“I think the fact I was a woman of 84, 1人, was important. When older people come in like that, they don’t get the same level of commitment to do something to rectify the situation. It’s like ‘Oh, here’s an old person with pain. 上手, that happens a lot to older people,'” 彼女は言いました.
Whitney’s experiences speak to ageism in health care settings, a long-standing problem that’s getting new attention during the Covid-19 pandemic, which has killed more than half a million Americans age 65 以上.
Ageism occurs when people face stereotypes, prejudice or discrimination because of their age. The assumption that all older people are frail and helpless is a common, incorrect stereotype. Prejudice can consist of feelings such as “older people are unpleasant and difficult to deal with.” Discrimination is evident when older adults’ needs aren’t recognized and respected or when they’re treated less favorably than younger people.
In health care settings, ageism can be explicit. An example: plans for rationing medical care (“crisis standards of care”) that specify treating younger adults before older adults. Embedded in these standards, now being implemented by hospitals in Idaho and parts of Alaska and Montana, is a value judgment: Young peoples’ lives are worth more because they presumably have more years left to live.
Justice in Aging
, a legal advocacy group
, filed a civil rights complaint with the U.S
. Department of Health and Human Services in September
, charging that Idaho’s crisis standards of care are ageist and asking for an investigation
Ageism can compromise care
In other instances, ageism is implicit. 博士. Julie Silverstein, president of the Atlantic division of Oak Street Health, gives an example of that: doctors assuming older patients who talk slowly are cognitively compromised and unable to relate their medical concerns. If that happens, a physician may fail to involve a patient in medical decision-making, potentially compromising care, Silverstein said. Oak Street Health operates more than 100 primary care centers for low-income seniors in 18 州.
Emogene Stamper, 91, of the Bronx in New York City, was sent to an under-resourced nursing home after becoming ill with Covid-19 in March. “It was like a dungeon,” 彼女は覚えていた, “and they didn’t lift a finger to do a thing for me,” 彼女は言いました. The assumption that older people aren’t resilient and can’t recover from illness is implicitly ageist.
Stamper’s son fought to have his mother admitted to an inpatient rehabilitation hospital where she could receive intensive therapy.
“When I got there, the doctor said to my son, 'ああ, your mother is 90,’ like he was kind of surprised, and my son said, “You don’t know my mother. You don’t know this 90-year-old,” Stamper said. “That lets you know how disposable they feel you are once you become a certain age.”
At the end of the summer, when Stamper was hospitalized for an abdominal problem, a nurse and nursing assistant came to her room with papers for her to sign. “ああ, you can write!” Stamper said the nurse exclaimed loudly when she penned her signature. “They were so shocked that I was alert, it was insulting. They don’t respect you,” 彼女は付け加えた.
ほぼ 20% of Americans ages 50 and older say they have experienced discrimination in health care settings, によると 2015 報告する, and it can result in inappropriate or inadequate care. One study estimates that the annual health cost of ageism in America, including over- and undertreatment of common medical conditions, 合計 $ 63 十億.
Nubia Escobar, 75, who emigrated from Colombia nearly 50 数年前, wishes doctors would spend more time listening to older patients’ 懸念. This became an urgent issue two years ago when her longtime cardiologist in New York City retired to Florida and a new physician had trouble controlling her hypertension.
Alarmed that she might faint or fall because her blood pressure was so low, Escobar sought a second opinion. That cardiologist “rushed me — he didn’t ask many questions and he didn’t listen. He was sitting there talking to and looking at my daughter,” 彼女は言いました.
It was Veronica Escobar, an elder law attorney, who accompanied her mother to that appointment. She remembers the doctor being abrupt and constantly interrupting her mother. “I didn’t like how he treated her, and I could see the anger on my mother’s face,” 彼女は言いました. Nubia Escobar has since seen a geriatrician who concluded she was overmedicated.
The geriatrician “was patient. How can I put it? She gave me the feeling she was thinking all the time what could be better for me,” Nubia Escobar said.
Pat Bailey, 63, gets little of that kind of consideration in the Los Angeles County, カリフォルニア, nursing home where she’s lived for five years since having a massive stroke and several subsequent heart attacks. “When I ask questions, they treat me like I’m old and stupid and they don’t answer,” 彼女は言いました.
One nursing home resident in every five has persistent pain, studies have found, and a significant number don’t get adequate treatment. Bailey, whose left side is paralyzed, said she’s among them. “When I tell them what hurts, they just ignore it or tell me it’s not time for a pain pill,” 彼女は付け加えた.
Most of the time, Bailey feels like “I’m invisible” and like she’s seen as “a slug in a bed, not a real person.” Only one nurse regularly talks to her and makes her feel she cares about Bailey’s well-being.
“Just because I’m not walking and doing anything for myself doesn’t mean I’m not alive. I’m dying inside, but I’m still alive,” 彼女は言いました.
Ed Palent, 88, と彼の妻, 89-year-old Sandy of Denver, similarly felt discouraged when they saw a new doctor after their long-standing physician retired.
“They went for an annual checkup and all this doctor wanted them to do was ask about how they wanted to die and get them to sign all kinds of forms,” said their daughter Shelli Bischoff, who discussed her parents’ experiences with their permission.
“They were very upset and told him, ‘We don’t want to talk about this,’ but he wouldn’t let up. They wanted a doctor who would help them live, not figure out how they’re going to die,” Bischoff added.
The Palents didn’t return and instead joined another medical practice, where a young doctor barely looked at them after conducting cursory examinations, 彼らは言った. That physician failed to identify a dangerous staphylococcus bacterial infection on Ed Palent’s arm, which was later diagnosed by a dermatologist. 再び, the couple felt overlooked, and they left.
Now they’re with a concierge physician’s practice that has made a sustained effort to get to know them. “It’s the opposite of ageism: It’s ‘We care about you and our job is to help you be as healthy as possible for as long as possible. It’s a shame this is so hard to find,” Bischoff added.