Ageism is prevalent in medical care

Ageism in Medical Care: Strategies for Overcoming it

Introduction

Dear Doctors:

Your column regarding an older man’s doctor who denied him a PSA test struck a nerve. He was just told no without an explanation. As I get older, I find that my doctors don’t listen to me. Can you please talk about ageism in medical care? Are there strategies for patients to overcome it?

The Issue of Ageism

Dear Reader:

The term “ageism” refers to the various stereotypes, assumptions, and preconceptions that are connected to someone’s older age, which result in their being treated differently.

Unfortunately, as with many other areas of life, ageism is present in medical care. Age bias shows up in the way that health care providers talk to their patients, the degree to which they listen, the range of diagnostic tests they offer, and the scope of treatments they are willing to make available.

Prevalence and Impact of Ageism

A number of recent studies have focused on the growing prevalence of ageism in health care. Not surprisingly, they have found it leads not only to a lower quality of life for older patients but can also result in missed or delayed diagnoses, more emergency room visits, more frequent hospitalizations, and a shorter lifespan.

Elderspeak and Communication

A common form of ageism is “elderspeak.” Nurses, doctors, and support staff may address older patients as “honey,” “dear,” or “young lady”; limit the vocabulary they use and dumb down explanations; or even use a sing-song voice, as when soothing an infant. This type of communication is not only embarrassing, but it is patronizing and can be isolating. Patients with poor hearing or eyesight say they are often treated as cognitively impaired. Some older adults find that treatable conditions — such as chronic pain, arthritis, and neuropathy — are dismissed as a feature of older age.

Approach to Older Patients

While it is true that guidelines for screening tests and therapies change as we grow older, the intent is not to limit care. Rather, it reflects the shift in risks and benefits that can take place in older age. In our own practices, we do embrace a more conservative approach with older patients in diagnostics and management. For instance, our approach to a 40-year-old with knee arthritis differs from that of a 90-year-old. Our goal is not to over-diagnose or over-treat. That said, we strongly believe that shared decision-making is even more paramount with older adults. We will explain a diagnosis in detail, and in outlining treatment options, we always ask our patient, what matters to you? Is it symptom management, quality of life, fewer interventions, longevity? The answers become the starting point of our treatment.

Seeking Geriatric Care

Some older adults may benefit from a geriatrician as a primary care physician. Geriatricians have advanced training in health issues that affect older adults, and they often have more time for appointments.

Addressing Ageist Behavior

If you are otherwise happy with the care you are receiving, you may have to firmly but politely alert a health care provider to their ageist behavior. A matter-of-fact statement like, “I am older, but I am mentally sharp, I’m interested in all of my medical options and I need our appointments to reflect that,” can be quite effective.

SDGs, Targets and Indicators

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease.
   • Indicator 3.4.2: Suicide mortality rate.

2. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
   • Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex and persons with disabilities.
   • Indicator 10.2.2: Proportion of people who feel safe walking alone around the area they live, by sex and age group.

The article addresses two Sustainable Development Goals (SDGs): SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities).

Under SDG 3, the article highlights the issue of ageism in medical care, which can lead to a lower quality of life for older patients, missed or delayed diagnoses, more emergency room visits, more frequent hospitalizations, and a shorter lifespan. The specific target under SDG 3 that can be identified is Target 3.4, which aims to reduce premature mortality from non-communicable diseases and promote mental health and well-being. The article mentions the importance of shared decision-making with older adults and considering their preferences in treatment options, which aligns with the goal of promoting well-being.

Under SDG 10, the article discusses ageism as a form of inequality in medical care. Age bias can result in differential treatment based on age, limiting the vocabulary used, dumbing down explanations, and dismissing treatable conditions as a feature of older age. The specific target under SDG 10 that can be identified is Target 10.2, which aims to empower and promote the social, economic, and political inclusion of all, irrespective of age. The article suggests that older adults may benefit from having a geriatrician as a primary care physician, highlighting the need for inclusive and age-sensitive healthcare.

The article mentions several indicators that can be used to measure progress towards the identified targets:

• Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease. This indicator can be used to assess progress in reducing premature mortality from non-communicable diseases.
• Indicator 3.4.2: Suicide mortality rate. This indicator can be used to monitor mental health and well-being.
• Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities. This indicator can be used to measure economic inclusion and inequality.
• Indicator 10.2.2: Proportion of people who feel safe walking alone around the area they live, by sex and age group. This indicator can be used to assess social inclusion and safety.

Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.

Source: bryantimes.com

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