Ageism Unmasked: Exploring Age Bias and How to End It1 considers the deep-seated presence of ageism in society, whether in laws and policies, work, the health care sector, or everyday functioning, based often on culturally perpetuated, erroneous presumptions and stereotypes. It demonstrates how, particularly for the older segment of society, ageism has become conflated with ableism, resulting in oppression, discrimination, and a denial of rights.
While the term ‘ageism’ in itself covers any discrimination based on age, whether against younger segments of society who are dubbed reckless or immature, or older segments, who are associated with illness and inability to function,2 the book focuses on the latter group due to the more severe consequences they face resulting from ageism, preventing them from living a dignified life with all its possibilities.3
The author, Tracey Gendron, holds master’s degrees in gerontology and psychology and a PhD in developmental psychology and has over 25 years of experience working in the field of gerontology.4 Prompted to re-examine the concept of age and ageism by the realisation that her own approach too, despite vast experience in the field, was coloured by a negative perception of ageing (p. 2), she attempts in this book to identify the misconceptions and stereotypes that have taken root and encourages readers to reflect on them. The book is written in a way as to be accessible to both common and academic readers (in the fields of law, medicine, social sciences, and, of course, gerontology and public health) and is not encumbered by technicalities. This is a well-researched book as evidenced both in its writing and notes, which also benefit from the author’s rich professional and personal experience.
The review that follows is structured in five sections. After a brief overview in the first section, sections 2 and 3 explore two significant themes highlighted in the book, specifically, understanding ageing in all its nuances, and the discrimination, rights-denial, and structural barriers experienced by older segments of society. The fourth section attempts to identify some learnings from the book that would benefit the fields of law and policy-making, in particular, and the concluding section recapitulates major contributions of the book and considers some limitations.
Overview
In an Introduction and eight chapters, the author engages with a range of aspects and materials associated with ageing, ageism, and related concerns. Laying the foundation for the discussion that follows, the Introduction (pp. 1–18) highlights how ‘old’ and related terms like ‘aged’ or ‘elderly’ have become pejoratives or hold negative connotations. It goes on to note how the dominant cultural narrative leads to the internalisation and perpetuation of ageist notions, bringing about oppression and marginalisation. The chapter also provides conceptual clarity, discussing forms of ageism (positive, negative, cultural, and so on), and its damaging effects whether on health, the economy, or equity.
Flowing from the idea that tools to empower ourselves to fight ageism can be developed by learning from the past, Chapter 1 (pp. 19–30) considers historical outlooks on ageing in various cultures from the Judeo-Christian Bible to Islam, the Hindu Dharmasastras, and Confucianism, which revered the aged, to Greece and the Middle Ages, which on the other hand idolised youth and viewed old age as decrepitude, to demonstrate how age has been a complex issue right from the beginning. Ageing is not one stage but a series of processes which may involve experiencing decline, growth, and maintenance all at the same time, and one that can be addressed with the realisation that it encompasses both challenges and opportunities.
Shifting the focus to technology and medicine, fields which have impacted older persons, Chapter 2 (pp. 31–48) discusses how developments in these areas have led to greater longevity, at the same time also leading to loss of value of elders and the perception of them as a burden on society, besides limitations in opportunities, and segregation of those thought unable to lead independent lives. These changes have driven ‘twin’ forms of discrimination against elders, ageism and ableism, with age being perceived as a disease, and ageism manifesting in health care, structurally and in practice.
Chapter 3 (pp. 49–63) argues that the notion of retirement, a social institution, has become equated with a developmental stage, symbolising complete withdrawal from what one used to do. This has led to age erroneously being equated with decline and inability, and consequent ageism and negative stereotypes at the workplace, including in the form of subtle microaggressions. Taking further the discussion on ‘retirement’, Chapter 4 (pp. 64–89) highlights problems of segregation created by the establishment of retirement communities (however ‘active’ these may be), and by theories claiming to define ‘successful’ ageing, which not only take a narrow view of the term, but fail to consider the multiple factors that determine an individual’s ageing process, and shift the ‘blame’ for ‘unsuccessful’ ageing onto the individual.
Chapter 5 (pp. 90–110) sheds light on another phenomenon that has implicated and thereby further entrenched ageism, namely, ‘anti-aging culture’. Media in particular plays on fears and shame over ageing, thus encouraging the multi-billion-dollar anti-ageing consumer industry. Alongside, this creates an additional obstacle to an understanding and appreciation of elderhood, and fosters an environment that marginalises elders. Visual ageism or stereotypical (negative) representations in the media add to this.
