A lot of the negative stereotypes about older adults

Older people are a disagreeable bunch

A lot of the negative stereotypes about older adults are based on the idea that personality changes with age, and not for the better. Nevertheless, there is considerable evidence that the reverse is true, that personality change is more the exception than the rule. People do not typically grow more neurotic with age and therefore do not somehow age into hypochondriasis. And the same is true for stinginess – people don't get that way with age. However, a young adult who is careful with money is often described in admirable terms, like frugal. When that person is older and is still careful with money, it's really not fair to change the description to stingy. As for grouchy, a lot of young people are grouchy, too.

Myth #17 Older people are hypochondriacs

What a negative thing to say about someone! Even the American Psychiatric Association has noticed, and it has eliminated hypochondriasis as a psychiatric diagnosis. In the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) the American Psychiatric Association admits that the term hypochondriasis is “pejorative and not conducive to an effective therapeutic relationship” (American Psychiatric Association, 2013, p. 11). Most people previously diagnosed with hypochondriasis would now receive a diagnosis of “somatic symptom disorder.” These folks would have physical symptoms and also abnormal thoughts, feelings, and behaviors; they may or may not have a diagnosed medical disorder. There is also “illness anxiety disorder.” In DSM-5, this diagnosis is for people with high health anxiety but without specific physical symptoms. Nevertheless, considerable research up until now has used the terms hypochondriac and hypochondriasis. Therefore, in our discussion of the myth we too will use these terms.

Why might the myth that older adults are hypochondriacs be so pervasive? First, there is little doubt that entry into older adulthood brings an increase in chronic diseases, some of which may be accompanied by pain. An excellent example is osteoarthritis, a degenerative joint disease that most commonly affects weight-bearing joints (e.g., knees, hips, and spine but also fingers, wrists, elbows, and neck), which can cause pain with physical movement. Although rarely fatal in and of itself, mild cases of arthritis can cause stiffness and discomfort. Severe arthritis can have a major impact on quality of life and sometimes even leads to a loss of independence. So if an older person voices a physical complaint (or two or three), is it more likely that he or she is a hypochondriac or that he or she is really afflicted with a painful condition that has not been properly diagnosed?

Not only are older people more likely than younger people to suffer from real health problems, but also it is realistic for older adults to be more concerned about their health when something seems to be not quite right. So are some older adults misinterpreting symptoms that could just be the result of normal aging and then fearing the worst? According to Stein (2003), concern with physical symptoms can be an adaptive strategy older adults use to cope with their changing health; visits to medical providers reduce their anxiety because doing so assures them that they are being proactive in attempting to maintain their health. Many older adults have witnessed friends' illnesses. It is a matter of good judgment, then, for them to be watchful over their own symptoms and to check up on minor complaints that may develop into major illnesses. Rather than being a sign of hypochondriasis, going to the doctor with a new symptom could be a way for older adults to gain a sense of control over a troubling change from their previous physical hardiness.

As with all age groups, older adults vary in their pain thresholds, and it is usually the level of discomfort that triggers visits to health-care providers. Thus, it is important to take into account how people perceive, interpret, and report their symptoms. One person (at any age) may be the type to pass out before calling an ambulance. Another may go to the doctor with a stubbed toe. It's not fair to give the second individual a psychiatric label and assume that the toe is not broken. People vary in their sensitivity to pain, and such individual differences are likely to persist throughout life.

The view that individual differences are stable over time seems to be the hallmark of personality itself. McCrae and Costa's (1997) Five-Factor Model (FFM) is a highly influential framework within which to consider personality in general as well as a useful perspective from which to view several myths about personality in the older years. Initially, FFM, which was based on findings from the Baltimore Longitudinal Study, proposed a personality structure consisting of five dimensions, or factors: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness (NEO-AC). Individual personalities fall somewhere along each dimension, or factor. Table 3.1 shows the five personality factors as well as the traits typical of a person who scores high on each.

