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In the 1960s, Robert Butler coined the phrase ageism, which he defined as:
"A process of systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish this with skin color and gender. Old people are categorized as senile, rigid in thought and manner, old-fashioned in morality and skills . . . . Ageism allows the younger generations to see older people as different from themselves; thus they subtly cease to identify with their elders as human beings . . . ."
(See R. Butler, Why Survive? Being Old in America, 1975 - item no. 71 of this bibliography.)
While some advocates for elders suggest that ageism is a cause of elder abuse, neglect, and exploitation, we do not have enough valid research into the attitudes of known perpetrators of elder mistreatment to be able to definitively make that statement. However, as the following references indicate, ageism contributes to conditions that disadvantage and marginalize older individuals in society.

Inequitable treatment occurring in the workplace, in the health care sector, and in the legal arena appears to be based, at least in part, on age discrimination. Even efforts to offer protection may be based upon compassionate ageism that may lead to disempowerment. Ageist beliefs and policies categorize seniors as a homogenous group, ignoring diversity issues and individual needs. Furthermore, it appears that aging individuals are not only subjected to ageist beliefs by others; they internalize these beliefs as well. Age discrimination can impact elders in tangible ways by contributing to reduced financial security and poorer health outcomes, but also appears to a have subtler, though perhaps more pervasive impact, by contributing to social isolation (a risk factor for mistreatment), lower self-esteem and poorer quality of life. When combined with other prejudices, such as sexism, racism and biases against the disabled (known as "ableism"), the health and well-being of elders is further jeopardized.

The body of literature on this topic is vast. The following references have been selected to represent multiple perspectives on ageism and its impact upon older individuals. Resources from other countries have been included to demonstrate its universal nature. Materials have been presented to provide a recent historical outline of the recognition and response to ageism.

Most of the reference materials can be obtained through local university and community libraries or interlibrary loan services. Some must be ordered directly through the publisher or production company. When available, contact and pricing information is included with the abstract. Increasingly, many resources are available online, and the Web addresses are also included.*

If you have difficulty obtaining any of these materials, please contact the CANE office for assistance by emailing cane-ud@udel.edu or telephoning (302) 831-3525.

Note: This is a selected annotated bibliography, which does not include all published references related to this topic. To search for additional references on this and related topics, please visit the CANE Web site at http://db.rdms.udel.edu:8080/CANE. To search the CANE Bibliography Series, go to www.elderabusecenter.org/default.cfm?p=cane.cfm .

*Web addresses may change without notice. If an address provided is no longer accurate, we recommend using a generic search engine, such as Google, to find a current link. If you cannot locate the online publication, contact the CANE offices for assistance at cane-ud@udel.edu or 302-831-3525.

The National Center on Elder Abuse (NCEA) serves as a national resource for elder rights advocates, law enforcement and legal professionals, public policy leaders, researchers, and citizens. It is the mission of NCEA to promote understanding, knowledge sharing, and action on elder abuse, neglect, and exploitation.

The NCEA is administered under the auspices of the National Association of State Units on Aging.

NCEA Partners
  • National Association of State Units on Aging (NASUA), Lead Partner
  • American Bar Association (ABA) Commission on Law and Aging
  • Clearinghouse on Abuse and Neglect of the Elderly (CANE) at the University of Delaware
  • National Adult Protective Services Association (NAPSA)
  • National Committee for the Prevention of Elder Abuse (NCPEA)
This publication was made possible through the support provided by the National Center on Elder Abuse. Major funding for the National Center on Elder Abuse comes from the U.S. Administration on Aging, Department of Health and Human Services.
Grant No. 90-AM-2792.

Opinions or points of view expressed do not necessarily reflect the official position or policies of the U.S. Administration on Aging.


1. S6156-125
The Anti-Ageism Taskforce at the International Longevity Center (ILC) - USA, sponsored by the Open Society Institute
Ageism in America
International Longevity Center - US, LTD.; New York; 2006
Report (online)
This publication begins with a "report card" of seven major areas where ageism is evident within the United States (elder abuse, discrimination in health care, nursing homes, emergency services, the workplace, the media, and in marketing). It is also considered within the context of the family and culture. A history of ageism in America is presented, and topics covered include the creation and perpetuation of ageism, personal and institutional ageism, and the costs of ageism. The effectiveness of existing policies designed to combat age discrimination are reviewed, along with recommended initiatives. (Note: This publication is available online at: http://www.ilcusa.org/news/story_aging.htm . To request a hard copy of this report please contact the ILC-USA Communications Department at meganm@ilcusa.org or 212-606-3380.)

2. S6145-7
Hinrichsen, G.
Why Multicultural Issues Matter for Practitioners Working With Older Adults
Professional Psychology: Research and Practice; Vol. 37 (1), 29-35; 2006.
Journal article (scholarship)
This article describes the need for mental health practitioners to be sensitive to multicultural issues among older clients. It is noted that the percentage of elders in American society is increasing, as is the percentage of minorities among all elders. Minority elders are at risk for ageism as well as ethnic and racist stereotyping, and experience more health and economic disparities, in comparison to White elders. In particular, minority elders under-utilize mental health services due to barriers to entry. Using a number of actual clinical experiences, the author explores a number of issues and dynamics, using the American Psychological Association's "Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists" (2003) as background.


3. S6303-6
Barnett, R.
Ageism and Sexism in the Workplace
Generations; 25-30; Fall 2005.
Journal article (scholarship)
In this discussion, the author considers the manner in which ageism and sexism synergistically create a "double jeopardy" for older women, particularly in the workplace. Due to shifting demographic trends, including increased life expectancy and smaller nuclear families, the role of caretaking (particularly unpaid, informal caretaking) has expanded significantly as older individuals, most often women, are responsible for assisting aging parents. To accommodate this role, women are more likely to work part time, take leave(s) more frequently, and change jobs more often, all of which tends to result in fewer opportunities for advancement as well as short and long-term financial disadvantage when compared to male workers. Gaps in the Family and Medical Leave Act (FMLA) also tend to disproportionately affect women. These factors, along with negative societal stereotypes of aging women, create a risk for financial insecurity as women age.**

4. S6325-6
Binstock, R.
Old-Age Policies, Politics, and Ageism
Generations; 73-78; Fall 2005.
Journal article (scholarship)
In this commentary, the author outlines policy changes in the U.S. that have had both positive and negative effects on older Americans. He points out that compassionate ageism forms the backdrop for many social programs that provide economic and service benefits to elders based upon age, not on need, and that treat "the aged" as an artificially homogeneous group. The backlash of this trend has been to scapegoat the elderly by portraying the generation as a burden on society. He debunks the senior-power model of politics, which assumes that seniors in the U.S. will vote cohesively as a unit guided by their self-interests and wield considerable power. Research demonstrates that older voters are as diverse in their voting patterns as younger voters, not only in the U.S. but in other developed countries as well. Furthermore, age is only one characteristic of older voters; therefore, "old-age" policy issues may not be the most significant among all issues considered.**

5. S6226-14
Bytheway, B.
Ageism and Age Categorization
Journal of Social Issues; Vol. 61 (2), 361-374; 2005.
Journal article (scholarship)
In this discussion, the author indicates that ageism is experienced on multiple levels. In a narrow sense, one experiences ageism when judged to be old. In a broader sense, one experiences ageism simply by being made aware of age and by judgments based upon aging. The history of tracking one's age and the process of categorization by chronological age for purposes of research and administration are presented. The tendency to use broad age group and open-ended categorization in research (for example, a cohort of individuals aged 60 and over which may also include individuals over 110) leads to homogenization and stereotyping. Alternative frameworks to facilitate scholarship and research in the field of gerontology are considered, including encouraging volunteer participants who perceive themselves as older, or are willing to talk about being older, regardless of chronological age. Other frameworks include focusing on transitions, such as retirement and bereavement, regardless of chronological age and recruiting study participants using other criteria and then studying the significance of age.**

6. S6326-6
Cutler, S.
Ageism and Technology
Generations; 67-72; Fall 2005.
Journal article (scholarship)
This article describes the complex relationship between technology and ageism. On the one hand, technological advances may widen the chasm between younger and older employees and consumers, and may reinforce the cliché that older individuals are uneducable. On the other hand, adaptations to technology and through technology may enhance the older employee's ability to retain high productivity. In addition, technological devices that may ameliorate physical and sensory changes that can accompany the aging process may not only level the playing field for older individuals in the workplace but also allow for greater independence in the home.**

