r s o n ' s p e r s p e c t i v e is i n v a l u a b l e .

• M a k e sure that y o u n g people are general m e m b e r s to c o m m i t t e e s a n d b o a r d s , n o t just o c c a s i o n a l r e p r e s e n t a t i v e s .

• T o k e n r e p r e s e n t a t i o n is n o t h e l p f u l i n the l o n g t e r m .

I n m e e t i n g s , a s k y o u n g people to t a l k f i r s t . N e v e r believe t h a t they d o n ' t k n o w .

• Y o u m a y h a v e to ask t h e m to e x p r e s s their ideas at least ten times a n d y o u m a y h a v e to a s k i n ten d i f f e r e n t w a y s .

• T h e y m a y say they d o n ' t k n o w or d o n ' t have a n o p i n i o n . T h i s is w h a t w e have a l l been t o l d as y o u n g p e o p l e m a n y times b e f o r e .

• T h e y do h a v e thoughts o n a l m o s t a n y s i t u a t i o n if g i v e n e n o u g h i n f o r m a t i o n , time to t h i n k a n d the e x p e c t a t i o n that of c o u r s e they can t h i n k .

5 8 4 I A G E I S M A N D A D U L T I S M

A s k y o u n g people w h a t they t h i n k s h o u l d be d o n e i n a i l s i t u a t i o n s .

• D i s c u s s the goals of the g r o u p a n d h o w events reflect these goals, but resist the t e m p t a - t i o n to s w a y the g r o u p i n the d i r e c t i o n y o u t h i n k it s h o u l d go.

I n s i s t t h a t y o u n g people are represented at e v e r y m e e t i n g , e s p e c i a l l y w h e r e y o u n g p e o p l e are b e i n g d i s c u s s e d .

• I t w o r k s better i f there are at least t w o y o u n g p e o p l e p r e s e n t . • M e e t w i t h t h e m ahead of t i m e . G e t t h e m to share t h e i r t h i n k i n g w i t h y o u about the

m e e t i n g t o p i c . R e m i n d t h e m h o w i m p o r t a n t their t h i n k i n g is a n d e n c o u r a g e t h e m to speak d u r i n g the m e e t i n g .

G e t y o u n g people l e a d i n g q u i c k l y .

• I t ' s great f o r us as a d u l t s to begin f a c i l i t a t i n g a n d l e a d i n g m e e t i n g s . T h e faster w e c a n t u r n it o v e r to y o u n g p e o p l e , h o w e v e r , the faster it w i l l g r o w .

A p p r e c i a t e y o u r s e l f f o r the m a n y i m p o r t a n t w a y s that y o u h a v e been a n d c o n t i n u e to be a c o m m i t t e d a l l y to y o u n g p e o p l e .

1 2 5

Taking a Stand Against Ageism at All Ages

A Powerful Coalition

Margaret M. Gullette

N e w a g e i s m is the t e r m I use to describe the c u r r e n t A m e r i c a n v i e w o f a g i n g - p a s t - y o u t h . W h a t e v e r y o u r age, y o u are l i k e l y to be a f f e c t e d by the n e w ageism—-in y o u r jo b, i n y o u r s e x u a l l i f e , i n y o u r sense o f identity, i n y o u r i n t e r g e n e r a t i o n a l r e l a t i o n s .

T h e n e w ageism has gotten so o u t o f h a n d t h a t i t is c u l m i n a t i n g in the c u r r e n t R e p u b l i c a n w a r against S o c i a l S e c u r i t y , M e d i c a r e a n d M e d i c a i d . T h e f i r s t t w o are the m o s t b e l o v e d a n d necessary g o v e r n m e n t p r o g r a m s in the h i s t o r y of the R e p u b l i c . A n d the t h i r d . M e d i c a i d , o u g h t to be a n o t h e r .

V i r t u a l l y a l l A m e r i c a n s w i l l e v e n t u a l l y need M e d i c a i d if w e r u n out of m o n e y a n d need to be i n a n u r s i n g h o m e . T h i s l o o k s l i k e l i e r f o r m a n y of the s o - c a l l e d " B o o m e r s " — e s p e - c i a l l y the l o n g - l i v e d f e m a l e B o o m e r s — w h o lost savings i n the o n g o i n g G r e a t R e c e s s i o n , h a d t h e i r p e n s i o n s a n d u n i o n s t a k e n a w a y or lost t h e i r jobs a n d h e a l t h i n s u r a n c e .