Chapter 6 (pp. 111–123) explores the benefits and challenges brought about by the information age, which has introduced unprecedented opportunities to enhance the lives of elders but has also created digital ageism, ‘othering’ groups in the context of digital media use. Various aspects, including older people often being left out of the R&D for applications designed for them, younger persons writing algorithms, and lumping of big data, lead age stereotypes to become embedded in digital platforms. The discussion also addresses the issue of loneliness, which is often enforced by ingrained stereotypical thinking and ageism, and to which proposed technological solutions are an inadequate answer.
Chapter 7 (pp. 124–140) takes up the changed context brought by the COVID-19 pandemic, which ‘propel[led] ageism into mainstream consciousness’ (p. 124). The chapter discusses how ageism became rampant during the pandemic based on misconceptions linking age with health and underestimating elders’ economic contributions, leading to older segments being viewed as ‘dispensable’, age-based bullying, positive ageist practices depriving older persons of agency, and deepened isolation. Not only that, structural ageism also led to devaluing of long-term caregivers, who received less attention and bore severe consequences.
Finally, Chapter 8 (pp. 141–164) considers the path to ‘elderhood’,5 which needs to be normalised as a life-stage with its uniqueness and value. Ageing being an individual experience, this process requires awareness of one’s thought patterns, asking future-oriented questions (which ageist perceptions prevent one from ordinarily doing), and embracing ageing so as to fully participate in meaning-making activities, amongst other steps. Meaningful roles that elders can play in society, bringing inclusivity and fluidity, are also explored, as is the need to address cognitive dissonance, confront systemic ageism, and celebrate milestones so as to welcome rather than fear this natural process.
A central thread running through the chapters is how cultural messaging, often based on incorrect or incomplete understandings of ageing and its implications, pervades different areas of life, causing ageist attitudes to be imbibed by most. This establishes and maintains ageism in society, both against others and oneself. In keeping with the aims of the book, the chapters trace how ageist notions which had historical roots in some threads of traditional thought, became more firmly entrenched with developments like the industrial revolution, the emergence of the notion of retirement, and consumerism and advertising that exploit people’s shame and fear. This process has only deepened with recent advances in digital technology, and has become especially pronounced in the COVID-19 pandemic. While examining these themes, the author adopts a balanced and even-handed approach, acknowledging the benefits of various developments but also underlining how these may act to the detriment of older segments.
A nuanced understanding of ageing
The starting point in addressing ageing is to recognise that ‘[a]ging is not something that just happens to older people. We all age, every moment of our lives, from birth through death’ (p. 4). This is distinct from the notion of ‘senescence’ which refers to ‘biological aging that leads to the gradual deterioration of function in cells and/or organisms’ (p. 5). Not understanding this difference, or the related fact that age is simply a condition of life, not of itself ‘good’ or ‘bad’,6 results in the term ‘ageing’ being associated with only certain segments of society, who are also seen as ‘not useful’ and are necessarily associated with illness, decrepitude, and disability, resulting in their being segregated, in a sense, from mainstream society.7
More shocking is the fact, as the book points out (p. 93), that the World Health Organization itself had classified ageing, a natural, universal phenomenon, as a disease under the International Classification of Diseases (ICD)-10 in 1992 as ‘senility’, and again as ‘old age’ in the category of ‘symptoms, signs, or clinical findings not elsewhere classified’ under ICD-11 in 2019.8 In fact, the Biomedical Model (of medicine),9 which became the dominant framework for understandings of ageing and disability, medicalised these conditions which in Gendron’s view enabled the proliferation of both ageist and ableist practices (p. 40).
