Negative Messaging and the Older Adult

Professional Resource Article

This article will explore how negative age-stereotyping affects both younger and older people, and influences the care that older people receive. We will explore how internalized beliefs in older people cause fears, self-imposed limitations and selffulfilling prophecies which may contribute to stress-related disorders and psychiatric illnesses. We also look at coping strategies, especially functional exercise paired with a therapeutic component. Finally, we discuss a possible wellness program for individuals and groups of older populations as a gateway to participation in enriching emotional and physical activities.

Some Research

According to research conducted by Levy et al (2019), one in every 6 adults over the age of 60 suffers from such psychiatric conditions as generalized anxiety disorder (GAD), major depressive disorder (MDD), suicidal ideation (SI) and posttraumatic stress disorder (PTSD) Since these disorders are thought to arise concurrently with the aging process, cohorts in this population do not receive the specific attention required to alleviate suffering. These conditions may therefore remain untreated or under-treated.

Negative age-stereotyping throughout the life span contributes to internalized negative beliefs about the aging process as it highlights loss of youth along with need to hide or mask age.

Negative self-perceptions of aging are promulgated through social stereotyping, which create fear of getting older in young people and cause older adults to limit themselves Younger people may feel contempt, loathing and other negative emotions towards older adults, which only adds to the dehumanizing of aging people. Younger people may see older people as superfluous, chronically sick and disabled, and dependent. These perceptions will lead younger people to embrace youth culture, partially out of fear of the aging process for themselves.

Various studies have attempted to address negative attitudes –or cognitive ageism – towards older adults but have neglected to explore subjective experience and beliefs about aging.

Although human populations are living longer courtesy of advances in medicine, persistent cognitive stereotypes foster fear of aging which trigger harsh treatment of aging people.

The stress-vulnerability model demonstrates how environmental stressors lead to higher rates of psychiatric disorders. Stereotype-embodiment theory postulates that exposure to negative stereotypes causes disorders. Age stereotypes arise within the environment and continue over time to become reinforced to such an extent that aging individuals will apply the negative messaging to their own lives.

Prejudices and stigmatization cause stress-related disorders in those who are targeted. Coping strategies to mitigate deleterious effects have previously focused on how sexism and racism affect individuals. Active coping can succeed where passive coping fails.

Experimental research on the impact of negative stereotyping and the development of psychiatric illnesses demonstrate how negative age biases become environmental stressors for older people, whereas positive age-stereotyping engenders environmental buffering. Previous longitudinal research has shown how aging individuals present with higher cortisol levels after having internalized negative age-stereotyping across a 30 year time span, with only a few studies investigating active coping skills in relation to stress caused by prejudices.

In Levy et al's study (2019), participants filled out an Expectations Regarding Aging (ERA) questionnaire, and were provided a list of 14 active and passive coping mechanisms from which they were asked to pick 3 strategies they more commonly utilized to deal with most disturbing events or challenges. Screenings for MDD, GAD, SI and PTSD were administered after 2 and 4 years; event-history and moderator analyses were also conducted.

Findings from this study showed that the more numerous the negative-stereotypes, the more likely participants were to develop new-onset psychiatric conditions within the 4 years post-study

When participants engaged in active coping skills, those with negative age-stereotyping experienced a reduction in the prevalence and intensity of negative psychiatric symptoms. Those participants in the positive age-stereotyping group were not as affected by active coping strategies. It is interesting to note that participants in the negative age-stereotyping category had better outcomes than those in the positive agestereotyping category, as the former used active coping and thereby experienced an empowering effect, whereas participants in the positive age-stereotyping category experienced fewer illness whether they engaged in active coping or not The authors conjectured that this second group of participants had benefited from never having been negatively impacted by harmful stereotyping and were therefore in less need of applying active coping skills.

The active coping strategies, though not tailored to directly address negative age-stereotyping, were most likely effective since active coping strategies are generalizable to various kinds of stressful situations This study has proven that psychiatric conditions diagnosed in older age are not due to the aging process itself The development of psychiatric illnesses can be predicted by investigating the deleterious effects of negative age-stereotyping Active coping strategies can mitigate the harmful effects of age bias and should be incorporated as interventions for those older people who can be at risk of developing psychiatric problems.

