 Welcome to Don't Just Age, Engage, Kantec Hawaii's program for aging and the issues that come up personally, primarily in people's lives, the lives of the families and communities that support them in their aging process. Don't Just Age, Engage. I work to empower people to make their aging an extraordinary elderly. And so in the process, we look at various resource people that are available online and in other ways to empower you to do that well, to age well. We have a society that doesn't seem to like the age, but alone die. And so how do we age well and also die well is part of the calling that I like to fulfill and help people move towards. But ageism is one of those isms that I've never really known much about until now. I thought as a Presbyterian minister, I worked against to dismantle racism. I've worked against gender discrimination and sexism. But now working with elders and being an elder, I come up against ageism. And I'm wondering, can ageism kill you? So to answer that question or to at least respond to some of your questions around this, I've invited Dr. Lucas Morgan to join me again on this program. Dr. Morgan was on with a while back with us, discussing, hello, Dr. Morgan. Hi there, Larry. Thanks so much for having me on again. Pleasure to be here. Last time you were with me, we were discussing psychological issues that come up in aging process. And you did a great job of helping us look at some of those. And then at the end of the conversation, you mentioned ageism to me. And I thought, what a great opportunity to talk about it, revisit that. And to hopefully, and to highlight it so that our elders, our viewers, recognize when they're dealing with ageism. I read a recent article in Atlantic about a woman who was 84 years old and she talked to herself as being a pharmaceutical and a pharmacist. She had trained as a pharmacist, worked as a pharmacist, was living in a long-term care facility and needed a certain kind of medication. And she knew she needed it and she knew what the medication was and what it would do. And she asked for it and was ignored. And she said, I couldn't believe it, ageism. So part of what I hope we do here today is identify with your help, look at some of those signs that people may encounter daily of ageism in their lives. So give us an introduction about yourself. We're on the island of Oahu and you have a long-standing career here. Share a little bit about that with new people here who haven't met you yet. Sure. So yeah, I'm from Kama'ina families here, going back seven generations. So Hali, but we just celebrated 200 years here since our first ancestors arrived. And so very, very much committed to Hawaii and its people and just really grateful to be able to have been able to come back after getting my clinical psychology doctorate degree in Boston, where we focused a lot on the effects of social disadvantage on mental health and things like different forms of stigma, including ageism on people's experiences and their mental health and how big a part those things play, often invisibly. And so getting to come back here, I focused my psychology work, both in my individual practice, but also in doing lectures and workshops with other psychologists, you know, groups of doctors, medical students at JABSON, talking about aging and aging mental health and ageism in specifics. So yeah, it's something that's very near to my heart. Yeah. That's terrific. And we're fortunate to have you here with that sort of emphasis and focus. I have read a wonderful book by Dr. Aronson, Louise Aronson named a Elderhood, which I've enjoyed so much. And I'm just delighted to find that we have you here with that same kind of intent focus from a slightly different point of view from a psychological point of view, she, me and MD. And so I'm very grateful to have you here and helping us to ask this and answer this very important question. So let's jump into it. Where does ageism come from? That's a great question. Ageism comes from, I guess you could say social stigma that connects and sort of teaches us stereotypes about older adults. And it gets perpetuated through things like media where older adults are not typically included. You think about movies where 30-year-old actresses play 70-year-old parts. And so the sort of ageism or exclusion of older adults as protagonists, as sort of the center of the story really leaves younger folks only with stereotypes about what older people are like. And so ageism and aging is just a really unique part of our identities because other things like our race or ethnicities, our gender, sexual orientation, most of these things for most people do not change during the person's lifespan. Of course, there are exceptions, but age is one of the few categories where we actually grow up learning the negative stereotypes about those old people. And then if we're lucky enough and we live to become one of those old people, we start to turn that stigmatizing and stereotyping finger back towards ourselves. And so this is one interesting aspect of ageism in that ageism can become internalized. And that's where this is speaking to your initial question, can ageism kill you? So internalized ageism, right? Internalized ageism becomes a force against our own health and well-being? It does, it does. Oh my God, that is amazing to think about. Yeah, because think about it. A lot of younger folks, they may have very limited exposure to older adults and they see sort of portrayals of older adults as lonely, helpless, frail, demented, all these negative stereotypes, which are really not the norm for most older adults, but can be true, but are not the norm. And then they think, wow, must be depressing to be old. I don't really wanna ever have to do that, right? I don't wanna grow old because it seems so hopeless. And then if you have that belief that old age is depressing and hopeless, if you find yourself later in life as an older adult and you feel depressed, you might just think, this is just normal. And so you're less likely to seek help and you're much less likely to get treatment. So you're much less likely to get out of that depression because of those beliefs that were ingrained. Excellent, excellent, that was so well stated. I think of this and also in terms of when I understand what the Hindu practice, the native, the indigenous Indian people from India, who believe that there were four stages of life. And so there was a student stage at first, there was a productive stage second, a wilderness wandering stage third, and then returning as a wise person or a sage. And when we think of elderhood as being that fourth sage element of our lives or time of our lives, we can actually kind of get