The representation of old people: comparison between the professionals and students

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The representation of old people: comparison between the professionals and students

La représentation de la personne âgée : comparaison entre les professionnels et les étudiants

Sandrine Gaymard*,**

Résumé

Dans les écoles de formation d’in- firmières et d’aides-soignantes, on observe l’existence de préjugés et stéréotypes entretenus à l’égard des personnes âgées. On se demande si la représentation des professionnels présente des aspects plus négatifs que les autres populations. À cette fin, nous comparons dans cette étude la représentation d’infirmiè- res et d’aides-soignantes travaillant dans différents contextes professionnels à celle d’étudiants d’uni- versités laïques et catholiques sans expérience professionnelle auprès de personnes âgées dépendantes.

L’utilisation d’un test associatif révèle l’existence de deux pôles, un positif associé à des valeurs comme la sagesse et l’autre plus négatif lié au dépérissement physique et intel- Abstract

In training schools for nurses and nursing auxiliaries, it is possible to observe the existence of prejudices and stereotypes concerning older people. We wonder if the professionals’ representation presents more negative aspects than the other populations. For this purpose, we compare in this study the representation of nurses and nursing auxiliaries working in different professional contexts to that of lay and Catholic university students without professional experience of dependent old people. The use of an associative test reveals the existence of two poles, one positive linked to values such as wisdom and another more negative linked to physical and intellectual wasting.

The analysis of frequencies brings

* Université d’Angers. UFR Lettres langues et sciences humaines. Laboratoire de Psychologie UPRES EA 2646. Département de psychologie. 11 boulevard Lavoisier. 49045 Angers Cedex 01. France. Phone : +33 241 226 487. E-mail: Sandrine.gaymard@univ-angers.fr

**Centre Mémoire de Ressources et de Recherches de la région des pays de Loire.

Département de Neurologie, Centre Hospitalier Universitaire, 49033 Angers Cedex 01. France.

Acknowledgements

We would like to thank Professor Claude Flament for his contribution to the Guttman methodology.

Key-words Social representation and practices, stereotype, older people, nursing staff, students.

Mots-clés Représentation sociale et pratiques, stéréo- type, personne âgée, personnel paramédical, étudiants

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Introduction

O

lder people occupy a growing place at the heart of social preoc- cupations. This is linked to their increasing demographic importance and to the desire to improve the quality of aging. If several studies highlight the stereotyped perception with respect to “old people” (Brewer & Lui, 1989; Cuddy & Fiske, 2002), the originality of this work lies in the way it is structured with the theo- retical concept of social representations and the use of specific methodologies (Abric, 1994, 2003; Flament, 1994; Flament &

Milland, 2003, 2005). Our objective will be to study the representation of old people in the nursing staff sector and to make a comparison with students. We can think that the professional practices of nursing staff near the dependent elderly accentuate negative representations.

Stereotyped processes and Ageism

Brunswik (1956), presented photos of soldiers to students who had to give their impressions using two scores: an intelligence score and a likeability score. The author showed the correlation between these two characteristics, one person judged to be intelligent will also be judged likeable. These illusory correlationsare the basis of stereotypes, which constitute the beliefs and judge- ments of a group towards the ascriptions of another group (Ashmore & Del Boca, 1981). Studying representations of handicapped people, Paicheler, Beaufils and Ravaud (1987) show how we ascribe a particular personality to the group of “invalids”. The up differences between the two

populations according to their respective practices. The use of a semantic differentiator show that students, in particular lay students, have a more “charitable” and less discriminating representation than nursing staff.

lectuel. L’analyse des fréquences met à jour des différences entre les deux populations en fonction de leurs pratiques respectives.

L’utilisation d’un différenciateur sémantique montre que les étudiants, en particulier laïques, ont une représentation plus « charitable » et moins discriminante que le personnel paramédical.

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authors observe the ascription of an anxious and introverted type of personality to the “handicapped person in a wheelchair” and

“blind” groups. A pathological personality is associated with the physical deficiency which enables us to justify the place occupied by this group in society. Thus, the implicit personality theories give legitimacy to the exclusion situation experienced by handicapped people.

