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Ageism in Current Practice: Experiences of Occupational Therapists
Abstract
This study examined the perceptions of gerontological occupational therapists and their experiences with ageism in their practice. Sixteen gerontological occupational therapists participated in this interpretive inquiry study. Semistructured interviews along with written responses to focused questions were used to obtain the data. Constant comparative analysis of transcripts and written responses generated themes. Two contextual influences impacting the work experience were noteworthy: (a) person-level (i.e., societal, colleagues, clinicians themselves) attitudes and values and (b) organizational constraints. Findings indicated participants perceived a presence of covert discrimination toward seniors, health professionals who work with seniors, and the organizations that provide service to this population. Participants recognized ageism within their own behaviors. The presence of ageism and its impact were examined in three areas: attitudes within our profession, occupational therapy discourses, and finally resource allocation within health care. The findings from this study may help practitioners examine ageism in their practice.
... OT education programs must address ageism to combat ageism in practice. Life review allows students the ability to reflect on their attitudes toward older adults and how those negative attitudes can influence clinical care (Klein & Liu, 2010). ...
Background: Addressing student ageism is essential for promoting desires to work with older adults, but little is known about how life review intervention, used as an educational tool in OT programs, can affect ageism. This study aimed to explore the effect of life review on OT students’ ageism perceptions and desires to work with older adults. Design: A qualitative focus group research approach was performed. Method: Thirty entry-level occupational therapy students from a Texas university were used as a convenient sample. After participating in a 4-hour workshop, students conducted a life review with older adult volunteers. Data was collected during a focus group using audio-recording and field notes. A thematic approach to analysis was used including Dedoose web-based software with a code-recode procedure by 2 raters. Measure: A focus group was conducted 2-weeks after the intervention using a semi-structured interview guide with 4 open-ended and 7 probing questions to elicit in-depth discussion of the life review experience. Results: Four themes emerged related to the intervention: (1) experience influenced attitude; (2) preconceived ideas changed; (3) finding similarities and commonalities, and (4) reflective insight. Conclusions: To impact ageism and desires to work with older adults, students should participate in life review experiences during program education.
... In this sense, a critical and reflective vision of the ideas that health professionals have about the elderly is relevant. This is not alien to the practice of Occupational Therapy as shown by different researches: age discrimination is also seen in attitudes and speeches in the practice of Occupational Therapy (Klein & Liu, 2010) and can be found in the undergraduate students (Friedman & VanPuymbrouck, 2021). ...
Introduction In Chile there has been an accelerated process of aging of the population while prejudices towards older people are maintained that can limit their autonomy and social participation. In this context, health measures were applied due to the COVID-19 pandemic that limited daily activities, especially in people over 75 years of age. Objective To describe and analyze the repercussions of the measures adopted in Chile due to the COVID-19 pandemic on the daily activities of people over 75 years old in relation to autonomy and social participation and analyze them from the framework of Occupational Justice. Method Qualitative and descriptive research with a narrative research design. Semi-structured interviews were conducted through video calls to nine people over 75 years of age, residents of different communities in Chile who have been in quarantine during the year 2020. Results The measures forced older people to modify their routines, affecting the range of occupations they previously carried out, causing social isolation, feelings of loneliness and a decrease in autonomy, mainly due to dependence on carrying out procedures through technological devices. Most of the interviewees consider that the specific measures for them were exaggerated, poorly contextualized and did not consider the heterogeneity of this age group. Conclusion The measures adopted for people over 75 years of age have deepened stereotypes typical of ageism that were previously present. This has implied an occupational deprivation that, however, has led the participants to seek adaptation strategies that realize their potential.
... Esto no es ajeno a la práctica de Terapia Ocupacional tal como lo demuestran diversas investigaciones: la discriminación por edad también se ve en actitudes y discursos en la práctica de Terapia Ocupacional (Klein & Liu, 2010) y se puede encontrar en estudiantes de la carrera (Friedman & VanPuymbrouck, 2021). ...