a sense of how underappreciated that really is, underappreciated socially, aesthetically and in the arts, underappreciated by myself. Finally, to your point, excellent, thank you. Feeling worthless. Yeah, right. And then, go ahead. Oh, just gonna say in Western society, there were two really main sort of social, cultural lines in the sand or periods in time where the value of elders as a repository for really important knowledge for a group of people got sort of demoted. One was the invention of the printing press. And so all of a sudden you can make books, right? And if you can write stuff down and mass produce books, what do we need sort of the collective knowledge of older adults, that becomes less important as a repository of things that gets passed down orally. And the second was the Industrial Revolution where people's value as humans in our societies, in Western society became more equated with how many hours can you work in the factory? And if you are older and less able to do that, your social status started to plummet, so your value. So some interesting cultural factors from Western society that contributed to where we find ourselves today. And that certainly feeds the whole notion that we value ourselves in terms of our productivity and are we really of any use to anyone? I mean, I've heard this in my work with people in hospice care that I've done that's chaplain in hospice where they feel useless. And there is no sense that that's valuable to be useless. Right, or that's the only way to assess value, right? Yeah, well, good. How do we recognize ageism as it occurs in our everyday life? Now you've suggested that it is something we can look for. How can I recognize ageism? Well, ageism, I recognize it myself if I'm coming up with stereotype beliefs that say old people are blank. So if I'm running through those types of sort of thoughts in my head, old people are blank. I'm probably just sort of saying these ageist stereotypes that I've learned since I was a little kid, that we all are socialized to learn. So that's one thing to look out for in ourselves. If I say, so that's one way to look for internalized ageism if you are saying, well, what's the point I'm old? That is ageism, that is internalized ageism. So what about other people, right? Because ageism is not only internalized, it's also interpersonal and it's institutional. And so I'm going through really the four eyes of any form of discrimination, including ageism is give me internalized. It happens between people. So that's when maybe there's ageist microaggressions or ageist sort of comments that can be well intentioned. It can be institutionalized in sort of how doctors treat older adults. We see patterns in care, in differential care between older adults and younger adults that institutionalize ageism. And then the fourth is intersectional. So it also depends on are you a man or a woman? How ageism affects you is going to depend on those types of things. What racial category does the world put you in? So those types of things also affect ageism. Okay, how about in a doctor's office? Doctors are by and large really very good hearted folks. They are helping professions and of course, the majority of them are very well intentioned but they're socialized beings just like you and me and everybody else, so there's ageism there too. If a doctor says, well, it's just age when they're talking about a condition, that's a place where I would encourage folks to assert a little bit more of well, as far as I know age is not a disease. And as far as I know, you're not billing insurance for treating my age. So there must be something else besides age that we can talk about here. If my right knee hurts and you say, well, that's just age. Well, my left knee is the same age. So I'm not sure why that one's not hurting. So sometimes doctors get stuck and they don't know what's causing an issue. And so age is often an easy thing to blame the doctor. But let's not accept that. Good, that's a good example. That's great. We're encouraged, I think, rightly so recently, perhaps more so than in the past, we're encouraged to be responsible for our own healthcare. So when we bring up some of these things, we can often gauge ages and perhaps by the way they're received. It can be, yeah. And the way that our problems are sort of thought about by providers, they can definitely have those lenses of, well, this is probably age. But so an important aspect of aging is that we don't wanna focus on too much on, that really it's all up to you. If you try harder, maybe you won't feel this pain. Or if you try hard enough, maybe you can defeat aging because that's also problematic. It's the other end of the extreme of what's the point? It's helpless, it's a downward spiral. The other extreme is also not helpful and not realistic, which is if only I could try harder, I could defeat aging, which is what a lot of the beauty stuff in the stores want you to believe. If you buy this product, you can defeat aging, right? And so there's a middle ground where it sort of matches up with that sort of serenity prayer that a lot of folks are familiar with, which is, let me identify things that I can still do. And if I can still exercise in some way and no matter if I'm in a wheelchair, I can still find some exercises to do to help the body do what it still can. And at the same time, work on accepting the things that I can change. And that's often where I'm working on in therapy. What is going in which category? So sometimes that's not clear. So sometimes ageism, as with other isms, are personal prejudice either others towards us or it's an aging person or I towards myself. Other times, ageism is structural and systemic and built into the system. How is that, how do you hear that or from your clients in terms of that systemic ageism that they encounter? Well, in healthcare, there are folks that do research on this and they find that just based on age alone, older adults are much less likely to be, to get assessments for depression compared to younger adults because of the myth that depression is a normal part of aging. And those who are assessed for depression are much less likely to be referred for psychological treatments and usually only provided medication options compared to younger adults. Cause there's this other myth that older adults can't learn new things. And of course, therapy is all about learning things and exploration. And so these myths could sort of seep into healthcare amongst of course, very well-intentioned providers. And so these are myths. Depression is not a normal part of aging. It's not inevitable. It's very treatable and older adults benefit just as much as younger adults from