Welcome to the WA Country Health Service and WA Primary Health Alliance Ageism module. This module has been developed by funding from the Australian Government Primary Health Network (PHN) Program.
This learning resource has been produced to facilitate awareness of ageism and promote positive change in how we think about ageing and what it means to be an older version of ourselves. Ageism and stereotypical views of older people can lead to prejudiced attitudes, devaluing older people and social exclusion.
This module addresses the issue of ageism towards older people; the negative attitudes towards getting older and towards older people; the different categories of ageism and it explores how we carry our personal beliefs, experience and perceptions about ageing and how people can be better supported to age healthily in place.
Questions about this resource can be directed to the WACHS learning and Development team by email to WACHStraining@health.wa.gov.au. Feedback can be provided via the evaluation link at the end of this product.
This program is appropriate for all levels of staff working across the continuum of care in health and for any community members. It supports healthy ageing, addresses prevention and aims to improve attitudes towards ageing to support better health outcomes for older people.
This module will help you identify, understand and challenge ageist beliefs and behaviours as they occur in your home, workplace or community.
On completing this module, you will be able to:
Ageism, like other “isms,” is prejudice and discrimination against individuals or groups because of age. Unlike other “isms,” however, ageism is something many of us will experience at some time in our lives.
‘Stereotyping and discrimination against individuals or groups on the basis of their age; ageism can take many forms, including prejudicial attitudes, discriminatory practices, or institutional policies and practices that perpetuate stereotypical beliefs.’
Ageist beliefs and behaviours can be:
Take the two-minute Am I Ageist Quiz to find out (this will take you to an external website).
This module aims to promote positive attitudes toward older people. Select the most appropriate ending to each of the concept statements below:
Click on each person in the community to listen and work through their stories.
Remember that ageism can be interpersonal, institutional or internalised. Drag each example below into the relevant box on the right.
Ageism is associated with poor self-image, loneliness, reduced civic engagement and more frequent help-seeking. At a societal level, ageism can influence policies that, without intending harm, can marginalise older adults, pushing them aside, so we no longer benefit from their participation in society.
Watch the short video below to hear how ageism impacts on Jeanette's experience of Alzheimer's.
Click on each person in the community to listen and understand possible impacts of ageism.
Click on each person in the community to challenge ageism and apply concepts of positive ageing.
You may have noticed that as you progressed through this module, the community depicted in the images became more vibrant - with more places for all generations to sit, socialise and live life to the fullest. There are many ways our communities could be more liveable, safer and more compassionate.
Watch the short video from the Compassionate Communities workshop below for ideas on how to build a better community.
Imagine a world where all older adults are respected and included.
1. Select a setting where you would like to see positive approaches to ageing applied:
2. Choose some of the positive approaches on your list and describe how they would look.
3. What one thing will you commit to doing to challenge ageism?
You have passed the module - but you're not quite finished!
Launch and complete the reflective practice activity tool to:
Congratulations! You have successfuly completed this module on challenging ageism. Before you exit the module you might like to:
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Video transcript:
Jude is an 84-year-old woman who has been receiving treatment for angina for the last two years.
She has an appointment with her doctor for bunion surgery and because of her angina, Jude is sent for a heart scan. The scan shows Jude has a leaky valve, not angina.
Jude asks her doctor about heart valve surgery. Her doctor replies “What are you bothered about? At your age?”
Jude sticks to her guns and the surgery is organised.
Ageing is a natural and lifelong process of growing and developing. It is a process of progressive change in an individual’s biological, psychological and social structures. Many health professionals show bias and negative attitudes towards older people. Reasons for this include anxiety around death and a general disinterest in the ageing process.
Video transcript:
Li Wei is a 94-year-old Chinese man who presents to his local hospital emergency with high fever and confusion. He is accompanied by his wife, Yang.
Because of his confusion, Li Wei finds it difficult to answer questions about his symptoms, his medical history and the medications he’s currently taking. His wife, Yang, has limited English and is unable to answer their questions.
The staff do not follow up on Li Wei’s medical history and no interpreter is arranged for Yang to tell them about his existing conditions and medication.
