Fighting Ageism, Accepting Death

Two instructive new books deal with aging: One casts a knowing eye on ageism in Israel, and the other is an eye-opener about the reality of life in what once were called old folks' homes.

Amia Lieblich
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Amia Lieblich

“Ageism in Israeli Society: The Social Construction of Old Age in Israel ,” edited by Israel Doron. Van Leer/Hakibbutz Hameuchad Publishing House, 242 pp., NIS 88

“A prelude to Paradise: Life in a Contemporary Old-Age Site,” by Dr. Aviva Kaplan, Resling Publishing House, 262 pp., NIS 94

It’s true that today’s world belongs to the young, which means that older people are marginalized. But this is a very unusual marginalized population, since each and every one of us, if we live long enough, will eventually become a member of it.

Coping with old age is an experience we will all go through. Thus, an interesting topic that’s worthy of investigation is the contemporary stereotypes of elderly men and women in Israeli society. A related, more practical question is whether a person can be disqualified from certain areas of life, such as jobs, merely on the basis of his or her chronological age, without regard to qualifications? Is this not a form of discrimination similar to that based on gender, race, sexual preference or other characteristics?

The study of ageism, a term not yet commonly used in its Hebrew equivalent ‏(gilanut‏), is an important endeavor. There are many definitions of this phenomenon, which involves the stigmatization of older people and also discrimination directed against them in many spheres of life. The stigma includes the perception of elderly people as helpless, senile, old-fashioned and set in their ways, as well as lacking certain knowledge and being technologically unskilled.

Such perceptions often preclude placing of any responsibilities in their hands − whether for others or for themselves. This kind of ageism erects a barrier between young and old people, since there’s a feeling that older people are “different.” It can even impair more natural feelings of empathy toward the elderly, since among some people, an older person can no longer be considered a human being.

A group of researchers met recently at the Van Leer Jerusalem Institute to discuss various aspects of the topic and consolidated their results clearly and convincingly in a collection of essays called “Ageism in Israeli Society.” The book presents discussions of topics from different disciplines, such as the image of the elderly in Hebrew poetry and fiction; how the elderly are perceived by young people in Israel; and, especially, the attitudes of care providers such as hospital nurses and physiotherapists toward the elderly.

One fascinating chapter deals with legal issues concerning this part of the population. In particular, the book’s editor, Israel Doron, addresses the definitions of sanity and inheritance as per the law, as well as the rights of older people to age with dignity. Another important chapter − on a topic similar to that covered in Dr. Aviva Kaplan’s book, reviewed below − deals with radio, television and print advertising that is geared toward elderly people who are considering a move to housing that is thought to be more appropriate to their age.

In combination, these essays are an important contribution to the study of old age in Israeli society. One can only hope that they will be read by policy makers and will serve as a basis for a corrective discourse that will curb the phenomenon of mounting ageism here.

Aviva Kaplan’s “A Prelude to Paradise: Life in a Contemporary Old-Age Site” is a work of courageous research. Kaplan does not mince words and states her arguments clearly. The book contains much theoretical material dealing with studies related to old age and aging, but this is of interest mainly to the professionals among us. Nevertheless, there is much that can be of practical value to many readers.

Kaplan challenges the concept of “assisted living” − a novel, “upgraded” term for what used to be called an “old folks’ home.” Her message is directed at old or aging people, usually around or beyond the age of 70 − not at what marketers and advertisers of such properties call “mature” people − and this message is clear: Don’t move into an assisted living residence and burn all your bridges to an independent lifestyle ‏(such as by selling your apartment in order to finance the move‏). I’m stating this message in a more definitive and simplistic manner than the author does, but this is my personal conclusion, based not just on professional considerations but on personal experience.

I, myself, am presently at the age that is dealt with in Kaplan’s book. Currently, only 7 percent of elderly people in this country live in an assisted living framework, but many people with financial interests are trying to increase this segment of the population. The most updated figures that Kaplan had while writing her book were from 2004, in which there were 165 such facilities, private or run by other frameworks. They have surely increased in number since then.

Is this the correct mode for dealing with old age? Kaplan is very emphatic in her
negative response. In her incisive language, she states, “The steamroller employed by these organizations shatters one’s individuality, effaces one’s uniqueness, reeks of alienation and lacks any practical ability to deal with the growing fragility of the elderly.”

Elixir of life

The challenge of maintaining an independent existence is the mental equivalent to an elixir of life for an aged person. In contrast, living in an assisted living facility usually only enhances one’s loneliness, augmenting the feelings of frustration associated with getting old and the elderly person’s feeling that he or she is useless or redundant.

Kaplan herself is a specialist in gerontology, and for over a decade managed such a facility for the elderly. In her book, she sums up the research she conducted over six years at one of the more veteran of these establishments in Israel ‏(to which she gives the fictional name Oasis‏).

From the outside, she writes, this facility for the elderly set looks like an upscale hotel, making every effort to conceal its mentally frail inhabitants. But it is neither a hotel nor a home: It is, in essence, an organization or institution that deprives its inhabitants of personal autonomy, dignity and self-definition. With the help of courageous observations, interviews she conducted and written reports given to her by residents, Kaplan exposes the deeper, multilayered existence of these residents.

“I don’t have fun here,” says one of the interviewees. “I wasn’t realistic when I arrived. My expectations were too high. I was living a fantasy.”

That is the common thread in most of the interviews. One exception is a couple who came to the home together and are conducting their lives independently, taking great efforts to distance themselves from other residents.

In presenting the research and theories summarized in her book, Kaplan relies on renowned gerontological experts in Israel and overseas, and particularly on the writings and lectures of Prof. Haim Hazan from Tel Aviv University, who has said that in contemporary society “social death arrives before biological death.” In other words, there is a gap of years, or even decades, between retirement from work and the voluntary or enforced retirement from life’s activities, and one’s actual demise. Loneliness, emptiness and boredom are our greatest enemies, no less than the physical signs of being worn-out or disease.

The advertising and marketing of assisted living facilities promise people a way of escaping these enemies and some degree of consolation during old age. In practice, these promises are only usually fulfilled for a small minority of people residing in such institutions. For most of the others, life in these frameworks takes away an aging person’s autonomy and only serves to hasten his or her “social death.”

As Kaplan puts it, living in a “golden cage” together with other old people, in an strange environment comprised of “timeless existential bubbles with no future,” does not benefit the residents of such institutions. Many express regret at having moved into this world, which constitutes a final stop for the elderly person before death.

It’s true that a few residents related pleasant experiences to Kaplan. The book reports findings that were obtained by qualitative and not empirical research per se, so there are no numbers or statistics that indicate the scope of such positive experiences.

For me as a reader, however, the conclusion is clear-cut: Living out one’s final years in a community or an environment in which one has lived for a long time, when possible, enables one to find a purpose in life, to accept the inevitability of death and to cope with an existential challenge during this phase. It is rare to find qualitative research that delivers such a clear recommendation. An author who dares to say what Kaplan has written should be congratulated.

Amia Lieblich’s book “In Spite of Everything: The Story of a Binational Settlement” has recently been published in Hebrew by Schocken and Dvir publishing houses.

As 'assisted living' facility. A novel, 'upgraded' term for what used to be called an old folks' home.Credit: Tomer Appelbaum

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