The work carried out by North American gerontologists has high- lighted the “ageism” concept, which represents a set of negative and discriminating prejudices concerning older people.

Gerontologists declare that ageismis still having a negative role on healthy aging (Grant, 1996). The development of multidimen- sional analyses has made it possible to differentiate between the stereotypes concerning older people, different sub-types. This is true of the work by Brewer and Lui (1989) as well as that carried out by Schmidt and Boland (1986) who made a list of negative sub-types (i.e. shrew/curmudgeon…) and positive sub-types (i.e.

perfect Grandparent…). The fact that the image of old people is stained by negative stereotypes does not constitute a new phenomenon since Tuckman and Lorge (1953) had already observed it in an older study. Nevertheless the stereotypes of old age have changed with the rise of the “young-old” (the age group 55 to 75), who are relatively healthy, affluent and free from tradi- tional responsibilities of work and family (Neugarten, 1974).

Thirty years ago, the present author thought that this group had potential in the evolution of society, and saw them as becoming the major agents of social change in creating an attractive image of aging.

For Cuddy and Fiske (2002), old age is one of the most outstanding characteristics in the building of impressions and old people are discredited without fear of censure. The creation of impressions is situated on a continuum including on one side the evaluation linked to group membership and on the other a much more individualistic evaluation (Fiske & Neuberg, 1990).

The creation of impressions does not represent one type with the exclusion of the other because people use several strategies to understand other people. The stereotyped processes respond to systematic principles and are stable but it is also presupposed that they have a “changing” content. Stereotypes contain both

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positive and negative beliefs and are built around two central dimensions: competence (independent, worker, intelligent, productive, self-confident) and warmth (pleasant, affectionate, sensitive, trustworthy). By taking these two dimensions into account, it is possible to notice that older people are classified in the warm/incompetent group close to incapacity and intellectual retard (Fiske, Cuddy, Glick & Xu, 2001, quoted by Cuddy & Fiske, 2002). Hummert, Gartska, Shaner & Strahm (1994) asked to young, middle-aged and elderly adults to provide traits of the Elderly. The results show that older adults have more complex representations of aging than middle-aged and young -and that middle-aged have more complex representations than young.

They observe similarities across the age groups but also increasing of complex stereotype sets with age. Elderly adults created more groupings of the traits than did the middle-aged and young adults. For instance, for the positive stereotypes, the number of mid-level subcategories ranged from three for the young: Golden ager, perfect Grandparent, John Wayne conservative, to four for the middle-aged: Liberal matriarch/patriarch, golden ager, perfect Grandparent, John Wayne conservative, to five for the elderly adults: Golden ager, perfect Grandparent, activist, small town neighbor, John Wayne conservative.

Social representations and practices

According to the structural approach, social representations have a central core and peripheral elements (Abric, 1994; Flament, 1994). The central core determines the signification and the organization of the representation. It is composed of the absolute or non-negotiable elements, according to Moscovici’s terminology (1993), which ensure the stability of the representation. The periphery represents the operating part, and it has “flexible”

elements which help individual adaptation and its principal characteristic is “conditionality”. The core’s absolute elements explain the resistance to change on the part of the representation and the periphery serves as, according to Flament’s expression (1987), a “bumper” because it softens possible contradictions.

Indeed, the act of questioning the central core would bring about a transformation of the representation.

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The importance of professional practical on representations has been described many times. Guimelli (1994) showed that the implementation of new practices modified the representation’s structure. His analysis of the nurses’function revealed that the

“own role” has become the organising principle which influences decision making. Reynier (2001), studying the representation of the nursing function with students during training, observed changes in terms of the representation between the first and third year; the integration of the “own role” being more pronounced in the third year. Trévisan-Virol and Lecigne (2000) have shown that the old age social representation is linked to the practices of the nursing staff and their voluntary participation in an organization’s activities (i.e. journeys, games, painting etc.).

The present study, using Principal Component Analysis, was conducted in retirement homes and it shows one group repre- sented by nurses and staff involved in different activities, and on the other hand and opposed to the first, a group made up by staff not involved and also hospital service employees¹. The representation of old age is more positive in the first group with “a blissful feeling”, as opposed to “restriction – affliction”. Nursing staff having different relationships with the elderly in retirement homes (with a distinct professional status and involved in various activities) build different representations of old age.