Table 3.1 The big five personality factors and six specific traits within each factor

Source: Erber, 2013, adapted from McCrae and Costa, 1997.

Personality factor	Traits
Neuroticism (N)	Anxiety, angry hostility, depression, self-consciousness, impulsiveness, vulnerability
Extraversion (E)	Warmth, gregariousness, assertiveness, activity, excitement-seeking, positive emotions
Openness to experience (O)	Fantasy, aesthetics, feelings, actions, ideas, values
Agreeableness (A)	Trust, straightforwardness, altruism, compliance, modesty, tender-mindedness
Conscientiousness (C)	Competence, order, dutifulness, achievement-striving, self-discipline, deliberation

McCrae, Costa, and their colleagues have gathered evidence that the FFM personality model can be applied not only in the United States but in many other countries as well (McCrae, 2002). They demonstrated that the five-factor structure holds true for individuals in countries such as Germany, Italy, Portugal, Croatia, South Korea, Estonia, Russia, Japan, Spain, Britain, Turkey, and the Czech Republic. Not only do these factors describe residents of various countries, but also they seem to apply to adults of various ages and stages of life. We will revisit the FFM in several of the myths that follow. However, the factor most relevant to hypochondriasis is neuroticism (N) – individuals high on the N factor tend to be high in traits such as anxiety, depression, hostility, self-consciousness, impulsiveness, and vulnerability. They generally show various signs of emotional distress, one of which may be manifested in somatic complaints. With regard to the myth that older people are hypochondriacs, the findings of longitudinal research indicate that where an individual stands on each FFM factor does not change significantly over the years, particularly after middle age (Roberts & DelVecchio, 2000). This means that individuals high on the neuroticism factor earlier in life tend to maintain the same relative position over their adult lifespan. If a person shows signs of hypochondriasis in older adulthood, this will most likely be so only to the extent that he or she always did – not more so with age – although the specific nature of that individual's complaints may vary over time. According to the FFM, neuroticism tends to remain stable across the adult lifespan. Thus, the idea that hypochondriasis is especially prevalent in the older adult age group is just plain inaccurate; rather, unfounded complaints, or the over-reporting of medical symptoms, are probably nothing new even for an 85-year-old person with hypochondriasis.

Research on prevalence rates of hypochondriasis bears this out. For example, in a study of general medical outpatients in a Boston hospital, 4.2% to 6.3% were estimated to warrant a diagnosis of hypochondriasis, but the rate did not differ by age (over 65 vs. under 65) or sex (Barsky, Wyshak, Klerman, & Latham, 1990). Furthermore, other studies indicate that older people are no more likely than the young to suffer from hypochondriasis (e.g., Barsky, Frank, Cleary, Wyshak, & Klerman, 1991; Boston & Merrick, 2010; McCrae, 2002).

Costa and McCrae (1985) published an important article on the subject of hypochondriasis specifically, entitled “Hypochondriasis, Neuroticism, and Aging.” They discuss the “difficulties in conceptualizing and assessing both subjective perceptions of health and objective medical conditions” and also how “preconceptions and stereotypes can exert undue influence in so ambiguous an area” (p. 26). These investigators compare three models that describe the relationship between somatic complaints and medical conditions. The first and simplest model, naïve realism, represents the view we generally hold about ourselves, but possibly about other people as well: we take people's medical complaints at face value; that is, we believe that someone with symptoms has a physical illness – the greater the number of symptoms, the more dire the illness.

A second model, psychiatric-categorical, refers to a scenario in which a person lists so many symptoms that anyone would find these complaints unbelievable. Such individuals may indeed be suffering from hypochondriasis: they believe, probably incorrectly, that they are physically ill. For these individuals, symptom self-reports may not be trustworthy, but a medical professional needs to decide if there is physical and/or mental illness. After all, a hypochondriac actually can have a physical disease as well. (Obviously, this fact is inconvenient for relatives and for health-care providers.)

