Too often, individuals with intellectual and developmental disabilities and autism (IDD/A) also face a double-edged sword of bias—ableism and ageism.
Ableism is discrimination, prejudice, or social bias against people with disabilities. Ageism is discrimination, prejudice, or social bias directed toward people based on their age, particularly older adults.
Individually, both systemic ableism and ageism in America present formidable challenges. Indirectly and directly, subtly and overtly, these negative attitudes define and limit people based on their differences.
Ableism devalues people with disabilities by assuming they need to be “fixed” in order to be “normal.” And ageism remains “one of the last socially acceptable prejudices,” according to the American Psychological Association.
When ableism and ageism converge in healthcare, then, they can have especially negative effects on individuals’ dignity and potential.
For example, caregivers may overlook or dismiss the needs of older adults with disabilities. They may mistakenly think aging inherently limits older adults’ capabilities, or their disabilities make them less deserving of comprehensive care.
Or, healthcare professionals might unconsciously prioritize treating younger, nondisabled patients over those who have disabilities, leading to significant health outcome disparities.
Dr. Sailaja Musunuri, Chief of Psychiatry and Executive Vice President of Integrative Medicine at Woods Healthcare, spoke with Hailey Gould, Manager of Structured Day Programs at Beechwood NeuroRehab in Trenton, New Jersey about the ableism and ageism individuals with IDD/A encounter.
Watch their conversation, then keep reading for more information about how you can help individuals with IDD/A overcome these persistent twin prejudices.
Misconceptions About Aging in Individuals With Disabilities
Ageism often paints a grim picture of aging, associating it with decline and incompetence. This outlook can especially harm people with IDD/A.
When ageism converges with systemic ableism—that is, pervasive and entrenched beliefs and practices in society that disadvantage individuals with disabilities—those at the intersection of IDD/A and aging may encounter:
- Infantilization
People with IDD/A are too often treated as if they are much younger or less capable than they actually are. They experience overprotectiveness, paternalistic and patronizing behavior, and lack of respect for their autonomy and needs. Infantilization can hinder their ability to express their opinions, make decisions, and live independently. - Lack of Recognition
Individuals with IDD/A often remain unseen in mainstream discussions about aging. Consequently, they don’t always get the support they require. “As healthcare professionals,” says Hailey Gould, “we tend to project things we think these populations need without directly letting these individuals have an influence on what they actually need.” - Negative Perceptions
Older adults with IDD/A often face ageist stereotypes that can compound the discrimination they face. Such stereotypes include assumptions that they are inevitably deteriorating as they grow older, that they have less value to society when compared to younger individuals, and that their lives aren’t worthy of enrichment and meaningful engagement.
In addition to unfair ways others treat people with IDD/A who are aging, many older adults who acquire disabilities don’t view themselves as disabled. They often attribute their challenges to aging alone. This self-perception can prevent them from accessing the vital resources they need.
“We have conversations about people with disabilities on their own,” says Gould, “and conversations about people who are aging on their own, but don’t really look at how those two things happen in parallel.”
How Ableism and Ageism in Healthcare Can Affect Treatment
Unfortunately, ableism and ageism often persist even in healthcare settings. Both can have a significant, negative impact on treatment and outcomes for people with IDD/A who are aging.
For example, providers may focus on managing disabilities rather than promoting overall well-being. Such an approach inadvertently reinforces the ageist narrative that equates aging with decline. Healthcare professionals might overlook symptoms of comorbid conditions in patients with IDD/A due to ageist biases, assuming these symptoms are age-related rather than potential indicators of treatable health issues.
Meanwhile, ableism in healthcare settings often results in patients with IDD/A, who generally already face challenges receiving equitable care, being further marginalized. Negative stereotypes that undermine their cognitive and emotional capacities. As a result, they lack tailored interventions addressing their specific needs.
Gould points out another potential problem: “You might not have people who are necessarily the most informed working with some of these populations. They’re trying to learn new skills while maintaining, hopefully, a higher level of support. But when you’re working with people who aren’t necessarily able to verbalize the care they need or to form thoughts to share what care they need, they almost get swept under the rug.”
What Caregivers Can Do Against Ageism and Ableism
Tackling ableism and ageism within the IDD/A community requires a collaborative approach. Along with healthcare professionals, caregivers have crucial parts to play.
- Raising awareness of these issues is critical. Starting dialogues about them, as Dr. Musunuri and Hailey Gould have done, is a positive first step.
- Actively challenging stereotypes associated with aging and disability matters. Acknowledge these individuals’ unique identities and experiences. As much as possible, empower them by engaging them in making decisions about their care.
- Learning about specific challenges older adults in the IDD community face lets caregivers better advocate for necessary resources and services.
In addition, by advocating for individualized care plans that recognize each person’s needs and preferences, caregivers can dismantle the notion that older adults with disabilities are less deserving of tailored support.
The Center for Behavioral Health at Woods provides tailored, comprehensive treatment to individuals of all ages with disabilities, including older adults. We help each person realize their highest potential, independence, and quality of life.
“At Woods System of Care,” says Dr. Musunuri, “ we are spending a lot of resources on training providers, and also the residents, the fellows, and the nurse practitioners to really care for these individuals.”
Request an appointment online now, or call us at 215-750-4004.
