Entrenched Ageism in Healthcare Isolates, Ignores and Imperils Elders
Perry, Daniel, Aging Today
The late Dr. Robert N. Butler did more than simply name the prejudicial attitude diat values young lives over old ones. He taught us that ageism is the original sin of societies blessed with greater longevity: it is the snake in the garden corrupting the monumental social achievement of longer lives for more people. Despite being sought fervently since antiquity, greater human longevity, once achieved, seems to trigger an illogical self-loathing of our future selves, cruelly robbing the victory of its purpose, dignity and worth.
Dr. Butler identified ageism as a deeply ingrained distemper in American culture, and called it out where it thrives: in politics and government, the media, popular entertainment and the workplace. But he saved his sharpest criticism for medicine, medical education and healthcare.
In 2003, the Alliance for Aging Research, guided by Dr. Butler's concerns, published a report to the U.S. Senate Special Committee on Aging called Ageism: How Healthcare Fails the Elderly. The report examined the following domains of ageism in healthcare:
* Healthcare professionals do not receive sufficient training in geriatrics;
* Older patients are less likely to receive vaccines and other preventive care;
* Older patients are less likely to be tested or screened for common health problems;
* Effective medical interventions beneficial for older patients are often ignored, leading to inappropriate or incomplete treatment; and
* Older people are consistently excluded from clinical trials, though they are the largest users of tested and approved drugs and devices.
The Alliance documented how these manifestations of ageism take a serious toll and harm older patients by exacerbating and prolonging illness, isolation, unnecessary institutionalization, loss of independence and premature death.
Negative stereotypes of older people are internalized early in life: they operate on the subconscious, and are as virulent in elders as in younger people. Ageist attitudes among healthcare providers lead to missed or delayed diagnoses, poor management of multiple chronic conditions, lost independence, overuse, under-use and misuse of prescription drugs, and more.
Ageism and the Sin of Omission
Ageism begins with the sin of omission in medical and health education. Stinting on geriatric orientation at all levels of professional education creates a fertile breeding ground for bias, insensitivity, misdiagnosis and poor care of older patients.
"Train wreck," "nightmare on a stretcher," "dotty old guy in bed three" and "Gramps down the hall"- these are just a few of the derogatory terms used by emergency care workers as reported by Richard Currey, a certified physician assistant and freelance journalist, in the winter 2008 issue of AgingWell magazine.
In 1978, the first of what would be four major studies by the prestigious Institute of Medicine (IOM) cited a shortage of specialized training in geriatrics as a serious problem, given that people ages 65 and older are the largest and fastest growing group of health services users. …