Being a patient contradicts the definition of manhood, leaving a person vulnerable, weakened, and dependent. Learn how masculinity affects the way male Alzheimer’s patients (and their caregivers) cope with the disease. From Alzheimer’s in America: The Shriver Report on Women and Alzheimer’s, a study by Maria Shriver and the Alzheimer’s Association.
In the United States, the dominant image of masculinity that emerged in the 19th century was “the self-made man.” Known generally for manly stoicism and fierce resolve, he was emotionally impenetrable, an armor-plated machine who showed no weakness. In the mid-1970s, psychologists created a masculinity scale that codified these traits. Brannon defined these as the four basic “rules” of manhood:
1. “No Sissy Stuff”: Manhood is defined by distance from what was perceived as feminine.
2. “Be a Big Wheel”: Manhood is measured by the size of one’s paycheck; wealth, power, status and success are its defining features.
3. “Be a Sturdy Oak”: Manly stoicism is what makes men reliable in a crisis.
4. “Give ’Em Hell”: Men are adventuresome, exhibiting risk-taking and aggression.
More recently, Kilmartin broke these down into 12 distinctive personality traits: strength, independence, achievement, hard working, dominance, heterosexuality, toughness, aggressiveness, unemotional, physical, competitiveness and forcefulness.
This traditional definition of masculinity retains a powerful influence over what both men and women believe men should be. Moreover, psychologists argue that gender conformity is both unattainable and internally contradictory, and men who cannot conform appropriately feel adherence to the role is a strain. Even men who succeed feel the strain in doing so, and the harmful components of the role present problems.
Masculinity and Males with Alzheimer’s
Being a patient contradicts the definition of manhood, leaving a person vulnerable, weakened and dependent. As a result, many men resist seeking health care. Men pay far less attention to diet and substance abuse than women, and they perform self-exams and seek preventive screenings less often as well. Why? As health researcher Will Courtenay writes:
“A man who does gender correctly would be relatively unconcerned about his health and well-being in general. He would see himself as stronger, both physically and emotionally than most women. He would think of himself as independent, not needing to be nurtured by others. He would be unlikely to ask others for help … He would face danger fearlessly, take risks frequently, and have little concern for his own safety.”
Or, as one Zimbabwean man put it to an interviewer, “Real men don’t get sick.”
The Alzheimer’s Association Women and Alzheimer’s poll shows a stark gap in the responses of men and women caring for someone with Alzheimer’s when asked if they themselves fear developing the disease. Two-thirds of women report they are frightened of developing Alzheimer’s; nearly 60 percent of men state they are not. This feeling and acknowledging of health-related vulnerability and fear is one of the largest gender gaps of the poll.
Avoidance of health care could also be related to the often demeaning nature of the visit — it’s cold, you’re naked and the doctor is talking to you as if you’re a child. Others, even, see it as a waste of money — perhaps why more men are uninsured than women. One New Yorker summed it up as the “What I don’t know can’t hurt me” approach.
However, the very requirements that make a man a “real” man may be the very things that endanger his health. The four causes of death that have the highest differential by sex are the four illnesses most closely associated with gender behavior, not biological sex: accidents, suicide, cirrhosis (drinking) and homicide. A researcher once suggested creating a warning label: “Caution: Masculinity May Be Hazardous to Your Health.”
Alzheimer’s can be experienced by men as emasculating: the mind’s gradual diminishment may be experienced as a loss of manhood. Caregivers, both male and female, need to be aware of the ways that succumbing to Alzheimer’s — indeed, developing the disease in the first place — can be experienced as gender non-conforming and that some male patients will attempt to compensate for their perceived loss of manhood by emphasizing other dimensions of that traditional role.
For example, the strain on gender identity experienced by male care recipients may be the source of some gender differences in patient behavior. Research suggests that males with Alzheimer’s are more likely to act out and less likely to help their caregivers. Care recipients’ problematic behaviors have been studied extensively and are consistently found to be influential predictors of caregiver distress. Such problems (e.g., falling down, making excessive demands or asking repetitive questions) are typically associated with either physical illness or cognitive impairment. A recent study discovered that wife-caregivers reported a higher incidence of problem behaviors among their care-receiving male spouses.
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The psycho-social aspect of this article is really interesting. Where would I be able to read more about gender roles in society?