The Many Faces of Ageism

Apr 1

The Bias Hiding in Plain Sight

Ageism is one form of discrimination that every single one of us will experience at some point in our lifetimes. One of the most difficult parts of recognizing and combating ageism is that it can sound reasonable or come across as an effort to care for or protect an older adult—but the impact is far from helpful.

Ageism refers to stereotypes, prejudice, and discrimination based on a person’s age. While it can affect people at any stage of life, it most often shows up in how we think about and treat older adults. These beliefs are so well ingrained that they often pass as common sense rather than bias. You can’t teach an old dog new tricks, right?

That is part of what makes ageism so powerful. It doesn’t always look like discrimination. Often, it looks like assumptions, common knowledge, or an attempt to protect an older adult.

What does ageism actually look like?

At its core, ageism shows up in the stories we tell about aging. That older adults are frail, forgetful, resistant to change, or less able to benefit from treatment. These assumptions influence how care is delivered and how it is received.

If you’re a health care provider, they can shape everything from your diagnoses, treatment recommendations, and communication with an older adult. If you’re a patient, they can shape what you expect from yourself and what you’re willing to ask for.

Most of the time, ageism is subtle. And sometimes, it even sounds kind.

Here are a few key forms it can take:

1. Overt (or explicit) ageism
This includes clearly negative attitudes or discriminatory practices. For example, assuming an older adult would not benefit from therapy or excluding them from certain treatments based on age alone.

2. Benevolent ageism
This is the kind that often flies under the radar. It shows up as over-helping, speaking in a patronizing tone, or making decisions for someone “for their own good.” While it may come from a place of care, it can quietly erode autonomy and confidence.

3. Internalized ageism
Over time, people can absorb societal messages about aging. This might sound like “I’m too old to change,” or “This is just what happens at my age.” These beliefs can influence behaviour, limit engagement, and shape health outcomes. Research suggests that those who hold more negative beliefs about aging live an average of 7.5 fewer years than those who hold more positive beliefs about aging.

4. Structural ageism
This refers to how systems are set up. In health care, it can include limited access to services for older adults, fewer referrals to mental health care supports, or clinical guidelines that don’t fully account for the unique needs of those in later life. Outside of health care it can include hiring biases toward younger people or urban planning that doesn’t take mobility challenges into consideration, for example.

How ageism shows up in health care

In practice, ageism often shows up in quiet, everyday ways.

Symptoms get dismissed as “just aging”
Low mood, fatigue, sleep problems, or memory changes may be normalized rather than explored. This can lead to missed diagnoses or delayed care.

Fewer options are offered
Older adults are less likely to be referred for psychotherapy, rehabilitation, or preventative interventions, even though these can be highly effective. They also tend to be over-prescribed medications relative to younger adults who present with the same set of symptoms.

Communication changes
Providers may simplify language too much, provide less information overall, speak to family members instead of the patient, or make assumptions about understanding. This can feel disempowering and, at times, dismissive or condescending.

Lower expectations for change
There can be an unspoken belief that growth is limited in later life. This can shape goal setting and the level of effort invested in care.

A strong focus on safety
Safety matters, but when it becomes the primary lens, it can lead to overly cautious recommendations that limit independence, autonomy, and quality of life.

Why this matters

Ageism is not just a social issue. It has real health consequences. When concerns are dismissed, physical or mental health conditions go untreated. When fewer treatment options are offered, outcomes are limited and quality of life decreases. And when people internalize ageist beliefs, they may stop seeking care or pushing for improvement. They end up behaving in ways that perpetuate negative aging stereotypes, limiting themselves and their lives in significant ways. Bottom line, the way we think about aging influences how we age in powerful ways.

What can we do about it?

This is where both providers and patients have a role to play.

If you’re a health care provider:

Notice when you’re attributing something to age without fully assessing it
Offer the same range of evidence-based options you would to a younger adult, then tailor as needed
Ask about goals and values rather than assuming them
Support autonomy, even in small decisions
Be mindful of tone and language; don’t fall into the trap of speaking to an older adult like they were a child.

If you’re a patient or family member:

Ask questions if something is dismissed as “normal aging”
Advocate for options. Therapy, rehabilitation, and lifestyle interventions can be effective at any age
Pay attention to your own beliefs about aging. Are they helping or limiting you?
Seek providers who take your concerns seriously and involve you in decisions

A different way of thinking about aging

Aging is not a diagnosis. It is a normal and unavoidable part of life that includes both challenges and opportunities. When we move beyond age-based assumptions, we make room for more accurate care, more meaningful goals, and better outcomes. Just as importantly, we preserve something that often gets lost in the process: a sense of agency. Irrespective of age, we all need to feel like active agents of change in our lives.

This post is for informational purposes only and should not be considered therapeutic advice or a replacement for individual therapy. For more information on locating a psychologist near you, please contact your family doctor, the Ontario Psychological Association, the Canadian Association for Cognitive Behavioural Therapy, or Psychology Today