Expectations around decline in cognition and functionality during the aging process create self-fulfilling prophecies that manifest as poor psychological, physiological and behavioral health outcomes People 80 years and older tend to attribute compromised health to old age, demonstrating how a selfperpetuating stereotype blocks older people from actively seeking treatment and expecting it to work These older individuals believe they have lost any sense of control over their own health outcomes. In addition, the healthcare setting presupposes that aging and chronic physiological decline are inevitable, further leaving older adults to struggle on their own with ageist stereotypes

Negative-age stereotyping, or ageism, needs to be addressed both at the societal and individual levels. This type of prejudice continues to go unchallenged in televised and social media. This complicated and multidimensional form of prejudice affects people in the workplace, in health care settings and in their interpersonal relationships.

Exercise programs and involvement in sports allow older adults to bypass many conditions associated with aging, since mobility, strength and cardiovascular processes are improved through movement. Unfortunately, these active older adults, whether casually spending time in the garden or involved in purposeful exercise, still grapple with the meaning of aging in a society which has labeled aging people as superfluous.

Transforming Negative Self Perceptions of Aging

Previous studies to determine whether and how negative selfperceptions of aging can be transformed into more positive perceptions through cognitive-restructuring exercises embedded within physical activity programs have demonstrated that aging stereotypes are most affected. A study by Beyer et al, (2019) addresses how cognitions and physical activity can combine to directly change self-perceptions of aging, and explores whether exercise without the psychoeducation component can yield similar results.

Functional Exercise with a Therapeutic Component

Functional exercise regimens designed to reverse physical deficits arising from sedentary aging improve mobility, balance, strength, ability to tackle activities of daily living, and quality of social functioning. When a therapeutic cognitive component is added to this type of program, significant improvements in mental health can address and remediate cognitive impairments, motivation, quality of life and physical health In this setting, people experiencing negative self-perceptions of aging (SPA) find an outlet for processing of pros and cons of the aging process This type of program encourages both those who are younger to shift their views on and behaviors towards those who have already hit aging milestones, and allows those who are already older to discover a new meaning to the passing of time.

A Study

Beyer et al's (2019) 12-week functional exercise program targeting reduction in falls for an aging population already experiencing negative SPA due to first-hand experience compared an intervention group (IG) consisting of exercise and cognitive restructuring targeting individual stereotypes with an exercise control group (CG)

After baseline assessments, 84 participants were invited to pick from one of several locations where they would be involved in the program; participants remained blind to which control group they were assigned. Additionally, questionnaires were administered at the beginning, the middle and at the completion of the study.

The study utilized one manual for all locations and both control groups; the IG received 4 cognition interventions during the second half of exercise sessions, while the CG received commensurate activity time.

Measurement tools included the think-aloud method which prompted participants to gauge both gains and losses related to aging, with future expectations formulated through use of the AgeCog Scale. Physical performance, and mental health as measured through depression questionnaires, were also assessed at the beginning of the study.

Results demonstrated how participants evinced a beneficial increase in positive self-perceptions of aging gains along with a decrease in loss-perceptions in the period immediately following the completion of the program The study furthered other research into how to facilitate the transformation of negative attitudes towards aging into more positive beliefs and perceptions.

Discussion

Though positive self-perceptions of aging declined after the termination of the program, Beyer et al (2019) postulate these effects being attributable to the programming design wherein a number of participants were not provided the chance to speak and process their own perceptual accounts. More in-depth and longer lasting psychological interventions may be required to achieve more constant positive self-perceptions of aging.

Menkin et al (2022) discuss interventions designed to shift older adults' views on aging. Types of curriculae used either single sessions events or assignments spanning several weeks, and focused on increasing positive views of aging while also helping participants understand that age is not the cause of sedentary behaviors. Views of aging are malleable and benefit from interventions no matter how brief.