According to a third and more sophisticated model, dimension of somatic concern, there are “consistent and enduring individual differences in the perception, interpretation, and reporting of bodily symptoms” (Costa & McCrae, 1985, p. 20). Thus, each individual's self-reported symptoms must be evaluated in light of his or her characteristic style of reporting, which may be anywhere on a continuum from underreporting to overreporting.

Clearly, it is important that health-care professionals be able to tell the difference between actual illness and complaints that are unfounded. It might contribute to family harmony if relatives could do so as well. Unfortunately, it is often difficult to know for sure whether an older relative is really in pain or not. So let's say that your Aunt Tillie complains that this hurts and that hurts, or that something just doesn't feel right in her chest, or that her back aches when she sits but not when she stands. For starters, ask yourself whether she was always a little bit over the top about medical issues. If not, then do not assume late-onset hypochondriasis; instead, assume that it's time for her to see the family doctor.

Finally, let's remember that some people face new symptoms with denial rather than hypervigilance. For example, if older adults fear that their cognitive symptoms are related to dementia, they may prefer to avoid getting a diagnosis – even when a diagnosis might mean that they have a condition less dire than they feared, or an illness that would respond positively to medical and/or psychological intervention.

In sum, the preponderance of the evidence does not support the assumption that people are more likely to suffer from hypochondriasis when they are older. Of course, some older adults do complain a lot, but it is likely that that these are the very same people who complained a lot when they were younger. A blanket statement that older adults are hypochondriacs is, unambiguously, a myth. By the way, an important consideration is this: if older people actually do have more physical symptoms to complain about, yet do not complain any more than younger people do, perhaps they are behaving in a way that is actually the opposite of hypochondriasis!

Myth #18 Older people are stingy

“Old people are stingy!” There is little doubt that we have all heard a comment like this at some time or other. It seems that stinginess is an entrenched myth that many people attach to aging.

First, let's take a moment to consider the meaning of the word “stingy.” Stingy can apply to many things, but most commonly it refers to money. On the most basic level, it suggests giving or spending money reluctantly and/or being overly careful in money matters. Synonyms for stingy include parsimonious, penny-pinching, and frugal. However, “stingy” has connotations beyond the idea of special care when it comes to spending money, and these are mostly negative. Stingy implies an absence of generosity and an inclination to be grudging, petty, and annoyingly cautious in money matters. It also suggests a tendency to be greedy and to hoard wealth for its own sake. In short, referring to someone as stingy is hardly complimentary.

We've probably all heard the “greedy geezer” stories that come our way every so often. Sometimes these stories are about older people who vote against the tax increases needed to fund schools or libraries or to improve roads. How could older people have so little concern for children or for the larger community? Or maybe the stories are about older adults skimping on tips in restaurants. How could older adults not care about a wonderful, deserving wait staff forced to work for the minimum wage or less if it weren't for the gratuities diners are expected, though not strictly required, to pay?

An extreme example of what might be viewed as stinginess was featured in an episode of the popular television comedy show Seinfeld, in which Jerry spies his old Uncle Leo shoplifting in the local bookstore. This episode has regular reruns and rarely fails to elicit a chuckle from viewers. In actuality, shoplifting is not funny, so why do we find this episode so humorous? We know from other Seinfeld episodes that Uncle Leo is not a wealthy man, but neither is he poverty-stricken to the extent he would be unable to pay for the books he so stealthily appropriates. So should we consider Uncle Leo to be a “greedy geezer”? In other shoplifting scenarios, older adults steal hearing-aid batteries from pharmacies or stash raw steaks under their clothing in grocery stores. Some people make allowances for older shoplifters that stem from sympathy (see Cuddy & Fiske, 2002), whereas others believe that older adults mean to pay for items but are simply absentminded and forget to do so (see Erber, Szuchman, & Prager, 2001). Even so, many people have nothing but scorn for those who behave this way, and reports of older adults shoplifting simply fuels the negative stereotypes they already hold for this age group.

