IFA Virtual Town Hall Chat Summary 21 August 2020

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Key Resources

• IFA #Agequality Resources
• John A. Hartford Foundation
• Institute for Healthcare Improvement
• Nurses Improving Care for Healthsystem Elders (NICHE)
• Trust for America’s Health
• Aging and Disability Business Institute
• National Center on Elder Abuse
• Gerontological Society of America (GSA) Reframing Ageing
  • Webinar: Reframing Aging in the Age of Covid-19: A Primer for Health Care Professionals
• FrameWorks Institute: Finding the Frame: An Empirical Approach to Reframing Aging and Ageism
  • To sign up for FrameWorks Institute ‘On Frame’ Newsletter
• Interventions to Reduce Ageism Against Older Adults: A Systematic Review and Meta-Analysis
• Oireachtas Committee report calls for urgent action to protect nursing home residents in potential Covid-19 second wave

Upcoming Events

• IFA Virtual Town Hall – COVID-19 and Older People: Humanitarian Responses in the Middle East
  Thursday 27 August 2020 at 7:00 am EDT (Toronto)

• National Institute on Ageing
  Webinar: Inclusion Across the Lifespan-II
  Wednesday 2^nd September 2020 10:30 am (EDT)
  More information: https://bit.ly/34pAGMR

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Speaker Biographies

Dr. Jane Carmody:

Dr. Jane Carmody, DNP, MBA, RN is a Program Officer at The John A. Hartford Foundation (the “Foundation” or “JAHF”), a national private foundation dedicated to improving the care of older adults.  As Program Officer, Dr. Carmody works with Foundation leadership and staff to guide and support grant-funded initiatives in the United States in three priority areas: Age-Friendly Health Systems, Family Caregiving, and Serious Illness and End of Life.  Her portfolio of grants includes programs to create age-friendly public health systems, strengthen community services for older adults, disseminate dementia care programs and resources, and improve emergency department care and surgical care for older adults.  Dr. Carmody also helps lead the Foundation’s grant and participation with the Reframing Aging Initiative, a long-term social change endeavor designed to improve the public’s understanding of what aging means and the many ways that older people contribute to our society.

Dr. Carmody has held significant leadership positions with health care systems prior to joining the Foundation, including executive director of a large regional health system’s home health care and hospice services, hospital chief nursing officer (CNO), system CNO for a health care system and chief clinical leader for a large national home health care and hospice company.  She has a doctorate in nursing practice (DNP) from Rush University, an MBA from Creighton University, a social work degree from the University of Nebraska-Omaha and a diploma in nursing from Mercy College in Des Moines. She has national certification in executive nursing practice (CENP) from the American Organization of Nurse Executives (AONE) and a board certification in nurse executive-advanced from the American Nurses Credentialing Center (ANCC).

Mr. James Appleby:

Mr. James C. Appleby, BSPharm, MPH, ScD (Hon), is the Chief Executive Officer of The Gerontological Society of America (GSA), the nation’s largest interdisciplinary organization devoted to research, education, and practice in the field of aging.  GSA works to advance innovation in aging and disseminate information among scientists, clinicians, policy makers, and the public.  He is leading GSA’s current initiative to “reframe aging” in America by fostering accurate narratives of aging to replace the outdated “conventional wisdom” that dominates public understanding.  The 5,500-member society is advancing major initiatives related to improving adult immunization rates, earlier detection of cognitive impairment, improving oral health, and demonstrating the impact of the longevity economy.  Mr. Appleby also is currently serving a four-year term on the National Advisory Council on Aging after being appointed by the U.S. Secretary for Health and Human Services.  Prior to joining GSA, he had a 17-year career with the American Pharmacists Association (APhA) where he served in a variety of roles before being appointed Chief Operating Officer.  Before joining APhA, he was on faculty at the Philadelphia College of Pharmacy and Science (PCPS).  Mr. Appleby holds a bachelor of science degree in pharmacy from PCPS and a master of public health degree from Temple University.  He has been awarded an honorary Doctor of Science degree from the University of the Sciences in Philadelphia.