Resumen Introducción En Chile se ha dado un proceso acelerado de envejecimiento de la población a la vez que se mantienen prejuicios hacia las personas mayores que pueden limitar la autonomía y participación social de éstas. En este contexto se aplicaron medidas sanitarias por la pandemia por COVID-19 que limitaron actividades cotidianas, en especial en personas mayores de 75 años. Objetivo Describir y analizar las repercusiones de las medidas adoptadas en Chile por la pandemia de COVID-19 en actividades cotidianas de personas mayores de 75 años respecto autonomía y participación social y analizarlas desde el marco de Justicia Ocupacional. Metodo Cualitativa y descriptiva con un diseño de investigación narrativa. Se realizaron entrevistas semiestructuradas a través de video llamadas a nueve personas mayores de 75 años residentes de distintas comunes de Chile que hayan estado en cuarentena durante el año 2020. Resultados Las medidas obligaron a las personas mayores entrevistadas a modificar sus rutinas afectando la gama de ocupaciones que antes realizaban, ocasionando aislamiento social, sentimientos de soledad y una disminución en la autonomía, principalmente por la dependencia para realizar trámites mediante dispositivos tecnológicos. La mayoría de los entrevistados considera exageradas y poco contextualizadas las medidas aplicadas a personas de su edad. Conclusión Las medidas adoptadas para personas mayores de 75 años han profundizado estereotipos propios del edadismo presentes de forma previa. Esto han implicado una privación ocupacional que, sin embargo, ha llevado a los participantes a buscar estrategias de adaptación que dan cuenta de sus potenciales.
... In healthcare settings, professionals report a shared stereotypical perception of older patients as low-value, difficult, and boring. This results in Downloaded from https://academic.oup.com/gerontologist/advance-article/doi/10.1093/geront/gnaa119/5899780 by guest on 08 October 2020 A c c e p t e d M a n u s c r i p t professionals working with older people experiencing structural ageism in resource allocation among patient groups (Klein & Liu, 2010;Samra et al., 2015). ...
Background and objectives:
This review investigates the contribution of discursive approaches to the study of ageism in working life. It looks back on the 50 years of research on ageism and the body of research produced by the discursive turn in social science and gerontology.
Research design and methods:
This study followed the five-step scoping review protocol to define gaps in the knowledge on ageism in working life from a discursive perspective. 851 papers were extracted from electronic databases and, according to inclusion and exclusion criteria, 39 papers were included in the final review.
Results:
The selected articles were based on discursive approaches and included study participants along the full continuum of working life (workers, retirees, jobseekers, students in training). Three main themes representing the focal point of research were identified, namely, experiences of ageism, social construction of age and ageism, and strategies to tackle (dilute) ageism.
Discussion and implications:
Discursive research provides undeniable insights into how participants experience ageism in working life, how ageism is constructed, and how workers create context-based strategies to counteract age stereotypes, prejudice, and discrimination. Discursive research on ageism in the working life need further development about the variety of methods and data, problematization of age-based labelling and grouping of workers, and a focus on the intersection between age and other social categories. Further research in these areas can deepen our understanding of how age and ageism are constructed and can inform policies about ways of disentangling them in working life.