7. S6301-19
Cuddy, A., Norton, M. & Fiske, S.
This Old Stereotype: The Pervasiveness and Persistence of the Elderly Stereotype
Journal of Social Issues; Vol. 61 (2), 267-285; 2005.
Journal article (research)
This discussion centers on a variety of aspects of the elderly stereotype: research that demonstrates the mixed nature of the stereotype; the pan-cultural nature of ageism; and indications that such complexities are also prevalent pan-culturally. By employing the stereotype content model (SCM), a framework which predicts how groups are sorted and may experience prejudice in a given society, research is cited that suggests the elderly stereotype is one of warmth and incompetence, evoking a common response of pity which, while it may appear relatively benign, has been shown to foster helplessness in those who internalize the response. Admiration was also an elicited response. In similarly structured research by the authors conducted in Belgium, Costa Rica, Hong Kong, Japan, Israel, and South Korea, elders were also viewed stereotypically as warm and incompetent, refuting the notion that ageism is limited to western cultures. Research also suggests that it is difficult to overcome the elderly stereotype even when participants are presented with stereotype-inconsistent behavior. While the elders perceived as warm and incompetent are often pitied, and therefore helped, elders perceived as competent and less warm tend to be excluded.**

8. S6225-13
Donlon, M., Ashman, O. & Levy, B.
Re-Vision of Older Television Characters: A Stereotype-Awareness Intervention
Journal of Social Issues; Vol. 61 (2), 307-319; 2005.
Journal article (research)
Research has indicated that elders are underrepresented in television programming, and that the medium promotes negative ageist stereotypes. This study considers the impact of television exposure among older individuals and the impact of an intervention designed to promote awareness of negative ageist stereotypes. Seventy-six individuals, aged 60 to 92, took part in this control group experiment. The control group was asked to record television exposure throughout the course of one week, and the intervention group was asked to record their impressions of older characters as well. Participants were then asked about their perceptions of aging. Results support the researchers' hypothesis that increased exposure to television is significantly associated with more negative stereotypes of aging. In addition, the intervention raised awareness of ageism depicted on television, and participants in the intervention group expressed the intention to watch less television. Findings suggest that such consciousness raising among older individuals provides a means to address ageism.**

9. S6209-30
Glick, J.
Protecting and Respecting Our Elders: Revising Mandatory Elder Abuse Reporting Statutes to Increase Efficacy and Preserve Autonomy
Virginia Journal of Social Policy & the Law; Vol. 12; Spring 2005.
Journal article (scholarship)
In this legal commentary, the author argues that mandatory reporting statutes should be revised to "protect those seniors who lack the capacity to make their own decisions, while preserving the autonomy of others who are fully capable of exercising independent judgment..." She describes the perceived flaws of current mandatory reporting statutes which appear predicated on ageism when applied to elders who are not lacking in decision-making capacity and therefore may decrease their autonomy and perpetuate emotional victimization. Both ethical concerns can be addressed by revising mandatory reporting laws to include an assessment to distinguish between those elders who are competent and those lacking capacity. The analogy between a competent elder's right to refuse medical treatment with a competent elder's right to refuse "unwanted state intervention under mandatory reporting" is drawn. A framework for making such determinations is presented. In addition to making a determination about the appropriateness of reporting, a number of other recommendations are made, including the need for a uniform definition of elder abuse, and the empowerment of competent victims of elder mistreatment.

10. S6233-10
Gunderson, A., Tomkowiak, J., Menachemi, N. & Brooks, R.
Rural Physicians' Attitudes Toward the Elderly: Evidence of Ageism?
Quality Management in Health Care; Vol. 14 (3), 167-176; July-September 2005.
Journal article (research)
Observing that ageism can negatively impact clinicians' decisions regarding health care services, with negative implications for older patients, this study was undertaken to examine the attitudes and perceptions of rural physicians towards three cohorts of elderly patients in Florida: The elderly in general; those aged 85 and over; and those living in nursing homes or residential care facilities. The "Health Professionals Beliefs and Opinions about the Elderly," an instrument comprised of 17 items measuring four factors (competence regarding health, patient intelligence, uniqueness of the elderly, and frustration with aging) was completed by 212 practitioners of family medicine, internal medicine and psychiatry. Results indicate that the participants reported ageist perceptions, especially against nursing home residents and those aged 85 and older, particularly in the areas of competence regarding health and patient intelligence.

11. S6304-6
Hatch, L.
Gender and Ageism
Generations; 19-24; Fall 2005.
This article considers the converging concepts of aging and gender as they are reflected through the media, social policy, and inequitable treatment in healthcare settings. The author presents discussions regarding under-representation and stereotypic representation (even when positive in nature) in media coverage, describes how U.S. long-term care health policies and Social Security are disadvantageous to older women as compared to older males, and cites research that demonstrates biases against older women in terms of health care services. Research regarding the internalization of ageism and sexism among older individuals is also reviewed. Strategies for combating these prejudices include raising the awareness (particularly of older consumers) of stereotyping, harnessing the "presumed clout" of the growing older population to create change in social policy, and developing and implementing training in health care curricula to address ageism, sexism, and other prejudices.**

12. S6329-6
Kane, R.L. & Kane, R.A.
Ageism in Healthcare and Long-Term Care
Generations; 49-54; Fall 2005.
Journal article (scholarship)
This commentary presents a number of perspectives and questions concerning evidence of ageism in health care and long-term care. While acknowledging the existence of age discrimination in the delivery of health services particularly when decisions are based solely upon chronological age, the authors point out that not all health care disparities are rooted in ageism and that in some cases may reflect clinically sound treatment and intervention choices. Both overt and subtle forms of age-based rationing of health care are discussed. In terms of long-term care, ageism appears prevalent in the frequent assumptions on the part of hospital discharge planners that nursing home placement is not only the best, but often, the only alternative presented to elderly patients. The article concludes with a thought provoking consideration of the practice of urging older individuals, particularly those in nursing homes, to file advance directives such as do not resuscitate (DNR) orders.**

13. S6232-26
Kite, M., Stockdale, G., Whitley, B. & Johnson, B.
Attitudes Toward Younger and Older Adults: An Updated Meta-Analytic Review
Journal of Social Issues; Vol. 61 (2), 241-266; 2005.
Journal article (research)
In this meta-analytic survey of the literature on ageism, the authors update and expand upon a previous study (Kite and Johnson, 1988) on age-related stereotypes. Whereas the initial review was based upon 43 studies, the current review is based upon 232 studies. In addition, the current analysis categorizes the research according to the following five variables: age stereotype, attractiveness, competence, behavior or behavioral intention, and evaluation. Two new research questions were considered: whether or not older women are evaluated more negatively than older men, and whether older people view aging more favorably. The article presents a discussion of the social role theory which provides the framework for the analysis. Summary statistics for all categories indicate that respondents demonstrate a preference for younger rather than older adults; younger adults were viewed as more attractive, competent and were less likely to be stereotyped. Overall, older participants demonstrated less age-related biases than did younger participants, and middle-aged respondents demonstrated the largest age-related biases in studies addressing competence and evaluation. In terms of gender bias, when assessing competence, aging males were viewed more negatively; however, older women were viewed more negatively when considering behavior and behavioral intentions. While the summary results of the meta-analysis are similar to those of the previously conducted analysis, they also demonstrate the complexity of attitudes towards aging and older adults.**

14. S6300-17
Martens, A., Goldenberg, J. & Greenberg, J.
A Terror Management Perspective on Ageism
Journal of Social Issues; Vol. 61 (2), 223-239; 2005.
Journal article (scholarship)
This discussion examines the concept that ageism is an outgrowth of terror management theory, which suggests "...that elderly individuals present an existential threat for the non-elderly because they remind us all that: a) death is inescapable, b) the body is fallible, and c) the bases by which we may secure self-esteem (and manage death anxiety) are transitory..." A review of the research that supports this perspective is also presented. The authors propose that a greater conscious acceptance and/or awareness of one's own mortality, and the willingness to maintain more lasting bases of self-esteem (through the principles of generativity, for example) may be effective means to reduce ageism.**