Discrimination, denial of rights, and creation of barriers
The consequence of such attitudes is the perpetuation of ‘widely prevalent’ ageism, or ‘discrimination, marginalization, and/or oppression based on age’ against older segments of the population, as well as ‘ableism’, which refers to discrimination based on (perceived) ‘physical, intellectual, and/or cognitive ability’, even though not all older persons have a disability (pp. 8–9). Such outlooks have an impact on health (which includes both negative impacts on the health of persons who carry a negative perception of age as also the overall health of society), the economy (both by denying older persons the opportunity to engage in meaningful economic activity where needed or to contribute to the economy where desired), as well as conditions of inequity or denial of rights where a segment of society faces discrimination and barriers to a life of freedom and equity (pp. 14–15). Ageism further intersects with sexism, racism, classism, and so on, with discriminatory consequences like pay disparity, workplace harassment, housing instability, inadequate access to health care, and food insecurity, faced disproportionately for instance by older women, and more so, women of colour (pp. 16, 98). Yet, ‘age’ is not expressly mentioned as a ground of discrimination in most international human rights instruments,10 and the argument that it can be addressed under the category of ‘other’ is seen as lacking strength and furthering invisibility.11 The Constitution of India, too, in its non-discrimination provisions, does not mention ‘age’.12
The notion of retirement (pp. 51–53, 64–65), which became the norm in the post–World War II era in view of developed social security systems, and which is based on the criterion of age alone, rather than interest, need, or ability, also raises a set of issues. The concept, which is a social institution but has become equated to a life-stage, reinforces stereotypes about elders as ‘useless’ and ‘unfit for work’ or ‘non-productive’ and ‘non-contributing members of society’ (pp. 50, 52–53). Moreover, it involves, to an extent, a forced withdrawal from active society, and is blind to or overlooks vulnerability factors such as race, gender, education, and social class which impact the ability to retire as well as the fact that for many, engagement in a productive work life provides a sense of purpose which is summarily dismissed irrespective of ability.13 In the Indian context, where the retirement age is among the lowest in the world,14 workplace discrimination based on age is reported by a substantial segment of the population,15 significant levels of poverty prevail among elders,16 and no strong constitutional and statutory framework17 exists for combatting discrimination so as to address ageism in the workplace; thus these issues need to be considered from both legal and social perspectives.
Relatedly, the notion of retirement as a life-stage has seen the development of retirement communities, marketed as a sort of aspiration,18 but which result in segregation and the creation of age-restricted communities denied healthy everyday interactions with members of other age groups including their own families (a situation intensified in the pandemic). Barriers are thus created in living a meaningful life for not only elders themselves but also society as a whole, which can develop in a healthy manner through regular interactions between people of all ages.
Flowing from ageism, and linked to perceptions of elders being seen as somehow withdrawn from or no longer part of active society, is the lack of consideration of their needs and interests in broader society. This lack of consideration manifests in advertising that targets them, which sees them as only interested in certain products like assistive devices, hearing aids, and so on rather than a broader range of products for general utility, well-being, and self-actualisation (p. 109). It also manifests in the context of technology, where opinions of elders are rarely reflected in studies on digital practices (and more generally in the context of all technology) (pp. 32, 114), leading to ageist development of technology, thus worsening and perpetuating stereotypes regarding elders’ inability to handle technology. In the health sector, it reflects in patronising and infantilising attitudes towards elder patients, denying them personhood, agency, and voice (for instance, by addressing family members over the patients themselves), and seeing pain and suffering as ‘expected’ in old age (pp. 45–47). An issue in the health care sector which has legal implications is the tendency of systems like Medicare19 to limit elders’ access (p. 47).20
The pandemic exacerbated the already prevalent ageism with many expressing the opinion that the elder segment was ‘disposable’, as also by the perception that the entire segment of the population was equally vulnerable and susceptible to the disease (see pp. 125, 128–130).21 Not only that, caregivers and facilities caring for the elderly also saw a devaluing as compared to other caregiving roles.
Some learnings
The book under review raises a number of issues regarding ageism, discrimination against and the ‘othering’ of elders, as well as provides many insights on age and ageing which are relevant from the perspective of law and policy-making (in addition to their relevance for broader society).
In the present-day context, with increasing longevity over the past many decades, the demographic situation has seen a significant change. As noted by World Population Ageing: 2019,22 in 2019, there were 703 million persons aged 65 and above the world over,23 comprising 9 per cent of the population. This figure is projected to reach 1.5 billion or 16 per cent of the population in 2050. Soft law measures like the Vienna Action Plan on Ageing adopted in the World Assembly on Ageing in 1982,24 the UN Principles on Older Persons in 1991,25 Madrid International Plan of Action on Ageing in 2002,26 besides an important general comment,27 have been introduced in the recent past. Significantly, an Open-Ended Working Group on Ageing was set up in 201028 towards strengthening the human rights of older persons. Debates and discussions are under way regarding a specific international convention for the protection of the rights of older persons29 in view of the specific forms of rights violation and ageism experienced by them and dispersed standards of protection in existing frameworks.
