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.

social worker and clientAs 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.

Who Is Old?

Edith Connors 77 year old body builder
Edith Connors 77-year-old body builder

Who is old?  What does old mean?  Who decides that you are old?  Who do you identify as old?

Is it age?  Do you automatically become old the day you start collecting your social security? Some people collect at 62, some at 66, and some at 70.  Or, maybe it’s the year you become eligible. Can it be the day you retire from your career job?  Or maybe it’s the day you become a grandparent.

My mother-in-law didn’t become old until she turned 90, while my mother decided she was old at 80. They self-selected when to be old. Meanwhile, my best friend who has a form of rheumatoid arthritis self-identified as old when she was only 55. So, it’s possible that old is when you need assistance with certain activities and realize that you are slowing in your performance. A 72 year old friend mentioned to me, “I can’t believe how much longer it’s taking me to walk to the office each morning. I used to be such a fast walker.“  Is she now old?

I am certain that my grandchildren identify me as old, while my peers tell me how young I look. Maybe that’s the answer. Old, like beauty, is in the eye of the beholder. My husband tells me I look as young as the day we met, which can hardly be true since that was over fifty years ago. Maybe we are old when our hair turns gray. Yet, I have a friend who went prematurely gray in her thirties.

Another answer might be that we are old when we start receiving senior discounts. I do have a senior Metro-Card that entitles me to use New York City’s subways and buses at half price. I have an AARP card, and I now go to movies and visit museums for senior admission rates.

Do all cultures and societies see “old” similarly?  Eastern cultures tend to value age and equate age with wisdom. Unfortunately, Western cultures put a higher value on youth. This causes many of the aging people I know to go to great lengths to appear younger than their actual age. I have an 85 year old constituent who came to see me one day carrying a large umbrella. “Is it raining?” I asked. “Oh, no”, she replied, but I refuse to walk with a cane.”

We, here in the United States and other Western industrialized counties, are experiencing a longevity boom. People here may not be perceived as old until they are in their 70s or maybe even 80s. Yet, in third world countries that are ravaged by war and hunger, people are perceived as old at a much younger age.

So, old may be determined by the place you live or the era in which you were born. My grandmother at 70 was an old woman. I am 68 and would not be described as an “old woman” by most people I know. Old can also be determined by one’s environment or the circumstances under which one lives. Those who live in poverty and those who are marginalized may not have access to good health care or healthy food. People who live in these minority communities are old sooner than those from middle and upper class majority neighborhoods.

So, it seems then that old is a socially constructed category. What old is to me may be different than what old means to you.

There is much truth in the adage, “Once you’ve seen one old person, you’ve seen one old person.” We are aging from the moment we are born; and the more we age,–the more we experience our own individual lives–the more diverse we become. Our individual lived experiences then may be the only key to determining when each of us is old.

Are you old?  If so, when did you become old?  If you are not old, what makes you see someone else as old?  Why do you think a society’s definition of old is important?

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