COVID-19 highlighted the vulnerability of older adults and our country’s preexisting treatment of elders. Other cultures have cultivated a higher social value for elders, including the Native American, Japanese and South African cultures.
On top of the comorbidities and risks that older adults disproportionately face in our healthcare system, according to a study in The Lancet, we need to begin considering ageism as a social determinant of health. With the pandemic, healthcare providers and systems had to confront the ethical implications of age-based care rationing and crisis standards of care. How different could the outcome have been if, as Americans, we embraced and valued our elders more?
This brings about a vital conversation on ageism in America. How can we create a country that makes it safe to age? We can look to other countries for solutions, through intergenerational socialization, communication and living.
Other cultures and countries have treated their elders with more respect, dignity and inclusivity than ours. Below are several examples of how such cultures avoid ageism.
Successful Aging Through Intergenerational Socialization in Indigenous Populations
Native American and Alaska Native people make up the smallest racial population in America despite their recent rapid population growth surpassing that of all other groups. Although there are 574 recognized tribes dispersed throughout the United States, there are some commonalities between tribes, one being a three-generation, extended family component.
‘This earth isn’t a vacation; we have work to do while we’re here.’
Many indigenous people call dying “passing over,” rather than passing away. It’s a transition into another phase in life. This verbiage removes the stigma and taboo surrounding death, and allows older adults more freedom to focus instead on spending quality time with loved ones.
“In my view, this earth isn’t a vacation; we have work to do while we’re here. In fact, one of those elder ladies would always say, ‘I’m here on this earth because I have something to learn or something to teach,’” wrote Hope Flanagan (Seneca, Community Outreach and Cultural Teacher).
By recognizing this unified purpose to learn or to teach, we can cherish the knowledge, wisdom and lived experience of elders. Communicating with people of different generations can help us shape our understanding of the world through other lenses.
Japanese: A Language That Welcomes Flaws and Imperfection
The Japanese language has a lot of words that acknowledge and accept the existence of flaws without being disparaging and hurtful. For example, 侘寂 (wabi-sabi) is a point of view focused on imperfection.
The process of aging cannot be reversed, but one of the beauties of aging is accepting one another. The act of repairing broken or cracked objects with gold, 金繕い (kintsukuroi), is an ornate aesthetic choice but also a testament to the Japanese appreciation for flaws, imperfections and aging that is inherent in their language. In Japan, individuals observe Respect for the Aged Day, 敬老の日 (Keirō no Hi), on the third Monday of September each year.
Coresidence later in life for older adults is normal in Japan. Adults with children benefit from older family members being available to help with childcare and household tasks, which results in a more equitable distribution of labor. Older adults in Japan have been found to be happier than those in the United States in a variety of categories, according to research in the International Journal of Aging and Human Development, including personal development, maintaining a sense of purpose and establishing supportive relationships with others.
Intergenerational Living In South Africa: A Necessary Norm
Older adults in South Africa maintain a sense of purpose and are productive long after they receive their pensions. Having a purpose is critical as life tends to slow down and bodies become more frail. Purpose falls under the “self-actualization” category in Maslow’s hierarchy of needs—a psychological theory that ranks essential human needs in addition to physiological, safety, love and belonging and esteem.
Older persons have taken on care-work responsibilities related to sick HIV-positive adult children and fostered and orphaned grandchildren.
Institutional and age-specific housing options are limited in South Africa, which is why older adults prefer to move in with their children as they retire from work and begin needing additional support. The pensions that older adults receive are not self-funded or contributed to, which stimulates the South African economy, lowering elder poverty and homelessness rates. Pensions are an invaluable asset to help older adults contribute to their households in a variety of ways that offset caregiving, transportation and other costs.
“Older persons, particularly grandmothers, have taken on care-work responsibilities related to sick HIV-positive adult children and fostered and orphaned grandchildren,” wrote Sangeetha Madhavan and her research team.
Productivity can increase with age; it doesn’t end in retirement. Older adults that move in with extended family are more likely to transition into productive roles as caregivers or homemakers handling domestic chores, and those who do are more stable in terms of social positioning.
Supersizing Family Through Multigenerational Living
America is known to be a place of rugged individualism; a place where the individual good is valued over that of society in general. Individuals can super-size an order at a local fast-food chain, but when it comes to family, Americans favor a tightly wound, limited-access family structure.
Research from the SSM Population Health journal demonstrates three reasons to live in multigenerational households: improved health, happiness and decreased stress. These benefits increase with the number of generations in the household. Healthy adults have lower mortality rates in two-generation family structures than those living in one. But, who will care for the elders if family members are unable to?
A recent senior housing trend in the United States is to build senior living communities near college campuses, thus facilitating intergenerational communication and socialization. One of the drawbacks of moving to a traditional senior living community has always been the loss of society. Older adults living in these settings are exclusively surrounded by people in their age cohort (aside from staff). They’re not seeing babies, new moms, crossing guards, butchers or children walking home from school.
To extinguish ageism in America, aging terminology needs to evolve. By assembling families with a mosaic of generations, individuals will develop an appreciation for older adults. Older adults wouldn’t be as likely to be called senile, demented or crazy. According to The Gerontologist, the harm in such language costs $63 billion annually. The cost of ageism warrants its status and nomenclature as a social determinant of health.
By infusing our culture, our language and our communities with age-friendly language and flexible (chosen and blood) family coresidence structures, Americans will develop a greater appreciation for adults of all ages and cultures.
Jennifer Lagemann is a freelance writer, researcher and journalist in the senior care industry with a background as a family caregiver, professional caregiver and home care administrator.