15. S6228-15
Nelson, T.
Ageism: Prejudice Against Our Feared Future Self
Journal of Social Issues; Vol. 61 (2), 207-221; 2005.
Journal article (scholarship)
While racism and sexism have been studied considerably, age discrimination has received comparatively little attention, in large part because it is condoned in our society. This discussion provides an overview of ageism, tracing its roots to significant historical and sociological events. Manifestations of ageism in daily life include patronizing language pseudo-positive attitudes, infantilization, disparities in health care treatment, and elder abuse, neglect and exploitation. Theories of ageism are presented and include the functional perspective (which suggests that ageism is the result of self-denial on the part of the younger, stereotyping individual), and the terror management theory (or TMT, which suggests that ageism is an attempt to distance oneself from the threat of mortality associated with aging). The article serves as an introduction to an issue of the Journal of Social Issues that is dedicated to the topic of ageism, and provides brief descriptions of the other references in the periodical.**

16. S6323-4
Palmore, E.
Three Decades of Research on Ageism
Generations; 87-90; Fall 2005.
Journal article (scholarship)
In this essay, the author and noted sociologist recounts his professional and personal efforts to address ageism. The work began as an outgrowth of research on racism, when he observed that age discrimination shared many features with racial and sexual discrimination. His development, adaptations, and applications of various instruments such as the Equality Index (EI), the Facts on Aging Quiz (parts One and Two), The Facts on Aging and Mental Health, and the Ageism Survey are described. Overall, he suggests that efforts to reduce ageism and its impact can be successful, but progress has been minimal.**

17. S6330-5
Sheets, D.
Aging with Disabilities: Ageism and More
Generations; 37-41; Fall 2005.
Journal article (scholarship)
Due to advances in medicine and greater life expectancy, many older individuals are living with disabilities for longer periods of time. This population not only faces ageism but also ableism. While these attitudes may be internalized by elders themselves, and result in not using assistive devices, such as hearing aids or canes for fear of appearing disabled, discrimination by others may lead to social isolation and experiencing unequal treatment. Just as elders are not a homogenous group, individuals with even the same type of disability possess individual capabilities and require varying degrees of support. The author points out the benefits of cross-network collaboration between aging and disability services.**

18. S6314-9
Shippy, R. & Karpiak, S.
The Aging HIV/AIDS Population: Fragile Social Networks
Aging & Mental Health; Vol. 9 (3), 246-254; May 2005.
Journal article (research)
This study assessed social support systems and other resources for the aging HIV/AIDS population in New York City. Although 25 percent of the city's AIDS/HIV population is over age 50, and 64 percent are over age 40, AIDS services organizations (ASOs) do not provide age-sensitive services. Misinformation, stigmatization of the disease and ageism combine to create barriers to support services and medical treatment. One-hundred and sixty individuals (106 men and 54 women) aged 50 and older, living with HIV/AIDS, were surveyed regarding demographic information, HIV-related information, physical and mental health status, and social support. Among the findings, 89 percent of the respondents were persons of color, most lived alone, three-quarters self-identified as heterosexuals, and depression was the most commonly reported health problem followed by Hepatitis C. Seventy-nine percent of the participants indicated that they had unmet instrumental support needs and 57 percent indicated that they had unmet emotional support needs. Results suggest that informal support systems are inadequate to fully assist this population and awareness of formal support systems is limited. That many participants report that support members also are diagnosed with HIV/AIDS places these individuals at increased risk for unmet instrumental, health, and emotional needs. As a result, older HIV/AIDS patients may require premature nursing home placement.

19. S6313-51
Sperino, S.
Disparate Impact or Negative Impact? : The Future of Non-Intentional Discrimination Claims Brought by the Elderly
The Elder Law Journal; Vol. 13; 2005.
Journal article (scholarship)
This article considers a recent Supreme Court decision (Smith v. City of Jackson, Mississippi) interpreting the Age Discrimination in Employment Act (ADEA) in such a manner that ostensibly expands the theories available to plaintiffs but actually, the author argues, will have a negative impact upon elder litigants. Among other issues, the decision limits liability judgment. The author concedes that the ruling may have a positive impact for older employees as it may induce employers to reconsider existing termination and other policies. A historical review of the disparate impact theory of discrimination under the ADEA and Title VII of the Civil Rights Act of 1964 is also presented.


20. P5943-19
Doron, I.
Aging in the Shadow of the Law: The Case of Elder Guardianship in Israel
Journal of Aging & Social Policy; Vol. 16 (4), 59-77; 2004.
Journal article (research)
This article presents the results of a quantitative analysis of a random sample of 523 cases of adult guardianship in Israel (Haifa, Nazareth, and the Krayot areas) from 2000 through 2002. The following issues were considered: the personal and social characteristics of those elders whose guardianship cases were reviewed in Family Court; the reasons for requesting guardianship; the characteristics of the legal process of guardianship appointment, and the extent to which alternatives are considered; and the typical rulings on guardianship through Family Court. Among the findings, guardianship was typically assigned to individuals who were older than 74, single, poor and living in institutions (such as retirement homes, hospitals, and nursing homes). Although reasons for requesting guardianship were complex and unique, most often the proceedings were triggered by health-related declines. In none of the reviewed cases was the potential ward represented by an attorney or present during the court proceedings. In most cases the guardian appointed was a family member, and very few cases reviewed revealed specific legal limitations. The authors suggest that ageism is a significant factor in this process. A number of recommendations are proposed for the reform of the guardianship process, particularly the need for due process and comprehensive legal assessment of the proposed ward. (Israel)

21. S6247-315
Eglit, H.
Elders on Trial: Age and Ageism in the American Legal System
University of Florida Press; Gainesville, FL; 2004.
In this book the author, an elder law attorney, examines the interactions among court personnel and aging victims and witnesses who become involved in the legal system. He begins by asserting that ageism is as pervasive in the justice system as it is throughout American society. In particular, stereotyping is observed when addressing competency issues, impacts the credibility of the older witness, and appears to restrict damages awarded by juries in civil cases. Chapters are dedicated to the effects of age upon attorneys, judges and juries. (Note: This book is not available through CANE. For more information, visit the publisher's Web site at: http://www.upf.com/book.asp?id=EGLITS04 or telephone: 1-800-226-3822. Price: $49.95. )

22. S6234-14
Jerant, A., Franks, P., Jackson, E. & Doescher, M.
Age-Related Disparities in Cancer Screening: Analysis of 2001 Behavioral Risk Factor Surveillance System Data
Annals of Family Medicine; Vol. 2 (5), 481-487; 2004.
Journal article (research)
Drawing upon data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS, a national database that collects uniform, state-specific information on preventative health practices and risk behaviors), this study considers whether ageism is operant in age-related disparities in cancer screenings. Findings reflect a complex picture; trends regarding colorectal screenings appear to favor the elderly over younger patients, while mammography screenings appear underused by older women. The use of PSA testing for prostrate cancer screening appears overly prescribed among older males. While age-related disparities do appear to exist, it is unlikely that ageism is the sole reason for these discrepancies.

23. S6268-4
Never Too Old to Be Treated Right
Consumer Reports on Health; Vol. 16 (4), 3-6; April 2004.
Journal article (scholarship)
This article recaps the 2003 study conducted by the RAND Corporation on the quality of medical care for older patients. Findings suggest that doctors often assume that many complaints of older patients are the inevitable results of aging and under-treat them, ignore certain conditions that they would not in younger patients, counsel older patients against many drugs and invasive procedures despite clinical evidence that they can be effective and safe for use with this population. The article also offers guidelines for older health care consumers and their families to ensure appropriate treatment. Tables include a list of conditions not inevitable to aging and a list of risky drugs and possible alternatives for older patients.

24. S6269-8
Weir, E.
Identifying and Preventing Ageism Among Health-Care Professionals
International Journal of Therapy and Rehabilitation; Vol. 11 (2), 56-62; February 2004.
Journal article (scholarship)
This overview of ageism describes the research that indicates such biases are identified in various professional student groups throughout the health care spectrum and outlines educational strategies to address these attitudes. Ageist attitudes are acquired at an early age through popular avenues such as children's and adolescent literature and the public media. Research conducted on the topic with medical, dental, nursing, occupational therapy, and podiatry students is reviewed. The role of fear in ageism and "gerontophobia" is discussed. The author recommends that gerontological content be integrated not only into medical school curricula but also into related undergraduate studies. The National Service Framework (NSF) for Older People, an initiative to develop national standards and service models of health and social service care throughout the U.K. is described.