In the exploratory study proposed here, our first concern is to compare the representation of nurses and nursing auxiliaries who have an effective experience with dependent old people and we ask them to think about the old people in general. Does the fact of working with dependent old people on a daily basis make a representation of “disabled old age” more pronounced? Do these professionals have a stereotyped vision of elderly people?

Is it possible to detect specificities according to the function and the work context? These questions concerning the influence of practices on representations will then lead us on to the task of studying the representation of students not having any professional practice with dependent old people.

1. In France: ASH “Agents de service hospitalier”.

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Method

Population

We gave a questionnaire to 72 nursing auxiliaries and 62 nurses.

As the objective was to analyse different work contexts, we targeted a home care association, three clinics, a retirement home and two hospitals. At the moment of the survey, they have professional practices with old people but their professional training brings them to have various experiences with different populations.

The procedure that we used is as follows: after an interview with the chief nurse, we left the questionnaires and they were self- administered by the nurses and nursing auxiliaries; once completed, we received the questionnaires. Presenting the study and the questionnaire to the competent authorities was the most time-consuming part of the process. The difficulty of gaining access to certain institutions prevented us from obtaining compa- rable samples in each work context (Table 1). It seemed relevant to compare nursing auxiliaries and nurses, since French texts regulate their combined work (Lelièvre, n.d.). The role of nurses fits into an overall approach which concerns administering care but also includes responsibility for the psychological and behav- ioural aspects of the person receiving care. However nursing auxiliaries do not have the technical training of nurses and for this reason always work under their responsibility. Article 4 of the French decree of 11^thFebruary 2002²relating to the professional actions and the work of nurses specifies that the care linked to the nurses’role can be administered with the assistance of nursing auxiliaries, assistance which takes place under the nurses’responsibility. This assistance is limited to care concerning hygiene, comfort and monitoring of patients. Nurses can therefore call on the skills of nursing auxiliaries depending on their training and ensure their management.

2. Décret n° 2002-194 du 11 février 2002 relatif aux actes professionnels et à l’exercice de la profession d’infirmier. NOR: MESP0220026D, Journal Officiel n° 40 du 16 février 2002 page 3040.

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The same questionnaire was answered by 76 first cycle students with an average age of 20.6 years old. Among these 76 students, 35 were studying in a “lay” university and 41 in a Catholic university. At the moment of the survey, all these subjects have only

“familial practices” with elderly. The students were brought together in a room in order to complete the questionnaires.

Free association test

This questionnaire contains two methods: a method with free associations and a questionnaire of the semantic differentiator type which has 16 pairs of personality characteristics antonyms.

The free association method enables quite quick access to the representational universe of the subjects. In the social representation study, several indicators are used in the analysis of the production of associations: the frequency of the item, its rank in terms of appearance and the importance of the item for the subject. The first phase of this methodology consists of asking the subject all the words which come to (his) mind, using an inductor: “when you hear the term old person, which words or expressions come immediately to mind”? In a second phase the subject is asked what importance he attaches to the terms mentioned. In particular, we asked the subjects to underline the two most important answers.

Personality questionnaire (or semantic differentiator).

To make up this list of characteristics (Appendix 1), we used the work of Paicheler et al.(1987) as a basis for the representation of handicap. In their study, these authors used 32 pairs of personality characteristics corresponding to Cattell’s 16 factors (16 PF).

In our study we used 16 pairs of characteristics, each pair corresponding to a primary personality factor. As this list of

TABLE1:

Number of nurses and nursing auxiliaries in all professional contexts.

