Ageism: Looking Back over My Shoulder

How the author originated the term ageism, and what he thinks now. I was aware of ageism before it had a name, conscious as I was of being different from other boys by virtue of having older "parents" who, in fact, were my grandparents. Here is a brief history of my encounters with this self-destructive prejudice. MEDICAL SCHOOL: ENCOUNTERS WITH AGE PREJUDICE As a medical student I was dimly aware of Henry Simms, a scientist with a reputation for being odd because he was interested in exploring how cells age. More vividly, I remember my shock upon hearing a variety of words in the cruel medical lexicon, generally unknown to the public, that reflect negative attitudes toward patients, especially older patients: "crock" to describe older people and middle-aged women, "GORK" (God only really knows), "GOMER" (for get out of my emergency room), "vegetable," and "SPOS" (for Special Piece of S___). One night during my internship, the charge nurse called me to look in on a 72-year-old man who had become agitated. I prescribed a dose of seconal to calm him down, but he became even more agitated and was transferred to Bellevue, the city's mental hospital. I searched the literature to try and understand why the patient had responded in this unusual way to a sedative and discovered that older people, particularly those with dementia, are prone to have paradoxical responses to drugs and may become agitated when sedated. But this lesson was never taught. STUDIES IN THE FIELD In 19551 became deeply involved in research on aging at the National Institute of Mental Health. Some of my old friends and colleagues questioned the wisdom and logic of my choice, and one jokingly called me a necrophiliac. My group included James Birren, Louis Sokoloff, Samuel Greenhouse, and Marian Radke-Yarrow, now recognized as pioneers. Along with Ewald Busse's group from Duke University, we studied healthy, community-resident older people from 1956 to 1966. We concluded that much that was attributed to aging is, in fact, a function of diseases such as AlZheimerX social adversity, and even personality traits. For example, a person does not have to be a centenarian to be a hypochondriac. We also concluded that so-called senility is not an inevitable function of aging but rather of diseases that should be studied. Thus, in 1975, when I became the founding director of the National Institute on Aging, I decided to name Alzheimer's disease a major national priority. In 1960, having listened with great interest to healthy elders who resided in the community, I realized the inaccuracy of the idea that old people are boring and garrulous, and that they simply repeat life stories. I recognized that something important was going on-reminiscences and life review-and that along with devaluing older people, our ageist culture was devaluing their memories. I worked in nursing homes during the 19505 and 19605 and observed how residents were effectively stripped of their identity because the information about them provided to the staff failed to include background, work history, ethnicity, or religion. I came to the conclusion that to call these institutions "nursing homes" was, in many cases, a misnomer: In the first place, most had no nurses, and, in the second place, the institutions had not earned the right to include in their name the warm and inviting word home. Not only were nearly a million older persons tucked away and made invisible in these facilities, with anodier million in personal-care homes or boarding houses, but their poverty was invisible as well. Too proud to seek such public assistance as Supplemental security Income (ssi), Medicaid, or food stamps and put off or confused by the bureaucracy, dicy were often physically or psychologically unable to gain access to appropriate transportation. I am distressed that, fifty years later, only one of ten nursing homes meets basic federal staffing standards. …