Z Amaç: Bu çalışmanın amacı; ergoterapi lisans öğrencilerinde yaşlılara yönelik tutum ve özgeciliğin incelenmesidir. Gereç ve Yöntem: Bu çalışma 175 Ergoterapi lisans öğrencisi ile gerçekleştirildi. Çalışma çevrimiçi olarak gerçekleştirildi, katılımcılara araştırmacılar tarafından hazırlanan bilgi formu ile Yaşlılara Yönelik Tutum Ölçeği (YYTÖ) ve Özgecilik Ölçeği (ÖÖ) gönderildi. Sonuçlar: Çalışmada katılımcıların yaşlı bireyler ile ilgili nitel sorulara verdikleri yanıtlar ön-test ve son-test şeklinde incelendi ve genel olarak olumsuz düşüncelerinin azaldığı ve olumlu düşüncelerinin arttığı belirlendi. Mezuniyet sonrası yaşlı bireylerle çalışmayı düşünen ergoterapi lisans öğrenci sayısında da öğrenim yıllarına göre artış saptandı (%43.43). YYTÖ ve ÖÖ açısından ise ön-test ve son-test değerlendirmeleri arasında istatistiksel olarak anlamlı bir fark olduğu belirlendi (p<0.05). Elde edilen verilere göre öğrencilerin yaşlı bireylerle ilgili olumsuz tutumunda azalma olurken, olumlu tutumlarında ise artış saptandı. Ayrıca öğrencilerin özgecilik düzeylerinde de artış olduğu belirlendi. Tartışma: Çalışmadan elde edilen sonuçlar çevrimiçi ergoterapi lisans eğitiminin olumlu etkilerine dikkat çekmektedir. Yaşlanan nüfus artışı göz önüne alındığında; ergoterapi lisans müfredatı öğrenciler için yaşlanma ve yaşlılıkla ilgili daha fazla içeriği kapsayabilir. Anahtar Kelimeler: Ergoterapi; Öğrenciler; Eğitim; Yaşlı; Özgecilik. ABSTRACT Purpose: The aim of this study is to examine altruism and attitude towards the elderly in occupational therapy undergraduate students. Material and Methods: This study was carried out with 175 occupational therapy undergraduate students. The study was conducted online and the participants were sent the Attitude Towards the Elderly Scale (ATES) and the Altruism Scale (AS) with the information form prepared by the researchers. Results: In the study, participants' responses to qualitative questions about older individuals were examined as pre-test and post-test, and it was determined that their negative thoughts in general decreased, and their positive thoughts increased. There was also an increase in the number of occupational therapy undergraduate students considering working with older individuals after graduation (43.43%). In terms of the ATES and AS, there was a stastisitically significant difference between the pre-test and the post-test evaluations (p<0.05). It was also found that there was an increase in the level of altruism of students. Discussion: The results of the study draw attention to the positive effects of online occupational therapy undergraduate education. Considering the ageing population growth, the occupational therapy undergraduate curriculum may cover more content related to aging and old age for students.
Our core professional values have been enduring and remarkably relevant to decades past and times present. Our values ensure the currency of our professional contribution, our resilience, readiness, and adaptability, to meet the challenges as we move into the next decade and beyond. In this Sylvia Docker lecture, I draw on my career experience from practice and academic research to examine this premise. The social isolation during the COVID-19 pandemic gave us all a picture of what our clients experience in an enduring way and the challenges of maintaining healthy lifestyles, meaningful occupations, and life roles. One of the greatest population challenges of this century is healthy ageing and the impact that ageism has on health. We live in a society that is ageist, and such cultural thinking impacts our beliefs and expectations as it does for older adults themselves. As occupational therapists, we strive to maintain our relevance, and we drive transformational change through using research-informed evidence-based approaches and adopting enablement programmes that meet the needs of people who are ageing. While prominent in enablement and therapeutic approaches, we are not immune to ageism. Being exposed to ageist views throughout our lives means, we internalise these and believe that ageing is a process of decline. Such self-perceptions and stereotyping impact the health of older people and influence the choices we make in our everyday practice. There are examples of emerging evidence and approaches that will meet these challenges and ways to re-frame ageist thinking. Occupational therapy values of working with people's strengths, what they can do, indicates we are well placed to engage and provide leadership in moving societal views. Addressing ageism requires self-reflection and action in order to be part of changing the narrative on ageing.
Amaç: Bu çalışmanın amacı; ergoterapi lisans öğrencilerinde yaşlılara yönelik tutum ve özgeciliğin incelenmesidir. Gereç ve Yöntem: Bu çalışma 175 Ergoterapi lisans öğrencisi ile gerçekleştirildi. Çalışma çevrimiçi olarak gerçekleştirildi, katılımcılara araştırmacılar tarafından hazırlanan bilgi formu ile Yaşlılara Yönelik Tutum Ölçeği (YYTÖ) ve Özgecilik Ölçeği (ÖÖ) gönderildi. Sonuçlar: Çalışmada katılımcıların yaşlı bireyler ile ilgili nitel sorulara verdikleri yanıtlar ön-test ve son-test şeklinde incelendi ve genel olarak olumsuz düşüncelerinin azaldığı ve olumlu düşüncelerinin arttığı belirlendi. Mezuniyet sonrası yaşlı bireylerle çalışmayı düşünen ergoterapi lisans öğrenci sayısında da öğrenim yıllarına göre artış saptandı (%43.43). YYTÖ ve ÖÖ açısından ise ön-test ve son-test değerlendirmeleri arasında istatistiksel olarak anlamlı bir fark olduğu belirlendi (p<0.05). Elde edilen verilere göre öğrencilerin yaşlı bireylerle ilgili olumsuz tutumunda azalma olurken, olumlu tutumlarında ise artış saptandı. Ayrıca öğrencilerin özgecilik düzeylerinde de artış olduğu belirlendi. Tartışma: Çalışmadan elde edilen sonuçlar çevrimiçi ergoterapi lisans eğitiminin olumlu etkilerine dikkat çekmektedir. Yaşlanan nüfus artışı göz önüne alındığında; ergoterapi lisans müfredatı öğrenciler için yaşlanma ve yaşlılıkla ilgili daha fazla içeriği kapsayabilir.
