I will never forget the words from the Emergency Room Doctor when my mother-in-law was transported from the assisted living to the local Emergency Room for pain and shortness of breath. He told me that there would be no CPR or attempt for resuscitation. I immediately responded that there was no DNR order in her chart. He told me point blank that she was too old, and he would not resuscitate her. He would enter the DNR. She was 93.
How could this happen? Recently, as more and more of the patient population become part of geriatrics, I have found that we do not have an age-friendly system.
Older patients are often not treated fairly and do not get the care they deserve, simply because of age. On the other hand, I have witnessed physicians ordering imaging tests not related to older patients’ diagnoses, so there is little benefit from the results. Many times, our healthcare workforce often lacks the knowledge or experience to treat a group of patients who are 35% of hospital inpatient stays and 27% of office visits.
Negative stereotypes and unhelpful negative perceptions can cause medication errors, missed diagnosis, and reinforcement of self-defeating behaviors that may lead to disease and disability.
Many older patients list disrespect as a top cause of discrimination in ageism. Patients feel as if they are “invisible”. One patient told me that the doctors treated her “like I’m old and stupid and don’t answer her questions.” Patients feel overlooked and disregarded.
It’s important to identify ageism in our system and give physicians education and training regarding treating this important booming patient population. Ten thousand Baby Boomers per day are retiring and joining the geriatric treatment population. They deserve the attention, respect, and time we can give them.
Healthcare is not the only sphere where ageism exists in society. It can take different forms of expression. One of the most recent examples of ageism in law enforcement happened in Dallas – Ft Worth, where an immigrant health aide murdered more than 20 older adults, mostly women living in upscale independent living communities. These murders occurred from 2016 to 2018 and went undetected due to being reported as death by natural causes. When the tale began to unravel and information led to a series of deaths seeming all the same in the same age ranges, suspicion finally led to an arrest.
The most damning admission of ageism came from the medical examiner, Jeffrey Barnard, MD. He conceded his office rarely orders autopsies for anyone who is over age 65. Instead, thousands of “unattended deaths” (outside the hospital with no doctor present) are handled by phone- even those involving robbery or burglary. Otherwise, he claimed, the workload would be overwhelming.
The general consensus is that old people do not have value. In our ever-changing society age does not equal stupid. The new 50 can now be 70 or older. There is no unique yardstick or group of characteristics to measure age.
In healthcare we should be doing the opposite of ageism. The system should be free of danger. We should care enough about our patients to keep them as healthy as possible for as long as possible. Elderly patients deserve the same amount of care granted to younger patients, and discrimination has no place in our healthcare system.