Reducing ageism combining ageing education with clinical practice: A prospective cohort study in health sciences students.

AIM: To analyse the impact of an intervention combining ageing education with clinical practice in nursing homes on a nursing cohort's negative stereotypes and prejudices towards ageing. DESIGN: A prospective cohort study was conducted in September 2019-October 2020 in a population of health sciences students (n = 222). METHODS: Questionnaire of Negative Stereotypes towards Aging (CENVE) and Aging Semantic Differential (DSE) were used to examine negative stereotypes and prejudices towards ageing in the nursing cohort exposed to the ageing education and practice intervention compared to a medical cohort that received no intervention. Group-by-time interaction, controlled by sex and age, for the effect of the intervention on CENVE and DSE scores was determined by mixed-design ANOVA. RESULTS: The nursing cohort significantly reduced negative stereotypes and prejudices towards ageing when compared to the medical cohort in total (F = 26.926; p < 0.001), health factor (F = 16.812; p < 0.001), motivational and social factor (F = 11.266; p = 0.001), and character and personality factor (F = 19.202; p < 0.001) scores of CENVE scale and in DSE (F = 7.826; p = 0.006).

Trends in elder abuse and age discrimination during the COVID-19 pandemic in Hong Kong: Findings from a two-wave representative telephone survey study.

OBJECTIVES: Empirical evidence about the heightened risks of elder abuse and age discrimination during the COVID-19 pandemic is scarce. This study aimed to track the changes in rates of both, and investigated their associated factors in the community-dwelling older population in Hong Kong. METHODS: In this two-wave, cross-sectional telephone survey, we interviewed a population-based sample of individuals (≥55 years), and captured the situation of elder abuse and age discrimination before the COVID-19 outbreak (n = 1209, Wave 1: October-December 2019) and during the pandemic (n = 891, Wave 2: December 2020-January 2021). Participants reported their experiences of different types of abuse and discrimination, financial health, subjective well-being, satisfaction with environment, health and social services, and resilience. RESULTS: Abuse was reported by 20.2% of the sample before the outbreak and 17.8% during the pandemic; while discrimination was reported by 24.6% and 29.8% at the two time points, respectively. A drop in physical abuse was observed, but it was accompanied by a rise in discrimination in the form of harassment or refusal of services. Findings of logistic regression analysis show that abuse during the pandemic was associated with younger age, poorer subjective well-being, and lower resilience; while discrimination was associated with female gender, being married, and poorer subjective well-being. CONCLUSIONS: Elder abuse and discrimination were prevalent across time points. The pandemic has highlighted the marginalization of older persons in our communities. There is an urgent need for development of effective interventions to end abuse and discrimination.

Explaining the process of formation of ageism among the iranian older adults.

BACKGROUND: Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people. METHODS: The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding. RESULTS: Fear of loneliness and rejection striving to tackle ageism "was identified as the core category of the study. Concepts such as "family context" and "cultural context" were relevant. After identifying the strategies used by the older adults in response to the context ("maintaining integrity", "socio-cultural care" and "proper health care", "striving to tackle ageism") was the most important process in ageism by the Iranian older adults. CONCLUSION: Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect.

Neighborhood-Built Environment and Ageism in Later Life.

Ageism is a global challenge and a public health concern that the recent COVID-19 pandemic has further exacerbated. Existing research has mainly focused on individual factors, overlooking the association between the neighborhood-built environment and ageism. This study examined this association and whether its effect varied among areas possessing different socioeconomic characteristics. We conducted a cross-sectional survey of 1278 older people in Hong Kong and merged this with the built environment factors derived from geographical information system data. We used multivariable linear regression to examine the association. Findings revealed that more parks were significantly associated with a lower level of ageism, an impact that remained significant in low-income or low-education areas. Conversely, more libraries in high-income areas were associated with a lower level of ageism. Our findings provide urban planners and policymakers insight into planning for the built environment that reduces ageism enabling older people to achieve a better life.

Short- and Medium-Term Effects of Ageism on Loneliness Experienced During the COVID-19 Pandemic.

