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  • Larissa Kowalski

The Power of Stigma: How does Self-Ageism Contribute to Missing Occurrences?

Over the course of the COVID-19 pandemic, many of us have watched in horror as harrowing outcomes have been documented in long-term care across Canada, reminding us that our social programs to support the aged need to be strengthened, revamped, and even reimagined. Equally revealing is that in the early days of the pandemic, we witnessed countless evasions to public health restrictions, with people refusing to wear masks or hosting large gatherings because “the virus only affects old people”. The world clearly responded by measuring human value in terms of chronological age and older adults appeared to be more disposable during this pandemic.


Vaccine hesitancy can be considered no different. For the past five months, we have witnessed media campaigns encouraging us to get vaccinated to combat the spread of COVID-19. However, as vaccination rates slow and our threshold for reaching herd immunity feels like a distant past, there appears to be a trade off of risk. It seems that only when contracting the virus becomes ‘serious enough’, meaning it will affect children or youth, or even middle aged adults, will vaccine rates skyrocket despite the millions of lives lost across the globe in our older adult populations.


These circumstances reify and reflect what many of us working in healthcare and gerontology have known for decades – that is, Western societies, like Canada, exert high levels of societal ageism. Ageism underlies our social programs and policies, it is embedded within our discourses surrounding aging, and it frames what it means to age ‘well’ or ‘successfully’ in our society. Indeed, social pressures to “age successfully” have implied that many older adults often place great importance on maintaining independence in old age (Rowe & Kahn, 1998) and these models are predicated on the belief that one must be self-reliant and maintain complete physical, emotional, and cognitive functioning. Otherwise, they will be conceived of as dependent.


If ageism can influence individual and communal responses to a pandemic, might it also impact missing occurrences among the aged?


Yes, indeed it can.


When global levels of ageism rise, so do levels of self-ageism — that is, older adults bearing witness to rising levels of ageism internalize these negative stereotypes (Levy, 2009; Levy et al., 2018). It leads them to doubt their abilities, perform poorly on cognitive tasks, and have poor health outcomes (Haslam et al., 2012; Kotter-Grühn et al., 2009; Levy et al., 2000; Rothermund, 2005). Self-ageism increases morbidity and mortality (Levy et al., 2002; 2009) and perhaps, most concerning, older adults who hold more negative views of their own aging are also less likely to seek preventive health services (Kim, Moored, Giasson & Smith, 2014).


How does ageism connect to missing occurrences?


In my research examining factors that contribute to older adults being reported missing to police in Canada, I found that ageism is connected to missing person cases insofar as missing occurrences involving older adults have not been the focus of much policy attention. For example, Canada does not have a national response strategy for missing persons nor does it have a national Silver Alert strategy. These biases extend to media reporting of missing occurrences as well.


Despite media being considered an important tool for locating and recovering missing persons, older adults appear to receive the least media attention of all age groups (Fyfe, Stevenson, & Woolnough, 2014; Jeanis & Powers, 2017; Ferguson & Soave, 2020). Not only do older adults receive fewer articles as well as smaller word counts (Jeanis & Powers, 2017), a one unit increase in age is associated with a 4.41 decrease in article word count. Older adults, aged 75 and older, also received the least amount of media attention compared to all other age groups in a recent Canadian study (Ferguson & Soave, 2020). Further, despite the high incident rate of persons with dementia being reported missing, only three persons with dementia were reported missing on police social media accounts over a two-year period (Neubauer et al., 2019). The limited media coverage of missing older adults could thus be considered a consequence of public perceptions of the aging process which conceal, or indeed, erase older adults from missing occurrences completely.


How does self-ageism play out in missing occurrences?


An emerging body of literature has examined how the internalization of age-based stereotypes has had a host of negative effects, particularly when older adults strive to maintain independence inappropriately (Swift, Abrams, Lamont & Drury 2017; Sun & Smith, 2017). One example of particular relevance to my research is that the more negative perceptions an older adult has of their own aging process, the more likely they are to delay or constrain help-seeking behaviours (Sun & Smith, 2017).


