Dr. El
Dr. El

“There’s no one here to talk to,” a new resident, Claire, said to me, “They’re all so old!” 

Claire was in her early 80s but thought of herself as two decades younger. She, like most residents I’ve encountered, have their own prejudices about aging and older adults. It negatively impacts them in a wide variety of ways, including in their long-term care experiences.

Social isolation

Residents may dismiss their peers due to their perception of them as old, infirm and uninteresting, keeping themselves isolated and preventing the opportunity to gain friends or at least “rehab buddies” who can support them through the taxing process of getting back on their feet again. 

In busy, understaffed facilities (and what nursing home isn’t?), catalyzing resident engagement with one another isn’t just a nice thing to do, it can meet vital needs that staff members wish they had time for. With assistance in getting over their initial prejudices, residents can not only encourage one another, they can ease anxiety, mourn losses together and notify workers if a neighbor appears lethargic or depressed or about to fall. 

All departments, not just recreation, can make efforts to connect like-minded individuals. One of my favorite things is to be a “matchmaker,” introducing women who enjoy similar activities or men who hail from the same county or country. Matchmaking can begin with something as simple as seating a potential friend next to someone’s “good” ear and commenting, “Did you two know you both … [fill in the blank]?” 

Effect on adoption of mobility aids

Societal prejudices against growing old and “weak” keep many seniors from acknowledging their growing frailty. They may eschew tools such as canes, walkers or hearing aids because they “don’t want to look old”1 or be treated as such. Most of us in the business of long-term care recognize the irony that by avoiding these devices, elders are more likely to come through our doors. We might speculate that they’re also more likely to return once discharged.

In addition to training on residents how to use mobility aids, therefore, it may be beneficial to acknowledge and address the resistance that short-term residents might have to using these items upon their return to the community. 

I’m thinking a short movie could do it.

I still recall the brief film they showed in drivers ed class when I was 16. It compared the travel time of a rule-abiding driver to one who flaunted traffic laws, speeding around other cars on the highway and running red lights, only to arrive a mere five minutes before the lawful driver. 

Following that lead, here’s a potential plot for a movie to show prior to discharge from rehabilitation services: Two residents meet in rehab, successfully complete physical and occupational therapy and are discharged from the facility. One friend goes about his days using his walker around his home and his rollator and wheelchair for longer distances, handling comments from neighbors with grace and humor. The other friend tries to get around his apartment without his walker and is embarrassed to be seen with even a cane on the streets. He falls, and the first friend comes to visit him in the hospital. The end. Point made.

Additionally, snazzier, less medical-appearing devices and more helpful accessories might increase the use of mobility aids. There are colorful canes, those that stand up when not in use, cup holders for walkers and wheelchairs, attachable carry bags and more, all of which increase usefulness and appeal. We can inform residents that those are available if they wish and can afford them.

Negative self-perceptions

Ageism also can affect the self-esteem of elders. A hospitalization and subsequent move to skilled nursing or rehab can abruptly alter one’s self-perception from being “young old” to “old old.” This can lead to feelings of depression, particularly when one has strong negative views about aging. 

Treatment by a consulting psychologist can result in an improved outlook, reduced depression and increased acceptance of the joys and difficulties of this phase of life. 


For many elders, aging is accompanied by stigma. When illness brings them to a rehab or skilled nursing center, they have become part of a club they didn’t want to belong to. 

As aging experts, we can help residents like Claire connect with like-minded and supportive peers, use tools to maintain as much independence as possible and develop a positive sense of self despite disability.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition and a Gold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements and/or content writing, visit her award-winning website at MyBetterNursingHome.com.