Professional contexts Nurses Nursing Auxiliaries Total

Home care association 8 28 36

Clinic 24 8 32

Hospital 24 18 42

Retirement home 6 18 24

Total 62 72 134

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characteristics presented some words which are too harsh to be acceptable in the answers, we decided to present 16 pairs of characteristics instead of 32. For example, the following pairs of characteristics were not chosen: “hard/tender”; “not jealous/jealous”; “fearful/fearless”; “not easily frustrated/easily frustrated”. In the same way, certain formulations changed; we adopted the expressions “slow-witted/quick-minded” instead of not very intelligent/very intelligent”; “emotional/calm” instead of

“emotionally unstable/emotionally stable”; “shy/daring” instead of “shy/adventurous”; “docile/authoritarian” instead of “domi- nated/authoritarian”. This work seemed necessary to us in order to make the questionnaire more easily accepted during its presentation but it did not prevent the stereotyped perception of the characteristics.

The subjects had to think about the old people in general by putting a cross on a scale going from 1 to 9. For example, the adjective “docile” is opposed to the adjective “authoritarian”; if the subject thinks that the elderly are rather “docile”, he will put a cross between 1 and 4, if he thinks that they are rather authoritarian, he will put a cross between 6 and 9.

Analytical strategies Free association test

For a given population we thus have a set of items which is the content of the representation and two indicators, the frequency at which the word appears and the average rank of importance which the subject gives it (Abric, 2003). The centrality of an item is determined by the frequency at which it appears and by the importance which the subject gives it. By cross-linking this information we can fix the limits of certain areas in the representation:

-The central core which puts frequent and very important items in the same group; -The first periphery which brings together elements which are important either in terms of their frequency or because of the importance which subjects give to them; -The second periphery which brings together low frequency and low importance elements which therefore play a minor role in the representation. For this reason, our discussion will be limited to the central core and first periphery associations.

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For this analysis we have brought together nurses and nursing auxiliaries on one side, and the lay and Catholic students on the other. Indeed, this analysis requires a certain number of free associations to be able to isolate the different fields of the representation. Finally we used a c² test to compare frequencies between nursing staff and students.

Semantic differentiator

We used a two-sided t-test when comparing means between nurses and nursing auxiliaries. In order to compare the differences according to work contexts, we used an Analysis of Variance (^ANOVA) with a post-hocmultiple comparisons (Tukey’s HSD test³). In order to present an overall analysis of results enabling comparisons of the 4 recognized groups of subjects: nurses, nursing auxiliaries, lay students and Catholic students, we propose to involve the “Guttman effect”. This effect has been known for a long time in factorial analysis of correspondence (Lebart, Morineau & Piron, 1997; Rouanet

& Le Roux, 1993), but it has only recently been identified in Principal Components Factorial Analysis (Flament & Milland, 2003, 2005).

We speak about the “Guttman effect” when the analysis of tabu- lated data reveals an “unidimensional structure”. To show this effect, we start from a table of means instead of a table with individual values (Flament, 1999; Gaymard, 2003). This table presents means of each group (named conditions of populations or experimental conditions) for each item (or characteristics). This approach is descriptive and the items of the questionnaire (i.e. reserved/outgoing) are placed at the start of the rows and the “conditions of populations” (nurses, nursing auxiliaries, lay students, Catholic students) at the head of the columns. It is therefore a transposition with respect to the kind of table which is usually presented (Reuchlin, 1976, 1991). By using this type of table, it is possible to carry out a Principal Components Analysis (PCA). If a Guttman effect exists we will have an order on the conditions; some of the items will be in ascending order and others in descending order. All the other items remain indifferent to this order. So this structure is unidimensional with a unique principle.

3. Also known as honestly significant difference test.

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Results

Free associations

Comparison between structure of representation For the free association test, the “Evoc” program (Vergès, 1997) leads us to determine a response threshold for the calculation of the frequencies and the average ranks and we obtain a table with central and peripheral words. For the nursing staff (Table 2), the terms “dependence”, “old age”, “wisdom”, “respect”, “experience” constitute the central core, that is to say that they organize and give a sense to the representation. In the first periphery, we have words for which we observe contradictions between the ranking and frequency criteria. These are the words most often used but in the last ranks or the words used very little but in the first ranks. We notice that the peripheral associations are more

TABLE2:

Replies of nursing staff to the question of free associations: “when you hear the term old person, which words or expressions immediately come to mind?”

(We used the “Evoc”

program (Vergès, 1997)).