After two hours waiting and without any further investigation, Li Wei is sent home with antibiotics.
A holistic approach to treatment and care of the older person should be adopted, which focuses on improving and preventing deterioration in their health.
Video transcript:
Amy is a 75-year-old Aboriginal woman, who lives on an outstation community. She visits the local community mobile clinic for a routine health check.
When Ben, the new Remote Area Nurse, asks Amy questions about her health, she looks at the ground and answers quietly in language.
Ben assumes Amy has dementia. He continues with the health check, speaking to Amy in clear and simple English - just like he would with his 3-year-old son.
Assuming someone has dementia just because you can’t understand them is an example of ageism; dementia is not a normal part of ageing.
Video transcript:
Mark is a fit and healthy 75-year-old cyclist. He’s had few medical conditions over his life and rarely visits the doctor.
Mark’s best friend, Tony, has recently been diagnosed with bowel cancer. Shaken by his friend’s diagnosis, Mark looks into getting a free bowel cancer test.
When Mark goes to order his bowel cancer screening kit online, he finds out an age limit applies and people over 74 (without symptoms) aren’t eligible for a free screening.
One of the most explicit forms of age discrimination in healthcare is the age limits applied to screening programs. This is often justified by the ageist belief of how healthcare resources should be allocated.
All health professionals have access to complaints procedures, through which alleged instances of institutional ageism can be highlighted and addressed. Check your organisation's complaints procedures to explore the options you have to take action. Remember that policies and programs are often reviewed, so your input is important.
Video transcript:
Beth is an 82-year-old woman living at home. She presents to a locum GP with lethargy, lack of appetite and a sore back.
Beth tells the GP that she’s feeling “foggy and forgetful” but that “it’s probably just old age”.
The GP nods, smiles and prescribes an anti-inflammatory medication for Beth’s sore back. She doesn't review her medication or run a urine screen.
Health professionals sometimes make assumptions about a diagnosis, based purely on a patient's age and condition. Would they conduct more thorough screening with a younger patient? If so, this behaviour could be seen as ageist.
Video transcript:
Bill is a 77-year-old man who lives with dementia and mobility issues in a residential facility.
After activities one day, Bill is left in a recliner chair in the common area for two hours.
The common area is loud and bright and as the time passes, Bill is increasingly confused.
Bill wants to get out of the chair but is unable due to his limited mobility. He calls out to a care worker walking past. The care worker doesn’t come to help. Bill becomes increasingly agitated.
Health and well-being are determined not only by our genes and personal characteristics but also by the physical and social environments.
Video transcript:
Claire is a 55-year-old woman living in a lifestyle village who has recently been diagnosed with breast cancer.
Claire’s specialist has told her she will need to have a mastectomy.
Claire can’t imagine life without her breasts. She has always loved wearing low-cut tops as they make her feel sexy.
She asks her specialist whether a lumpectomy is an option. He replies “Why would you want this? You are too old for it to matter.”
Claire insists that her breasts are very important to her and they proceed with a lumpectomy.
The assumption that sexuality is not important to older people is one of the most common forms of ageism. This type of ageism tends to affect women more, as women tend to be viewed as less valuable or ‘desirable’ as they age.
Video transcript:
Jude is an 84-year-old woman living in aged care facility. She has just seen her doctor about heart valve surgery.
When Jude returns home from her appointment, she finds a beautiful bunch of flowers in her room.
Jude doesn’t need to look at the card to know who the flowers are from. Over the last few months, a romance has blossomed between her and another resident, Sam.
Jude and Sam would like to spend time alone together, however there is nowhere for them to have privacy.
It is often assumed that older people are not sexual or sexually active. This is a myth. Many older people are still sexual or sexually active well into their 80s and even 90s.
Good health in older age is not just the absence of disease. Aged care facilities must balance privacy and sexual expression with care and observation.
Video transcript:
Li Wei is a 94-year-old Chinese man, who has presented to emergency with fever and confusion.
Li Wei has called his 60-year-old daughter, Zhi Zhi, to come in from work and to help translate.
Together with the doctor, they discuss the option of Li Wei moving into residential care.
