Investigación · 22 February 2021

Mutual care, an antidote to ageism and ableism

A fortnight ago I had to get on the metro to go to the Complutense University of Madrid to give a PhD seminar on boredom. I had not travelled by train since classes were suspended in March last year, when total confinement was declared as a containment measure for the COVID-19 pandemic. Not much has changed: platforms crowded with people waiting for their turn to arrive, eagerly squeezing in front of the door to the carriage they think will be the emptiest and jostling to get in quickly, in the hope of finding a free seat in which to rest for the duration of the journey. The only difference is that, from the neck up, we all look like surgeons about to enter the operating theatre. In rush hour it is difficult to travel seated, everyone knows that. I'm lucky enough to catch my line at the second stop from the exit, so there's always a seat. There I was sitting comfortably, going over my notes for class, when the world came crashing down on me. 

The train stopped at a stop near Atocha, at a height at which, whatever time it is, there is no room for a pin in any car. The doors opened once more, letting the crowd in. They closed and the vehicle continued on its way. From my vantage point I managed to peer into the gaps between trousers and skirts to see the twisted legs, covered by a pair of flesh-coloured stockings, of an older woman who, with the help of her cane, was moving towards me in search of a place to stand in the crowd. As best she could, she clutched at the ten centimetres of metal bar that had not yet been occupied with her trembling hand, which reminded me of the Tagus' affluents. I soon began to gather up my notes and put them in my backpack, as I turned my headphones off with the intention of listening to the lady thank me as she discovered I was giving up my seat for her. I was almost on my feet when a voice in my head said, "Wait a minute. What are you doing? Go back to your seat and think twice about the implications of your actions".  

What if the lady was offended by my assumption that, as an older person, she would want to sit down? Would this imply that she must be tired because of her age? Would she feel discriminated against because of my unconscious belief that her years made her more frail than others? "She carries a cane," I thought, "that's because it's hard for her to walk. "Maybe he's even in pain, as is often the case with many elderly people. "I'm sure he's having a hard time, struggling to keep his balance. "Or is she? "Let's see if I hurt her feelings with my offer by sending her the unintended message that I think she's old and weak and needs looking after." "My goodness!". "Am I an ageist? "Am I an ableist?". "Better not do anything, don't screw up," I said to myself. As I was thinking about it, my stop was announced over the public address system to ease my ordeal. I stood up, and immediately the woman took my place. "Wow!" "Have I acted correctly or not?", I asked myself. It took me quite a while to regain my concentration on what I was supposed to be engaged in that day, my talk of boredom. In fact, here I am, still going on and on, seeking solace and answers from the readers of this blog. 

My parents brought me up with the idea that you had to give up your seat on the bus to the elderly (there is no metro in Murcia). There are signs everywhere reinforcing this moral obligation! It seemed logical to me: when in doubt as to whether or not the person in question wants to sit down, it is always better to offer them the possibility and let them be the one to accept or reject the gesture. On countless occasions in my life this has happened, but I had never stopped to think about whether after saying "no" that person would have been left ruminating on things like "I must be old for people to think I need to sit down" or "People think I'm fragile and need to be looked after" or "What does this girl think, that because I'm 70 years old I'm useless and can't stand for half an hour? How awful, I don't want anyone to think that! But I wouldn't want to be considered rude, unsupportive and disrespectful to the elderly just to avoid hurting their sensibilities. Or worse, that my fear would end up condemning someone to suffer an uncomfortable journey for not doing what is expected of me without them having to ask me to do it. 

That's just it! There's the solution: it's the grown-ups who, if they require it, should ask me to give up my seat. Wait, no. They may not do so because this also reinforces for themselves negative ideas about old age. But what a mess! I still remember when I was once travelling with my best friend from my teenage years on the bus from my village to the city centre and an elderly man, seeing that no one was taking the initiative to offer him his seat, exclaimed loudly - "What a lack of shame! To which my companion replied without any blushes, "No, sir, what's missing is a seat", much to my embarrassment, as I hadn't got up out of sheer laziness. 

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Now, having very much in mind what ageism and ableism represent, I am going crazy. I thought I had become, over time, an example to everyone, always thinking about how to make life easier for the elderly, but suddenly I find that acting on the premise of "give and give" can foster their feeling of uselessness; what my colleagues at the Eden Alternative know as the plague of "helplessness" when they give you everything done and make you feel that you are no longer good for anything. These days I walk down the street and it doesn't occur to me to offer an elderly person my help to carry the shopping bags, lest I make them feel useless. And maybe they're looking forward to it! But I don't want to gamble, even if my over-precaution means that his osteoporotic hands will burst. Or if he thinks that youth is too young to do anything. Prevention is better than cure. Are you sure?