In this regard, the issues raised and points highlighted by the book become relevant. In discussing the various forms that ageism, including that against elders, can take, the book brings up the notion of positive ageism which, while based on a view of age which is tinged with respect or kindness, can perpetuate prejudices by being ‘patronizing or infantilizing’, thereby limiting older people’s opportunities through ‘over-accommodating behaviors’ (p. 11). Legislation that is seemingly for the protection of elders, such as the Older Americans Act 1965 highlighted by the book, seeks to address the needs of older persons but in doing so defines ‘all older persons as vulnerable and needy’ (p. 65; emphasis in original). This denies the heterogeneity of the segment of older persons and also further perpetuates stereotypes against them. Recognition and protection of the human rights of older persons should imply enabling them to live a meaningful life with dignity as any other member of society and thus must ensure that the provision of protection, where required, does not become an act of denying them agency and creating barriers to their living a life with all its opportunities and facets.30
Instead, as highlighted by the example in the context of ageist structural barriers (p. 123), what may be needed is not merely protection, but, drawing from the case of rights of persons with disabilities, the need for society to make space for elders as equal and contributing members, whereby they can exercise all human rights, bringing about the required structural inclusivity.
The law and policy process can also draw lessons from the book’s insight that ageism or ageist attitudes are impacting negatively not simply on elders alone but on society as a whole. This is because such perspectives and self-directed ageism can result in the realisation of stereotypes, which is shown to be linked with the higher presence of markers of Alzheimer’s, lower physical and cognitive function, and depressive symptoms, among others (p. 14). Moreover, a society where people from all walks of life can meet, interact, and learn together is seen as key to combatting fears of ageism (pp. 74–75).
Conclusion
Negative attitudes towards old age and discrimination against elders have become deeply ingrained in society and are seen in laws, policies, and structural constraints, and, as the book highlights, in cultural messaging, practices, and daily microaggressions (such as fairy tales portraying stereotypical depictions of age, jokes based on age, or advertising for ‘anti-ageing’ products that plays on the fear and shame that have become associated with age). This is an issue that has social dimensions and also requires changes in laws, policies, and practices (p. 142).
The important insights provided by the book under review can help in identifying and recognising these negative perceptions and addressing them both at the individual level and also more broadly, in law and policy. Such insights include the inaccurate association of ageing with old age alone, the equating of old age with illness and inability and the application of such an understanding to deny the heterogeneity of elders, positive ageism impeding elders in exercising their rights and living life with all its possibilities, the extent to which such attitudes have become deeply embedded in society, and the negative impacts of such practices on society as a whole.
While the book, in tracing historical attitudes and perceptions regarding elders and in making recommendations for practices that can address the prevalent ageism in society, draws from different cultures and parts of the world, the core chapters are essentially focused on the American scenario and experience. Including negative and positive instances and trends from other parts of the world in line with the concerns it highlights and the recommendations it makes, would make it a richer resource.31
Overall, the book provides understandings and highlights concerns, taking note of which can be the first step towards ensuring that elders can live as active, informed citizens with value and agency and exercise their human rights.
Declarations
Conflict of interest
The author has no conflicts of interest to declare that are relevant to the contents of this article.
Footnotes
Tracey Gendron, Ageism Unmasked: Exploring Age Bias and How to End It (Steerforth Press 2022). This is a substantially revised version of a short review of this book which has appeared previously on the author’s blog: https://potpourri2015.wordpress.com/2022/03/05/book-review-ageism-unmasked-exploring-age-bias-and-how-to-end-it-by-tracey-gendron/ (Accessed 12 September 2022) and parallelly on Goodreads.
The recent World Health Organization (WHO) Global Report on Ageism looks into the issue of ageism against older as well as younger segments of the population. See WHO, Global Report on Ageism (2021). https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/combatting-ageism/global-report-on-ageism. Accessed 22 July 2022.
The more specific reasons Gendron offers for this focus are ageism against older persons being a social justice issue; the absence of an alternative narrative to the view of older adulthood as a period of decline; and the severe and damaging consequences of ageism for people’s health and happiness across their lives. Gendron, Ageism Unmasked (n 1) 10–11.
https://gerontology.chp.vcu.edu/our-team/tracey-gendron-ms-phd.html. Accessed 22 July 2022.
The term is used by Gendron to capture the complexity, dimensions, and directionalities of the ageing experience. Gendron, Ageism Unmasked (n 1) 17.