25. S6239-16
Anderson, D. & Wiscott, R.
Comparing Social Work and Non-Social Work Students' Attitudes about Aging: Implications to Promote Work with Elders
Journal of Gerontological Social Work; Vol. 42 (2), 21-36; 2003.
Journal article (research)
As the population ages, there is an increasing demand for social services for elders, yet many novice social workers prefer working with other age groups. This study was designed to compare attitudes about aging among social work and non-social work college level students and to consider factors related to the desire to work with older individuals. A convenience sample of 97 social work and 60 non-social work majors taking gerontology courses were surveyed regarding attitudes towards aging, personal and professional experiences, and values and other characteristics. Overall, participants reported negative attitudes and experiences towards aging and older individuals. Only ten percent reported a strong desire to work with elders and only twelve percent reported a slight interest in this career path. The only difference among student groups was that non-social work students appeared to have significantly higher levels of knowledge about the aging process. Analysis of the relationships among study variables suggests that a number of factors, such as having more college experience, higher levels of spirituality, hardiness and optimism, a more developed ego, and lower levels of depression were associated with more positive attitudes towards aging. Results further suggest that more positive attitudes towards aging, higher levels of knowledge regarding the aging process, and greater degrees of personal and professionals experience with elders were associated with an increased desire to work with elders. The authors recommend incorporating knowledge and experiences regarding aging issues into social work curricula whenever possible.

26. P5311-51
Dessin, C.
Financial Abuse of the Elderly: Is the Solution a Problem?
McGeorge Law Review; Vol. 34; Winter 2003.
Journal article (legal scholarship)
This article provides a comprehensive discussion and examples of the "often vague" definition of financial abuse in existing state legislation which allows for flexibility in addressing financial exploitation, but also weakens effectiveness in terms of prosecution. Many laws presume that an abusive act benefits the perpetrator and involves lack of consent. The simplistic assumption that one's assets should always be retained for one's own benefit is considered as it negates the autonomy of many elders who, out of a sense of duty or generosity, may wish to give to others. The author argues that legally defining financial abuse and exploitation in terms of age is an example of "new ageism" and proposes an alternative that is without ageist stereotyping.

27. P5478-13
Fischer, L. et al.
Treatment of Elderly and Other Adult Patients for Depression in Primary Care
Journal of American Geriatric Society; Vol. 51 (11), 1554-1562; 2003.
Journal article (research)
The objective of this study was to consider whether depression in older patients was treated differently than depression in younger patients. Over one thousand primary care patients diagnosed with depression were divided into six age groups which were compared to analyze differences in clinical interview questions and referrals. Charts were audited for two specific pieces of information: whether the patient was assessed for suicide risk, and whether the patient was referred for mental health services (in addition to medication). Results indicate that while the severity of symptoms was relatively similar for all age groups, the care process revealed differences in interventions by physicians. Specifically, doctors were more likely to ask younger patients about suicidality, to explicitly address the depression, and to provide written information on depression. Physicians were three times more likely to refer young-adult patients to mental health specialists than old-old patients. Approximately 75 percent of patients across all age groups were prescribed antidepressants. (Note: This article is available online through Medscape at http://www.medscape.com/viewarticle/463910?mpid=21863 . A no-fee registration is required.)

28. P5173-5
Grief, C.
Patterns of ED Use and Perceptions of the Elderly Regarding Their Emergency Care: A Synthesis of Recent Research
Journal of Emergency Nursing; Vol. 29 (2), 122-126; April 2003.
Journal article (literature review)
This article provides a literature review of research on elderly patients' perceptions of and satisfaction with emergency medical treatment. Overall, when compared to younger patients, the elderly experienced increased length of stays, more diagnostic tests, higher rates of recidivism, and less satisfaction. It is unclear if the lower rates of satisfaction (resolution of presenting problem) are related to ageism on the part of emergency health care professionals, or due to health and social complications related to the aging process. Geriatric education for emergency room (ER) professionals and research focusing on interactions between elderly patients and ER staff are recommended.

29. P5409-8
Ory, M. et al.
Challenging Aging Stereotypes - Strategies for Creating a More Active Society
American Journal of Preventive Medicine; Vol. 25 (3Sii), 164-171; 2003.
Journal article (scholarship)
This article presents an overview on ageism and examines its prevalence, nature, and impact upon preventative efforts to enhance health, functioning, and well-being among older patients. Physical activity programs are highlighted as activity level is an indicator of morbidity and mortality. One myth that has been particularly negative is the idea that behavioral changes later in life are "too little, too late." Concrete suggestions for overcoming barriers and for reaching out to older patients are provided.

30. P5105-7
Peake, M. et al.
Ageism in the Management of Lung Cancer
Age and Ageing; Vol. 32, 171-177; 2003.
Journal article (research)
In this study, data was gathered on the diagnosis and treatment of 1,652 lung cancer patients in the U.K. treated from 1997 through 1998. The results indicate that there are age-related differences regarding the management and survival of non-small cell lung cancer (NSCLC) patients. Although age alone does not appear a significant prognostic factor in NCSLC, and elderly patients' response rates to chemotherapy are comparable to younger patients, older patients appear to be under treated. This research suggests that ageism in health care practices may account for higher mortality rates of NSCLC in the U.K. as compared to the U.S. and most of Europe. (U.K./England)

31. S6311-20
Schigelone, A.
How Can We Ignore the Why? A Theoretical Approach to Health Care Professionals' Attitudes Toward Older Adults
Journal of Gerontological Social Work; Vol. 40 (3), 31-50; 2003.
Journal article (scholarship)
This discussion applies the Katz model of Functional Approach to Attitudes (which emphasizes the necessity of understanding their psychological basis in order to change them) to analyze ageism demonstrated among health care professionals. Literature is cited that strongly suggests such biases and demonstrates that diagnosis and treatment is unfavorably inequitable for older patients. The Katz framework implies that attitudes can fulfill one or more of four functions: an instrumental or utilitarian function; a knowledge function; an ego defense function; and a value-expressive function. Some research findings indicate medical students prefer not to work with older patients due to relatively poor financial compensation and significant time costs, which supports the existence of utilitarian-based attitudes. There is mixed evidence that a lack of direct knowledge of elders is the source of ageism; in some studies increased contact with elderly patients appears to result in more positive attitudes, but other studies indicate the opposite. The context of the contact, which is rarely considered, may likely be an important factor. Little research exists on interpreting the value-expressive function of ageism among health care professionals. Some, though not much, has been conducted on the ego defense function, which suggests that ageism may be related to one's own fear of death. Effective strategies to address ageism should be tailored to the source of the bias. Social workers are encouraged not only to examine their own attitudes, but to play a leading role in developing relevant research and in promoting an understanding of these barriers throughout the health care and social services networks.

32. S6320-12
Stewart, S.
"A Tapestry of Voices": Using Elder Focus Groups to Guide Applied Research Practice
Journal of Social Gerontology; Vol. 42 (1), 77-p88; 2003.
Journal article (research)
Perhaps as a result of ageism, elders are frequently uninvolved in research and in establishing an agenda for research to address their needs. In this qualitative study, designed to elicit the input of older individuals in determining a research agenda not based solely on the medical model but one that addresses quality of life issues, fifteen focus groups of elders and caregivers of cognitively impaired individuals were conducted. Participants represented various ethnic backgrounds, social and living circumstances, and geographic regions of Ontario, Canada. Data analysis involved not only content analysis of discussion but analysis of group process as well and its impact upon members. While a number of themes emerged that were related to specific life circumstances, general themes also emerged: the need for adaptations to the physical environment that would allow elders to maintain greater independence; affordable housing alternatives; reducing barriers between generations; and reducing the prevalence of ageism. Participants reflected that the process was empowering. (Canada)


33. P5172-4
Administration on Aging (AoA)
Age Discrimination: A Pervasive and Damaging Influence
Online resource
This overview provides basic information regarding ageism in the workplace. The Age Discrimination in Employment Act of 1967 is described. Subtle forms of age bias, such as a negative work environment or not being considered for advancement, are considered most detrimental to the older employee. (Note: This synopsis is available online at http://www.globalaging.org/elderrights/us/age.htm)

