Talk to me, not to my daughter
Published 5:00 am Friday, June 15, 2012
The first time Corky Alkin remembers being a nonperson was 20 years ago, at a shoe store in the San Fernando Valley suburbs of Los Angeles. Although Alkin was the one shopping, the salesman spoke only to her grown daughter, Jodie Reff.
“I think he thought, ‘This old lady didn’t know what she was doing,’ ” said Alkin, a retired executive assistant and grandmother of two, now 84.
Reff, 53, said the same sort of treatment still occurs when she accompanies her mother on visits to doctors.
Even if the doctors do not know that Reff is a retired nurse, “they’ll ask me about her condition, and they’ll explain to me what’s happening with her,” the daughter said.
Reff said that she typically turns to her mother to answer the questions. But the doctors keep talking to Reff anyway.
About six months ago, Alkin finally had enough. When she went to the drugstore, and the pharmacist began — as usual — conversing with her daughter, Alkin interrupted. “I said, ‘Talk to me!’ ” she recalled.
Such indignities seem to happen to almost everyone with gray hair or a few wrinkles, and at every sort of place. Store clerks, bank tellers, government workers, pharmacists, hairdressers, nurses, receptionists and doctors alike ignore the older person and pay attention exclusively to the younger companion, regardless of who is the actual customer or patient.
“Older people are invisible in society after a certain point,” said Nancy Perry Graham, editor-in-chief of AARP The Magazine, the flagship publication of the advocacy group for people 50 and older. “It’s one of the last remaining acceptable prejudices.”
Graham and other gerontology experts said they knew of no formal statistics or academic studies concerning the interaction of older adults, younger companions, and employees. However, Graham estimated that she encountered an example from an AARP member, a co-worker, or personal experience once a month. Most of the specialists interviewed for this article promptly volunteered tales from their own lives, without being asked.
The stories come from every part of the U.S. and from service workers of both sexes. The customers and their companions, however, are almost always female. That is mainly because these situations are unlikely to happen with a married couple, and wives usually outlive their husbands, and elderly women who need caretakers usually rely on daughters or daughters-in-law.
Advocates for older people acknowledge that the employees’ behavior is sometimes practical. Older people often have physical problems — including deterioration in sight, hearing, balance, memory and agility — that make it difficult to comprehend complex instructions or react quickly to directions. Of course, those with severe disabilities, like Alzheimer’s disease, certainly need assistance.
Phyllis Moen, a sociology professor at the University of Minnesota who does research on retirement, described a typical encounter when someone has a hearing problem: “The clerk may have just asked the person something, and they didn’t hear her. Now she’s short-tempered.”
Thus, the clerk, nurse, or other service worker is tempted to turn to the younger adult, who seems more likely to understand.
As director of the geriatric medicine program at the University of Cincinnati and a former president of the American Geriatrics Society, Gregg Warshaw said he tried to focus on speaking with the older patients in his private practice and not their relatives. However, he said, not all of his colleagues were so considerate.
“Health professionals are not immune from a certain amount of bias that the older person is not going to understand what you’re talking about and it’s going to be easier to get the information from the children,” he said.
Moreover, as soon as someone walks into a store or office with a grown child, Graham of AARP said, “the assumption is that the parent must need help understanding.”
Although the daughter may be merely the chauffeur, the service worker thinks she is also the interpreter, decision-maker and controller of the pocketbook.
The type of office or facility could make a difference, although experts disagree on which types or why. Some say that retail outlets may be the worst offenders, because their staffs do not get much training, while others point out that these workers need to be nice to their customers in order to make the sale.
Graham has found some of the most condescending attitudes in medical offices. But Lori Simon-Rusinowitz, an associate professor at the University of Maryland School of Public Health, said she expected doctors to be particularly alert to their patients’ disabilities.
Who’s to blame?
Most of all, experts say that these experiences are a small piece of a much larger problem, the social marginalization of the older generation.
“As the elderly, we lose our identity,” Moen said.