As discussed in the previous section, it is interesting to note that even historically, both positive (reverent) and negative views of ageing prevailed at different times and in different cultures. See Gendron, Ageism Unmasked (n 1) 21–24, 25.
In fact, even care for elders within the family has become something that is seen as a burden or undesirable, as against care for children which is seen as a ‘normal’ part of life. See Gendron, Ageism Unmasked (n 1) 34.
For another view arguing that the classification or equating of old age as a disease ‘is potentially detrimental and deleterious from clinical, research and humanitarian points of view’, see Debanjan Banerjee et al., ‘Not a Disease: A Global Call for Action Urging Revision of the ICD-11 Classification of Old Age’ (2021) 2(10) Lancet: Health Longevity E610. https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00201-4/fulltext. Accessed 11 May 2022. Further, as the authors also note, ‘Considering chronological age as a sole cause for diseases may be largely inaccurate and misleading.’ Ibid. E610. Also, on these lines, Gendron argues that it is both problematic and unethical for medical decision-making to be dictated by age alone, as it is not of itself an indicator of health status. See Gendron, Ageism Unmasked (n 1) 46. A contrary view, according to which this move of equating age with illness would lead to ‘economic and health care benefits for all stakeholders’ and better resource allocation, is Alex Zhavoronkov and Bhupinder Bhullar, ‘Classifying Aging as a Disease in the Context of ICD-11’ (November 2015) Frontiers in Genetics. https://www.frontiersin.org/articles/10.3389/fgene.2015.00326/full. Accessed 11 May 2022. It may be noted, however, that a subsequent piece of literature refers to the terms ‘old age’ and ‘pathological’ as having been ultimately withdrawn from ICD-11. See Kiran Rabheru, Julie E. Byles, and Alexandre Kalache, ‘How Old Age Was Withdrawn as a Diagnosis from ICD 11’ (2022) 3(7) Lancet: Health Longevity E457.
As explained by Carver and Buchanan, according to the ‘biomedical model’, ‘successful aging requires that the elder is disease free, disease-related disability free and engaged in activities with family and/or community.’ Lisa F Carver and Diane Buchanan, ‘Successful Aging: Considering Non-biomedical Constructs’ (2016) 11 Clinical Interventions in Aging 1623–1630.
Two exceptions are the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families which mandates against age discrimination (see arts 1, 7); and the Convention on the Rights of Persons with Disabilities in terms of access by older persons with disabilities to social protection and poverty reduction programmes (art 28). See International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (adopted 18 December 1990) General Assembly Resolution 45/158; Convention on the Rights of Persons with Disabilities (adopted 13 December 2006, 61st session of the General Assembly) Resolution A/RES/61/106. Also see UNGA, ‘Report of Secretary General: Follow Up to Second World Assembly on Ageing’, A/66/173 (22 July 2011) para 5. https://www.ohchr.org/en/documents/reports/follow-report-second-world-assembly-ageing. Accessed 25 July 2022.
See UNGA, ‘Report of Secretary General’ (n 10) paras 5–6; UN Department of Economic and Social Affairs, ‘Report of Expert Group Meeting: Rights of Older Persons’ (Bonn, 05–07 May 2009) 15. http://www.un.org/esa/socdev/ageing/documents/egm/bonn09/report.pdf. Accessed 21 May 2022.
Constitution of India, arts 15, 16. The Constitution does however mention ‘old age’ in the context of public assistance (art 41) and also ‘age’ in the context of rights of children (for example, arts 21A, 24, 45) and qualifications of various office holders, members of Parliament, and so on. Indirectly however, the issue of age discrimination in employment (although in the context of younger persons) was considered in Anuj Garg v Hotel Association of India AIR 2008 SC 663.
For a discussion on the myths surrounding and implications of mandatory retirement, see Elaine Fox, ‘Mandatory Retirement: A Vehicle for Age Discrimination’ (1974) 61(1) Chicago Kent Law Review 116; also see Lynn MacDonald, ‘The Evolution of Retirement as Systematic Ageism’ in Patricia Brownell and James J Kelly (eds), Ageism and Mistreatment of Older Workers (Springer 2013) 69.