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Experiencing Ageism

• Ageism in the workplace starts at about age 40 years and does not exclusively affect the “oldest old” population, for instance those living in care homes with severe functional decline.
• Ageism is a conscious and unconscious feedback loop across society, which can be seen from media advertisements to greeting cards.
• Caregivers and those who work alongside older people experience ageism first hand in health care settings including hospitals and community care. These individuals are important advocates against ageism facine their older loved ones.
• VISIONS Services for the Blind and Visually Impaired in the Metro NYC area operates an older adult center that is completely adapted for independent use by older adults with vision loss, with staff comprising many blind older adults. The public and families of older blind adults and the blind older adults themselves experience ageism and ablism on a daily basis, and have low expectations of what is possible in terms of programs and services.  However the centre has adapted evidence based programs for blind participants and for blind instructors to improve outcomes.
• COVID-19 has generated global attention around older people and as such this is an opportunity to cast an intergenerational push to promote both understanding and support of ageism initiatives.
• Advocacy and education on ageism must start in childhood to ensure understanding of the discrimination facing older people, and to combat it.
• Many older adults feel a sense of pride with being older and being a grandparent. It is sometimes unwarranted to refer to older people as “young lady/man.”  However, while it is important to be concerned with the language used, it is also important to understand the different circumstances and intentions (i.e. a friendly sense of humour rather than a malicious comment).
• In Indigenous and other cultures, older people are revered and respected as knowledge keepers and their wisdom is sought-after. This attitude should be promoted in more societies and cultures.

Research and Language

• Language is very important – we can see how the disability sector managed to change the language of disability but how do we influence policy makers and our leaders  to start using appropriate language which would start influencing and draw attention to how we segregate older people by using ageist language?
• Terms like “elderly” or “seniors” are not appropriate and the terms “older people/persons” should be used when possible.
• The GSA’s Reframing Aging Initiative partners with the FrameWorks Institute to disseminate the evidence-based narratives and train advocates to use reframed language.
• Did the research have a questionnaire that individuals can use themselves to determine their own bias and sterotyping ageism and particularly to address self directed ageing – is there a ‘take away’ Even the definition of gerontology ‘the scientific study of old age, the process of ageing, and the particular problems of old people.’ So even the dictionary emphasis ‘PROBLEMS’
• Implicit Bias testing was part of the FrameWorks research. Take the test here.
• The NEJM recently published an article showing ‘left digit bias’ in medical specialists that negatively impact older people. How are the GSA and JAHF incorporating these data in their work with health care professionals?
• A general discussion about the left digit bias can be found here.
• GSA published an infographic entitled Understanding Ageism and COVID-19
• In Ireland many research initiatives excluded those aged 70 years and over from their research, which is an example of Ageism.

Interventions

• SĀGE based out of Tel Aviv honours the expertise of those aged 60 years and over and provides supplemental income. During the COVID-19 SĀGE has provided support to older people through intergenerational classes taught by international experts.
• Intergenerational programs demonstrate the capability of older adults, and their contribution to society on many fronts.
• Role modelling is essential for creating non-ageist attitudes. Sometimes we as older persons reinforce the ways others others see us.
• As older people, we have to be the examples of positive ageism – what we say, what we do, how we interact within our community can make a difference. It is our individual and collective responsibility.
• The JAHF has done pioneering work to bring physicians, nurses and social workers into gerontological practice. There is interest in sharing the results of JAHF initiatives.
• Older people in long-term care homes made up more than 80% of COVID-19 deaths in Canada. It is clearly a human rights issue.  There is interest in sharing advice on how to frame the ageism advocacy narrative going forward.
• Some public health settings in Europe remove the age section on intake forms in order to stop ‘triage’ based on age.
• In Canada a forum called Spotlight on Aging explores how older adults are portrayed in the media, and there is much work still needed.
• The French Society of Geriatrics and Gerontology has launched a campaign entitled “Old Lives Matter”
• An inclusive common agenda is critical and may be moved forward by linking to initiatives such as the WHO Global Network for Age-friendly Cities and Communities or the UN Policy Brief on Older Persons