Brief messaging was implemented through The Reframing Aging initiative conducted in 2019 and targeting adults aged 18 through 92 years. Brief online public messages centered on anti-ageism resulted in lowered bias against aging when scored through the Implicit Attitude Test.

Menkin et al (2022) undertook a study in 2021 which avoided the pitfalls of some anti-aging messaging In general, the strategy of debunking aging myths may be counterproductive because it surreptitiously reinforces the negative myths. Extolling unrealistic achievements in aging may disappoint participants who then decide to reject all positive views on aging. Understanding the diversity that exists among older adults within their physical and emotional dimensions plays a large role in helping this population overcome negative selfperceptions of aging.

Since more research into useful and effective strategies and techniques for facilitating mental health improvement in older adults is needed, in conjunction with targeted and functional exercise programs, various organizations, medical boards and facilities, agencies, clubs, groups and mentors can promote ways for older adults to discover motivation for activities engagement.

Positive self-perceptions of aging are linked to increased desire for engagement in beneficial physical activities; when these activities become more easily available and accessible within communities, and older adults can more easily encounter communion with and support from others, healthy aging becomes a by-product of increased physical health and functional fitness. Motivation to connect with others remains consistent.

Current access to community-based healthy aging programs remains very limited. Evidence-based instructor or peer-led activity groups could be implemented in health care, residential, community center and other settings so that groups of people can meet, socialize and concentrate on the maintenance and improvement of physical functioning while also re-discovering a purpose to their developmental position in life.

Health psychology should be re-tooled to require a developmental focus so that when applied to older adults, developmental needs and barriers can be included in health behavior interventions Ensuring that self-perceptions of aging are addressed within group and individual sessions can facilitate motivation to open up to possibilities for connecting with others and to gaining deeper access to age-related wisdom, the latter which may have been restrained by unrelenting negative societal messaging.

Interventions to Consider

Psychoeducation along with brief writing exercises can help older adults readjust negative self-perceptions Specificallyorganized materials which explain how negative messaging exists across many media platforms can guide older adults to appreciate their own strengths as they understand what has been compelling them to underrate their abilities.

New findings about how older adults can rebuild and maintain strength and cognitive abilities could be included in educational packets Older adults could be able to choose a functional fitness program that has already been designed to accommodate their current abilities Performance-enhancing visualizations can be built into these functional fitness programs as an addition to strengthen positive beliefs while resolving any existing negative self-beliefs.

Fullen et al (2023) looked at programs which promote holistic wellness for older populations Individual and group coaching encouraged senior living residents to explore their unique wellness goals while also providing supportive environments for connection and interaction with peers and staff.

This type of programming produced high resident satisfaction and increased sense of purpose and higher quality of life. With its 9-week sessions consisting of psychoeducation, processing of physical, spiritual, cognitive, emotional and vocational wellness, and consistent goal check-ins, the program allowed residents to encounter each other and staff within a context of mutual and collective benefit.

If we conceptualize this type of programming as a motivator for participation in functional fitness routines, we may increase not only the success rate of the programming with regards to efficacy, but also the older adult's access to good mental health.

Conclusion

This has been a short overview of negative messaging and the older adult. Ideas to incorporate into therapeutic interventions which could help older people change the way they view themselves and their peers could include psychoeducation, narrative therapy, group processing, goal setting, and visualizations.

References

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Written By: Amy Discepolo, LMHC, EMDRIA Certified Therapist

Amy is a Licensed Mental Health Counselor with years of experience in inpatient and outpatient settings She works with individuals, groups, families and couples She specializes in people who are seeking help for anxiety, depression, mood, trauma, use of substances, and other issues

Amy is a EMDRIA Certified therapist and is a Certified Clinical Trauma Professional and a Certified Family Trauma Professional She is also certified in Emotional Freedom Technique, and as a life and group coach

Amy can be reached at info@gentletherapyplace com or 904-344-8320 to discuss therapeutic, coaching or consulti website is gentletherapyplace com