Ageism in Medicine: Do seniors get the same medical care as younger patients?

By Joanna Leefer, Senior Care Advisor

Older people are often treated with less urgency than younger patients. This “ageist” attitude is being recognized as a form of discrimination similar to sexism and racism. Here are some ways to recognize this behavior and how you can change it.

An older man walked into his doctor’s office. “Doc,” he said, “my right knee is killing me. The pain is shooting through my leg like a knife.” “Sir, you are 86 years old; you must accept the fact that you will experience pain. It’s part of the aging process.” The older man looked the doctor in the eye and responded, “I don’t understand Doctor, my left knee is 86 years old too and it has never bothered me. “

This is a common conversation between physicians and their older patients far too often. Many physicians dismiss senior’s complaints as a “normal” part of aging and feel they don’t need to treat them with the same urgency as they would a younger person’s complaints.

Studies show that many physicians hold preconceived stereotypical opinions of the elderly. They assume aches and pains are a normal part of aging and do not treat it with seriousness or compassion. Other studies indicate that doctors often spend less time with older people, minimize their difficulties and often do not take care of their condition as intently as they do younger patients because they are “getting on in years” and will die soon anyway.

Another generalization commonly held by medical professionals about older patients is that they all should be treated the same. This is despite the fact that the term “seniors” spans from the age of 55 to over 90 years old. There is little acceptance that a 55-year old person is different than a person who is 90+. There is also little regard that many seniors are more fit than younger counterparts; that many of them still are physically active, and participate in strenuous activities such as swimming, running, and tennis. This misconception often results in seniors not being considered for new and innovative treatments or for organ transplants even if they are healthier than younger candidates.

Other common evidence of this dismissive attitude can be seen in how often geriatric patients are not offered early appoints because their needs are not considered urgent or as important as a younger person’s. Other studies show that seniors are given less time with their doctors and the physician spends less time exploring reasons for ailments because they are old and are expected to tolerate their age. Treating patients based on their age means the doctor might miss a significant, treatable situation.

Another example of doctor’s attitudes towards seniors is evident when an older patient is accompanied by an adult child. In such cases, the doctor often address his questions and comments to the adult child rather than to the patient and refer to the patient in the third person rather than addressing him directly. This behavior negates the patient and relegates him to an inferior role, almost like a person returning to childhood.

Fortunately, some doctors are beginning to question this behavior. Dr. Robert Butler, a pioneer in geriatric care and the first Director of the National Institute on Aging coined the term ageism to describe the systematic stereotyping of people over a certain age. In his book, Why Survive Being Old in America, published in 1969, Dr. Butler compared this behavior to attitudes such as racism and sexism. He offered examples of how older people are routinely undervalued in all areas of life and compares this treatment to discrimination against older people.

Since Dr. Butler’s writings more and more doctors are reconsidering their treatment toward senior patients. Some hospitals such as New York Presbyterian are beginning to offer training to doctors to make them more aware of these attitudes and how to work against them.

One big step is the acknowledgement that seniors are not one homogenous group. A 55-year-old person is quite different than one who is 95 years old and should be treated accordingly. Medical facilities are now dividing the geriatric population into three broad age categories, the young old, the middle old, and the old old. Each grouping has its own distinct medical and social needs and treatment. Younger seniors in the 50 to 65 year old category are healthier and living longer than ever before. Older patients, on the other hand, often have psychological issues that impact them and should not be disregarded. Some medical facilities are teaching doctors to become more sensitive to major issues impacting seniors including personal losses, such as loss of job status, loss of friends, family members and spouses, social isolation, and sensory losses such as hearing loss, loss of eye sight, and cognitive loss.

Doctors are being taught to take into considerations some of these sensory losses by sitting closer to patients, talking to them slowly and clearly without shouting, making sure the room is well lit and written information is presented in large print. Finally doctors are becoming more aware of the richness of the experience they can gain from listening to their older patients. Doctors are learning to understand that older patients are entitled to the same respect and treatment as younger patients.

There is much that we as family members of seniors or seniors ourselves can do to make sure geriatric patients get the proper medical attention

1.Demand the doctor gives each patient as much time as necessary. Don’t let the doctor rush you.

2. Ask plenty of questions; make sure all your concerns are discussed thoroughly

3. Don’t settle for platitudes; insist the doctor take your complaint seriously. Ask yourself, would he give the same answer to a younger patient?

4. Make sure you are seen in a timely manner. If the office won’t give you a convenient appointment, consider going someplace else.

5. Insist the doctor talk directly to you. Do not let yourself be addressed in the third person. You might be older but your mind is still good.

Ageist attitudes would be more understandable in the early 20th century when the average life expectancy was 61 years old. Now that a person can live into her 90’s or even 100, this attitude about an individual’s care seems ludicrous.

as seen in the Community Newspaper Group, June 2-6, 2014
http://joannaleefer.com/ageism-in-medicine/

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