Average Rank First rank

Dependence 62

Old age 19

Wisdom 16

Respect 11

Experience 10

Central words

Last rank

Loneliness 42

Death 12

Illness 12

Isolation 10

Fragility 10

Sadness 10

First periphery

Family 8

Grandparents 7

Slowness 7

Retirement 6

Lived 6

Tired 4

More than …years 4

First periphery

Needy 7

Memory 7

Past memories 7

Handicap 6

Senility 6

Tenderness 6

Anguish 5

End of live 5

Retirement Home 5

Knowledge 5

Mental disorder 4

Incontinence 4

Past 4

Slowing down Cares

Second periphery

Frequency

High

Low

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TABLE3:

Replies of students to the question of free associations: “when you hear the term old person, which words or expressions immediately come to mind?”

negative. There are elements which refer on one hand to loneliness, sadness, physical/intellectual wasting of old people and on the other hand, to the family. These elements fulfil the function of giving a concrete form to the representation since they are linked to individual practices.

Analysis of students’free associations (Table 3), shows that The terms “old age”, “wisdom”, “retirement”, “dependence” and

“retirement home” represent the central core. Two specific associations appear in the students’central core. It is possible to observe that they acknowledge the importance of retiring from active life and that they imagine old people in retirement homes.

On the periphery we can see the term “grandparents” but also negative elements observed with respect to nurses and nursing auxiliaries: illness, death, loneliness.

Average Rank First rank

Old age 40

Wisdom 27

Retirement 27

Dependence 23

Retirement home 14

Central words

Last rank

Illness 25

Grandparents 23

Death 14

Loneliness 13

First periphery

Experience 7

First periphery

Wrinkles 6

Grandchildren 5

Leisure 5

Travelling 5

Second periphery

Frequency

High

Low

The c²test reveals significant differences between nursing staff and students (Table 4). In the central core, “dependence” is more important in the representational universe of the nursing staff (p.02). Thus their representation seems directly linked to their professional practices with dependent old people. Wisdom is more often mentioned by students (p.0001) and also the term

“retirement” (p.0001) which is peripheral in the representation of the nursing staff. We notice that in the periphery, “loneliness”

has a particularly high frequency for the nursing staff (p.02)) while the terms “grandparents” (p.0001), illness (p .0001) and “death” (p.04) appear more important for the students. We

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observe less variety in the replies of students by comparison with nursing staff ’s replies, particularly in the periphery.

TABLE4:

Free associations:

c²test.

Semantic differentiator

Comparison of the “nurse” and “nursing auxiliary”

functions

We observe that there is little difference between nurses and nursing auxiliaries. The “serious/carefree” and “practical/imaginative” characteristic pairs significantly differentiate nurses from nursing auxiliaries. Nursing auxiliaries consider the old people as being less serious (t = 2.85; p .005) and more imaginative (t= 3.16; p.002) than nurses.

Comparison of the work context

When we compare the different professional contexts, only the

“docile/authoritarian” pair of characteristics is significantly different (F_(3,130)= 5.18; p.002). The post hoc multiple comparisons (Tukey’s HSD Test) show that the “association context” is significantly different from the “clinic context” (p.01), from the

Free Nursing-Staff Students c² P

associations frequencies frequencies

Dependence 62 23 5,16 .02

Old age 19 40 35,49 .0001

Wisdom 16 27 16,57 .0001

Respect 11

Experience 10 7 ns

Retirement 6 27 35,29 .0001

Retirement Home 14

Loneliness 42 13 5,08 .02

Grandparents 7 23 24,83 .0001

Illness 12 25 19,15 .0001

Slowness 7

Family 8

Death 12 14 4,01 .04

Isolation 10

Fragility 10

Sadness 10

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“hospital context” (p .03) and from the “retirement home”

context (p .003). In the association sector, old people are perceived as being more docile, a character which according to Albou (1999), relates to “old people’s wisdom”.