She blames what she calls “a work-oriented society,” adding, “When people say they’re retired, they’re no longer a person of interest.”
Another crucial factor, said Simon-Rusinowitz, is the cultural focus on youth. Exhibit A: television commercials that use sexy young models to pitch everything, including Viagra.
Whatever the cause, the marginalization of older shoppers stretches back decades. Fran Kiem, 83, a neighbor of Alkin’s at the Village, a senior residence home in Northridge, Calif., said that when she took her own mother, Meta Jacobson, shopping in Chicago years ago, her mother would say, “If people think you’re older, they talk more slowly, because your brain can’t possibly understand what they’re saying.”
Now Kiem, a former real estate broker and abortion-rights lobbyist, and a graduate of the University of Chicago, finds herself in her mother’s position, when she goes on errands with her adult daughter, Liz Shaffer.
The mothers and daughters also contribute to the problem through their own behavior.
The older women rarely complain — at least, not visibly or at the time.
“Sometimes, with the elderly, there may have been an emphasis in their upbringing to be very polite and not be assertive,” said Georgia Yesmont, a psychologist in New York, who specializes in elderly patients.
Simon-Rusinowitz said her mother, Maxine Simon, 88, would challenge store clerks but not doctors, because “that generation is not so questioning of professionals.”
For her part, Kiem said she usually shrugged off the sales workers’ attitude.
“I decided it’s not worth it,” she said. “It doesn’t reflect on me.”
However, the mothers may have stronger responses in private. Shaffer — Kiem’s daughter — said that “she will mumble to me, ‘I’m not an idiot!’ ”
The daughters, meanwhile, often have mixed feelings.
“She’s completely able to make decisions. People should give her that respect,” Shaffer said of her mother. Yet at the same time, Shaffer added, “It’s a little sad for me that we’re getting to this point that she’s looking more to my guidance. She needs an extra beat or two to process things.”
Sometimes, in fact, the younger women are so eager to help that they do not realize they are elbowing their parents out of the way.
When bank tellers talked to her about her mother’s debit card, or doctors conferred about medical treatment — with her mother next to her — Graham of AARP said she plunged right into the discussion.
“I thought I was doing my mother a favor, getting the information,” she said.
Then, after one event, her mother commented, with annoyance, “Did you notice that entire conversation was directed toward you?”
Graham’s mother, Dorothy O’Brien, would not reveal her age, but Graham is 56.
With attitudes on all sides baked in by decades of training and social standards, shifting the dynamic will not be easy.
Clearly, taking the indirect approach, as Reff does — turning to her mother, Alkin, every time medical personnel ask her a question — does not always work.
“I would be very direct,” Simon-Rusinowitz said. “I would say to the person, ‘My mother has difficulty seeing and she has some hearing issues, but cognitively she is as sharp as a tack. Don’t just talk to me.’”
To set the tone, Alkin suggested that the parent initiate the conversation.
“Try to establish a connection to a particular sales person,” Yesmont added.
And if one clerk is unresponsive, ask for the manager.
Simon-Rusinowitz said that her combination of direct and indirect tactics was usually successful. But Alkin does not know whether her rebellion at the drugstore has had any lasting impact, because she constantly sees different pharmacists, and they deal with so many different customers.
From the other side, Graham said, the doctor or sales clerk could bluntly ask whom to address.
“They could even say, ‘Is your mom able to make decisions?’ ” she said. While that might seem rude, “it would be less insulting than for them to address the whole conversation to the daughter,” she said.
Warshaw, of the University of Cincinnati, said he asked his patients at the start if they wanted the family members to accompany them to the consultation and exam.
“I will introduce myself to the patient directly,” he continued, “and then I’ll say, ‘Who do you have with you today?’ ”
In any case, demographics will probably force attitudes to change.
As the baby boomer generation descends upon malls, motor vehicle offices, medical clinics and more, “there’s going to be more managerial interest in catering to them,” Yesmont predicted. “This will result in better training.”