The doctor looks at Zhi Zhi and adds: “Or it might be time to retire and look after your dad yourself. There are so many young people out of work these days.”
The doctor's comments leave Zhi Zhi feeling disrespected, however it's nothing she hasn't heard before.
Employment gives many older people a sense of meaning and purpose, however employment discrimination is one of the most common examples of ageism. This is based on a myth that older people need to ‘make way’ for the younger generation, however, research has shown that mandatory retirement ages do not help create jobs for youth.
Video transcript:
Amy is a 75-year-old Aboriginal woman who is being seen by Ben, a new Remote Area Nurse.
Things didn’t get off to a good start when Ben assumed Amy had dementia.
Ben continues asking Amy about her health. When he asks her how frequently she has dialysis, Amy realises that Ben doesn’t know anything about her.
Had Ben read the info he was given about Amy during his induction, he would have realised that Amy has a heart condition, and that there is nothing wrong with her kidneys.
Older people are diverse in age, cultural background, marital status, incomes etc.
Video transcript:
Mark, a fit and healthy 75-year-old man, has gone to see his physiotherapist after a minor cycling injury.
While waiting for his physio, Mark takes out his phone to catch up on the news of the day.
Mark sees a news report on ‘corpses found in nursing home’ due to a recent pandemic. He puts his phone away and instead, picks up one of the cycling magazines from the waiting room table.
The media, including advertising, plays a significant part in forming negative community attitudes towards ageing.
Video transcript:
Beth, an 82-year-old woman living at home, has recently seen her GP for lethargy, lack of appetite and a sore back.
The GP prescribed anti-inflammatories but didn’t do a urine screen or medication review.
Beth still feels acutely unwell and is admitted to emergency.
They find gastritis (from the anti-inflammatory that she was taking on an empty stomach). Beth is treated with antibiotics and her medication changed.
Older people should receive care and treatment in the right place, at the right time and in the right setting.
Video transcript:
Bill is a 77-year-old living with dementia and mobility issues in a residential facility.
He has been left sitting in a recliner chair for two hours and he has finally got the attention of one of the care workers to let them know he needs to go to the bathroom.
The care worker comes over to him and asks, “What’s wrong, sweetie?”
Speech is powerful: the stereotypes and infantilisation of older people through use of patronising language affects their self-esteem.
Have you ever called an older person 'sweetie'? Although terms like ‘dear’ and ‘sweetie’ are mostly used with good intentions, they can lead to more negative images of ageing, and those who have more negative images of ageing have worse functional health over time, including lower rates of survival.
Video transcript:
Claire is a 55-year-old woman, who had a lumpectomy after a cancer diagnosis.
Claire recovered quickly from her surgery and was able to continue living her life with gusto.
Three years after her surgery, Claire gets very sick and her health deteriorates suddenly.
Claire visits her GP who tells her not to worry, ‘it’s just ageing’.
For the next six months, Claire is in and out of hospital.
Poor health in old age is not inevitable.
Age discriminiation can lead to palliative conditions being missed. The older person may then spend unnecessary time in and out of emergency instead of being admitted to hospice care, which would provide them with more holistic care and comfort.
Video transcript:
Jude is an 84-year-old woman living in an aged care facility.
Jude is going to the toilet before bed one evening and as she leaves the bathroom, her dressing gown catches on the door handle. She loses balance and falls to the floor.
Jude can’t get herself up so presses her call button. When the nurse arrives, he asks Jude if anything hurts and when Jude says no, he proceeds to help her up and back to her chair. He checks Jude is not injured. Jude says she is a little shaken up but nothing hurts.
Jude asks the nurse not to tell her daughter that she’s had a fall: “It was me being clumsy and she’ll just worry”.
Jude’s daughter visits the next day and whilst chatting to the nurse in the lift, she hears that her mum had a fall the night before.
Video transcript:
Li Wei is a 94-year-old Chinese man who has presented to emergency with high fever and confusion.
The doctor attending to Li Wei notices that this is his second visit to emergency in two weeks.
Li Wei is accompanied by his daughter Zhi Zhi. The doctor directs all his questions to Zhi Zhi, who redirects them to Li Wei - who attempts to answer despite his confusion.