Comparison between nursing staff and students

We refer to the Guttman effect when the representative points of the columns form a circular shape. In this case, the first 2 factors together reveal a very large part of the variance (90%). This circular shape shows the chain of different populations, and is the first result of the Guttman effect which concerns the columns of the table. Subsequently we have to analyze the rows corresponding to the items. The factorial scores characterizing the rows are used to identify the way that each item fits in with the Guttman effect. According to Flament and Milland (2003), when the circular arc is drawn vertically the rows which have extreme scores on Factor 1 are the ones which have homogeneous values through the profiles: it is the size component of the Guttman effect. The rows which have extreme scores on Factor 2 are those which increase, or decrease, quite often according to the linking of columns: this is the diagonal component of the Guttman effect.

The ACP using means (Figure 1) shows that the 4 representative points of the 4 average profiles form a vertical circular arc, revealing an interesting Guttman effect on linking: nursing auxiliaries (component 1 =.88; component 2 = -.45)/nurses (.96;

-.25)/Catholic students (.96;.19)/lay students (.81;.56). The two- dimensional factor space explaining 97.3% of the variance: Factor 1 shows 81.8% of the variance and Factor 2, 15.5%. The distinc- tion between these 2 factors does not appear to yield any conclusive information (Flament and Milland, 2003).

The factorial scores characterizing the rows enable us to identify the way in which the items fit in with the Guttman effect (Table 5).

The diagonal component (scF2) reveals the importance of certain items in differentiating populations. To characterize this bipolar axis we used the edges (extremity) in the table. First we begin with the conditions, and in our case, we have 4 population groups who have different practices with the elderly. Certain items are going to vary throughout the chain, for instance, the items serene/anxious

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vary from 6.94 (nursing-auxiliaries) to 4.48 (lay students). Then, the order of items will interpret itself with extremes scores on Factor 2 which increase or decrease according to linking of the columns (i.e. serene/anxious (-2.09); relaxed/tense (-1.49); serious/carefree (-1.11); and on the opposite: Emotional/calm (1.52);

Impulsive/restrained (1.50); Fickle/persevering (.68) to shy/daring (.36). To able to choose these items we rely on the use of the value of R2 and on the series of values within the column (.60). In this way, we have selected as best contributions, items A: serene/anxious;

relaxed/tense; serious/carefree, and items B: shy/daring; slow- witted/quick-minded; reserved/outgoing; naïve/clear-minded;

fickle/persevering; impulsive/restrained; emotional/calm⁴. Figure 2 illustrates the diagonal trajectories of these items through the linking of the 4 populations. In this way if at an extreme, the nursing auxiliaries perceive old people as being anxious, tense and carefree (items A), at the other extreme, lay students perceive old people as being serene, relaxed and serious. Likewise, if nursing auxiliaries see old people as being

lay

Cath

nurse Nursing aux 1,0

1,0 ,5

,5 0,0

0,0 –,5

–,5 –1,0

–1,0

Component diagram

Comp. 2

Component 1 FIGURE1:

Guttman effect

4. When the slope of the linear regression is low, value of R2 can be high without the item was really interesting; it’s the case of the item “docile/authoritarian”.

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TABLE5:

Overview table showing data for the four profiles and the main resultats of the PCA carried out on these profiles.

FIGURE2:

Diagonal trajectories of items A and B through the linking of 4 profiles.

Means Factorial scores

Nursing Nurses Cath. Lay Total ScF1 ScF2 R2 -aux. students students

Serene/anx. 6.94 6.61 5.83 4.48 5.96 -1.09 -2.09 .96 Relaxed/ten. 5.47 5.93 5.27 3.91 5.14 -.36 -1.49 .74 Serious/caref. 4.46 3.56 3.05 3.23 3.57 1.04 -1.11 .66