The reality is that shoplifting is not confined to older adulthood; according to the National Association for Shoplifting Prevention (n.d.), an estimated 25% of shoplifters are teenagers. Furthermore, many adult shoplifters started down this path much earlier in life. One of the longest criminal shoplifting careers ever reported was that of an 83-year-old woman who began shoplifting at the age of 6, swiping small gifts just to get her mother's attention and affection. She continued to shoplift for decades while raising a family of five and working as a nurse. She did not have a financial need to shoplift; in fact, she often felt guilty afterward and returned the items to the stores from which they had been taken. The happy ending is that, at the age of 83, she was finally able to kick the habit with the help of psychotherapy and anti-anxiety medication (Adler, 2002, February 25).

Widrick and Raskin (2010) asked people to choose between generous and stingy to describe a number of different identities (e.g., lawyer, homeless person, nurse, senior citizen, elderly person, retired person, and grandparent). Not surprisingly, more people chose stingy than generous for “senior citizen” and “elderly person.” It is possible that “senior citizen” is associated with marketplace discounts (“senior discounts”), which trigger the “greedy geezer” stereotype about older adults. As for “elderly person,” Widrick and Raskin contend that in general, “negative connotations are associated with the term elderly” (p. 281). However, it is interesting to note that the negative adjective, stingy, was not attributed to “retired person” or to “grandparent,” both of whom were more likely to be labeled generous. Why the more positive label for these two? “Retired person” is associated with the workforce – even though that association has actually been terminated – which may trigger a positive stereotype. And one's own grandparent may not be perceived as a member of the stigmatized class. “Grandparent” is more personal than that. In a meta-analysis (a statistical summary of many research studies) on attitudes toward older adults, Kite, Stockdale, Whitley, and Johnson (2005) found that people are not likely to have negative perceptions about or responses to individual older adults for whom they have some prior information (e.g., health, employment and/or financial status, or personal familiarity). In contrast, negative bias is more probable when minimal information is available (Braithwaite, 1986).

If older adults are indeed more careful than are younger adults when it comes to spending money, another word that comes to mind is frugal, a term mentioned earlier. Frugal is sometimes considered a synonym for stingy, although usually without the added implication of greediness or lack of generosity. Frugal usually refers to someone who is thrifty, meaning that he or she generally avoids unnecessary expenditure of money. So you may think your grandmother and your great aunt Bessie are frugal, but at the same time you may consider older adults in general to be stingy.

It is conceivable that today's older adults are more frugal than today's young or middle-aged adults, so let's explore some possible explanations for why this could be so. A cohort is a group of individuals, or a generation, born at approximately the same time and likely to encounter similar societal influences throughout their development. The present-day cohort of older adults was raised by parents who came of age in the Great Depression, which began in 1929. Many were taught by their parents, either by word or deed, that being frugal is an important virtue. Not only were their parental role models careful about money, but credit cards were not readily available when today's older adults were in their adolescent, young adult, or even middle-aged years. These older adults were accustomed to paying in full for most purchases. There may have been payment plans for large purchases, but these were usually specific to the store the item came from. Some stores had layaway plans, but taking possession of an item from layaway was permitted only when the total payment (plus some type of fee) was paid. It is entirely possible that today's older adults have not aged into frugality; rather, they are just a frugal generation accustomed all along to paying for the majority of their purchases using cash or checks.

Hummert, Garstka, Shaner, and Strahm (1994) investigated traits that would be named most frequently by young, middle-aged, and older adults when they were asked to describe a “typical elderly adult.” “Worried about finances” was among the 20 most frequently mentioned traits. It was named by 7.5% of young adults and 5% of middle-aged adults, but by 35.5% of older adults. It seems that concern with money, which Hummert at al. categorized as a trait, had especially high priority among older adults themselves.