How can we strike a balance between not being ageist and enabling and still being respectful and supportive of the elderly? The WHO defines ageism as "ageism as well as inappropriate and prejudicial age-related behaviour directed towards older people". It is one of the major forms of discrimination in our society, second only to racism and sexism, which people suffer in this case simply because they are older. ableism, on the other hand, is "a form of discrimination or social prejudice against people with disabilities". So much for "What does this have to do with giving up your seat?

Alana Officer and Vânia de la Fuente-Núñez, WHO experts, explained in an interview for 65Ymás in June 2019 that ageism includes three dimensions: stereotypes, prejudice and discrimination. "Basically, ageism affects our thoughts, feelings and actions towards people based on their chronological age or the perception that they are [...] too old to do something. The consequences of this type of behaviour result in a lack of dignity for people, usually related to their abilities, and have an impact on their self-esteem," they argue. They also claim that ageism and ableism are negative for health and well-being, worsen cognitive and physical capacity, lead to poorer mental health and slower recovery from disability, and even reduce life expectancy, affecting the participation of older people in society and generating a negative perception of ageing. 

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I return to my initial questions: am I prejudiced in thinking that older people, because they are older, are tired and have aches and pains that come with age? Am I buying into the stereotype that all older people fall into these states? Am I ageist or ableist if I think an older stranger needs help and care because of their chronological age or their appearance? Will I be discriminating against someone by giving them a seat or offering to help them carry grocery bags? Will I be making them feel useless? Or will I be rude and unsupportive if I act on the assumption of avoiding ageism and ableism at all costs? What if, in order not to make someone feel useless, I decide not to help them and they end up having a fall? Won't this be worse for their health? If my prejudice triggers something beneficial for the older person, such as not having to stand or carry bags, then is it no longer ageism? Or does it depend on how the person I am addressing subjectively interprets it? And how am I supposed to know? Wow, how am I supposed to find the middle ground!

The antidote to the plague of helplessness, "helplessness", which is generated in some older people as a result of certain behaviours that can be interpreted as ageist or enabling, based on certain prejudices and stereotypes - even when they are born of the best intentions - does not consist in ignoring the elderly, ceasing to care for them or abandoning them to their fate. On the contrary, the remedy lies in promoting a concept of care partnership in the consciousness of all parties, based on the premise of "give and take". If we internalise (or recover) the idea that we all care for each other because we are all valuable and have something to offer, the young to the old and vice versa, no one needs to feel offended when we try to make life easier for them, because it is part of the two-way care exchange. I'll carry your bags and give you the seat, but you enlighten me with your wisdom and teach me how to prepare that recipe I like so much. It is not about who is more useful or valid, but about everyone contributing according to their ability and receiving according to their need (do not take the aphorism in its ideological sense), under the recognition that we all have something to give to others and we all need to receive something from others, regardless of age and, of course, regardless of race or gender. 

Officer and de la Fuente-Núñez say that one of the causes of ageism and ableism is that nowadays there is limited contact between different generations: some of us are unaware of the deficiencies and abundance of others. Moreover, the role of older people has changed and they are no longer seen as the main agents of knowledge in society. Therefore, it is not enough to promote the idea of mutual care through education. It is necessary to facilitate its implementation on a daily basis by creating spaces for intergenerational interaction, for example through collaboration and volunteering programmes and activities. Because the problem is everyone's problem and the solution also involves everyone. Stereotypes about old age that lead to ageism and ableism are not only on one side of the spectrum. The commitment of older people is equally necessary to eradicate this scourge. If I convince myself that I should take care of the elderly, just as they should take care of me, but when it comes to putting it into practice I find a person who is prejudiced about himself because of his age, who will take my care badly, we are not moving in any direction. There is no point in settling into the belief that society discriminates against the elderly and victimising oneself by consolidating one's own stereotype. You have to prove the discriminator wrong by asserting yourself through such spaces of interaction. 

So, can I be kind and helpful to the elderly or will I make them feel useless? Without being overly paternalistic, I believe we all appreciate being cared for, whether we are thirty or sixty, and we feel good when we care for others. We simply need to ensure that the path is a two-way street so that no one feels out of place. We can all sit on the mutual care train.

Under the framework of: Programa Operativo Cooperación Transfronteriza España-Portugal
Sponsors: Fundación General de la Universidad de Salamanca Fundación del Consejo Superior de Investigaciones Científicas Direção Geral da Saúde - Portugal Universidad del Algarve - Portugal