How Ageism in Health Care Affects Seniors

Most Americans Are Not Aware of Ageism

Recent research published by the FrameWorks Institute found that most Americans are not aware of the dangers of ageism.2 Older Americans are left out of socio-civic activities and opportunities related to employment, recreational activities, housing, business, and more. Many older adults accept the discrimination they face as a normal aspect of growing old.

The Dangers of Ageism in Health Care

How might jokes about getting older, or your doctor saying your aches and pains are just part of normal aging, cause harm? Dismissing or minimizing symptoms can lead to the misdiagnosis of serious illnesses. Read on and we’ll reveal the negative repercussions of ageist attitudes on your mind and body and what you can do to safeguard your health.

Your Own Ageist Views Affect Your Health

You see ageism in the media, and hear it from your family, at your job, and in your doctor’s office. Maybe you’re afraid of aging because older people are “the other,” and you don’t see enough positive examples of seniors thriving. Being immersed in negative aging stereotypes might lead you to have a pessimistic outlook on getting older.

The problem is that when older adults view aging negatively, they accept depression or chronic pain as normal parts of getting old and are less likely to seek care. Seniors with pessimistic attitudes might be less interested in exercising, eating a healthy diet, and other healthy behaviors if they believe their body’s breakdown is inevitable. The social-psychological effect of adopting this attitude can influence your body and senses.

For example, hearing loss is one of the most prevalent conditions among seniors. One study in the Journal of Gerontology3 found that people who embraced ageist stereotypes demonstrated worse screened hearing, whereas positive views of aging correlated with better performance on hearing tests.

Ageism adversely affects the psychological well-being of older adults in a significant way.4 Seniors who accept disrespectful, demeaning ageist attitudes (maybe their health care workers belittle them, let’s say) will predictably have lower self-esteem and likely, anxiety and depression. Positive-minded seniors who appreciate getting older, on the other hand, are less likely to develop anxiety, post-traumatic stress, and suicidal intentions. Developing active ways to cope and viewing aging more positively, therefore, can better your psychological health.5

How Staff and Institutional Ageist Views Affect Your Health

In addition to your own views about aging, the views of people you trust with caring for your health can have a big impact on your outlook. Here are the ways medical practitioners demonstrate ageism and what the adverse effects on seniors might be:

Ageist Communication in the Health Care Setting

It’s easy to find a lack of effective communication between health care workers and older patients. Here are common complaints from older adults about how medical practitioners can be disrespectful and patronizing in their communication:

• They use “elder speak,” which is a kind of sing-song baby talk, or they might speak to you in a high-pitched, exaggerated voice.
• They yell or speak too loudly because they assume all seniors have hearing loss.
• They discuss your condition with your adult child or a third party instead of directly with you.
• They discuss your condition with fellow nurses or medical practitioners while you sit in the same room.
• They may simplify and dumb down their explanations to you about your condition.
• They may withhold information about your condition, assuming you’re cognitively impaired.

Undertreatment of Older Patients

Ageism can result in doctors dismissing treatable concerns, such as joint pain, neuropathy, or arthritis, according to UCLA Health. Ageist physicians might view these conditions as features of old age and might take them more seriously in younger patients.6 National Public Radio says age-based prejudices are more common than you might realize.7

Here are some serious ways that undertreatment can result in negative outcomes for patients:

• Missed diagnoses
• Delayed diagnoses
• Less information for doctors to make medical decisions
• Less information given to patients about treatment side effects

Overtreatment of Older Patients

When medical providers treat patients based on their age and exclude other factors, the results can be harmful. Physicians might order excessive tests and overprescribe medications, thus overtreating older patients. For example, physicians might jump to prescribe antibiotics for urinary tract infections (UTIs), which are common in seniors, without clinical signs or symptoms of infection. Over time, this can result in antibiotic resistance.

Consider that seniors already spend three weeks, or 21 days per year, going to doctor’s visits and other health appointments. Additionally, older adults account for about 40 percent of all hospitalizations.8 Overtreatment can be costly, medically harmful, and create more stress for the patient.

How to Combat Ageist Attitudes Related to Health Care

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, old

American society can start changing skewed perceptions about aging and embrace it for what it is – a normal process of living that doesn't necessarily involve disability, disease, and decline. The first step in changing prejudicial attitudes related to health care is to educate staff through systems and policies about ageism, which is often a subconscious bias.

Patients and health care providers should discuss the health impacts that can stem from biased views about seniors. To change ageist attitudes, it’s also helpful to emphasize the positive benefits of addressing it.

The FrameWorks Institute recommends the following systematic changes to achieve an age-friendly society:

• Offer more opportunities for seniors to be involved in the community through civic and social activities such as volunteer work, mentoring, and continuing education.
• Change our perception of work and retirement. Older adults may work past their retirement age due to economic or personal reasons. To address this, create flexible policies to avoid age discrimination and forced early retirement for older adults still capable of working.
• Bolster the health care workforce trained in geriatrics.
• Find solutions to the growing demand for long-term care.
• Give 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 families.

Society and health care workers need to “reframe” how we look at aging. Age-Friendly Health Systems, an initiative created to curb ageism in the health care industry, is already making progress. It has enlisted 3,700 sites across the country, including clinics, hospitals, and nursing homes. Some heavy hitters on board include Mount Sinai Health System in New York City, UCSF Health in San Francisco, Massachusetts General Hospital in Boston, and the Johns Hopkins Hospital in Baltimore.

Clinicians at these sites are trained to ask about and prioritize what matters most to their older patients. These medical centers have been designated age-friendly, as they address four main aspects of patient care, including what matters, mobility, medication, and mental health.

To learn more about combating ageism, watch the video below with SeniorLiving.org Editor-in-Chief Jeff Hoyt and Attorney Dan Kalish.