Are Social Workers Disempowering and Contributing to Widening the Power Differential

The last place one would expect to find ageism well and flourishing is in the helping professions, particularly among those who devote their careers to working with, helping, and advocating for older adults. Yet, we often see ageist attitudes prevail in these areas.  Not unnoticed are the unintentional ageist practices in our own field of social work.  A director of casework at a large senior service agency told me, “There are social workers who come into the field wanting to ‘help’ without realizing that their attitude could be disempowering and contributing to widening the power differential.”  These social workers are over-accommodating for what they perceive as a lack or weakness among their elderly clients.

As social workers, it’s easier to think of diversity in terms of race, ethnicity, religion, gender and nationality. However, do we experience the older people we work with as “the other”? We need to understand that these people who have lived their experiences through to almost a complete life are some of the most complex and interesting people we will ever encounter. We may think we understand the experience of this “other”, but that is impossible.  The only way we can begin to understand older adults is to listen.

Listening is a primary skill when interacting with most people and is particularly salient when interacting with older adults.  There is much we can learn if we allow them to share their stories with us, but in order for that to take place, social workers and others working in the field of geriatrics need to remember these people have the same desire for autonomy and deserves respect as the rest of us. Each time we over-accommodate for a perceived weakness in an elderly client, we disempower that client a little bit more.

One of the most prevalent ageist practices that takes place in senior environments is  “elderspeak” or talking to older adults in the same way one speaks to a child.  This type of speech infantilizes the seniors with whom we interact.  Sweet baby talk does not pass muster with older adults, especially the oldest among us.  When a social worker talks condescendingly or uses “baby talk” to address an elderly person, we are guilty of making that elder feel like she is less than we are.  I once heard an aide greet my 92 year old dad with the words, “Don’t you look like a handsome young man today.”  This was executed with the same sing-song voice we would use when talking to a young child. As she walked away, my dad turned to me and said, “I don’t like that person.”

My dad resides in a senior care community where I visit quite often.  He has problems with his shot term memory, gets confused,  and cannot physically take care of himself.  Yet, he does not think of himself as less than any of the people around him.  He loves to tell stories and share experiences.  I know he will never do this with the person who reacts towards him as if he were a child.  Now, think of someone not as strong as my dad…someone frail and anxious.  This person is much more likely to internalize the baby talk and begin acting like the baby she is being told she is.

When we infantilize older adults, we are disempowering them.  We are compromising their autonomy. Another form of over-accommodating is over-helping. A friend of mine who is 79 years old experienced two strokes in her seventies.  Although she was left with some speech and mobility issues, she worked very hard to overcome these challenges.  Today she has returned to her career as a college professor and researcher and lives an dependent life.  Recently she told me about her trip to visit her daughter for Thanksgiving.

As it was, one of the guests at Thanksgiving dinner was a nurse who insisted on following my friend around throughout the day, prepared to catch her should she stumble or fall.  Knowing that the nurse’s intentions were well-meaning and not wanting to cause a scene, my friend accepted her “help” graciously.  However, she told me, “I was seething inside and desperately wanted to tell her to leave me alone!” She added,  “If I needed her help, I was perfectly capable of asking for it”. The same question arises.  Had my friend not been the strongly confident woman she is, she could have easily internalized the message of helplessness that was being covertly sent by this person who insisted on following her around.

We all know how it feels to take pride and a sense of accomplishment when we overcome obstacles in our lives.  Why would one think that need disappears when we age?  The situation above could have easily been handled by simply asking my friend if she required any assistance.  And, if the answer was “no thank you”, to accept it as the authentic answer to a heartfelt question.

These are powerful lessons for all of us when interacting with the older adults who we work with, as well as with the older adults in our lives.