the psychological therapies and can really do a lot better and enjoy their older age when that depression is brought down. And have a right to enjoy that time alive. Oh yeah. It's not like we, well, aging people step out of their right to pursue happiness in all of their life and all aspects. But gosh, Lucas, this age is such a, such a great material for comedians, humorous. Right. You know, even when we talk about it ourselves, what do you do when somebody comes in to you with all these, you mentioned it before, well, this is what happens because I'm aging. And isn't it funny that I forget this and then a laugh that I stumbled down the stairs. What do you do? How do you counter that? Yeah. So if I noticed that someone sort of using self-deprecating kind of ageist humor, sometimes that's okay. Sometimes that's just sort of a way of coping with some of the challenges of aging, which are of course there for different people in different ways and are real for different people in different ways. But if I'm noticing it all, I might just mention that and be like, well, let's talk about that. Is that something you actually believe or how can we test out that theory that this is just age and that there's nothing we can do about it? Let's test that out. Because maybe that's part of this internalized ageism thing that we get taught to believe so early on. But yeah, humor and ageist sort of compliments or sayings are so common in our society that they're not even noticed. So a very common one is, you look so good for your age, right? And that itself is a very ageist statement. Although for both parties involved, it often feels like a compliment. But what is it saying? What is implied in that? Well, it's implying that your age is supposed to be ugly and you somehow beat the odds and are sort of the anomaly. If we wanna look at any joke or any sort of compliment, supposed compliment and just to test out, is it perpetuating ageist stereotypes or not, let's try replacing the word age or the age, the number itself with another aspect of identity. So what if I came up to somebody and I said, hey, you look so good for your race. That's not, that's a very racist thing to say because it's saying that your race is ugly and you somehow are the anomaly. But, you know, there's birthday card that's like, oh my God, you're 40 and the woman is like looking back in terror as if it's like a monster. And like, oh my gosh, you're gay. That's very heterosexist. And so when we compare it and switch out these different aspects of identity, we can see pretty clearly that there is a stereotype being reinforced in that statement. So just something to try. Very good. What other tricks are there that we can try? What other advice do you give when we are come up against was, well, it's often people of authority who are exercising their own prejudice. A prejudice that number one, age is ugly. Number two, ages means disempowerment and inability. Three, age is equated with ignorance. Sinility. Sinility, thank you. Can you encourage me to confront these authorities and their misunderstandings? How will I do that? Yep, and I think that the most powerful sort of way to confront something like that is with data that shows otherwise. Because these stereotypes that folks have are based on misinformation and stereotypes that are not founded in real data, which actually often show the opposite to be true or show a very different picture of what older adults are like. So reading, learning, getting immersed in sort of the literature on combating ageism to a very helpful... If there was one book that I would request folks to read and I'm not at all involved in this book myself, so I'm not pushing it for any financial gain at all, but I think it's a very really eye-opening introduction to ageism and exposes folks to a lot of the facts that folks can use to counteract their own and others' ageism. And that's called This Chair Rocks, A Manifesto Against Ageism, and it's written by a woman named Ashton Appelwight who is a very gung-ho sort of anti-ageist advocate. So This Chair Rocks, A Manifesto Against Ageism, I would really recommend for anyone because all of us are elders or elders in training, she calls it elders in training because we can always learn new things and always look for our biases. Excellent. This Chair Rocks, I like that. And it reminds me of back in the day when the Grey Panthers were on the rise. I don't know, you were too young for that probably, but there was such a strong Grey Panther movement in the follow-up to the Black Panther movement. It's kind of interesting that the racism often is on the cutting edge of change in our society. And then comes women's rights and rightly so, and then aging rights. But yeah, this Chair Rocks, and we really do need to reclaim or claim for ourselves as we move into elderhood, the right to be an aging person with all of the strength and the vitality that we have and have been given. And thank you so much, Dr. Morgan, Dr. Lucas Morgan for being available again through the, which, what is the name of the clinic? Oh, my private practice, Keelalani Counseling and Mindfulness Services and yeah, appreciate the chance to be here and the sort of, I guess take home message that I would really encourage folks to sort of view their own aging and others aging is, you know, let's live while we're still alive. You know, as far as I know, people are alive until they're dead. And if you're still alive, even if you have the challenges of your own aging process, changes in functionality, change in work situation, change in family situation, relationship of course, or losses. And yet if we're still alive, let's try to live whatever that can look like. And the first exposure to this may come in people who say, my mom and dad are experiencing terrible prejudice in the place where they live, or in the place where, and with a doctor they see or, and we, and you and people who are young enough for family or who are at the age of having family members in the care system might experience it right off the bat and begin to know what it is for themselves too. Well, thank you so much. Don't just age and gaze. That's my theme and I have a website that is personal coaching for life and faith. Make your elderhood extraordinary. And I'm available for conversation or follow up to this and for follow up to any aging issues so that you can make them extraordinary. Can ageism kill you? Yes, it can, but it doesn't have to. And you don't have to do it to yourself. Let's find a way out and make sure that you have the strength and have all of the strong empowerment that you're entitled to. Dr. Lucas Morgan, thank you so much. Aloha and to all of you, be at peace.