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How Ageism in Health Care is Affecting Society

Jeff Hoyt Jeff Hoyt Editor in Chief

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Experts say that ending ageism starts with changing the way society thinks about aging. Despite the advances in medicine giving humanity longevity, our fate of living longer remains riddled with discrimination and prejudice. Ideally, we consider ourselves equal regardless of our race, income, gender, or age. But the reality is, today’s society treats older people unfairly often. Many people lumps all aged 65 and up into a group of old, frail, decrepit, forgetful, and sickly beings separate from the rest of society. That notion couldn’t be further from the truth.

Ageism, or age discrimination, has deeply permeated our culture. People are so afraid of aging that they consider older people “others.” Experts call this the “us versus them” mentality. It is so common that even the health care system belittles the dangers of ageism.

According to a study published in the Journal of General Internal Medicine, one out of five older adults experiences ageism in health care settings. Those who frequently experience it have a higher risk of developing a new disability or worsening existing ones. Every day, around 10,000 Americans turn 65. The numbers are expected to rise as mortality rates decline. Experts believe that it is high time for ageism in health care to be put in the limelight.

Most Americans including older adults are not aware of ageism

New research published by The Frameworks Institute (FI) found that most Americans are not aware of the dangers of ageism. The researchers call this the “cognitive hole.” The cognitive hold describes people’s way of individualizing aging problems instead of recognizing ageism as a ubiquitous problem. The FI’s Gauging Aging: Mapping the Gaps between Expert and Public Understanding of Aging in America report was made to understand how people think about aging and use the results to identify challenging misperceptions that need to be changed by the whole society.

Older Americans are left out of socio-civic activities and opportunities such as employment, recreational activities, housing, business, and others. Even so, ageism remains absent from the public’s perception of growing old. Some older adults even accept the discrimination they face as a normal part of the last stage of living.

In the report, aging should be considered by society as “both a personal and a shared resource and opportunity”. This rethinking makes us view older Americans as “central rather than marginal participants in our collective life as a nation.” The study recommends developing information tools and ways to help society “reframe” or change their understanding and perception of the aging process. This reframing, they say, can lead to changing policy for the betterment of older generations.

To fight ageism, experts suggest changing the way we perceive aging. We should know how ageism manifests and recognize ageist situations, especially within the health care system.

The Dangers of Ageism in Health Care

Experts say that older patients comprise around 27 percent of all doctor’s visits and 35 percent of all hospital stays. Negative views about aging patients weakens the health care system’s ability to treat a major part of their clientele. It also hinders the addition of more capable medical practitioners to the workforce. Ageism among medical providers causes real damage to the patient. In Dr. Karin Ouchida and Dr. Mark Lams’ article on Ageism in Healthcare, they explain several manifestations of ageism in our healthc are system.

  1. Practitioners Belittling Geriatrics and Gerontology as a Profession. Obvious ageist comments proliferating among medical practitioners are depicted in the story of a surgeon asking a medical student what specialty she’s planning to pursue. She replied, “Geriatrics.” The professor immediately acted like a whiny high-pitched frail old man complaining about aching muscles and constipation. Many doctors also make jokes about their old patients. Humoring older adults’ predicaments is offensive and unethical. Because of these ageist comments, geriatrics is portrayed as a less rewarding specialization. The negative attitude that medical practitioners hold toward older adults keeps health care systems from recruiting medical professionals to practice gerontology.
  2. Under-Treating Older Patients. “It’s normal to be depressed because you’re old.” This doctor’s advice is one of the examples hindering medical providers from treating the real cause of an older adult’s ailment. Explaining all the aches and pains of an older patient as “normal signs of aging” is downright ageist. This means they do not get the proper treatment they need. Patients are forced to convince themselves that what they’re feeling is part of aging. Another common example of undertreatment includes ignoring other causes of complaints such as lifestyle, relationships, and home situation. A doctor attributed the bruises on an older patient’s arm as normal effects of anticoagulants to an aging body, without inquiring whether there was violence in the family. Another patient complained of frequent headaches, memory loss, and confusion but the doctor assumed it was normal for all older people to experience that, instead of conducting tests that may rule out brain tumors. There were also many cases where doctors assumed that their patients were sexually inactive because of their age and failed to treat ailments such as erectile dysfunction, sexually transmitted diseases, and HIV.
  3. Over-treating older patients. Ageism also becomes harmful when medical providers over-treat older patients based only on their age while excluding their preferences, abilities, and functionality. An example of this is the US health care system’s program to give universal prostate cancer screening for older adults. While seemingly positive, experts found that these screenings resulted in exaggerated diagnoses of harmless tumors. It led to unwarranted treatment requiring surgery, resulting in complications and intensive care. Other examples include giving high dosages of diabetes medication, triggering hypoglycemia, and prescribing antibiotics for urinary tract problems without clinical signs or symptoms of infection. To policymakers and economists, the overtreatment is a waste of public funds. According to their estimate, one-third of the budget for health is spent on waste. Overtreatment waste in the past cost the country around $158 to $226 billion.
  4. Ageist Talk in the Health Care Setting. One of the causes of under and over-treatment is the lack of effective communication between the doctor and the older patient. Experts have pointed out complaints from older adults on how most medical practitioners do not talk directly to them. Instead, they do the “elder speak” – a way of speaking similar to baby talk, with high pitch, exaggerated tones, and volumes. Some automatically shout near their ears without even knowing if they have hearing problems. They assume all seniors are deaf.. Like everybody else, older adults do not like to be talked down to. Doctors talking about older patient’s conditions to a third party instead of directly to them also keeps them from developing a good doctor-patient relationship. Sometimes they leave out the patients in the conversation about their own health. There are also times when nurses and other staff talk about their older patients in front of them as if they are not there. Multiple studies have shown that these ageist acts are disrespectful, and demeaning and can cause lower self-esteem and depression among older patients.
  5. Ageism innate to older adults. Even older adults have ageist views about their own aging process that can greatly affect their health. Experts have found that older adults who accept that depression, fatigue, chronic pain, low libido, and dependency are just normal parts of aging get less care. They also tend to refrain from participating in physical activities, exercising, using protective gear, and eating a balanced diet.
  6. Institutionalized Ageism. In their article, Dr. Ouchida and Lam argue that the US health care system is prejudiced against older adults because of the following:
    • Lack of support to increase the number of doctors specializing in geriatrics and lack of action to reverse its declining number.
    • More doctors are opting not to treat Medicare patients; which supports most of older adults.
    • Clinical Practice guidelines, which were studied based on adult populations, are not applicable when it comes to older patients with multiple chronic illness. As a result, physicians try to mix treatments for these diseases, which put older patients at risk of the adverse effect of multiple drugs combined.