Loneliness, common in old age, may be partially attributed to ageism. The present study explored the short- and medium-term effect of ageism on loneliness experienced during the COVID-19 pandemic using prospective data derived from the Israeli sample of the Survey of Health, Aging and Retirement in Europe (SHARE) (N = 553). Ageism was measured before the COVID-19 outbreak and loneliness in the summer of 2020 and 2021 using a direct single question. We also tested for age differences in this association. In both the 2020 and 2021 models, ageism was related to increased loneliness. This association remained significant after adjusting for a host of demographic, health, and social variables. In the 2020 model, we also found that the positive association between ageism and loneliness was significant only in people aged 70+. We discussed the results with reference to the COVID-19 pandemic, which drew attention to two global social phenomena: loneliness and ageism.

Vulnerability in context; hard numbers, tricky words and grey areas for gerontology.

At the start of the COVID-19 pandemic, the Portuguese government identified those aged 70 or more as a risk group, placing a special duty of protection on them to shelter-at-home. This paper asks how Portuguese municipalities, using Facebook posts, communicated the risk to older adults and to what extent ageist stereotypes were found in the language and frames employed. Over 3800 Facebook posts made by Portuguese municipalities concerning older adults and COVID-19 published between March and July 2020 were analyzed. Language counts for age-related words were used in a first round of content analysis followed by a process of thematic analysis. Findings indicate that the language used to address Portuguese older adults could be understood as ageist in terms of homogenizing older people as a fixed group. The communication of risk was often conflated with the vulnerability narrative already observed in the extant literature. However, context- and culture-specific themes of 'solidarity', 'inter-relatedness', 'duty of care' and 'support for those living in isolation' were also found. The study highlights the extent to which language, culture and context are intertwined with our understanding of age, aging and ageism. It provides a culturally-specific case study, which challenges both gerontological interpretations of vulnerability and neoliberal frames which focus responsibility on the individual regardless of age. We argue that these alternative frames echo the emerging discourse of mutual aid and solidarity, providing a wider context for addressing vulnerability in a health crisis.

Respecting Older Adults: Lessons from the COVID-19 Pandemic.

The COVID-19 pandemic has exacerbated many social problems and put the already vulnerable, such as racial minorities, low-income communities, and older individuals, at an even greater risk than before. In this paper we focus on older adults' well-being during the COVID-19 pandemic and show that the risk-mitigation measures presumed to protect them, alongside the generalization of an ageist public discourse, exacerbated the pre-existing marginalization of older adults, disproportionately affecting their well-being. This paper shows that states have duties to adopt and put into practice redress measures to compensate for the negative consequences of COVID-19 public health policies on older adults' overall well-being. These duties flow from the minimal ethical requirement of respect for persons. We show that respect is a morally basic attitude that presupposes taking the others' interests into account, with the aim of advancing their well-being. This duty is not limited to kinship, relatives, and friends but it extends to states and the rest of the civil society. In the conclusion, we draw lessons from the COVID-19 pandemic and sketch some redress measures that could compensate for the decrease in older adults' well-being as a result of the adoption of measures to contain the spread of the virus.

Representations of aging around the world: influence of culture and Covid-19 pandemic / Les représentations du vieillissement à travers le monde : l'influence de la culture et de la crise Covid-19

This article provides a synthesis about the representations of aging around the world. The population of the elderly is increasing from year to year and the support of elder people is becoming a major challenge. Understanding the representations of aging is an essential element to catch how societies take care of their elderly. Beyond presenting the influence of the cultural variable on the representations of old age, this article also proposes to highlight the impact of the Covid-19 on these perceptions. Indeed, the crisis emphasized the way seniors are thought and treated when ethical questions arise.

Cet article de synthèse s'intéresse aux représentations du vieillissement à travers le monde. Le vieillissement de la population s'accroit d'année en année et l'accompagnement des ainés s'illustre comme un enjeu de santé publique majeur. Appréhender les représentations du vieillissement est un élément essentiel pour comprendre comment les sociétés prennent en charge leurs personnes âgées. Au-delà de présenter l'influence de la variable culturelle sur les représentations de la vieillesse, cet article se propose également de mettre en lumière l'impact de la pandémie Covid-19 sur ces dernières. En effet, la crise sanitaire aura permis de mettre en exergue la façon dont les ainés sont pensés et traités, lorsque des questions d'ordre éthique viennent à se poser.

The trouble with vulnerability. Narrating ageing during the COVID-19 pandemic.

