The Impact of Ageism in Senior Living by Cynthia Thurlow

As a culmination of 3rdPlus' recognition of Anti-Ageism Day 2023, Saturday, October 7, we are sharing some national observations about how "benevolent ageism" could impact your senior living community's business and resident psyche.?

We all know that ageism is a pervasive issue that affects young and old. In most of its forms, ageism is entirely unintentional, and in fact, it can be well-meaning.

At 3rdPlus, we talk a lot about how ageism is at play in senior living communities and can negatively impact their financial success. Among the types that negatively affect senior living communities are internalized ageism and benevolent ageism.

"Benevolent ageism" is expressed through paternalistic beliefs or behaviors that older people need to be protected and taken care of by younger people because they can no longer make decisions for themselves.

Examples of benevolent ageism include "elder speak," when an older adult is addressed as though they are much younger and can't make decisions on their own — the voice may rise to a higher pitch. Simple words are used and spoken more slowly as if speaking to a child.

At the ancient age of 59, I experienced this a few weeks ago at a restaurant. A well-meaning, high school-aged hostess called me "hon" and told me to "watch your step" as I crossed a minor threshold onto a patio. I wasn't bothered by it and moved on, but it's a? perfect example of benevolent ageism. Perhaps it's a script running in her head for anyone older than 40!

So, how is ageism negatively affecting your senior living business? Let us count the ways:

1. Branding, Lead Generation and Marketing: For too long, advertising agencies in the senior living space have been getting away with simply using stock photos of older people and cookie-cutting other client's materials to create a brand and then market. This triggers internalized ageism in the prospective target audience. Internalized ageism is the "fear of the future self." For baby boomers, based on research, staying out of the nursing home is their number one goal. Fear of the nursing home is visceral. Therefore, showing older adults in often vulnerable positions (such as getting a hug or being touched by a stranger) triggers internalized ageism and makes your prospects look away. Benevolent ageism is at play when communities proudly state, "We only show our residents!" in their advertising. They'll spend large sums of money to create a photo library of their residents, which triggers the internalized ageism in your target market. Contrast that approach to other business sectors like the hotel industry. How many Four Seasons Hotel advertisements do you see with the "real hotel guests" at the swimming pool? Or up front and taking up the frame of their advertising without context to the environment? Therefore, unintentional ageism may be affecting your census in some way or another.
2. Assisted Living Transitions: For most clients, encouraging independent living residents to feel excited about moving to assisted living is difficult. The following list outlines where ageism is at play here too.

• The apartments are tiny. Because a person needs assistance, why must they suddenly live in a minuscule apartment? That in itself feels like the "end of the road."?
• Consuming adult beverages is often prohibited in assisted living. Avoiding alcohol is entirely understandable for those with medical reasons. However, that should not prohibit everyone from enjoying a ritual they have probably partaken in since their 20s.
• "They don't knock." I've often heard this in focus groups when assisted living residents state their concerns about having privacy in their assisted living apartments. Would we barge into a 30-year-old's apartment? I don’t think so.
• Dining quality tends to decline significantly when moving from independent to assisted living. Ironically, this is when dining experiences become more crucial as we lose the ability to drive and search for excellent food. However, suddenly, the food seems to cater to the least adventurous taste buds, and the service and presentation also deteriorate.
• Activities are matched to the least cognitively healthy residents rather than offering a robust engagement program.?
• It is evident to the residents when there is a noticeable difference in the amenities available between the independent living side and other areas of the campus. This segregation creates a significant challenge.

3) Dining in Skilled Nursing: Skilled nursing is based on an outdated approach that made being "old" associated with being "infirm." Thankfully, assisted living has become the solution for many people, providing a more residential environment. But for those who must reside or rehab in skilled nursing, the worst expression of ageism is treating dining as simply "feeding people" instead of providing a quality dining experience. This example is pure ageism combined with ableism. Akin to assisted living, there is primarily one thing to look forward to daily: meals when living in skilled nursing.?