Practical/im. 4.43 3.60 3.58 3.51 3.78 .87 -.78 .54

Insensitive/s. 6.81 7.14 6.51 6.89 6.84 -1.78 -.40 .07

Conservat/in. 2.37 2.27 2.51 2.11 2.31 2.15 -.29 .16

Confident/mis. 5.65 5.47 6.02 5.63 5.69 -.79 -.12 .10

Docile/author. 4.90 5.05 5.12 5.60 5.17 -.31 .23 .86

Dependant/ind 3.26 3.43 3.15 4.14 3.50 1.16 .29 .46

Shy/daring 4.49 4.39 4.98 5.14 4.74 .05 .36 .90 Slow-witted/ 3.65 3.81 4.12 4.66 4.06 .66 .52 .97 Reserved/ou. 4.43 4.27 4.80 5.34 4.71 .09 .52 .88 Naïve/lucid 5.18 5.42 5.58 6.51 5.67 -.74 .67 .87 Fickle/pers. 4.32 4.43 5.46 5.31 4.88 -.06 .68 .81 Impulsive/rest. 4.83 5.24 6.80 6.91 5.95 -.97 1.50 .91 Emotional/calm 3.67 4.19 5.09 6.00 4.74 .09 1.52 .99

Items AItems B

3 3,5 4 4,5 5 5,5 6

5,62

5,37

5,26

5,7

4,37

4,54

4,72

3,88

Items A Items B

Nursing auxiliairies

Nurses Catholic students

Lay students

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rather shy, slow-minded, reserved, naïve, fickle, impulsive and emotional, lay students perceive them as being daring, with lively minds, outgoing, clear-minded, persevering, restrained and calm.

It is thus possible to interpret this chain as linking the least charitable profile (nursing auxiliaries) through to the most charitable (lay students), moving through the intermediate profiles characterizing nurses and Catholic students.

Discussion

This study analyses the representation of old people. We used two tools, one used frequently to collect spontaneous representations and the other which suggests pairs of characteristics. With the free associations test we observe a representation both positive and negative. This representation has two faces and opposes

“the healthy old age” to the “the disabled old age” (Caradec, 2001). The c²test reveals differences between the two populations according to their respective practices. The term

“dependence” appears more important in the representation of nursing staff and it is probably linked to theirs practices near dependent elderly. Other elements appear specific to students’representations. The importance of the term “retirement” seems to us to be linked to their situation of being students, i.e. not having yet entered the world of work but also to a view of elderly in leisure activities and journeys. Moreover the

“retirement home” association in their representations indicates a rather positive vision of old age. A smaller range of associations can be observed in the students’periphery. Their representational universe appears less complex than that of the nursing staff (Hummert, Garstka, Shaner & Strahm, 1994). We think that these results are partly linked to the fact that students are younger and do not have any professional or practical experience with old people, whereas nursing staff have a multiplicity of experiences.

The first periphery presents, in terms of associations, a more negative representation of old people. We come across terms defining the two central dimensions of the stereotype (Cuddy &

Fiske, 2002). Old people are characterized by intellectual and physical decline (“slowness”, “tired”, “disease”, “dead”) but we also observe the presence of associations relating to a warmer

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dimension (“family”; “grandparents”). The importance of the term “loneliness” in the representation of nursing staff, can be explained by their personal experiences near lonely old person.

In students’representations, the frequency of the term “grandparents” characterizes their familial practices not only linked to

“healthy old age” but also to “illness” and “death”.

The characteristics suggested in the semantic differentiator appeared to be stereotyped. We expected this perception on the part of professionals working with the old people and for this reason we did not present the initial list and also modified certain expressions. When nurses and nursing auxiliaries means are compared, we notice that the characteristics attributed are on the whole consensual. However two dimensions present significant differences: the awareness of rules (serious/carefree) and abstrac- tion (practical/imaginative). Nursing auxiliaries perceive old people as conforming less but being more imaginative. We think that this less “normative” representation of old people is linked to their practices. First of all nurses have a “technical” training unlike nursing auxiliaries, a training which gives them a certain authority. Apart from the “own role” which concerns hygienic care and comfort, nurses have a “prescribed” role which concerns recognition through knowledge, and following prescriptions given by the doctor.

The more vulnerable the patient being cared for is the greater the importance of the “own role” since it forms the very base of the accompanying role. A few years ago, this role took up 80% of time but today various reasons including the lack of personnel mean that it has diminished somewhat. Nurses delegate to the nursing auxiliaries but they cannot be replaced for the prescriptive role.

