Women tend to live longer than men, and thus typically have more interactions with the healthcare system in old age than men do. Ageism and stereotypes of older people in general can have an important impact on elders’ physical and mental health and well-being. For example, internalized negative stereotypes can produce self-fulfilling prophecies through stereotype embodiment and contribute to weakness and dependency. Ageist beliefs and stereotypes can interfere with health care seeking as well as with diagnosis and treatment recommendations; they can, for example, contribute to gender disparities in the health care of older adults if older women are perceived as too frail to undergo aggressive treatments. Ageism also results in disrespectful treatment of older patients, which is communicated through baby talk and other forms of infantilization or the shrugging off of patients’ complaints and concerns as “just old age.” Intersectional identities can result in a cumulative burden for older women patients who may have a history of disrespectful treatment for other reasons (e.g., sexism, racism, bias against lesbians). Reduction of ageism and sexism and promotion of more realistic and diverse views of older women could improve doctor–patient relationships, facilitate adherence to treatment regimens, and reduce disparities in health and health care.

Ageism can be Hazardous to Women's Health: Ageism, Sexism, and Stereotypes of Older Women in the Healthcare System

Purpose: Language carries and con veys meaning which feeds assumptions and judgments that can lead to the development of stereotypes and discrimination. As a result, this study closely examined the specific language that is used to communicate attitudes and perceptions of aging and older adults. Design and Methods: We conducted a qualitati ve study of a twitter assignment for 236 students participating in a senior mentoring program. Three hundred fifty-four tweets were qualitatively analyzed to explore language-based age discrimination using a thematic analytic approach. Results: Twelve percent of the tweets ( n = 43) were found to contain discriminatory language. Thematic analysis of the biased tweets identified 8 broad themes describing language-based age discrimination: assumptions and judgments, older people as different, uncharacteristic characteristics, old as negative, young as positive, infantilization, internalized ageism, and internalized microaggression. Implications: The language of ageism is rooted in both explicit actions and implicit attitudes which make it highly complex and difficult to identify. Continued examination of linguistic encoding is needed in order to recognize and rectify language-based age discrimination.

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The Language of Ageism: Why We Need to Use Words Carefully

Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland. Data were analyzed from 6903 community-dwelling adults aged ≥ 50 collected in the first wave of The Irish Longitudinal Study on Ageing (TILDA) in 2009–11. Information was obtained on the self-reported occurrence (yes/no) and severity (frequency/activity limitations) of UI in the past 12 months. Loneliness was measured using the UCLA Loneliness Scale short form. Information was also obtained on depression (CES-D), anxiety (HADS-A) and other sociodemographic variables. Logistic regression analysis was used to examine the association between variables. In a model adjusted for all potential confounders except mental disorders, compared to no UI, any UI was associated with significantly higher odds for loneliness (odds ratio: 1.51). When depression was included in the analysis, the association was attenuated and became non-significant while the inclusion of anxiety had a much smaller effect. Similarly, although frequency of UI and activity limitations due to UI were both significantly associated with loneliness prior to adjustment for mental disorders, neither association remained significant after adjustment for both depression and anxiety. UI is associated with higher odds for loneliness among older community-dwelling adults but this association is largely explained by comorbid mental health problems, in particular, depression.

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Urinary incontinence, mental health and loneliness among community-dwelling older adults in Ireland

In a social–cognitive model of stigma, stereotypes (negative attitudes about a labeled group) are presented as the exogenous variable in a path model that leads to prejudice (emotional reaction to the group) and discrimination (behavioral response). A method is discussed in this article to identify stereotypes that are meaningful to and reflect the agenda of a stigmatized group. Using community based participatory research, investigators address 3 questions. First, who is the stigmatized group, requiring research about perceived groupness, perspective, and boundaries? Second, what are the stereotypes conducted as mixed methods research, beginning with qualitative work that seeks to identify candidates of stereotypes? Subsequent quantitative studies seek to cross-validate stereotype candidates in differing ways including demonstrating group specificity of stereotypes and supporting path models that shows good fit in the relationships between stereotypes and subsequent prejudice and discrimination. Third, how does defining stereotypes inform antistigma programs? The discussion here is split into those meant to diminish public stigma versus self-stigma. The article ends with implications for future research in this area.

Defining the Stereotypes of Health Conditions: Methodological and Practical Considerations.

Incontinencia urinaria e um problema de saude pubica por ser uma doenca multifatorial que acomete em termo 27,6% das mulheres e 10,5% dos homens, refletindo nas relacoes interpessoais, profissionais e sexuais. O estudo teve como objetivo Caracterizar o perfil sociodemografico, epidemiologico e clinico de mulheres com incontinencia urinaria atendidas em uma Clinica Ginecologica de um Hospital Universitario do Piaui. E uma pesquisa de campo do tipo exploratorio descritiva, transversal, realizada no mes de setembro de 2015, mediante a aplicacao de um formulario semiestruturado em 48 mulheres. A prevalencia de incontinencia urinaria foi maior em mulheres com faixa etaria entre 30 a 48 anos (52,1%), casadas (56,3%), pardas (72,9%) e com nivel de escolaridade de ensino fundamental incompleto (39,6%). Destaca-se como fatores de risco: consumo de cafeina (97,9%), cirurgia ginecologica (87,5%), infeccao urinaria (62,5%) e pratica de atividade fisica (56,3%). O tempo de inicio da doenca foi entre 1 a 5 anos (43,8%), com episodios de perda de urina ao espirrar (89,6%), ao tossir (83,3%) e antes de chegar ao banheiro (75%). Adotaram como atitudes comportamentais de ficarem proximas ao banheiro (54,2%) e a fazerem uso de absorventes ou forros (41,7%). Apenas 33,3% procuram o medico, 35,4% receberam orientacoes sobre a doenca, 25% conhecem o diagnostico medico e 12,5% realizaram algum tipo de tratamento.  O estudo possibilitou conhecer a realidade das mulheres com incontinencia urinaria que buscam assistencia a saude em um Hospital Universitario, com resultados que se aproximam de estudos anteriores sobre a tematica.

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Caracterização e fatores de risco de incontinência urinária em mulheres atendidas em uma clínica ginecológica

This literature review investigated stigma and identified episodes of microaggressions experienced by women with urinary incontinence. Three significant themes were revealed: lack of disclosure from psychological distress, microaggressions resulting from stigma, and factors associated with the intersections of gender, race, and ethnicity. Nursing implications include earning and maintaining patient trust, and demonstrating sensitivity about urinary incontinence.

Maryann M Deguzman

Papers

Stigma and microaggressions experienced by older women with urinary incontinence: a literature review