Aims: This study explored occupational therapy students’ implicit (unconscious) ageism. Because of the relationship between impairment and dependence, and ageism and ableism, we also explored if there was a relationship between occupational therapy students’ implicit ageism and their implicit ableism.
Methods: We conducted and analyzed implicit age and disability attitude data (i.e., Age Implicit Association Test; Disability Attitude Implicit Association Test) from 54 occupational therapy students.
Results: Most occupational therapy students in our study (70%) were ageist, with the majority strongly or moderately preferring younger adults over older adults. Our findings also suggest ableism plays a role in ageism – ableism accounted for almost 30% of variance in occupational therapy students’ ageism in our study.
Conclusions: Through attending to functional interdependence and home modifications occupational therapists can support older adults in the natural processes of aging, instead of reinforcing ageism and its influences on intervention and plan of care development.
Purpose
Ageism is a negative bias that results in stereotyping of and discrimination against older individuals and is one of the most institutionalized forms of prejudice in current society. Literature suggests that negative attitudes toward the elderly may have adverse effects, especially in health care settings. The purpose of this investigation was to examine the presence and level of ageism in a group of graduate students enrolled in an accredited speech-language pathology program over a 2-year period, to determine if the degree of ageism differed based on ethnicity, gender, age, or previous experience working with older adults.
Method
Eighty students of an accredited speech-language pathology graduate program completed the Fraboni Scale of Ageism over a 2-year period at the onset of a course on aging. Students were blinded to the type of assessment they were completing and were anonymous in order to blind the instructor to specific student performance. Demographic data for each protocol were gathered in order to analyze results.
Results
Data were analyzed using descriptive statistics and analysis of variance calculated for effect size between groups. Results indicated that the level of ageism did not significantly change when grouped by gender, ethnicity, age, or level of experience, though a level of implicit bias was demonstrated through overall participant scores.
Conclusions
Authors concluded that existing evidence should be used to develop graduate curriculum that encompasses all age groups, especially those aged 65 years and older. Opportunities for experiential learning may provide further benefit to decreasing ageism in graduate students, leading to positive societal change.
As rehabilitation specialists, occupational therapy practitioners play a gateway role regarding recommendation of various technologies for homecare. However, no study has investigated current occupational therapy practices concerning information and communication technology (ICT) for older adults in Canada. The objective of this study was to identify Canadian occupational therapists' (OTs) knowledge and practices of ICT with older adults as well as factors associated with its recommendation. A Canada-wide, cross-sectional, online survey was conducted. Of 387 OTs, only 12.4% reported recommending ICT in practice. ICTs supporting communication and cognition were the main types recommended. The reported barriers to use in practice differed between ICT familiar users and nonusers. Multivariate logistic regression analyses showed that clinicians with more years of clinical experience were more likely to recommend ICT. Clinicians' services, work environments, and client diagnosis were also factors associated with ICT recommendation. Additional research is needed to understand how to overcome barriers to ICT recommendation in OT practice.
Powerful rhetorical and marketing practices support ideals of timeless living.
