It lurks at work, at the store,
on the tube and at the doctor

June 10, 2006

     When Jean Caprera, 68, of Levittown retired six years ago, she decided to visit a local senior center. "It was near lunchtime, and the staff was gathering the seniors to be seated at the tables," she said.

"They were moving slowly toward the tables, but the hum of conversation was continuing," Caprera recalls. "One of the staff members loudly yelled, 'Shut up!' as though the seniors were children misbehaving. When I hit that magic senior number, did people view me as a child again? Did becoming a senior mean that I no longer was respected?"

Caprera didn't return to the center. Instead, she started a local chapter of The Red Hat Society, an organization of age 50-plus active women.

Harriet Morosoff, 67, of Massapequa Park, has been a bookkeeper for a Long Island car dealership for 38 years. "I am presently with a group of women who are 20 years younger, and I find myself ignored much of the time," said Morosoff.

"I have an equally active social life as they do," she said, "yet nobody ever asks, 'How was your weekend?'" Finally, she confronted co-workers and told them she was tired of being invisible. Now they've been including her in conversations.

Joseph Spiegel, 67, of Babylon, likens the words "geezer" and "whitehair" to racist slurs. "But it's OK to use those terms in America because older men and women, unless they are rich and powerful, are often considered invisible and disposable," he said.

Discrimination known as ageism isn't just about disrespect; it's about a potentially dangerous impact on anyone who gets older. The impact can surface in many areas, including health care, the retail world, the media and employment.

Ageism is manifested in many aspects of society - from the over-the-hill-greeting-card mentality of commercials and television programs to under-representation of older people in clinical trials of prescription drugs.

Problem seen worsening

Some of the 78 million baby boomers have begun turning 60 this year. And with people living longer, the proportion of the population age 60 and older is increasing. This deluge of new seniors will exacerbate existing age-related problems such as the critical shortage of geriatricians; the need for better wages for home aides who provide vital services to many seniors, permitting them to stay in their homes and out of costly hospitals and nursing homes; and protection of the elderly from abuse in nursing homes.

Dr. Robert Butler, 79, professor of geriatrics at Mount Sinai Medical Center, coined the term ageism in 1968 when interviewed by a Washington Post reporter about his neighbors' vehement opposition to senior housing being built in Butler's neighborhood. "It was like crosses burning on the lawn," said Butler. "I couldn't believe it."

Butler first encountered ageism in medical school, aghast at doctors' callous references to older patients as "crocks" (meaning difficult, uninteresting and complaining). Disrespect for and discrimination against seniors would continue to trouble him, and the battle against ageism would become a lifelong passion.

Butler, the first director of the National Institute on Aging, has written several books on the subject, including the 1976 Pulitzer Prize-winning "Why Survive?: Being Old in America," and is president and CEO of the International Longevity Center USA in Manhattan, a research, policy and education center. Its February 2006 report, Ageism in America, documents some disturbing statistics for anyone planning to live past 65:

In 2004, the U.S. Equal Employment Opportunity Commission (EEOC) ruled that employers can deny health benefits to retirees at age 65 without violating age discrimination laws. (The ruling is not in effect due to pending litigation in which AARP sued the EEOC).

Fewer than 2 percent of prime-time television characters are 65 or older, although that age group comprises 12.7 percent of the population.

1.5 million people reside in 17,000 nursing homes nationwide, and nine out of 10 nursing homes are inadequately staffed.

Health care is one of the areas most affected by ageism. As boomers burst upon the senior scene, and people live longer, the health-care system will be stretched even further beyond its capacity, experts believe. The lack of awareness and concern about older Americans' health-care needs and the absence of funding to resolve the problem already has resulted in a shortage of geriatricians.

The Ageism in America report noted that in 2005, Congress eliminated all 2006 funding for geriatrics education and training for physicians and other health-care workers. The programs received $31.5 million in 2005.

An unpopular specialty

Butler, who in 1982 opened the first geriatrics department in the United States at Mount Sinai, said, "Of the 144 medical schools in the U.S., there are only five departments of geriatrics. In Great Britain, every medical school has a geriatrics department."

The U.S. schools have approximately 35 geriatric programs, but they are rarely required and medical students often ignore them. Butler speculates that because aging is frightening to people, including medical students, there is a hesitancy to pursue this field of medicine.

Perhaps more damaging, doctors working in geriatrics generally aren't as well compensated as physicians in other medical specialties. Geriatricians are almost entirely dependent on Medicare revenues, and low Medicare reimbursement levels are a major reason for inadequate recruitment.

Bert Jablon, president of the Nassau Suffolk Regional New York State Public Health Association, agrees that the shortage of geriatricians is a major problem. "In the U.S. right now, there are approximately 7,600 geriatricians; we need about another 14,000," he said.

Jablon also is concerned about the elderly being too often ignored and how this can lead to unaddressed problems of abuse in nursing homes.

The issue has garnered attention locally - and some action. In May, the Suffolk Legislature unanimously passed a bill requiring nursing home operators to screen all current and prospective employees and volunteers, as well as current and prospective residents, to determine if they are in the New York State Sex Offender Registry.

"We've done a good job of protecting our children," said Presiding Officer William J. Lindsay (D-Holbrook), "but another vulnerable part of our society is our seniors."

Suffolk's law is the first in the state and only the second in the nation that specifically aims to protect the elderly from those known to pose a risk.

Informing the general population, as well as seniors, about the problems facing older people is paramount in combating ageism, advocates say. Information and communication are vital, especially to those homebound due to disability or illness. Technology plays an essential role.