The doctor asks further questions of Zhi Zhi about Li Wei’s home situation. Although Li Wei has never had a fall, the doctor advises Zhi Zhi that Li Wei should go into care “in case he has a fall”.
Video transcript:
Amy is a 75-year-old Aboriginal woman who is being seen by Ben, a new Remote Area Nurse.
Ben knows that Amy has had trouble paying her electricity bill.
When Ben asks why, Amy says that her family have been ‘humbugging’ her.
Amy looks distressed. She is scared of losing her family if they find out she’s told him. She urges Ben not to say anything.
Video transcript:
Mark is seeing a physiotherapist after a minor cycling injury.
The physio glances at Mark’s file and comments that he is “surprisingly old”.
He asks Mark about his injury, checks his responses and declares Mark’s flexibility is “good for his age”. He gives Mark minimal treatment.
Mark speaks up – he would like to work on his fitness, get back to cycling and return to his role as an emergency services volunteer in his community.
Video transcript:
Beth, an 82-year-old woman living at home, has recently been in hospital.
Beth is recovering at home when a health worker comes to see her.
The health worker chastises Beth about her cold house, “Why don't you old folk ever use your heating?” and tells Beth she “should be wearing a sensible tracksuit” rather than her favourite dress.
As the health worker takes Beth’s temperature, she shakes her head and says, “That's why you got so sick in the first place.”
Video transcript:
Bill is a 77-year-old man living with dementia and mobility issues in a residential facility.
A resident in the facility tests positive for coronavirus infection and it is not long before Bill is also infected.
Bill and the other residents are refused hospital admission.
Bill becomes increasingly distressed by the effects of his symptoms and his isolation from family and other residents.
Without Bill’s or his family’s consent or consultation, chemical restraint - including morphine and anti-psychotics - is used to manage Bill’s distress.
Video transcript:
Claire is a woman whose breast cancer has recently returned.
Claire is told her cancer is terminal and is moved into palliative care.
She talks to the care staff about having a small ceremony to marry her long-term girlfriend.
The palliative care staff make a joke that it’s a “shame there aren’t enough old men to go around”.
The idea that one group is better than another and gives permission for people to disrespect or mistreat individuals in the other group (e.g. jokes, slurs, stereotypes, threats, physical abuse, bullying).
For example, telling someone that they are "too old to wear that" is a form of interpersonal ageism.
The idea that one group is better than others rooted in institutions – laws, legal system, police, schools, health, employment, housing, media images, politics - so that discriminating or unequal practices are implemented.
For example, implementing mandatory retirement ages is a form of institutional ageism.
The idea that one group is better than others becomes internalised so that people start to believe the stereotypes, prejudice and negative messages about themselves (e.g. being weak, incompetent or worthless).
For example, uploading an old photo as your profile picture in order to appear younger is a form of internalised ageism.
LMS Code: AC20 EL2
Published: December 2020
Last Rev: March 2022
This module is supported by funding from WA Primary Health Alliance through the Australian Government’s PHN Program.
This learning resource has been produced to facilitate awareness of ageism and promote positive change in how we think about ageing and what it means to be an older version of ourselves. Ageism and stereotypical views of older people can lead to prejudiced attitudes, devaluing older people and social exclusion.
This module addresses the issue of ageism towards older people; the negative attitudes towards getting older and towards older people; the different categories of ageism and it explores how we carry our personal beliefs, experience and perceptions about ageing and how people can be better supported to age healthily in place.
Questions about this resource can be directed to the WACHS learning and Development team by email to WACHStraining@health.wa.gov.au. Feedback can be provided via the evaluation link at the end of this product.
This program is appropriate for all levels of staff working across the continuum of care in health and for any community members. It supports healthy ageing, addresses prevention and aims to improve attitudes towards ageing to support better health outcomes for older people.
These are the seven characters you will encounter when working through this module.
You will listen to their stories, reflect on their experiences and use these reflections to address examples of ageism in your home, workplace or community.
Estimated time to complete: 60 minutes
LMS Code: AC20 EL2
Published: December 2020
Last Rev: March 2022