34. P5411-44
Bergstrom, H.
Age in the Press
The Joan Shorenstein Center, Press, Politics and Public Policy, Harvard University, John F. Kennedy School of Government; 2002.
Through interviews with journalists, editors, and advertising and marketing specialists, and content analysis of articles, the author examined the ways in which print media has been affected by the changing demographics of an aging population. He focused upon the Boston Globe, Dagens Nyheter of Stockholm, Sweden, the San Francisco Chronicle, and the New York Times. Themes are considered as they are reflected by the press in terms of organizations composed of employers and employees, as markets, and as agenda setters for public discourse. Although nearly half of all journalists tend to be older employees, downsizing efforts have been geared towards older employees for cost benefits. Senior journalists also perceive content has become less important than marketing, which has been increasingly geared towards younger readers while older readers, constituting a significant portion of the audience, are typically ignored. Content analysis reveals that during the previous decade, while there was some increase in articles dealing with the term "aging," the trend was not strong or consistent, and typically emphasized aging as a negative or problematic issue. (Note: This paper is accessible online at http://ksgwww.harvard.edu/presspol/Research_Publications/Papers/

35. S6310-12
Giles, C., Paterson, J., Butler, S. & Stewart, J.
Ageism Among Health Professionals: A Comparison of Clinical Educators and Students in Physical and Occupational Therapy
Physical & Occupational Therapy in Geriatrics; Vol. 21 (2), 15-26; 2002.
Journal article (research)
In this study, attitudes towards older adults held by physical and occupational therapy educators and students were assessed. One-hundred and seventy-five participants completed questionnaires which included the Kogan's Attitude Toward Old People Scale and Palmore's Facts on Aging Quiz (FAQ1). Among the findings, students of both disciplines demonstrated significantly higher degrees of negative bias than the clinical educators did. Significantly higher degrees of positive ageism were demonstrated by both clinical educators and students of occupational therapy when compared with the physical therapy students and educators, which may belie a simplistic professional belief that there is a high degree of homogeneity among older patients. In particular, results from the FAQ1 suggest that clinical experience and health education did not enhance professionals' knowledge of the aging process. Such bias and lack of knowledge may have a detrimental impact on the delivery of these types of health care for older patients. (New Zealand)

36. P5050-8
Hatchett, B., Holmes, K. & Ryan, E.
Attitudes of a Predominantly Hispanic College Sample Towards Older Adults
Journal of Gerontological Social Work; Vol. 37 (2), 45-59; 2002.
Journal article (research)
This research examines the attitudes of 40 female and 31 male Hispanic college students towards aging older adults. Participants were asked to rate characteristics of male and female members of the following age cohorts: 50 to 64, 65 to 74, 75 to 99, and 100 and over. Although positive characteristics were attributed to males and females of all age groups, the ratings became less favorable for each advancing age group. The study also examines the link between experience with elders (familial and non-familial) and the desire to work in the geriatric social work field. Implications for social work curriculum planning are considered.

37. P5188-13
Hooyman, N., Browne, C., Ray, R. & Richardson, V.
Feminist Gerontology and the Life Course: Policy, Research and Teaching Issues
Gerontology & Geriatrics Education; Vol. 22 (4), 3-26; 2002.
Journal article (scholarship)
This article employs a feminist gerontological perspective, which addresses power dynamics, to analyze the impact of ageism and gender bias upon the lives of older women, in areas such as caregiving, work, and retirement. The authors suggest that the use of a feminist framework cultivates diversity and focuses attention to issues of racism and other power imbalances as well.

38. P5118-9
Kapp, M.
Health Care Rationing Affecting Older Persons: Rejected in Principle but Implemented in Fact
Journal of Aging & Social Policy; Vol. 14 (2) 27-42; 2002.
Journal article (scholarship)
Although rationing of health care based upon chronological age has been rejected in theory in the U.S., the author of this article examines four "...forms of de facto health care rationing that carry real but largely hidden ramifications for older persons: third-party payer behaviors, physician practice patterns, the spread of evidence-based clinical practice parameters or guidelines in medicine, and the shift toward greater consumer choice in selecting health plans...." Faced with increases in out of pocket expenditures such as premiums or uncovered prescriptions, some older Americans ration health services for themselves. Physicians may make decisions regarding diagnostic and treatment recommendations based upon patient age, and aggressive care is limited for the oldest hospital patients and nursing home residents. Recommendations are offered, and include the guarantee of access to "accurate, comprehensive, timely information about the health care options financially and logistically available to, and medically appropriate for" all individuals, including older consumers.

39. N4926-10
Levy, B., Slade, M., Kunkel, S. & Kasl, S.
Longevity Increased by Positive Self-Perceptions of Aging
Journal of Personality and Social Psychology; Vol. 83 (2), 261-270; 2002.
Journal article (research)
This is a discussion of research focusing on what impact, if any, positive self-perceptions have upon longevity. In 1975, 660 participants, aged 50 and over, took part in a research project, Ohio Longitudinal Study of Aging and Retirement (OLSAR), designed by Miami University. In 1998, this group of researchers determined how long the participants survived after the baseline survey. The survivor rates were correlated with positive or negative self-perceptions of aging, after other variables were controlled. Findings indicate that the participants demonstrating more positive self-perceptions of aging lived a median of 7.6 years longer than those demonstrating negative self-perceptions. A second study explores the impact of the will to live upon survival and self-perceptions. The article also includes an interesting discussion regarding differences between aging self-perceptions and those based upon gender and race.

40. S6246-390
Nelson, T., ed.
Ageism Stereotyping and Prejudice Against Older Persons
The MIT Press, Cambridge, MA; 2002.
Ageism is considered "...one of the most socially condoned, institutionalized forms of prejudice in the world - especially in the United States...." This book deals with the origins of ageism, its impact, and efforts to reduce this prejudice. Basic cognitive and affective processes underlying stereotyping are examined, along with the intrinsic fear of mortality. The concept that stereotyping may be subconscious appears to contribute to its pervasiveness. Discriminatory behaviors range widely, from those stemming from interpersonal actions to those sanctioned by formal policies. The ability for many older individuals to maintain positive self-esteem in the face of such discrimination is also considered. The concluding chapter reviews the major findings of research that has been conducted in this field throughout the past 30 years. (Note: This book is not available through CANE. For more information, visit the publisher's Web site at: https://mitpress.mit.edu/catalog/item/default.asp?ttype=2&tid=10385 or telephone toll-free 1-800-405-1619 in the US and Canada. Price: $13.00/£8.95.)

41. P5773-26
Old Age Psychiatry of the World Psychiatric Association and the World Health Organization
Reducing Stigma and Discrimination against Older People with Mental Disorders
Geneva, Switzerland; 2002
Technical consensus paper (online)
The World Health Organization and the World Psychiatric Association collaborated with other nongovernmental organizations (NGO) to produce this technical consensus statement to promote discussion aimed at reducing the stigmatization of older people with mental illness. The authors point out that to date, attention to the concept of stigmatization regarding the mentally ill was directed towards younger individuals. Older individuals experiencing mental illness are likely to be dually stigmatized, as both older and mentally ill people are routinely marginalized in society. Causes of this discrimination are discussed, including ignorance, fear, drive for conformity, internalization, cultural influences, social and economic instability, a lack (or perceived lack) of preventative strategies and interventions, and gender biases. Consequences include negative attitudes such as prejudice, ageism, damaging self-beliefs, secrecy, and distortions regarding costs of care and treatment. Such discrimination is not only directed at the mentally ill but at their families and mental health professionals as well. Negative attitudes impact upon quality of health care, and at times, undermine the credibility of elders when describing instances of abuse and mistreatment. (Note: This paper is available online at http://www.who.int/mental_health/media/en/499.pdf)

42. S6227-12
Robb, C., Chen, H. & Haley, W.
Ageism in Mental Health and Health Care: A Critical Review
Journal of Clinical Geropsychology; Vol. 8 (1), 1-12; 2002.
Journal article (literature review)
Observing that there has been much anecdotal discussion regarding ageism as a barrier to (and therefore the significant reason for underutilization of) mental health services for older individuals, the authors present a literature review on age bias in the delivery of mental and medical health treatment. The article begins with an overview of the recognition of ageism, the creation of Areas Agencies on Aging under the Older Americans Act of 1973, and the implementation of training initiatives to enhance therapeutic practice with older individuals. Few studies have been conducted on the presence of ageism among mental health clinicians, and results were mixed. While some biases were noted, negative attitudes towards the aged were not as evident as had been hypothesized, challenging the premise that ageism is a barrier to treatment for older individuals. In reviewing the literature on health care professionals, research has addressed the topic of age-based health care rationing, and considered the differences in screening, diagnosis and treatment interventions among older and younger patients. Explanations for treatment inequities have been offered, yet they appear invalidated by subsequent research; in other words, it appears that older patients would benefit significantly from screening and treatment interventions offered more routinely to their younger counterparts. In conclusion, it appears that systemic factors, such as accessibility and reimbursement, may be stronger barriers to mental health services for aging clients than ageism on the part of counselors and clinicians. The need for outcomes-based research among this population in the mental health field is considered paramount. The review also considers research on the effectiveness of enhancing awareness and exposing health care professionals to healthy, aging adults.