The nursing auxiliary looks after the cleanliness aspect more which brings them closer to the old person; she always works under the nurses’responsibility and is closer to the “doing”. As shown by Lachant (1999), in the representation of the role, nursing auxiliaries are essentially concerned by tasks. In this way if nursing auxiliaries perceive old people as conforming less and being more imaginative, it is because they have closer relationships with old people with a reduced hierarchical distance.

Dominance is the factor which differentiates professional contexts. The association context is different from all the others

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in its attribution of a more docile personality. To explain the importance of this characteristic, we come back to “old people’s wisdom”, the most important concerning their moral image (Albou, 1999). This wisdom is linked to knowledge acquired during their whole life and corresponds to a particular type of wisdom: “This type of wisdom is that of “well-behaved children”, that is to say those that are calm, docile, without any eccentric behaviour or whims”. In this sense, the “wise old person” is someone whose actions are restrained, controlling their passions, in no way bold and lacking originality.” (Albou, p.

47). So we interpret the attribution of a more docile personality as positive and probably due to the fact that nursing staff who work in association give home care. It is a family context without the hierarchy as is found in hospital. Home care has the particu- larity of associating the technical and relational dimensions as specified in the collective agreement (Aymot, 1998), but to stay at home of course depends in large measure upon health status.

When comparing descriptions of characteristics made by nursing staff to those of students, numerous differences can be observed.

The Principal Components Analysis (PCA), using the table of means, reveals an interesting Guttman effect on linking: nursing auxiliaries/nurses/Catholic students/lay students. This overall analysis makes it possible to illustrate each group’s representational difference. Compared with nursing staff, students, and in particular lay students, have a more “charitable” attitude towards old people: more serene, more relaxed, more serious (items A of the diagonal component), they also appear more daring, with more livelier minds, more outgoing, more persevering, more controlled and calmer (items B of the diagonal component).

In this way, if the nursing staff discriminate personalities of old people as had been observed in the representation of the handicap (Paicheler et al., 1987), students, and above all lay students, take a broader point of view and do not attribute a socially “handicapped” or a pathological personality to old people. We observe that lay students seem to have more charitable representation than Catholic students and we could suggest several interpreta- tions. Maybe lay students we have meet, have develop a more important spirit of solidarity than Catholic students. Lay students generally belong to middle-class or underprivileged middle, and

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in this case many of them work in a different context to help others. Maybe formation proposed in lay or Catholic university influences the representation (for example in lay university there is formation in gerontology). Or maybe familial practices of Catholic students are linked to the “disabled old age”, more than lay students. In fact the association of several factors could explain this result.

To analyze the representation of old people we have to take several factors into account – such as professional practices, familial practices, professional contexts, status and age groups. In the light of these results, we are led to think that contact with dependent old people has a negative effect on stereotypes (semantic differentiator) while the effect on social representations (free associations) appears more ambivalent. According to Devos (2002), it is in terms of the explicit beliefs that experience has positive effects but there are not necessarily any links between the explicit register and the implicit register. As far as this is concerned, the author mentions certain studies which suggest that contact with the old people might increase the importance of stereotypical associations.

With the free associations, the representation of old people appears both positive and negative for the two groups. This representation is more negative in the periphery and more complex for the professionals. We explain these results by the fact that social representations are also linked to individual practices.

Nurses and nursing auxiliaries have various experiences with old people who vary in the level of their dependency. For example, in hospital they are confronted with illness, solitude and death, while in associations (care homes) they are less confronted with the disabilities of old age. These various experiences appear influ- ential in not having a depressing representation.

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Appendix 1

Directions: Put a cross by line between the two opposites.

For example, if you imagine that old people are rather “reserved”, the cross will be between 1 (very reserved) and 4; if you imagine that old people are rather “outgoing”, the cross will be between 6 and 9 (very outgoing);

Think about old people in general

1 2 3 4 5 6 7 8 9

Reserved Outgoing

Slow-witted Quick-minded

Emotional Calm

Docile Authoritarian

Serious Carefree

Fickle Persevering

Shy Daring

Insensitive Sensitive

Confident Mistrustful

Practical Imaginative

Naïve Clear-minded

Serene Anxious

Conservative Innovative

Dependent Independent

Impulsive Restrained

Relaxed Tense