In addition to cohort influences, a tendency toward frugality could well be strengthened by older adults' realistic fear that they might outlive their savings. There is no dearth of publicity on the baby boom generation, with the oldest members now in their mid- to late 60s but others still in their 50s. Many are caught in a “generation squeeze” because they may be working to support aged parents as well as unemployed or underemployed adult children. They are well aware that life expectancy has increased noticeably during their own lifetime, and also that there have been years of notable inflation. Added to their concern are headlines driving home the fact that medical expenses are on an upward spiral and questioning whether older adults, or anyone for that matter, will be able to afford medical care. These constant reminders, combined with an awareness of their own economic circumstances, give older adults good reason to worry that the cost of health care is rising faster than they had anticipated. As for older adults who have already retired, a large number derive the bulk of their income from Social Security. Although originally intended only as an economic safety net, Social Security in the U.S. constitutes approximately 90% of the income received by 36% of those who are presently Social Security beneficiaries. Furthermore, in 2011, almost 3.6 million older adults, or approximately 8.7% of the older population, had incomes below poverty level. However, according to a Supplemental Poverty Measure (SPM) that takes into account regional variations in living costs and items such as out-of-pocket medical expenses, this figure rises to 15.1% (U.S. Department of Health and Human Services, Administration on Aging, Administration for Community Living, 2012).

Finally, it may be the case that older adults who are not well off, and even some who are, do have the benefit of senior discounts, early-bird specials, lower property taxes, and even reduced library fines. But let's not forget that many older adults who enjoy a bit more affluence are contributing to charity, cultural organizations, and religious groups. Keep in mind that approximately 25% of Americans aged 65 and older volunteer in places such as hospitals, schools, public gardens, zoos, and museums. And it is estimated that with the baby boomers entering their older adult years in large numbers, approximately 50% will contribute to their communities through some type of voluntary work (Morrow-Howell, 2006). In short, the older age group represents a considerable source of free labor that benefits many people and institutions in our society! Furthermore, older adults who are sufficiently well off, and perhaps some who are not so well off, contribute to the financial well-being of upcoming generations by paying for grandkids' orthodontia, school tuition, college expenses, and so on.

In sum, older adults who are seen as stingy might actually just be saving for a rainy day because they do not want to become a financial burden to their children now or in the future. Frugal means prudent, not wasteful. Unfortunately, for a stigmatized group, frugal may be translated to stingy (ungenerous) in many people's minds, so the myth that “older people are stingy” takes on a life of its own. It may well be the case that older people are more frugal than their children and grandchildren. Perhaps because of their frugality, they will not need to call upon adult children or grandchildren for financial support. Furthermore, they may even serve as a source of financial aid to the younger generation.

Myth #19 Older people are grouchy

The stereotype of the grouchy oldster is so blatant in our culture that even a movie entitled Grumpy Old Men doesn't sound politically incorrect. For the stereotypical grouchy old woman, one need look no further than the scores of Hallmark cards and related gift items (e.g., coffee mugs, t-shirts, and calendars) featuring Maxine. Hallmark calls her “The Queen of Crabbiness” (http://www.hallmark.com/maxine/). Even children don't escape exposure to the stereotype of grouchy older people – Robinson, Callister, Magoffin, and Moore (2007) surveyed 34 Disney animated films and found that 25% of the older characters were angry, grumpy, or stern.

By definition, a grouchy person tends to grumble and complain, and to be sulky and peevish. Remember the big five factors – NEO-AC? The “A” stands for agreeableness. According to McCrae (2002), agreeableness increases up to age 30 and then levels off or increases more slowly. It would seem that a person who is agreeable is not likely to be grouchy. Furthermore, older adults often focus on the sunny side of things. For example, when making decisions, they tend to pay more attention to positive information and less attention to negative information. In one study, Löckenhoff and Carstensen (2007) asked young and older adults to choose among descriptions of four different physicians and also four different health plans. Left to their own devices, older adults were more likely than younger adults to focus on the positive rather than the negative information about each physician and health plan prior to making a choice. Later on, older adults were able to recall more positive than negative information about the physician and health plan they had selected. The tendency to focus on positive information seems to be nullified only when older adults are specifically instructed to pay attention to all of the facts and details available to them.

