Shame is too often intertwined with aging in our culture. On TV, we hear taglines such as, “Growing old is optional” and, “You can reverse the aging process,” which lead us to believe that our naturally aging bodies are vessels to be fought against. Google “Age Shaming” and you will see many examples of ageism through articles, tweets, and stories. The underlying message is clear: If you just try hard enough, you can remain healthy and youthful. As a culture, we are enticed by this idea. However, this message comes with implications for our aging citizens and loved ones who require assistance in some way. Too many older adults internalize this message and assume that its counterpart must also be true: Those who age and decline in health must not be trying hard enough. Consequently, many of our older loved ones are left with feelings of shame.
In a culture where autonomy, self-determination, and self-sufficiency are highly valued, the reality for many people who need assistance is complicated. We all want to be as independent as possible for as long as possible. Oftentimes, a little help can go a long way for us to maintain a lifestyle of living independently. However, in a culture where independence is paramount, the very thought of asking for help is emotionally threatening. Many seniors over the years have described thoughts such as, “If I just try harder, then I could do it,” “I should be able to do this; what is wrong with me?” “My friend/neighbor/sister is my age and she still can ____,” and, “I am such an inconvenience.” The thought of asking for a ride to the store, for help with paying bills, or evermore personal tasks such as dressing and bathing (even if it means that receiving this aid could help maintain as independent a lifestyle as possible) is frightening. In our culture, a common assumption is that to ask for help is a sign of weakness and resignation.
So often, these assumptions are internalized by older adults and exacerbate feelings of inadequacy and shame. When left to fester, these feelings continue to grow and lead to increased fear, anxiety, depression, and withdrawal. Negative behaviors such as combativeness, substance abuse, isolation, and suicidal ideation arise and gain strength. At the root of these difficult behaviors lies fear, insecurity, and shame. How can we help older adults overcome shame as they age?
• Talk! Feelings of shame gain strength when they are held inside us and avoided. Painful feelings which are expressed and validated by a supportive listener weaken. Connection and good communication are essential to reducing shame and stigma.
• Empathize! Our mission is not to solve the “problem” of aging; rather, our goal is to support our loved ones and encourage them to make healthy and positive choices that will enhance their well-being as they age. Use empathy – put yourself in their situation and assess how you would feel in that position – rather than offering advice on what to do and how to do it. When we use empathy, it gives others a chance to fully express their truth and build a foundation for future conversations and enhanced connections. Connection is an antidote to shame and isolation.
• Educate! So often in the news, we hear stories of the people who seem to combat and overcome age – the 90 year-old marathon runner, skydiver, or bodybuilder; the 89 year-old college graduate, etc. These individuals do accomplish amazing feats and should be celebrated. The trouble comes when we glorify these outliers and hold them up along with the message, “If they can do it, you can too.” We as a culture gloss over what real, typical aging looks like, and as a result, we promote very unrealistic and unhealthy standards. Our typically-aging loved ones see these stories and often compare themselves unfavorably. It is essential for us all to learn more about normal aging so we have an accurate view of it. As we accumulate knowledge about aging, we can facilitate conversations with older loved ones and ease their fears of inadequacy or indolence. Many organizations, such as AARP and Area Agencies on Aging, and university geriatric programs have educational materials and resources to share. Public libraries also offer talks and presentations regarding aging and resources for older adults.
• Seek guidance! Enlist professional help from a care manager, therapist, or social worker who is experienced in care for older adults and families if you or your loved ones feel stuck. A professional’s knowledge will help guide you and your loved one toward helpful resources, navigate the complex medical system, and talk through difficult issues together.
Shame and aging may be intertwined in our culture, but they need not be. Good communication, empathy, education, and resources reduce the power of shame. Positive, healthy connections enable older adults to overcome shame and stigma and live with dignity.
Amy Neu received her Masters in Social Work from the Brown School of Social Work at Washington University. Amy provides private therapy for adults, families, and seniors who are facing a variety of issues including depression, anxiety, grief, coping with medical issues, and end of life. She has significant experience counseling seniors, caregivers, and families within medical systems and during transitional periods from home to alternate levels of care.
In addition to Amy’s clinical practice, she provides on-site counseling and education to staff throughout the continuum of senior living communities.