T A K I N G A S T A N D A G A I N S T A G E I S M A T A L L A G E S | 5 8 5

A p e r s o n w h o is o v e r 4 0 a n d has been l a i d o f f m a y w e l l be a v i c t i m o f middle a g e i s m , w h i c h is d i s c r i m i n a t i o n against p e o p l e o v e r 4 0 . People are s u i n g their e m p l o y e r s f o r m i d l i f e job d i s c r i m i n a t i o n i n greater n u m b e r s t h a n ever b e f o r e ; m e n i n t h e i r 5 0 s , w o m e n 10 y e a r s y o u n g e r . G e t t i n g r i d of m i d l i f e w o r k e r s is a t r e n d t h a t has been w o r s e n i n g f o r 3 0 y e a r s , as I describe i n m y b o o k , Agewise.

People u n d e r 4 0 are also i m m e r s e d i n w h a t I c a l l the A m e r i c a n " c u l t u r e of d e c l i n e " — t h r o u g h the d e s c r i p t i o n s o f l a t e r l i f e i n the m e d i a , i f i n n o o t h e r w a y . O l d e r p e o p l e r a r e l y a p p e a r i n m o v i e s a n d n e v e r i n ads f o r c o o l p r o d u c t s — n o t h i n g but the y o u n g , the f i t a n d the a i r - b r u s h e d . W h y n o t a i r b r u s h o l d e r m o d e l s ?

M u c h w o r s e : Y o u l i s t e n to the r a d i o a n d hear s e l f - p r o c l a i m e d " e x p e r t s " t e l l about the h o r r o r s of l o n g e v i t y — h o w a w f u l p h y s i c a l a g i n g - i n t o - o l d age w i l l be p e r s o n a l l y , or h o w w e o n the cusp of r e d r e m e n t w i l l b r e a k the b a n k by n e e d i n g too m u c h M e d i c a r e a n d S o c i a l S e c u r i t y . S o m e c o m m e n t a t o r s e v e n say t h a t people s h o u l d choose to die i n s t e a d . ( I c a l l t h i s the d u t y - t o - d i e c a m p a i g n . ) Y o u n g e r people o v e r h e a r t h i s , a n d it s k e w s t h e i r e x p e c t a t i o n s o f the f u t u r e a n d d i s h e a r t e n s t h e m . I t alienates t h e m f r o m people o l d e r t h a n they a n d f r o m the selves they w i l l one d a y b e c o m e .

PUSHING BACK TERROR AND DENIAL

A t the same t i m e , s o m e of us are t o l d that " 6 0 is the n e w 4 0 " a n d that " t h e B o o m e r s w i l l change e v e r y t h i n g to t h e i r l i k i n g . " T h e s e are the t w i n n a r r a t i v e s of age t e r r o r a n d age d e n i a l . Parts of these n a r r a d v e s are o u t - a n d - o u t silly, but too m u c h is m a l e v o l e n t .

E v e n w h a t is p o s i t i v e a n d t r u e c a n be t r u e o n l y o f i n d i v i d u a l s or a class of p e o p l e w i t h access to h e a l t h c a r e , a n d the a b i l i t y to m e e t o t h e r basic needs, r a t h e r t h a n o f e v e r y o n e o v e r a c e r t a i n age. O n e t h i n g is c e r t a i n : I n n o t h i n g , do people d i f f e r m o r e t h a n i n t h e i r aging. I n s h o r t , it m a k e s m o r e sense to fear a g e i s m , n o t aging.

T h e w a r against p e o p l e o v e r 5 0 changes e v e r y t h i n g f o r the w o r s e . I n m y state, M a s s a c h u s e t t s , m y D e m o c r a t i c g o v e r n o r w a n t s to raise the age of r e t i r e m e n t f o r p u b l i c e m p l o y e e s . U n i o n i z e d " B o o m e r s " i n g o v e r n m e n t s e r v i c e are t o l d t h e y are too costly. U n i n s u r e d p e o p l e f r o m 5 5 to 6 4 die at a h i g h e r rate t h a n any o t h e r age g r o u p o f u n i n s u r e d . R a i s i n g the age o f M e d i c a r e e l i g i b i l i t y w o u l d be d i s a s t r o u s . N o n e o f t h i s is to tny l i k i n g .