In this paper, we have used the exceptional circumstances created by the COVID-19 pandemic as a window for investigating the ambivalent, stereotypical and often-incongruent portrayals of exceptional vulnerability and resilient self-management that define the self-constructions available for older adults. From the onset of the pandemic, older adults were publicly and homogenously presented as a biomedically vulnerable population, and the implementation of restrictive measures also raised concerns over their psychosocial vulnerability and wellbeing. Meanwhile, the key political responses to the pandemic in most affluent countries aligned with the dominant paradigms of successful and active ageing that build on the ideal of resilient and responsible ageing subjects. Within this context, in our paper we have examined how older individuals negotiated such conflicting characterisations in relation to their self-understandings. In empirical terms, we drew on data comprising written narratives collected in Finland during the initial stage of the pandemic. We demonstrate how the stereotypical and ageist connotations associated with older adults' psychosocial vulnerability may have paradoxically offered some older adults novel building blocks for positive self-constructions as individuals who are not exceptionally vulnerable, despite ageist assumptions of homogeneity. However, our analysis also shows that such building blocks are not equally distributed. Our conclusions highlight the lack of legitimate ways for people to admit to vulnerabilities and voice their needs without the fear of being categorised under ageist, othering and stigmatised identities.

[Doing vulnerability : The social construction of age(ing) during the COVID-19 pandemic]. / Doing Vulnerability : Soziale Konstruktionen des Alter(n)s während der COVID-19 Pandemie.

BACKGROUND: Since the beginning of the COVID-19 pandemic old age has been "vulnerablilized" in the media by characterizing old age as a vulnerable and risky phase of life. Gerontologists have criticized the age-based definition of risk groups for their underlying agism. OBJECTIVE: From a practice-theoretical perspective the article asks through which social practices a vulnerable age is realized during the COVID-19 pandemic. MATERIAL AND METHODS: The article refers to data from six qualitative interviews with people aged 65 and older. The data was analyzed using fine structure analysis followed by a topic analysis. RESULTS: The results show that during the COVID-19 pandemic doing age was characterized by a not doing or the disappearance of routinized everyday practices. For the respondents this not doing age was connected to experiencing vulnerable ageing, in which they felt physically and temporally vulnerable. DISCUSSION: Practices of aging during the COVID-19 pandemic have developed against the backdrop of a societal discourse that has positioned activity as an indicator of good and positive aging. At the same time few opportunities have been created to maintain activity under the conditions of the COVID-19 pandemic.

Identifying and Addressing Implicit Ageism in the Co-Design of Services for Aging People.

In a world with an increasingly aging population, design researchers and practitioners can play an essential role in shaping better future societies, by designing environments, tools, and services that positively influence older adults' everyday experiences. The World Health Organization (WHO) has proposed a framework called Healthy Ageing, which can be adopted as the basis for designing for an aging society. There are, however, many challenges in achieving this goal. This article addresses one of these challenges identified by WHO, which is overcoming ageism as a form of discrimination based on age. In contrast with most other types of discrimination, ageism is not always easy to detect and overcome because of its generally implicit nature. This paper investigates adopting storytelling as a method for detecting implicit ageism and proposes a co-design process that utilizes this method to better address older adults' needs and requirements. The use of this method is discussed through two example case studies aimed at improving the design of assistive services and technologies for aging people. The findings from these case studies indicate that the proposed method can help co-design teams better identify possible implicit ageist biases and, by doing so, try to overcome them in the design process.

COVID-19 and the Elderly's Mental Illness: The Role of Risk Perception, Social Isolation, Loneliness and Ageism.

For almost two years, populations around the globe faced precariousness and uncertainty as a result of the COVID-19 pandemic. Older adults were highly affected by the virus, and the policies meant to protect them have often resulted in ageist stereotypes and discrimination. For example, the public discourse around older adults had a paternalistic tone framing all older adults as "vulnerable". This study aimed to measure the extent to which perceived age discrimination in the context of the COVID-19 pandemic, as well as the sense of loneliness and social isolation, fear and perception of COVID-19 risks, had a negative effect on older adults' mental illness. To do so, a self-report questionnaire was administered to 1301 participants (average age: 77.25 years old, SD = 5.46; 56.10% females, 43.90% males). Descriptive and correlational analyses were performed, along with structural equation modelling. Results showed that perceived age discrimination in the context of the COVID-19 pandemic positively predicts loneliness and also indirectly predicts mental illness. In addition, loneliness is the strongest predictor of mental illness together with fear of COVID-19 and social isolation. Such results highlight the importance of implementing public policies and discourses that are non-discriminating, and that favour the inclusion of older people.