43. S6231-11
Stallard, J., Decker, I. & Sellers, J.
Health Care for the Elderly: A Social Obligation
Nursing Forum; Vol. 37 (2), 5-15; 2002.
Journal article (scholarship)
Drawing upon a survey of the literature, this philosophical discussion focuses on ageism in the context of health care allocation. The authors argue that a society is obligated to provide adequate health care to all of its citizens, and that rationing health care solely on the basis of age denotes age discrimination. Global statements of human rights, traditions of religions and secular ethics, and principles of beneficence are cited in support of this belief. Among the arguments considered for and against age-based health care rationing are those of Rawls, Engelhardt, Daniels, Battin, Moody, and Callahan. The authors encourage the American Nurses Association (ANA) to assume leadership in researching the impact of ageism in health care allocation upon elders, to generate a policy statement supporting equal access to health care, to revise nursing curricula to accurately reflect the needs of elder patients.

44. P5410-00
U.S. Senate Special Committee on Aging
The Image of Aging in Media and Marketing
Washington, D.C.; September 4, 2002.
Hearing (online)
This hearing presents the testimony of actress Doris Roberts, Robert M. Butler, M.D. (President and CEO, International Longevity Center, NY, who coined the term "ageism" in 1968), Robert Snyder (Senior Partner, Mature Market Group, Dallas, TX), Paul Kleyman (Editor, Aging Today), and Dr. Becca Levy (Professor, Dept. of Epidemiology, Yale University). Dr. Butler described ongoing efforts to raise social awareness regarding ageism. Ms. Roberts notes that ageism in the entertainment industry perpetuates the myth that old people (particularly women) are feeble and incompetent, and that there are few employment opportunities. Dr. Levy describes her research that suggests that negative self-attitudes regarding aging contribute to poorer outcomes on a number of physical and mental health measures. In his testimony, Mr. Snyder states that a significant intervention in addressing ageism is the recognition of the potential impact that seniors have on the market. He provides an in depth discussion of his company's philosophy of "ageless marketing," which utilizes values-based research in cultivating the senior market but also notes that such an approach is also appropriate for younger consumers. Mr. Kleyman reports upon evidence of age biases in print journalism, but also notes that despite minimal coverage, an emerging "age beat" is developing as 60 daily newspapers currently devote at least part-time regular coverage to aging issues. (Note: The testimony of all witnesses is accessible online at http://aging.senate.gov/public/ . Select "107" from the Archives.)

45. P5047-34
Waysdorf, S.
The Aging of the AIDS Epidemic: Emerging Legal and Public Health Issues for Elderly Persons Living with HIV/AIDS
The Elder Law Journal; Vol. 10; 2002.
Journal article (scholarship)
This comprehensive article explores a variety of legal implications regarding the "graying AIDS epidemic." The author indicates that ageism is a factor in the frequent misdiagnosis or late diagnosis of AIDS in older patients, since they are rarely tested for AIDS. As a result, little research is available and treatment is less effective in ameliorating the effects of this increasingly chronic, rather than terminal, disease. The research that is available demonstrates that women, particularly minority women, are the fastest growing segment of AIDS patients over age 50. It also indicates that older individuals experience significant clinical differences from younger patients. Poverty of the elderly impacts prevention and treatment, while AIDS discrimination has been responsible for barring admission to nursing homes for some patients. The proposed Medicare Chronic Care Improvement Act of 2001 and The Medicare Wellness Act of 2001 are also discussed.


46. N4769-9
Emlet, C. & Farkas, K.
A Descriptive Analysis of Older Adults with HIV/AIDS in California
Health and Social Work; Vol. 26 (4), 226-234; November 2001.
Journal article (research)
Although 10-15 percent of AIDS cases reported in the U.S. represent individuals aged 50 and over, this group of patients (particularly older women) remain largely invisible. In this study, data from 571 HIV/AIDS case management clients in California was analyzed for trends among and across three age groups (63 cases aged 60 and over, 190 cases aged 50 to 59, 318 cases aged 30 to 49). Of significance, over half (53 percent) of the older patients lived alone and the mortality rate of the over 60 age group was almost double that of the 30 to 49 age group. Percentage of older adults exposed through heterosexual contact continues to increase with age. Implications include the need to address ageist and sexist beliefs about sexuality and drug use among older individuals, and the need to reconsider the optimal service delivery path for older patients.

47. N4590-11
Firbank, O.
Human Rights Enforcement Agencies and the Protection of Older Workers Against Discrimination: The Case of the Quebec Human Rights Commission
Journal of Aging & Social Policy; (12) 3, 65-85; 2001.
Journal article (research)
This article analyzes how the Quebec Human Rights Commission (QHRC) processes cases of age discrimination in the employment sector. Quebec has led Canada in protecting older employees against age discrimination since the enactment of the Act Respecting the Abolishment of Compulsory Retirement (1982). This research provides an in-depth analysis of thirty closed cases (approximately one-third of all cases closed between 1991 and 1996) to explore the QHRC's methods of investigation and determination. Only 16 percent of the discrimination complaints were substantiated with compensation awards, while another 8.5 percent of complaints were settled out of court. Several case synopses illustrate what the researcher identifies as shortcomings inherent in the conflicting role that the investigative officer plays and the conservative manner of investigation. However, the author finds these problems correctable and states that QHRC's impact on deterrence of ageism in the work place is immeasurable. (Canada)

48. A496-3
Krueger, B.
How Aging Is Covered in the Print Media
Generations; 10-12; Fall 2001.
Journal article (scholarship)
This article reflects upon the tendency in print media to under-represent the older population, despite efforts to increase diversity in newspaper reporting. The author describes his personal experience in trying to increase the visibility of seniors in the press and to promote awareness of issues that are relevant.

49. S6316-12
McMullin, J. & Marshall, V.
Ageism, Age Relations, and Garment Industry Work in Montreal
Gerontologist; Vol. 41 (1), 111-122; 2001.
Journal article (research)
In Canada, mandatory retirement is an acceptable practice in all but three provinces, and the scant research on age discrimination that has been conducted in the country suggests that employers discriminate against older workers in hiring and promotion practices. This qualitative study examines ageism in the garment industry as perceived by older workers (aged 45 and up), retirees, and those who experienced job displacement. Employing a theoretical framework that ageism is not simply the result of individual biases but also exists in terms of societal structure, and that it exists on both ideological and behavioral levels, researchers analyzed focus group dialogue from a larger study on the aging work force. While older workers appear to internalize ageist stereotypes, employers rely upon stereotypes to legitimize discriminatory practices, such as discouraging and intimidating older workers, subcontracting easier work while retaining more difficult tasks for older workers while expecting continued productivity rates, etc. Gender and ethnic biases were also observed. (Canada)

50. S6267-4
Palmore, E.
The Ageism Survey: First Findings
The Gerontologist; Vol. 41 (5), 572-575; 2001.
Journal article (research)
This brief article summarizes the development and testing of a survey designed to measure the extent of ageism, to identify the types of ageism most common, and to identify the subgroups of the older generation who report experiencing this form of discrimination most frequently. Eighty-four seniors completed the survey. Seventy-seven percent reported experiencing ageism at least once, and more than half had experienced incidents more than once. Most commonly reported were incidents that poked fun or disrespected older people, followed by incidents that were related to health care practices. Least frequently reported were specific and severe discrimination and victimization. Results suggest that the survey (included) is a reliable and valid tool.