Tom Cassidy, a clinical associate professor at Stony Brook and author of "Elder Care: What to Look For, What to Look Out For!," said, "With regard to the subject of ageism, I am concerned about the trend of using Web sites as the preferred source of senior- related information, especially with regard to Medicare." He noted that a recent survey conducted by the Kaiser Family Foundation found that only 21 percent of seniors go online for health information, yet the optimal place to get Medicare information is at the Web site.

"Seniors, especially those in their 70s, 80s and 90s, need help to address complicated programs such as Medicare Part D prescription drug coverage, yet there are no Medicare offices for them to receive one-on-one assistance," Cassidy said. The alternative of calling 1-800-Medicare can be frustrating and ineffective, as the quality of help from phone representatives has been found to be inconsistent.

Ignored on the tube

Even the healthiest of seniors may sense the sting of ageism. Bob Festa, 71, of Huntington felt discriminated against by the broadcast media when the television shows he enjoyed were canceled because their demographics skewed to the over-50 crowd. "Advertising is blatantly targeted to those in their 20s," said Festa. "'Judging Amy' and 'Joan of Arcadia' were two that were judged by the networks as having too old an audience."

Mark Preiser, a partner at Walter F. Cameron Advertising in Hauppauge, said, "More shows are developed to reach the youth market than the senior market because not only does the former watch significantly more TV, but they consume more of the products more likely to be placed within TV shows as revenue-producing product placements."

In addition, advertisers see long-term rewards. "A higher percentage of advertising than would be warranted by dollars spent will go to the youth market," said Preiser. "The thinking is, capture them now, establish a buying habit and you have them for life."

Worries in the workplace

Purchasing power is most likely determined by occupation. And the workplace is no stranger to ageism.

Ray Nardo, a labor lawyer in Mineola, has observed age discrimination. "I see male executives a lot of times who have been in that position for 20 years or more being terminated and replaced with younger people," said Nardo. He estimated that the age range for those being terminated is 45 to 65.

There is a widespread stereotype that older employees are going to be less ambitious and less productive than younger employees. Plus, they typically command higher wages.

David Feather, a labor and employment attorney in Garden City, sees a problem for those re-entering the job market. "Starting mid-50s, they have a difficult time obtaining employment," said Feather, noting that it's easier for someone who's 32 and making $40,000 to find a job than it is for someone who's 62 and making more than $100,000.

Elizabeth Grossman, regional attorney for the Equal Employment Opportunity Commission, said, "Employers are slow to realize people are living longer, working harder and are healthier. Some employers are still not realizing the potential they have from older employers."

Stores more family-oriented

Long Island's retail environment is also tailored toward young people and less inviting to seniors, especially when compared to senior-friendly states such as Florida. There, convenient parking, ample handicapped spaces, a slower pace and patient salespeople accustomed to an older clientele make shopping easier.

Despite the graying of Long Island, shopping is still geared toward a family-oriented consumer. Anil Mathur, associate dean and professor of marketing at Hofstra University, explained that the family consumer is favored over senior shoppers: "It is in the interest of business to serve the population they have."

For instance, the availability of motorized shopping carts reflects the population targeted. Recent trips to the Wal-Mart in Westbury showed there were three motorized carts; the Wal-Mart in Ocala, Fla., had 15.

And senior shoppers on Long Island often say they feel discriminated against by salespeople. "When a senior is shopping alone," said Morosoff, "they're looked upon as ... [unlikely] to make their decision without their mate."

What can be done?

In 1956, then-Sen. John F. Kennedy said: "Today we are wasting resources of incalculable value; the accumulated knowledge, the mature wisdom, the seasoned experience, the skilled capacities, the productivity of a great and growing number of our people - our senior citizens."

Senior advocates say it's ironic that prejudice against seniors exists at all, as most people will live to become seniors.

What can be done to address ageism? Paul Arfin, 65, of Hauppauge, president of Intergenerational Strategies - a nonprofit organization dedicated to intergenerational policy, programs, issues and the civic engagement of older adults on Long Island - suggested a few initiatives:

Educate employers about the myths and realities of aging and how to deal with ageist work situations.

Encourage political leaders to employ older adults and develop public relations campaigns that promote a positive view of aging.

Initiate education about aging issues in preschool, when attitudes are formed. "The absence of school curriculum material that accurately portrays the life cycle in its developmental stages promotes deep-seated attitudes when we are young that we reach a peak in mid-life and then decline in abilities," said Arfin. "Decline is the main theme of aging, which promotes ageism."

Give seniors reluctant to move out of state an option to continue living on Long Island by addressing the issue of affordable housing. "Recognize the critical need to encourage older people to stay here with their buying power and assets," said Arfin. "Older people, too, need affordable housing."

Resources to tap

Here are some resources for information about ageism and strategies to combat it.

International Longevity Center USA, www.ilcusa.org

Intergenerational Strategies, www.igstrats.org

The Long Island Geriatric Education Center at Stony Brook, http://inf-hscweb.hsc.sunysb.edu/centers/ligec/

Equal Employment Opportunity Commission (EEOC), www.eeoc.gov

Project 2015, a state initiative of 36 participating New York State government agencies examining and preparing for the impact of the aging and the increasing diversity of our state's population, www.aging.state.ny.us/explore/project2015/index.htm 

Office for the Aging (Suffolk County), www.co.suffolk.ny.us/webtemp3.cfm?dept=22&id=278

Senior Citizen Affairs (Nassau County), www.nassaucountyny.gov/agencies/Seniors/index.html 

Health Insurance Information Counseling and Assistance Program (HIICAP), www.hiicap.state.ny.us