4) Benevolent Ageism in the Sales Process: Benevolent ageism is also expressed during the sales process in senior living communities by the sales counselor who creates the experience for the consumer.? Sales counselors usually build the initial relationship by asking questions about health, limitations and special needs with an assumption of care needs.? There are different needs associated with independent and assisted living, but the person is the same.? An open compassionate objective conversation about their current lifestyle, joys, interests, and concerns respects them as an individual.? Approaching the prospect as a person first and not a senior builds a stronger relationship creating a “trust bank”. You can draw from this to ask more difficult personal and financial questions. This encourages them to go through the discovery process with a positive outlook on the community being considered due to the lifestyle opportunities available instead of a place that will care for them until they pass.? Benevolent Ageism often occurs when the adult child thinks they know what is best for their parents regarding care, location, or possibly price.? The adult child may interject and answer questions that are directed to the parents without allowing the older adult to express what is important to them.?

Some adult children experience internalized ageism because the life they have always known with their parents are changing.? The family gatherings, financial availability, and basic structure of the family is now not like they used to be. The adult child must now deal with their own mortality.? It’s important to make all involved in the decision feel like a Hero helping with the process! Yet the research clearly shows that we are all harmed by ageism. For instance, holding a negative attitude about your aging can shorten your life by up to 7.5 years, increase your risk for chronic disease, and reduce your ability to recover from a serious illness.?

Ageism is strikingly similar to other forms of discrimination, such as racism and sexism. Just as racial or gender discrimination erodes self-esteem and creates feelings of self-doubt and insecurity, internalized ageism can do the same for individuals as they grow older. People begin to believe the stereotypes associated with aging – that they are less capable, less valuable and less relevant.

One of the most difficult things about ageism is that it can be subtle and internalized. It starts with negative thoughts about oneself, such as "I'm too old to begin something new" or "I'm not as smart as I once was." These harmful self-perceptions can become true and limit one's confidence and ambitions.

The impact of internalized ageism extends beyond individuals and affects society at large. Older adults may feel less motivated to pursue active and engaged lifestyles when they internalize these biases. This can result in social isolation, decreased physical and mental health, and a reluctance to seek opportunities for personal growth.

Moreover, our society suffers when older adults are marginalized and excluded. This demographic's vast reservoir of wisdom, experience and potential often goes untapped. Ageism perpetuates a culture that dismisses the value of seniors, leading to fewer opportunities for intergenerational learning and collaboration.

On National Anti-Ageism Day 2023, it's important to start having conversations about unintentional ageism in senior living communities. By identifying any blind spots and turning them into opportunities, businesses can win more customers and earn the loyalty of their current residents, making them feel more respected and empowered to live their best lives.

Another huge opportunity is seeing your community as a “culture editor.” Doctors are culture editors as well as teachers. Senior living communities are major culture editors. The market perceives every communication your organization puts out. You can change the perception of aging from a sad time to a very cool time when people are becoming more of themselves and bringing their lives to completion. That is a success.

I’m approaching sixty now, and sometimes, when I see my reflection in the mirror, I think, “Oh my God. Who is that?” That’s because I still see myself at the age of 30-ish.?

Fear of getting older is also deeply intertwined with internalized ageism. Society has an obsession with youth and a fear of aging, perpetuated by advertisements, media and cultural norms. This fear can lead individuals to engage in age-denying behaviors, from excessive use of anti-aging products to avoiding discussions about retirement and end-of-life planning.

Overcoming internalized ageism requires a collective effort. It begins with recognizing and challenging ageist beliefs and stereotypes. Embracing the diversity and potential of individuals at all stages of life can reshape societal attitudes and empower people to age with confidence and dignity.

In conclusion, ageism in all its forms including benevolent and internalized ageism take a toll on the American psyche, affecting self-esteem and self-perception as individuals age. It also hinders our society's ability to harness the wisdom and contributions of older adults. Combating internalized ageism demands a shift in mindset and a commitment to valuing and empowering people of all ages. It's time to redefine aging as a period of growth, wisdom and continued possibility.