Purpose. Age bias may play a role in physicians' discussions of equivalent therapeutic options with patients, especially in respect to breast-conservation therapy. This study investigated bias based on age (ageism) among physicians-in-training in their treatment recommendations for breast-conserving procedures. Method. Second-year medical students responded to a questionnaire concerning recommendations they would make for breast conservation or mastectomies with or without breast reconstruction for eight patients with similar-stage breast cancer. The patients differed by age (older were ≥59 years, younger ≤31 years), race, and marital status. A total of 116 students made 1,146 recommendations. Percentages of the students' recommendations for breast-conservation therapy (BCT) were calculated for the two patient age groups and for the recommendations for breast reconstruction after the patient had already chosen modified radical mastectomy (MRM). Chi-square tests were used for statistical analysis. Results. The students recommended BCT for a significantly higher percentage of younger patients than older patients (86% versus 66%; p <.001). They recommended MRM to 34% of older patients versus 14% of younger patients (p <.001). Furthermore, the students recommended breast reconstruction after MRM to a significantly higher percentage of younger patients than older patients (95% versus 65%; p <.001). Conclusions. Medical students' recommendations of breast conservation and breast reconstruction showed age bias. Educational efforts should be instituted during the medical school to decrease ageism in students' treatment recommendations.
Acknowledging, confronting and changing the current practice of age-based decision making and ageism in the provision of health care is a political priority and a topic of public and media interest. Health-care providers function in a society that may be considered to have ‘ageist roots’ and when an individual begins training in health care, he or she presents with his/her own acquired stereotypical imagery and beliefs. If these students are ‘ageist’ before they begin their training, then the training period must address this.
This article considers the evolution of ageism and the influences from childhood and adult life that contribute to ageist behaviour. Using a wide range of literature from a variety of sources, the evidence of exposure to ageist behaviour in health-care education is reviewed and a series of strategies to reverse the trend are examined.
Rural elderly patients receive health services primarily in the outpatient setting, with their primary care provider often serving as their only point of contact with the health care system. Little is known however about the attitudes of physicians, and more specifically attitudes of those practicing in rural locations, toward differing age groups of the elderly. The current study was undertaken to examine the perceptions and attitudes of rural Florida physicians who routinely provide care for the elderly. We utilized an existing and validated survey instrument designed to measure the perceptions and attitudes of health professionals toward 3 different cohorts of elderly people: the elderly population in general, the elderly population older than 85 years, and the nursing home population. The study provides evidence that physicians who routinely provide care for the elderly in rural Florida demonstrate ageist perceptions, especially against those older than 85 years and the nursing home population. The trends identified are important because they may directly influence the quality of care that this population receives.
Professionals' views concerning the importance of dignity and how this can best be maintained is important for the planning and provision of appropriate services, especially for older people.Dignity was described as an integral part of being human and closely related to respect. Overall, participants painted a negative image of the lives of older people, although clear distinctions were drawn between fit and frail older people. Indignities associated with old age arose from ill health, dependency, vulnerability, frailty and loss of competence. It was considered that technological advances and information technology had left many older people behind. However, many described working with older people as an enjoyable experience offering variety, intellectual challenge and satisfaction, while recognising that working with older people was often given low status.Professionals identified the following factors as essential to dignified care: promotion of autonomy and independence; a person-centred and holistic approach; maintenance of identity and encouragement of involvement, participation and empowerment; effective communication and respect. Undignified care was associated with: invisibility; de-personalisation and treatment of the individual as an object; humiliation and abuse; narrow and mechanistic approaches to care.Policy development and professional education should give greater prominence to dignity and a greater emphasis ought to be placed on living with dignity in old age rather than solely dying with it.
The Relating to Older People Evaluation (ROPE) is a 20-item questionnaire that measures positive and negative ageist behaviors that people may engage in during everyday life. In this article, we report the first findings from several administrations of the ROPE along with initial psychometric information on the instrument. Respondents were college students, community-dwelling older adults, and persons affiliated with a university community. Results indicate that most people of all ages readily admit to positive ageist behaviors. Younger and older adults appear to participate in similar amounts of ageist behavior. Analyses by gender indicated that women endorsed the positive ageism items more often than did men. Psychometric analyses yielded estimates of adequate test-retest reliability and internal consistency reliability. Implications for current views of ageism as a social phenomenon and strategies for reducing ageist behaviors in everyday life are discussed.