The retirement age for private employees in India is 58. See ‘At 58, Retirement Age in India Is One of the Lowest Worldwide’ (Times of India, 25 April 2018). https://timesofindia.indiatimes.com/world/at-58-retirement-age-in-india-is-one-of-the-lowest/articleshow/63905499.cms. Accessed 28 June 2022. As per a circular issued by the Department of Personnel and Training (No. 25012/8/98-Estt. A dated 30 May 1998), the recommendations of the Fifth Pay Commission were accepted thereby raising the retirement age of central government employees from 58 to 60. It may be noted, however, that the relevant fundamental rule (56) of the Ministry of Personnel, Public Grievances and Pensions allows grant of extension to certain persons (for instance, experts, secretaries to the Government of India in certain departments such as defence, foreign affairs, and so on), while the age of superannuation for employees in teaching positions is fixed at 65. See https://dopt.gov.in/sites/default/files/Extracts%20of%20provisions%20in%20FR%2056.pdf. Accessed 13 September 2022. An unstarred question, No. 576, in the Lok Sabha brought up the issue of retirement of employees. In the response dated 16 September 2020, the Minister of State in the Ministry of Personnel, Public Grievances and Pensions, Dr Jitendra Singh, clarified that there was no proposal to change the retirement age of central government employees. See Lok Sabha, Unstarred Question No. 576 (Shri LS Tejasvi Surya). http://164.100.24.220/loksabhaquestions/annex/174/AU576.pdf. Accessed 13 September 2022.
See, for instance, S Bhatt, ‘Does India Need an Age-Based Employment Discrimination Law’ (Economic Times, 10 February 2022). https://hr.economictimes.indiatimes.com/news/workplace-4-0/does-india-need-an-age-based-employment-discrimination-law/89467382. Accessed 28 June 2022. Bhatt takes note of a survey wherein nearly 33 per cent employees reported having faced age-based discrimination at work. See also Diksha Madhok, ‘India’s Workplaces Have an Ageism Problem’ (Scroll.in, 30 September 2019). https://scroll.in/article/938761/ancient-menopausal-old-man-indian-workplaces-have-a-hypocritical-ageism-problem. Accessed 13 September 2022.
For instance, a study by Akanksha Srivastava and Sanjay K Mohanty estimates about 22.4 per cent elderly households live below the poverty line. See Akanksha Srivastava and Sanjay K Mohanty, ‘Poverty among Elderly in India’ (2012) 109(3) Social Indicators Research 493.
In the Indian context there is no specific statute that addresses the issue of ageism or age discrimination. The Maintenance and Welfare of Parents and Senior Citizens Act 2007, however, deals with some issues in the context of the elderly, such as enabling them to claim maintenance from children or relatives (this is in addition to remedies under personal law, the Code of Criminal Procedure 1973, and state legislation); providing punishment for abandonment by those responsible for their care; and protecting against loss of property by false promises, besides establishment of old age homes in each district. These provisions are however relevant in the context of elders who are either in need of care or protection, or have suffered due to certain acts of others.
Gendron highlights this aspect in the context of the American experience, but in India too, in the present context, we can see the development and ‘marketing’ of several senior-living facilities, which can go on to create a similar scenario. Some advertisements for such facilities use what we can now see as ageist language even if positively couched such as ‘age is just a number’, or referring to ‘looking and feeling young in your golden years’. For instance, Ashiana Senior Living, https://www.ashianahousing.com/senior-living-india. Accessed 13 September 2022. Alternatively, some perceive those older than 50 as requiring special facilities for ‘a stress-free, self-reliant and enlivening’ life, thus incorporating more negative connotations of ageism. See Ananya’s Nana Nani Retirement Homes. https://www.nanananihomes.in/?gclid=CjwKCAjw1ICZBhAzEiwAFfvFhPYNiPxbNxT1pAZsj2dCDgYsB2IxhqrR5aeudmikmNUpiJaOScBKpxoCogwQAvD_BwE. Accessed 13 September 2022.
Medicare is a federal health insurance programme for those aged 65 and over (as well as certain other categories like younger people with disabilities and those with end-stage renal failure) in the United States. See https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare. Accessed 15 September 2022. By permitting doctors to opt not to accept Medicare, thereby not treating many older patients, not covering certain preventive and support services, and its different reimbursement rates for older persons vis-à-vis those for younger patients under private insurance, elders’ access and standards of care become limited. See Gendron, Ageism Unmasked (n 1) 47.
Also Robert L Kane and Rosalie A Kane, ‘Ageism in Healthcare and Long-Term Care’ (2005) 29(3) Generations 49.
