Older people are often not treated fairly and do not get the care they deserve, simply because of their age. While one of our great success stories in the 20th century was the stunning gain in human longevity, research from The FrameWorks Institute, funded by The John A. Hartford Foundation and others, has found that the majority of us still don’t recognize ageism or its negative effects.
As more than 10,000 of us turn 65 each day, it is critical that we shine a bright light on ageism and ways to combat it. It is a way to honor the priceless and irreplaceable contributions that older adults make every day to enrich our society and culture. And for those of us at The John A. Hartford Foundation, it is critical to the broader effort to improve care for older people.
The Dangers of Ageism in Our Health System
Research during the last 2 decades has implicated ageism in the under- and over-treatment of older patients, as too many doctors mistake acute medical conditions for normal aging. Others ignore pain, anxiety, and depression as unavoidable as we get older (they're not) or unconsciously view older people as less worthy or less important than their younger counterparts (they're definitely not).
A classic example is the under-detection of elder mistreatment, when, for example, doctors attribute bruises to medication side effects instead of making an effort to ensure there is no family violence. Another is the assumption that all older adults become confused and forgetful when a brain tumor may be the real problem.
These negative and inaccurate views of older people consistently hamper our ability to recruit nurses, doctors, and other health professionals into types of care that focus on older adults. The result: Our health care workforce often lacks the knowledge and experience to treat a group of patients who make up 35 percent of all hospital stays and 27 percent of all doctor's office visits. And though more than 4 in 10 older people take five or more medications, clinical trials generally exclude older patients with multiple chronic conditions, so we may misjudge medications' dangerous effects on this important patient population.
Even our own views of aging can have important influences on health and well-being. Researchers note people with more positive expectations about aging live longer, experience less stress, and have a greater willingness to exercise and eat better. Conversely, negative perceptions of aging, amplified by unhelpful and negative stereotypes in popular culture, can reinforce self-defeating behaviors that make us more vulnerable to disease and disability.
Developing an Age-Friendly Health System
During the last century, our health care system has consistently demonstrated an impressive ability to adapt and to find innovative solutions to challenging problems. Looking ahead, we need an intensive effort to create an age-friendly health system where all older adults and their families feel that the care they receive is the care they want and that they feel respected in the process.
We need health care informed by aging expertise, devoted to person- and family-centered care and able to provide coordinated services in the hospital, clinic, at home, and in the community. This work is neither simple nor easy. Raising awareness about ageism and addressing it throughout the health care system and throughout society is a critical step toward delivering the care everyone wants and deserves as we get older.
For more resources on age-friendly care, visit johnahartford.org/agefriendly.
(A version of this article, by Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation, originally appeared on Next Avenue.)
FrameWorks: "Gauging Aging: Mapping the Gaps Between Expert and Public Understandings of Aging in America," “Aging.”
American Society on Aging: "Not for Doctors Only: Ageism in Healthcare."
World Health Organization: "Ageing and life-course."
Healthcare Cost and Utilization Project: "Overview of Hospital Stays in the United States, 2012."
CDC: "National Ambulatory Medical Care Survey: 2012 State and National Summary Tables," " Prescription Drug Use Continues to Increase: U.S. Prescription Drug Data for 2007–2008."
Contemporary Perspectives on Ageism: “Ageism in the Health Care System: Providers, Patients, and Systems.”
Institute for Healthcare Improvement: "Health Systems Recognized by IHI."
The John A. Hartford Foundation: "Age-Friendly Health Systems initiative."