T h e r e i s , h o w e v e r , a b a c k l a s h against the cuts a i m e d at S o c i a l S e c u r i t y , M e d i c a r e a n d M e d i c a i d . I t h i n k anger is b u i l d i n g . A n d j u s t i f i e d anger c a n l e a d to a c t i v i s m .

T h e possibiUty e x i s t s of a n a t i o n w i d e c o a l i d o n f o r m i n g i n o r d e r to t r y to save a l l the safety nets: W 7 C (Women, Infants and Children), S o c i a l S e c u r i t y , M e d i c a r e , p u b l i c h e a l t h — a n d t h i s c o a l i t i o n i n c l u d e s a l l of those c o n c e r n e d f o r the v u l n e r a b l e . I t w o u l d a d d together f e m i n i s t s , u n i o n p e o p l e , A A R P (the n o n p a r t i s a n g r o u p f o r m e r l y k n o w n as A m e r i c a n A s s o c i a t i o n o f R e t i r e d P e o p l e ) , OWL (Older Womeii's League), s o - c a l l e d B o o m e r s a n d X e r s , w h o are alleged to be e n e m i e s i n a contrived war, a n d p e o p l e i n c o h o r t s n o t y e t n a m e d by m a r k e t e e r s , plus people y o u n g e r t h a n 4 5 a n d o l d e r t h a n 6 5 .

I f that c o a h t i o n became not o n l y p o w e r f u l but s e l f - c o n s c i o u s , it w o u l d h a v e to declare itself " a n t i - a g e i s t " i n o r d e r to s h o w h o w p o l i t i c a l l y i m p o r t a n t the n o - l o n g e r - s o - y o u n g are. T h i s c o a l i t i o n is c o n c e r n e d w i t h s o c i a l justice a n d the r i g h t to l i f e i n the broadest sense.

I n the U . S . s u c h a c o a l i t i o n c o u l d t h e n be a c c o m p a n i e d , I t h i n k , by a r e v o l u t i o n i n r e p r e s e n t a t i o n , m e a n i n g t h a t s o m e i n the m e d i a w o u l d h a v e to l o o k at w h a t t o p i c s t h e y i g n o r e a n d h o w they treat the issues they choose to c o v e r .

I A G E I S M A N D A D U L T I S M

FINDING STRENGTH

F o r e x a m p l e , i n H u r r i c a n e K a t r i n a , 64 p e r c e n t of the dead i n N e w O r l e a n s w e r e over 65, a l t h o u g h they w e r e o n l y 1 2 p e r c e n t of the p o p u l a t i o n , suggesting that o l d e r p e o p l e w e r e i g n o r e d i n disaster p l a n n i n g . M o s t i n the m e d i a d i d not n o t i c e age or a g e i s m . P r i o r to a disaster, there have to be d e c i s i o n s about " w h o c o m e s f i r s t a n d w h o comes l a s t . " . . .

O l d , f r a i l a n d disabled p e o p l e seem to be the c o l l e c d v e target o f a n e w eugenics r h e t o r i c . T h e " d u t y - t o - d i e c a m p a i g n " i m p l i e s that s u c h p e o p l e are l i k e l y to be a " b u r d e n , " u n w o r t h y o f r e s o u r c e s . I f y o u are n o t a c t i v e , engaged, p r o d u c t i v e , a u t o n o m o u s , close to the i d e a l h e a l t h y ( m i d d l e - c l a s s ) " y o u t h f u l " p e r s o n , y o u s h o u l d s o m e h o w b o w out. H o w ? A r e w e e x p e c t e d to c o m m i t s u i c i d e ? T h i s d i s m i s s a l c a n e v e n be e x p l i c i t l y age-graded; o l d e r p e o p l e o n d i a l y s i s m a y f a l l i n t o this useless category, especially if they have some c o g n i t i v e i m p a i r - m e n t , but not p e o p l e on d i a l y s i s u n d e r 6 5 . I f s o m e i n o u r society are u n a f r a i d to say s u c h t h i n g s , I fear f o r the rest of us. T r i a g e i n v o l v e s s p l i t - s e c o n d d e c i s i o n s , a n d bias is q u i c k e s t o n the d r a w . I n e m e r g e n c i e s the w o u l d - b e rescuers a n d society at large h a v e to p u t the neediest f i r s t if h u m a n l y possible.

