By Gillian Vine

Dr Michael Kendrick, the keynote U.S. speaker at the Services for Older People Conference in Wellington in March is known for his advocacy on behalf of the disabled.

Asked what he thought was happening with the able elderly, he said: "It is difficult to know for sure what is happening in our western culture with more able elderly persons. Nonetheless, there is enough evidence of entrenched age related stigma to be reasonably sure that, at the level of social image, particularly in the form of unconscious stereotypes, that we are societies that do not like the aging process, and may well increasingly reject aging as a 'natural' part of life.

"This bias essentially equates youthfulness with the good life, and all manner of degradation with aging. Even very able and well aged persons commonly get consigned to the role of unwell and incompetent, simply on the basis of age," he said.

Such stereotyping belied a deeper (and frequently largely denied) devaluation of oldness and its consignment almost to the status of a universal malady in itself.

Dr Kendrick was reluctant to generalise on the reasons but said: "Nonetheless, it is hard not to see that the essential dignity of human beings arises not from (physical) life itself, but rather from the (metaphysical) meaning systems that help us interpret our existence. In the West, we have increasingly turned away from the authority of religion and transcendent values to explain life and its value in favour of materialism.

"Material values cannot cope with human decline and death, and instead tend to emphasise finding physical strategies to somehow offset or delay decline." However, the poverty and despair of materialism could all be transformed by a renewed emphasis on humans as being essentially spiritual beings temporarily inhabiting material homes, he said.

Within aged care, he would prefer to see a move away from the medicalised model. "I tend to favour ideologies in the aged care field that de-emphasise age as a medical calamity, keep people as part of the broader community and leave as much control and influence with ordinary people as opposed to professionals and bureaucracies.

"I would favour a gradual elimination of the building-based models and their replacement with person centred models. Since this is difficult to do in the beginning, it is best to start with good initial pilots or demonstrations and then expand from that point forward," Dr Kendrick said.

Asked about the role of central government, he said: "Governments can and do act and think laterally, but ... often this begins with non-governmental initiators who are restive for more progressive or enlightened policy, and who make themselves persuasive and compelling in their presentation of the case to government," he said.