One recurring theme I found through a thematic analysis of missing person cases was that older adults often alluded to a strong desire to maintain independence, even if it meant minimizing harm that had come to them. Although the desire to maintain their independence did not immediately contribute to missing occurrences per se, it did sometimes prevent older adults from asking for assistance while lost (Sun & Smith, 2017). In particular, the thought of having to report one’s whereabouts to their care staff or loved ones was considered reprehensible to some and a direct violation of their autonomy.


In other occurrences, older adults tried to “pass” as non-impaired by leaving walking aids at home or refusing to use vision or hearing aids in an attempt to dissuade detection of one’s impairment (Goffman, 1963). Although in most cases these decisions did not result in overt harm to the missing person, the absence of these aids sometimes hastened missing incidences insofar as the individual became injured while away from home which prevented them from returning safely.


More concerning is that oftentimes the strong desire for independence and fear of being considered dependent implied that some older adults, most often men, would resist asking for help while lost. Because health is often considered a marker of social status (Twaddle, 1974), it appeared that those who were seemingly ill or less healthy were more likely to engage in techniques of impression management to distance themselves from their “spoiled identity” (Goffman, 1963). Sometimes these techniques implied that older adults would perform activities beyond their individual capabilities or refuse to ask for help when needed.


These results were consistent with existing research which implies that gender influences help-seeking behaviours insofar as men were less inclined to ask for help while missing or seek medical attention (Thompson et al., 2016). Indeed, it could be argued that cultural perceptions of aging with dementia, as well as notions intertwined with hegemonic masculinity, create a “triple jeopardy” for men living with dementia who become lost – that is, asking for help is not simply just a question of need but requires confirming age-related defeat and disability status which is in direct violation of being a “real man” (Katz & Earp, 2002).


There were also cases where older adults felt a strong responsibility for their actions despite being affected by the onset of a pathology. In one case, Mateo, who recently had an onset of dementia felt a strong responsibility for his inability to successfully perform his role as an investment advisor. The report stated: “For the past month, Mateo has been showing signs of depression with decreased appetite and sleep disturbance but within normal limits. The depression is related to the volatile stock market with personal losses affecting [his and his wife’s] retirement income. He is also an investment advisor and felt responsible for financial loses affecting his clients.”


In this occurrence, Mateo appeared to be fraught with concern about burdening others to the extent that both his wife and police were concerned he might be at risk of self-harm. These feelings are actually quite common for older adults, particularly those living with an impairment (McPherson, Wilson, & Murray, 2007). They are referred to as self-perceived burden and are believed to arise from care-recipients’ feelings of frustration and worry about being dependent and the ensuing feelings of guilt about being responsible for other’s hardship (McPherson et al., 2007: 111). As with Mateo’s experience, the fear of burdening others has been ranked as one of the greatest reasons for not wanting life-extending medical treatment and desiring a hastened death in in previous studies (Cahill et al., 2011).


These negative feelings about one’s own aging process and the perceived inconvenience on others extended to their responses after being found as well. For example, some individuals reported feeling embarrassed for inconveniencing police or others by having them search for them. On other occasions, personal characteristics such as stubbornness or feelings of pride also appeared to prevent help-seeking behaviours. Indeed, the threat of losing one’s autonomy was substantial enough that it impacted interactions between a missing person and the police. For example, in one incident, despite police stating they were very concerned for an older man’s safety, he refused to stay at home after they found him missing. He said he was determined to maintain control over his own faculties and emphasized that he was able to make his own decisions whether he could stay or leave his residence.


Each of these themes and examples discussed above allude to the ways in which ageism permeates onto the individual – that is how macro-level or structural conditions, such as global ageism, are insidiously connected to the micro-level sphere of influence, or more specifically, one’s lived experience while missing. As we move throughout the world, it is important to be cognizant of the ways we think about and speak about the aged because if fortunate enough, we will all be older adults one day.


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Writer: Larissa Kowalski

Larissa Kowalski is Lead Researcher on Individual and Institutional Experiences of Aging and Living with Dementia at the University of the Fraser Valley. She has a Master's degree in Sociology from the University of Western Ontario and her research examines risk factors that lead vulnerable, in-risk older adults to go missing.