Letter

Time to do without ‘the elderly’

Dear healthmatters — Although the review that Steve Colwell has written of my book Ageism is generously positive (Reading matters, issue 25), he seriously misrepresents my account of how ageism generates an oppressive interpretation of age and of what should be the basis of a non-ageist vocabulary. This is most clear when he places inverted commas around the term ‘older people’ but not around ‘the elderly’, implying that the former is in some way less real than the latter.

Unlike some who have challenged ageism with the claim that ‘age makes no difference’, I argue in the book that the human body does change over time with socially significant consequences. For this reason there is nothing contrived or irrelevant about questions such as, to quote Paula Jones (healthmatters, 17): ‘Are older people getting a fair deal from current health care policy and practice?’ Because ‘older’ is a relative term, discussion of the rights of older people does not create a segregated category: to a greater or lesser extent we are all older people with a personal interest in this question.

When Colwell comments that ‘the book concentrates on ageism and the elderly’, this is only true in that one of my main conclusions is that the word ‘elderly’ should be abandoned. For this reason, I would like to stress that I am not interested in finding ‘a balanced way to portray the elderly’: the idea is about as irrelevant (and offensive) as that of a balanced portrayal of ‘blondes’.

I appreciate that (i) the concept of ‘the elderly’ reflects a wider cultural acceptance of the idea of ‘old age’, (ii) the power of the pensioners’ movement depends upon political solidarity among people of pensionable age, (iii) there is a strong case for the development of specialisms such as geriatric medicine intended to meet the special needs that tend to come with age, and (iv) many who have jobs which are explicitly related to ‘the care of the elderly’ will have difficulty in abandoning the term. Nevertheless, whenever the media fan the flames of the moral panic over ‘the rising tide’ of ‘the elderly population’ and whenever discussion of euthanasia brackets ‘the elderly’ with ‘the terminally ill’, I know that the word ‘elderly’ is dangerously ageist.

I argue on page 124 of the book that there is a different way of organising and providing services for older people, one which does not require providers to exercise an age bar. Age bars, no matter how sensitively managed, institutionalise an us/them perspective in which ‘they’ are easily set apart and seen as incompetent and difficult. I was disappointed that Colwell’s review did not make this important and simple point: that a non-ageist strategy for the development of health care policy and practice can draw upon specialist skills without imposing age bars and without using a segregationist vocabulary.