Representations of older adults in COVID-related newspaper articles: A comparison between the perspectives of older and younger adults.

During the COVID-19 pandemic, media sources discussed diverse perspectives on aging and older adults, providing opportunities to examine representations of older adults during times of crisis. This study aims to explore representations of older adults during the first month of the pandemic in the U.S. by comparing the perspectives of older and younger adults in national newspapers. A systematic search identified 115 articles published in four major newspapers in the U.S. between March 11 and April 10, 2020, in which older and younger adults were quoted on topics related to the intersection of COVID-19 and aging. Quotes were inductively reviewed using content and thematic analytic strategies. A total of 265 quotes were identified from older adults (n = 104, 39%) and younger adults (n = 161, 61%). We identified three primary themes: impacts on "vulnerable" older adults, debates over the value of older adults' lives, and a counternarrative of resiliency. Older adults were represented as a vulnerable group during the pandemic, in need of protection and support, while debates over the value of their lives similarly evoke images of frailty and dependency. Such depictions frame older adults as a burden on society and reduce their agency and subjectivity. Ageist biases were not only present in quotes from public figures and professionals, but also evident in quotes from older adults themselves. However, older adults also spoke to their own resiliency, survival, and strengths, thereby positioning themselves as elders worthy of respect and able to share wisdom with younger generations. These findings highlight the importance of listening to older adults' voices in order to understand their experiences from their own perspectives through their own agentive positioning and promoting intentionally age-positive and nuanced representations of older adults in public discourse.

Are You Willing to Protect the Health of Older People? Intergenerational Contact and Ageism as Predictors of Attitudes toward the COVID-19 Vaccination Passport.

Since the beginning of the COVID-19 pandemic, the vulnerability of older people to COVID-19 has been stressed in political discourse and the mass media, with the call to protect older adults. Therefore, policies aimed at reducing the spread of coronavirus, such as the COVID-19 vaccination passport policy, might be perceived as policies aimed at preserving the health of older people, and negative attitudes toward older people (i.e., ageism) might underlie negative attitudes toward such policies. While intergenerational contact is one of the main antecedents of reduced ageism, the pandemic has forced people to separate, and direct intergenerational contact in particular might have been reduced, possibly being replaced by telephone and virtual contact. In a correlational study (N = 153 Italian university students) we found that quantity and quality of direct intergenerational contact diminished during the pandemic. Virtual intergenerational contact was unexpectedly less frequent than direct contact. Quality of direct contact before the pandemic was associated, over and above the effects of other contact forms under investigation, with reduced ageism, which was in turn associated with negative attitude toward the vaccination passport. Findings will be discussed focusing on the roles of intergenerational contact and ageism for public health.

Attitudes of health professionals toward elderly patients during the COVID-19 pandemic.

The perceptions and attitudes of health professionals toward a certain group of society are among the factors affecting the quality of health service. This study aimed to investigate the attitudes of physicians and nurses about ageism in the COVID-19 pandemic. An easy face-to-face survey was used to collect the data. It involves the questions about demographic information and geriatric perspectives, and they were taken from the University of California at Los Angeles Geriatrics Attitudes Scale (UCLA-GAS). In the study, 58.1% of participants were over 35 years old, 76.6% were women, and 50% were physicians out of 308 in total. It was found that most of the participants have worked in inpatient services and intensive care units for the longest time, where the triage issue was the most discussed topic during the pandemic. An average of 75% of the participants stated that they did not witness any ageist attitude in health care provided. In the comparative analyses conducted with the UCLA-GAS sub-dimensions, statistically significant results, which were anti-ageist and prioritized human life, were obtained. In the extraordinary periods such as pandemic, especially physicians should be able to give the treatment without feeling any social or legal concerns during their medical applications with the light of guidelines accepted scientifically, legally, and morally. Thus, health professionals will not only be away from legal concerns such as malpractice but also will not be exhausted mentally and they can provide more sufficient health service by working under these conditions.