Lisa Spencer

doi:10.19080/JOJPH.2024.09.555757

Opinion Article

Opinion Piece: Does Ageism Exist in Nursing Homes? If So, What Are Some Strategies to Mitigate This Problem

Lisa Spencer*

DHA, Associate Professor of Long-Term Care, University of Hawaii-West Oahu, Doctor of Health Administration, USA

Submission: July 08, 2024; Published: August 08, 2024

*Corresponding author: Lisa Spencer, DHA, Associate Professor of Long-Term Care, University of Hawaii-West Oahu, Doctor of Health Administration, USA. Email: lisaspen@hawaii.edu

How to cite this article: Lisa Spencer*. Opinion Piece: Does Ageism Exist in Nursing Homes? If So, What Are Some Strategies to Mitigate This Problem. JOJ Pub Health. 2024; 9(2): 555757. DOI: 10.19080/JOJPH.2024.09.555757

Keywords: Acute-Care; Long-Term Care; Ageist Behaviors; Mitigate; Infantilizing Communication; Nursing Homes

Introduction

Working in nursing homes, where the average age of consumers is 85 years old, with 82% of the residents over the age of 65, one could speculate that the care providers are very familiar with ageism and how to prevent this in the work environment [1]. Staff are hired and trained to be courteous to the elderly resident and treat everyone with dignity and respect. In this essay, I discuss the theory of ageism and, through previous research, analyze whether ageism exists in nursing homes, and more generally, long-term care environments. Once I determine if ageism exists, I will provide strategies nursing homes can implement to mitigate this problem thereby creating a more resident-centered, homelike environment where the elder’s values and preferences are considered and respected. The theory of ageism refers to systematic discrimination toward a group of people based on chronological age. Ageism is the stereotyping of and discriminating against individuals. Because they are old [2]. Ageism occurs in all facets of American culture from the media to business to health care [2]. Examples of ageism can be found in the health-care environment; in acute-care and long-term care [3]. Ageist behaviors among health-care providers affect. Communication and access to health-care services [3].

Ageism in long-term care, i.e. nursing homes, looks quite different, when compared to acute care, primarily because the expectations of the elderly residents and staff in the nursing home are different [3]. Many residents accept the perception that, because they are old, they are frail, unable to care for themselves, and need nursing home care when other options, i.e. assisted living or aging in place, might be better, more viable, choices. This self-reflective attitude is further supported by the actions of the nursing home staff who justify the residents’ living arrangements, while failing to ensure the care provided promotes the resident’s highest practicable level of well-being. Making decisions for the resident or providing care instead of allowing the resident time to decide or complete tasks themselves, decreases the residents. Abilities over time thereby increasing their dependency on nursing home staff and decreasing their inability to care for themselves. This further reinforces the ageist attitude that the elderly need assistance and belong in the nursing home. Beyond providing services based on ageist stereotypes of the elderly, communication is another aspect that can be affected by ageism.

A study conducted by Legace, Tanguay, Lavallee, Laplante, and Robichaud [4] of 33 elders living in long-term care facilities in the province of Quebec found many of the elders interviewed perceived their communication with staff as ageist and that this interaction diminished their quality of life and well-being in the facility. Controlling and authoritative language and attitudes, infantile patterns of communication, not being listened to or completely ignored, were among the descriptions elders used to describe ageist communication among care providers [4]. Interestingly, the study also found, many of these elders coping with ageist communication by accommodating the caregivers, further reinforcing the pattern of ageism within the facility [4]. A related study by Williams, Shaw, Lee, Kim, Dinneen, et al. [5] concluded that elderspeak (infantilizing communication), a form of ageism, was linked to resistiveness to care in nursing home residents with dementia. A secondary analysis of 80 video- recoding transcripts from a NIH-funded study of staff-resident communication during daily care activities supported the conclusion that elderspeak and language systematically diminishes. The competence of the elderly leads to withdrawal, depression, reduced self-esteem, and continued dependency on staff, further promoting the stereotype of aging residents in nursing homes [5].

So, what should be done about the ageist treatment of residents in nursing homes? First, building awareness and educating staff on ageism. Activities that reflect on an individual’s prejudices and/or stereotypes about the elderly or those residents living in the nursing home might be a good indicator of what might be impacting their relationship with residents. Second, ask residents how they are being treated and educate them on ageism and acceptable behavior and treatment by the staff. Third, monitor the interactions between staff and residents and address any situations that are either ageist or can lead to ageist actions. Having staff monitor one another is a good way of helping staff recognize these situations and problem-solve a better opportunity to improve interaction. Ageism and ageist attitudes can cause residents in nursing homes to feel depressed, withdrawn, and lose their sense of well-being and quality of life. Our role as nursing home staff, and long-term care providers in general, is to base our care on person- directed values and practices ensuring their voices are heard, considered, and respected.