Also highlighting how ageism was sharply brought into focus during the pandemic is the ‘Report of the Independent Expert on the Enjoyment of All Human Rights by Older Persons, Claudia Mahler’, Human Rights Council (48th Session, 04 August 2021) A/HRC/48/53. https://ngocoa-ny.org/recent-documents-of-interes/a_hrc_48_53_ie-report-on.pdf. Accessed 25 July 2022. See also Sarah Fraser et al., ‘Ageism and Covid 19: What Does Our Society’s Response Say about Us’ (2020) 49(5) Age and Ageing 692. Vervaecke and Meisner discuss the nuances and implications of ‘compassionate ageing’ which also manifested during the pandemic. Deanna Vervaecke and Brad A Meisner, ‘Caremongering and Assumptions of Need: The Spread of Compassionate Ageing during Covid 19’ (2021) 61(2) Gerontologist 159.
Department of Social and Economic Affairs, Population Division, World Population Ageing: 2019, ST/ESA/SER.A/430 (United Nations 2019). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf. Accessed 05 May 2019.
In the case of India, in 2019, over 10 per cent of the population (139 million) was aged over 60, which figure is expected to nearly double to 19.5 per cent or 319 million people by 2050. See ‘Ageing Population in India’. https://ageingasia.org/ageing-population-india/. Accessed 10 May 2022.
United Nations, Vienna International Plan of Action on Aging (1983). https://generationen.oehunigraz.at/files/2012/07/Wiener-Aktionsplan-zur-Frage-des-Alterns-1982.pdf. Accessed 13 September 2022.
Adopted by General Assembly Resolution 46/91, 16 December 1991 (A/RES/46/91), Annexure.
Political Declaration and Madrid International Plan of Action on Ageing, Second World Assembly on Ageing, Madrid, Spain (8–12 April 2002) (United Nations 2002). https://www.un.org/esa/socdev/documents/ageing/MIPAA/political-declaration-en.pdf. Accessed 15 September 2022.
Committee on Economic, Social and Cultural Rights, General Comment No. 6 on ‘The Economic, Social and Cultural Rights of Older Persons’ (adopted at the 13th Session of the Committee on Economic, Social and Cultural Rights, 08 December 1995) E/1996/22.
‘Follow-Up to the Second World Assembly on Ageing’ (Resolution adopted by the General Assembly on 21 December 2010) A/RES/65/182 (7 February 2011) para 28.
See, for instance, Israel Doron and Itai Apter, ‘The Debate around the Need for an International Convention on the Rights of Older Persons’ (2010) 20(5) Gerontologist 568; John Williams, ‘An International Convention on the Rights of Older People?’ in Marco Odello and Sofia Cavandolli (eds), Emerging Areas of Human Rights in the 21st Century: The Role of the Universal Declaration of Human Rights (Routledge 2014) 128; Mallika Ramachandran, ‘Older Persons and the International Human Rights Framework: Arguments for a Specific International Convention’ (2014) 56(4) Journal of the Indian Law Institute 523; Paul Harpur, ‘Old Age Is Not Just Impairment: The CRPD and the Need for a Convention on Older Persons’ (2016) 37(3) University of Pennsylvania Journal of International Law 1027.
Such an approach is in line with the perceptions of older adults with regard to dignity, as noted in a study pertaining to dignity in mental health care which points out that ‘being respected as an individual, independence, safety, privacy and participation’ are seen as essential components of dignity. Debanjan Banerjee, et al., ‘Role of Dignity in Mental Healthcare: Impact on Ageism and Human Rights of Older Persons’ (2021) 29(10) American Journal of Geriatric Psychiatry 1000.
For instance, the book does not address the controversy raised some years ago around elders in Germany being sent to care homes in other, lower-income countries. See Bouke de Vries, ‘Granny-Export: The Morality of Sending People to Care Homes Abroad’ (2021) 18 Journal of Bioethical Inquiry 455; Naomi Kresge, ‘Exporting Grandma: Germany’s Answer for Elder Care’ (Toronto Star, 06 October 2013). https://www.thestar.com/news/world/2013/10/06/exporting_grandma_germanys_answer_for_eldercare.html. Accessed 12 May 2022. Another issue it bypasses is the notion of combining toddler and elder day care. See Ashley McGuire, ‘Toddlers and Seniors Together: The Benefits of Intergenerational Care’ (IFS Studies, 29 March 2019). https://ifstudies.org/blog/toddlers-and-seniors-together-the-benefits-of-intergenerational-care. Accessed 12 May 2022.
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