Ageism: Aging Is Not A Disease

Five of a nine-part series of articles on ageism.

“Ageism is a deep and often-unconscious prejudice against the old, an attitude that permeates American culture. It is a particularly apparent and especially damaging frame of mind that surfaces all too often in healthcare settings where older patients predominate. Like other patterns of bias – such as racism and sexism – these attitudes diminish us all, but they can be downright deadly to older people in receiving healthcare.” – Daniel Perry, executive director, Alliance for Aging Research.

Age discrimination has become so embedded in our culture, that most people don’t see it for what it truly is. That’s why it is crucial to identify, define and disseminate it. This day and age, discrimination in any form should not be tolerated.

Most ageism is implicit bias – attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. The consciousness of ageism is finally beginning to spread beyond the circle of professionals in the aging sector to the general population. Campaigns such as this one by the Fergus Falls Senior Center are, in part, why.

One significant area where ageism has been identified is in healthcare. In fact, that is where it is said to have sprouted. A great example of ageism in healthcare can be found in this exchange between a doctor and patient:

Joe says to his doctor, “My right knee hurts.”
“How old are you now, Joe?” asks the doctor.
“I’m 81,” he replies.
“Well, what do you expect at your age?”
Joe pauses for a second, then rises in anger.
“The problem with that, doctor, is that my left knee is also 81, and it doesn’t hurt at all!”

Does this sound familiar? I hope not. However, if you’ve ever had an ailment dismissed by a doctor as something caused by your age, you have not only been misdiagnosed – you have been a victim of ageism. Pain has a reason, and it is never simply due to old age. It is due to a disease process that might be more prevalent as we get older, but age – in and of itself – is not a disease.

Dr. Javad Hekmat-panah, a professor of neurology and neurosurgery at the University of Chicago with 40 years of practice and an interest in communication and neuroethics, takes it even further, “My suggestion that we avoid the term elderly in medicine goes beyond the word itself to encompass all that it connotes: stereotypes, unwarranted impressions, and bias. This is essentially a human rights issue. Medicine is the science and art of individualized communication, evaluation, recommendation, and treatment. Each patient has the right to be treated as an individual, according to medical standards based on their specific age, general condition, and comorbidities. To label everyone above a certain age as elderly and to treat them identically defies this principle, which should be at the heart of medicine.”

Older adults, if we’re lucky, see a geriatrician for our healthcare needs. Geriatricians are doctors who are certified in internal or family medicine who specialize in the care and treatment of older adults. Unfortunately, there are far too few of them considering that 10,000 people a day are turning 65. Today there are slightly over 7,500 geriatricians and over 17,000 are going to be needed, according to US News.

Here are some things we should be wary of when visiting a primary care doctor as we get older, according to Dr. Mark Lachs in his book, “Treat Me, Not My Age.” A good doctor should not: talk down to, ignore, be dismissive of complaints or be too quick to refer, test or prescribe when it comes to treating older patients.

A good patient should be able to: articulate the chief complaint, organize thoughts before the visit, prioritize complaints, know what medications they’re on, list all major things that have happened since the last doctor visit (a trip to the ER, surgeries, etc.), understand what the doctor explains and leave with a follow-up plan, if necessary.

According to Dr. Robert Butler’s 2006 report, Ageism in America, “Studies have shown that patients over 65 often do not get proper treatment for cancer, heart disease, and depression. The FDA does not require the representation of older persons in clinical trials.”

Scary, isn’t it, to realize that our lives as we grow older may be seen by some medical professionals to be less valuable than the lives of younger patients?

Hopefully, since the report was written inroads have been made to address ageism in healthcare. It varies, like everything else, with the individual doctor who is providing care. If a doctor was raised as a child to think less of a person based on their age, that doctor is likely to carry that implicit bias into practice, unless a mindful change in perspective is made.

That’s why it’s important to evaluate the way your doctor provides care. If you know how ageism manifests itself in healthcare, you are more apt to identify it, and if it happens, discuss it with your doctor or find a different one who can provide you with the best possible care.

See 2019 Ageism Series Bibliography for sources quoted.

2 Comments

  1. Lynn Fields Harris

    #combatageism . . . Kathy, your points about the manifestations of ageism in healthcare are well taken . . . I hope we are making progress by mentoring and working with students and fellows in the healthcare professions . . .

    • I hope so, too, because the consequences are too high for ageism in healthcare. Good to hear from you, Lynn.

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