A number of studies have investigated how young and older adults resolve dilemmas that are high in interpersonal emotional significance, such as conflicts with family members or friends. In these studies, older adults were less likely than younger adults to confront the interpersonal dilemma directly. Rather, they tended to deny a problem exists, or they either withdrew from an emotionally laden situation or passively accepted it. Birditt, Fingerman, and Almeida (2005) contend that when there is interpersonal conflict, older adults are more likely than younger adults to pick their battles and to refrain from arguing and yelling; they often prefer to wait until situations improve on their own. This same tendency seems to apply to marital relationships. Carstensen, Gottman, and Levenson (1995) videorecorded middle-aged and older married couples as they interacted during a 15-minute conversation about a problem that each couple claimed was causing continuing disagreement in their marriage. Later on, objective observers of these videorecordings rated older couples as showing less emotional affect with regard to verbal content, voice tone, facial expression, and gestures. In short, compared with middle-aged couples, older couples showed more emotional regulation, or greater control of their negative feelings (Gross et al., 1997).

Despite the losses we may incur as we grow older (e.g., deterioration in vision and hearing, and perhaps declining health), the emotional changes we experience tend to be positive. In summarizing several cross-sectional and longitudinal studies, Scheibe (2012) concludes that older adults tend to be happier, calmer, and more emotionally balanced than younger adults. Older adults achieve a higher level of affective well-being and often report feeing more positive, happy, and content, and less sad, angry, and anxious in their everyday lives.

Charles (2011) proposed the strength and vulnerability integration (SAVI) theory as a way to account for age-related gains (strengths) but also age-related losses (vulnerabilities) when it comes to dealing with stress. According to SAVI, as long as the level of stress is not too high and/or stress is not too chronic, older adults can use their lifetime of experience in dealing with difficult situations and their well-honed ability to regulate their emotional responses to overcome the negative effects of stress and thus maintain a high level of well-being. Nevertheless, SAVI concedes that experience and emotional regulation may be less effective when stress is too severe and/or too chronic. Scheibe (2012) points out that in very advanced old age, people may become less effective at emotional regulation, especially in unavoidable situations that are highly stressful.

Before we leave our discussion of the myth that older people are grouchy, let's not completely rule out the possibility that under some circumstances, they certainly can be. First, some health conditions (e.g., arthritis) that affect a greater number of older than younger people are associated with chronic pain. Also, older adults might suffer from diffuse pain that they cannot really explain. When this happens, it can seem to an observer that the person is just in a bad mood for no reason – grumpy.

Another possibility is that older adults in the early stages of dementia may still be capable of functioning with regard to many tasks of everyday life, but they may start to be forgetful. When this happens, it can be more protective of their self-esteem to blame others for missing items, forgotten mail, or for the misplaced keys or eyeglasses. If the person getting the blame does not recognize the onset of dementia, then it will likely appear that the older person is grouchy.

What if the perception of grouchiness comes from noticing that an older person doesn't laugh at your jokes? It's possible that older adults do experience some decline in the ability to appreciate jokes (Mak & Carpenter, 2007). Hearing loss could play a role. If part of the communication is missed, older adults with age-related hearing loss (termed presbycusis, which is characterized by missing some high-frequency speech sounds and also having difficulty in processing rapid speech) may seem grouchy when indeed they have simply missed out on the part of a “humorous” communication that makes it funny.

In sum, as a rule, older people are not grouchy unless some of the above circumstances apply, such as physical pain or cognitive or perceptual changes that may come with aging. Scheibe (2012) contends that, overall, older adults have a high level of emotional well-being, and “old age is likely to be a happy and balanced time, rather than a grouchy and distressed one” (p. 21).