51. S6318-5
Ragan, A. & Bowen, A.
Improving Attitudes Regarding the Elderly Population: The Effects of Information and Reinforcement for Change
The Gerontologist; Vol. 41 (4), 511-515; 2001.
Journal article (research)
Observing that ageism may result in such negative outcomes for older individuals as isolation, inadequate housing and income, premature nursing home placement, and untreated medical and mental health issues, this research was designed to study whether ageist attitudes can be altered. The sample consisted of 35 male and 64 female psychology students who participated in one of three treatment groups. Each group completed the Aging Semantic Differential (ASD) to obtain baseline levels of attitudes towards aging. Each of three groups then viewed a video tape with corrective information entitled "The Myths and Realities of Aging," and again completed the ASD. One group intervention was limited to the video tape; the second group viewed the video tape and participated in two group discussions and were reinforced when they spoke positively about elders; and a third group viewed the tape and also participated in two general follow-up discussions which centered on campus life. In the last group, comments about elders were ignored but participants were reinforced for all other appropriate statements. Pre-test scores for all groups demonstrated negative attitudes regarding elders at baseline, and as predicted, post-tests immediately following the corrective information demonstrated more positive attitudes. However, only the treatment group that experienced information reinforcement for making positive statements regarding elders demonstrated sustained significant improvement in attitudes when completing the ASD one month after intervention. The authors hypothesize that while information alone is necessary to change people's attitudes, reinforcement is necessary in order to sustain such changes.

52. N4706-5
Robinson, S. & Rosher, R.
Effect of the "Half-Full Aging Simulation Experience" on Medical Students' Attitudes
Gerontology & Geriatrics Education; Vol. 21 (3), 3-12; 2001.
Journal article (research)
Demographic trends suggest that by 2020 older adults may utilize more than half of all U.S. healthcare services. Therefore, the need for geriatricians and age-sensitive health professionals will also increase. This article describes a number of exercises designed to sensitize medical students to the aging process. It focuses on the results of a study of the "Half-Full Aging Simulation Experiment" of the Southern Illinois University School of Medicine. Not only did students experience simulated sensory and other physical limitations, they then participated in adaptation experiments that demonstrated how independence can be maintained in spite of such obstacles. Results demonstrated an improvement in the students' attitudes towards the aging process as measured by the Aging Semantic Differential Scale.

53. A482-5
Signorielli, N.
Aging on Television: The Picture in the Nineties
Generations; 34-38; Fall 2001.
Journal article (research)
This article explores the prevalence of older characters on television as well as the viewers' perceptions of these characters. Under-representation of older individuals and gender-related differences are among topics discussed. Although 11 percent of male characters aged 50-64 are considered elderly, 22 percent of women in the same age bracket are considered elderly, and the disparity continues as the characters age chronologically. The author cites research that implies that television viewing contributes to ageism in American culture.

54. N4707-5
van Zuilen, M., Rubert, M., Silverman, M. & Lewis, J.
Medical Students' Positive and Negative Misconceptions About the Elderly: The Impact of Training in Geriatrics
Gerontology & Geriatrics Education; Vol. 21 (3), 31-39; 2001.
Journal article (research)
In 1999, only 14 of 127 medical schools in the Association of American Medical Colleges required a geriatrics course. It is estimated that only three to four percent of all medical students express an interest in going into geriatric practice. These statistics, combined with the aging population projections, will likely lead to inadequacy of health care service delivery in the early 21st century. This article reports on a study of 254 University of Miami School of Medicine students who completed a two week course in geriatrics. Geriatric knowledge was measured before and after, using Palmore's Facts on Aging Quizzes (FAQ) 1 & 2, and the Facts on Aging & Mental Health Quiz. The results indicated that while the base knowledge improved slightly, the net negative bias increased due to a decline in the positive bias of the aging process. In order to promote a more balanced perspective, it is recommended that medical schools incorporate geriatric education that involves interaction with healthy, more autonomous elders as well as the chronically ill.


55. S6229-11
Ivey, D., Wieling, E. & Harris, S.
Save the Young - the Elderly Have Lived Their Lives: Ageism in Marriage and Family Therapy
Family Process; Vol. 39 (2), 163-175; 2000.
Journal article (research)
This study was designed to analyze whether client age and the level of marriage and family therapist experience had an impact on clinical assessment of couples presenting for conjoint therapy. Three-hundred and fifty-nine adults (128 non-therapists, 113 therapists in training, and 118 therapists) were randomly assigned to read one of two case scenarios. In each vignette, the couples presented identical complaints (decreased sexual intimacy, increased arguments, and an increase in alcohol use by the male) but in the first scenario the male was 74 and the female 69 and in the second the male was 34 and the female 29. Among the results, the older couple's relationship was perceived as healthier by all groups of participants, suggesting that sexual issues, increased arguments and increased substance abuse issues are viewed less seriously when presented by older clients. Non-therapists held significantly favorable perceptions of the older couple's relationship, and therapists in training held more favorable perceptions then did therapists.


56. K4204-9
Harbison, J.
Models of Intervention for "Elder Abuse and Neglect": A Canadian Perspective on Ageism, Participation, and Empowerment
Journal of Elder Abuse & Neglect; Vol. 10 (3/4), 1-17; 1999.
Journal article (research)
This article identifies six models of elder abuse intervention: the psychopathological model, the systems model, the hierarchical model, the quasi-legal model, the child welfare model, and the participatory model. Each intervention model is discussed regarding limitations related to ageism. The participatory model, which encourages the involvement of elders in terms of education and awareness of elder abuse, has the most potential for empowerment. (Canada)

57. S6244-268
Palmore, E.
Ageism: Negative and Positive (second edition)
Springer Publishing Company; 1999.
In this book, the author, a gerontologist, describes many different types of ageism, including negative stereotyping as well as positive ageism, which is prejudice that favors an age group. For example, some who think that the elderly are generally affluent believe that Medicare is a manifestation of positive ageism. Discussion considers the individual, social, and cultural factors that impact ageism. Institutional patterns of ageism found throughout the economy, government, family, housing, and health care sectors are examined. Finally, an evaluation of efforts to reduce ageism is presented. (Note: This book is not available through CANE. For more information, visit the publisher's Web site at: http://www.springerpub.com/prod.aspx?prod_id=70021 or telephone 877/687-7476. Price: $33.95)


58. P5971-12
Reynolds, S.
Protected or Neglected? An Examination of Negative versus Compassionate Ageism in Public Conservatorship
Research on Aging; Vol. 19 (1), 3-25; March 1997.
Journal article (research)
This study was designed to determine whether older adults under conservatorship (or guardianship) were likely to experience "negative ageism." Negative ageism was defined by four measures: to be served under powers that permit placement in locked facilities; to be served under powers that permit treatment with psychotropic medication; to be placed in locked facilities; and to be treated with psychotropic medications. Data was collected from 2,118 court records of adults being served under conservatorship by the Los Angeles County Office of Public Guardians (LAOPG) in July 1993. Results suggest that older individuals in conservatorship were treated differently than younger individuals; increasing age was negatively associated with the conservator receiving powers to place the conservatee in a locked facility or have the conservatee treated with psychotropic medications. They were also less likely to be placed in locked facilities than in nursing homes or independent living situations, and they were less likely to be treated with psychotropic medications than younger wards. The findings suggest that compassionate ageism may be operant.

59. J4039-5
Whitmer, R. & Whitbourne, S.
Evaluation of Infantilizing Speech in a Rehabilitation Setting: Relation to Age
International Journal of Aging and Human Development; Vol. 44 (2), 129-136; 1997.
Journal article (research)
Speech infantilization occurs when one regresses from normal speech patterns to address elders as if they were children, a behavior based upon stereotypical expectations that elders are more dependent. This study compared the responses of ten rehabilitation patients aged 65 and over with ten patients under 65, all of similar levels of independence, to speech infantilization. Results indicate that the older group preferred the childlike intonation, while the younger group preferred to be spoken to in an adult manner. This promotion of child-like identity is potentially harmful not only to the individual's sense of self and independence, but may also prove counterproductive to rehabilitation and recovery.

60. S6315-31
Whitton, L.
Ageism: Paternalism and Prejudice
DePaul Law Review; Vol. 46; Winter 1997.
Journal article (scholarship)
This legal note is intended to examine the ways in which individual and collective attitudes towards aging are developed, and how they impact the practice of law, the development of public policy and legislation, and judicial decisions. It opens with a discussion of a hypothetical case involving a wealthy elderly widow facing a guardianship hearing that served as a focal point for a law school course. Despite "a semester of consciousness raising about ageism and stereotyping" the student recommendations for future planning appeared to reflect ageist attitudes. Part I presents an overview of societal beliefs, practices and attitudes about aging, including age segregation and "gerontophobia." Physical and mental aspects of the aging process are also discussed. Part II summarizes the impact of age bias (including compassionate ageism or paternalism) on the health care system, and Part III considers how ageism is manifested throughout the legal system.


