Age in service delivery

Age shapes service delivery as well as the workplace. A federal law, the Age Discrimination Act, prohibits discrimination on the basis of age in programs and activities that receive federal financial assistance. The U.S. Department of Health and Human Services explains that it protects people of all ages, not only older adults. Many DHS programs and the county and provider programs DHS funds receive federal funds. The Act does not cover employment practices, which are addressed by the laws in the earlier lesson.

The Act also recognizes that some programs lawfully use age. Age distinctions set by federal, state or local statute, such as an eligibility age written into law, continue to apply, and HHS describes other narrow exceptions for factors that are necessary to a program's normal operation or that are reasonable factors other than age. So the question is not whether age ever appears in a program. It is whether staff are adding age-based assumptions that the program's rules do not require. Formal questions about whether a program's age distinctions are lawful go to DHS legal counsel and the civil rights office.

Assumptions show up in small moments. Staff may speak to an older person's adult child instead of the person, assume an older adult cannot use an online portal, use a slow, sing-song tone sometimes called elderspeak, or describe an older person's preferences as confusion. With young adults, including young people with disabilities moving from children's to adult services, staff may assume they are too young to make choices about where to live or work, or talk mostly to parents. In disability services, age assumptions can mix with disability assumptions, which makes them harder to see.

The alternative is person-centered practice, which DSD programs already expect. Speak first to the person the service is for. Ask how they prefer to receive information and offer more than one channel rather than assuming by age. Ask who, if anyone, they want involved in decisions. Treat preferences as preferences, whatever the person's age. When an age-based rule does apply, explain it plainly as a program rule, not a judgment about the person. These habits also help in workplace interactions with coworkers of every age.

Fictional case: Philippa, a county case manager working with DSD guidance, meets with Bertrand, who is seventy-eight and has a disability, about changing his services. His daughter, Linnea, attends. Philippa directs most questions to Linnea and suggests paper forms because online tools can be confusing at his age. Bertrand, who manages his own email and online banking, grows quiet. Later a DSD staff member reviewing the case notes the pattern.

Review one standard letter, form or intake script you use. Check whether it assumes a preferred channel or decision-maker by age, and suggest a change that offers the person a choice.

In your work with the public or with partners, when might you default to assumptions about what someone can do or wants based on how old they seem? What question could replace the assumption?