T h e r e is an o n g o i n g debate i n age studies about w h e t h e r w o m e n a n d m e n age d i f f e r - ently, a n d I t h i n k they d o . W o m e n are aged by c u l t u r e y o u n g e r t h a n m e n . I w o r r y about h o w f o r c e d r e t i r e m e n t w i l l u n d e r m i n e m y o w n c o h o r t of w o r k i n g w o m e n , because they are l i k e m e n in one n e w w a y ; they h a v e gotten a l o t of s a t i s f a c t i o n o u t o f w o r k a n d e a r n i n g . A n d m i d l i f e job d i s c r i m i n a t i o n is w e a r i n g m a n y people d o w n , w h e t h e r they k n o w this is a c o l l e c t i v e p r o b l e m or not.

B u t because of the w o m e n ' s m o v e m e n t a n d f e m i n i s m , w o m e n h a v e at least one big a d v a n t a g e — a c c e s s to a m o r e generous b o d y of k n o w l e d g e a n d a m o r e p r o g r e s s i v e set o f attitudes about g r o w i n g past y o u t h . F e m i n i s t s i n p a r t i c u l a r are the first to get the p o i n t o f m y b o o k : to b e w a r e of a g e i s m , n o t aging. M o r e w o m e n s e e m to be l i k i n g " n a t u r a l " l o o k s a n d f i n d i n g v a l u e i n t h e i r a c c u m u l a t i n g e x p e r i e n c e . T h e y read Ourselves Growing Older. T h e y enjoy f e m a l e c o m p a n y , w h i c h is g o i n g to be v e r y i m p o r t a n t i n late h f e .

A m e r i c a n w o m e n are also t u r n i n g against p l a s t i c surgery. T h e n u m b e r of p r o c e d u r e s r e a c h e d a p e a k i n 2 0 0 4 (at 1 1 , 8 5 5 , 0 0 0 ) , a n d has d r o p p e d e v e r y y e a r s i n c e . In 2010 the total was down to 9 , 3 3 6 , 0 0 0 — a decrease of o v e r 2 0 p e r c e n t . B u t w h e n a New York Times's blogger d i d the a n n u a l story, she d i d n ' t t r y to f i n d the t r e n d h n e ; instead she used o n l y the s u r g i c a l a s s o c i a t i o n ' s latest o n e - y e a r data a n d a lead about a tise i n one p a r t i c u l a r s u r g e r y (breast e n h a n c e m e n t ) . M u c h depends o n the m e d i a .

J o u r n a h s t s a n d s c h o l a r s need to be m o r e c a u t i o u s a b o u t u s i n g releases or p u b l i c i t y f r o m the u g l i f i c a t i o n i n d u s t r i e s (surgeons, p h a r m a c e u t i c a l c o m p a n i e s , f a s h i o n m a g a z i n e s , e v e n y o u t h - f o c u s e d h e a l t h a n d fitness magazines) a n d the d y s f u n c t i o n i n d u s t r i e s (those s e l l i n g aids to p e o p l e s u p p o s e d l y d e c l i n i n g f r o m great y o u t h s e x ) . T h e y get r i c h by p e d d l i n g a n x i - ety about o u r d e f i c i t s . New evidence f r o m n o v e l s , s c h o l a r l y studies, a n d m e m o i r s c o m e s o u t f r o m time to time suggesting that sex can actually improve across the life c o u r s e . B u t any g o o d n e w s o n l y gets w h i s p e r e d a r o u n d because those i n d u s t r i e s are b l a r i n g o u r defects a l l the t i m e .

T h e n e w longevity, a l o n g w i t h A l z h e i m e r ' s t e r r o r , c o i n c i d i n g w i t h R e p u b l i c a n d e f i c i t h y s t e r i a — t h i s h i s t o r i c a l c o n j u n c t u r e is a l a r m i n g . I f o u r s o c i e t y c a n ' t m a k e a n t i - a g e i s m a n d a n t i - m i d d l e ageism i n t o a n a c t i v i s t m i s s i o n , the consequences f o r A m e r i c a n society are d i s a s t r o u s , e v e n l e t h a l . . . . C h a n g e w i l l take not o n l y r e s i s t i n g stereotypes but c h a l l e n g i n g the c u r r e n t d i s m a l p o l i t i c s of m i d l i f e e m p l o y m e n t a n d o l d age.