How to Address Ageism

For Dr. Ouchida and Lam, getting rid of ageist attitudes in our health system requires medical practitioners to “recognize and appreciate the heterogeneity of older adults.” This involves effective integration and exposure with them outside the hospital setting. Heterogeneity means, like any age group, older adults also differ in their functional status, health, and financial situation. Some older people are still strong, active, and sharp in their 80s while some may be weaker than others. And when it comes to race, income, gender, education, class, and social status, disparities also apply to them as well as these apply to anyone.

We can start changing our unpleasant perceptions about aging and embrace aging for what it is – a normal process of living that doesn’t necessarily involve disability, disease, and decline.

According to the Framework Institute’s research, reshaping our negative thinking towards older people entails making adjustments to ensure that older people are not isolated from the rest of society. This includes making better age-friendly policies and increasing their opportunities for employment, transportation, health care, community development, and housing. “Our retirement culture was just not designed to support an aging society,” one expert from the study said. “We need to reengineer [our] institutions if we are going to be able to have a productive, secure, cohesive society.”

Fighting ageism in the health care system isn’t just about changing individual mindsets, but also applying positive attitudes on aging to change policies and systems. Based on their research; Framework Institute recommends the following systematic changes to achieve a truly age-friendly society:

  • Start by addressing institutionalized ageism to remove barriers prohibiting older people from engaging fully in civic and economic activities as part of the community. This can be done through education and information campaigns or training among health care providers on the dangers of ageism.
  • Giving more opportunities for them to be involved in the community through civic and social activities such as volunteer work, mentoring, and continuing their education.
  • Changing our perception of work and retirement.  Older adults prefer to work past their retirement age due to economic and personal reasons. To address this, flexible policies should be made to avoid age discrimination and forced early retirement for older adults still capable of working.
  • Spending public funds efficiently to avoid the humongous cost of health care programs
  • Increasing the health care workforce trained in geriatrics.
  • Finding solutions to the growing demand for long-term care.
  • Developing more efficient policy solutions to ensure income security in retirement.
  • Giving institutional and social support to caregivers providing unpaid care to their loved ones. Social Security credits should still be given to those who leave work to take care of their ailing family.
  • Investing in research on the persistent problems of the aging population provides more basis for institutional changes needed for older adults to age well in our society.

Fighting ageism is a matter of defending equality and justice. Fostering a future free from discrimination honors the contributions older adults have made to our society. If we start crushing the pillars of ageism now, future generations will also benefit greatly.

Written By:
Jeff Hoyt
Editor in Chief
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As Editor-in-Chief of the personal finance site MoneyTips.com, Jeff produced hundreds of articles on the subject of retirement, including preventing identity theft, minimizing taxes, investing successfully, preparing for retirement medical costs, protecting your credit score, and making your money last… Learn More About Jeff Hoyt