61. V52 and V53
New Jersey Association of Area Agencies on Aging
"It's Hard to Imagine" and "Closing the Gap"
New Jersey Association of Area Agencies on Aging - Elderly Abuse and Neglect Project, with funding from the Older Americans Act through the New Jersey Division of Senior Affairs; 1996.
Video Set and Teacher's Guide
"It's Hard to Imagine" is a 12 minute video that presents healthy and three-dimensional images of aging adults. Intended for use grades 3 through 5, children are asked to imagine themselves at age 80. The personal experiences of vital, older adults are presented. "Closing the Gap," a 22 minute video meant to promote discussion and respect regarding the process of aging, is intended for use with middle school students. The video presents older individuals sharing opinions with 6th, 7th, and 8th graders, and initially revealing evidence of the "generation gap." However, both generations describe mutual concerns, and students are prompted to consider their own future as aging individuals. Each video is accompanied by a four page teaching and activity guide. (Note: This product is available through CANE for the cost of shipping and handling; contact the CANE office for more details at 302/831-3525 or email at CANE-UD@udel.edu)


62. S6234-7
James, J. & Haley, W.
Age and Health Bias in Practicing Clinical Psychologists
Psychology and Aging; Vol. 10 (4), 610-616; 1995.
Journal article (research)
Ageism has been considered a factor in the under-use of psychological or mental health services by the elderly, however, empirical evidence to support this theory is minimal. It is also noted that negative attitudes associated with ageism may actually be rooted in "healthism" which is a negative bias towards individuals with health problems. In this study, researchers hypothesized that clinical psychologists would demonstrate both professional and interpersonal healthism biases while ageism, independent of health issues, would be less prevalent. Three-hundred seventy-one randomly selected doctoral level psychologists (of 800 contacted) completed this survey. Participants received one of four detailed vignettes describing the presenting problems of a hypothetical female client. The vignettes differed only in terms of client age (35 or 70) or health status (unremarkable or poor). Respondents completed questionnaires to assess professional and interpersonal bias. Results suggest the presence of age bias regardless of health status, but indicate that healthism is even more significant. When healthism and ageism combine, clients may be particularly susceptible to biased assessments and interventions on the part of mental health professionals.


63. H3422-6
Callahan, D.
Setting Limits: A Response
The Gerontologist; Vol. 34 (3), 393-398; 1994.
Journal article (scholarship)
Setting Limits: Medical Goals in an Aging Society, released in 1987, was highly protested because of its idea that health care allowances based on age might be needed as the baby boom generation began to retire. The idea was believed to be prejudiced, ageist, and threatening to the well-being of the elderly. In this reply to the controversy, the author suggests that age-based health care should be reconsidered in light of the complexities of the economic realities of health services and longer life expectancy. He suggests that the elderly are entitled to a "reasonable" claim on public resources for health care, not an unlimited claim.

64. H3413-6
Donow, H.
The Two Faces of Age and the Resolution of Generational Conflict
The Gerontologist; Vol 34 (1), 73-78, 1994.
Journal article (scholarship)
Drawing upon the literature of Shakespeare, Balzac, and Dickens, this essay presents a theoretical discussion of the two views of elders, as both victims and exploiters, which have persisted throughout the ages. The concepts of ageism, generational conflict, generational continuity, and generational equity are considered against this backdrop.


65. S6306-8
Gekoski, W. & Knox, V.
Ageism or Healthism? Perceptions Based on Age and Health Status
Journal of Aging and Health; Vol. 2 (1), 15-27; February 1990.
Journal article (research)
This research analyzes the possibility that negative stereotypes of aging are actually based on perceptions of health status rather than on chronological age. The sample was comprised of 80 male and 80 female introductory psychology students who were randomly assigned to one of eight condition groups that varied according to age of subject (or target) and health status. Results indicate that age alone did not elicit strongly negative responses from the participants while the health status effect was substantially more powerful. In particular, targets described as being in excellent health were rated significantly more positively than those described as being in average health for their age. Results underscore the complex nature of stereotyping often perceived as ageism.


66. A547-5
Chandler, J., Rachal, J. & Kazelskis, R.
Attitudes of Long-Term Care Nursing Personnel Toward the Elderly
The Gerontologist; Vol. 26 (5), 551-555; 1986.
Journal article (research)
This study assessed the attitudes of nurses toward the elderly, to determine if they are affected by nursing level (RN, LPN and nursing aides), differences in nursing facilities, and whether education could change such attitudes. In general, the findings suggested that the nurses' attitudes towards the elderly appeared positive or neutral rather than negative, and that increased patient dependency did not appear to have a negative impact. RNs appeared more positive than LPNs and nursing aides. The experiential educational program did not appear to have an impact on the attitudes; however, the experience was designed to improve negative attitudes, which were not evident at baseline. Research on the impact of nurses' and aides' attitudes towards the elderly and their impact upon care is recommended.


67. C1591-10
Bookin, D. & Dunkle, R.
Elder Abuse: Issues for the Practitioner
Social Casework: The Journal of Contemporary Social Work; 3-12; January 1985.
Journal article (scholarship)
This article examines the problems that workers assigned to cases of domestic elder abuse frequently experience and suggests appropriate strategies for dealing with them. It discusses the problems of identifying elder abuse victims, the difficulty of working with an abused person, and the impact that cultural and other biases have on the caseworker's investigation. Vulnerability of the elderly, ageism, patterns of violence within the family, caregiver stress, lack of family supports and pathological symptoms are among the areas that social workers are encouraged to consider.


68. A727-8
Binstock, R.
The Aged as Scapegoat
The Gerontologist; Vol. 23 (2), 136-143; 1983.
Journal article (scholarship)
This article critiques writings and policies that picture the aged as a homogeneous group. It argues that several axioms are used to describe the elderly and are the foundation for blaming the aged for a variety of economic and political frustrations. Axioms refer to the elderly's economic well-being, political power and their presenting an economic burden for society. The development and consequences of this scapegoating are described and avenues for changes are suggested.

69. C1974-5
Cheren, C., Patcher, M. & Cook, S.
Changing Attitudes Toward Aging Using Films
The Gerontologist; Vol. 23 (1), 106-110; 1983.
Journal article (scholarship)
The authors, members of Citizens for Changing Attitudes About Aging (CCAAA), previewed more than 75 films on aging and selected six films that present positive images of old age. These films are reviewed in this article, along with results from a study in which the attitudes of college students toward the elderly were significantly and positively altered after viewing films depicting positive images of older individuals.


70. A662-13
Bader, J.
Attitudes Toward Aging, Old Age, and Old People
Aged Care & Services Review; Vol. 2 (2), 1-14; 1980.
Journal article (literature review)
This article presents a review of the U.S. research conducted regarding age-related attitudes. The author argues that "the availability, accessibility, adequacy, and acceptability of human services intended for use by old persons are also influenced by the attitudes of younger persons. The aging-related attitudes of decision-makers, services personnel, and taxpayers are particularly important in this regard..." Not only is public policy shaped by such attitudes, but how one ages also appears to be affected by these perceptions. The review is divided according to age groups (youth, middle age, and older people) and each section provides highlights of research on age-related attitudes held by that generation. How such attitudes are developed is also considered. Methodological constraints to conducting research in this area are discussed.


71. S6243-512
Butler, R.
Why Survive? Being Old in America
Harper & Row, Publishers; New York, NY; 1975.
In this book, the author describes the plight of older Americans in terms of socio-economic realities and the cultural attitudes that have formally and informally contributed to the decline in status of the elderly. Myths concerning the elderly are identified, including the beliefs that the elderly are unproductive, prefer to disengage from society, become senile, or, in contrast, are ultimately serene in this final phase of life. The term ageism, which the author coined in the 1960s, is highlighted as a force that underlies and perpetuates the marginalization of this segment of the population. Among other topics, chapters address issues of financial security, the right to work, living arrangements, unfulfilled medical needs, and victimization. (Note: This book is not available through CANE. It is currently in print in paperback through Johns Hopkins University Press. For more information, visit http://www.press.jhu.edu/books/title_pages/3040.html or telephone 1-800-537-5487. Price: $25.00.)

**This journal issue is dedicated to the topic of ageism.

To search for additional references on topics related to elder abuse, please visit the CANE Web site at: http://db.rdms.udel.edu:8080/CANE.

To access other annotated bibliographies on topics related to elder mistreatment, visit the CANE Bibliography Series at: www.elderabusecenter.org/default.cfm?p=cane.cfm.

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