While the COVID-19 pandemic has brought to light and magnified many of the health disparities that exist in the United States, one topic that has failed to receive the attention it calls for is ageism. Ageism, or age based discrimination, acts in various dimensions, including cognitive, emotional, and behavioral aspects as older adults face stereotypes, prejudice, and discrimination in both implicit and explicit manners. Older adults experience ageism from trained medical professionals, family members, and even from themselves in a phenomenon known as self-ageism [5]. The effects of ageism can be extremely detrimental, and include factors such as fear of not being taken seriously, not being told the details of their health, being told that they are exaggerating symptoms, being told that their treatable illness is due to old age, being told ageist jokes and interacting with biased professionals, or being treated as ill even when aging naturally. This can lead to hesitation to seek care and impaired communication between the older adult and healthcare team [5].
There are endless accounts of older adults facing discriminatory attitudes based on their age. The World Health Organization states that every second person in the world is expected to hold ageist attitudes [6]. In an article written by Judith Graham, several older adults recount situations in which a physician was generally short tempered, less patient, less engaged, less respectful, and less responsive to them. For example, one older patient’s account notes that when she asked questions at the doctor’s office, she was treated like she was “old and stupid,” and her concerns were ignored by condescending physicians failing to communicate the details of her health with her. Others were simultaneously under- and over-treated for their illnesses; one physician told an 84-year old retired professor of pharmacy in severe pain from an anal fissure and a urinary tract infection that “we don’t give out opioids to people who seek them,” while another older adult was overdiagnosed with benign tumors and forced to withstand multiple unnecessary and taxing surgeries [4].
With the expectation of a growing elderly population in the United States expected to surpass the number of children under 18 by 2060 as well as 1 in 4 Americans projected to be 65+ by the same year, ageism in healthcare needs to be acknowledged and addressed to prevent the spread of ageist attitudes, the decrease in quality of care, and the likelihood of older adults to seek this care [5]. A 2015 study found that 20% of adults ages 50 and up experienced discrimination in healthcare settings, consequently leading to inappropriate and inadequate care, a figure that increases with the age of the patient [2]. The impaired communication and distrust that ageism in healthcare creates in turn prevents the formation of a cohesive, interconnected, individualized healthcare team to address the healthcare needs of older adults, and makes older adults less likely to engage in preventative behaviors (e.g. exercise and regular wellness exams). It also makes older adults more likely to be undertreated for their symptoms or overtreated/overmedicated for certain conditions.
The disproportionate impact of the COVID-19 pandemic on the health, survival, and overall well-being of older adults, combined with the prevalence of telehealth during the pandemic as well as the increase of hospital-based rather than preventative care, has only increased ageism in healthcare. Additionally, the circulation of statements including referring to the pandemic as a “Boomer remover” and the denigration of older people for living their daily lives have only magnified this ageism and decreased the likelihood of older adults to seek medical care [3]. There have also been several incidences during COVID-19 hospitalizations in which healthcare providers had to choose whether to give a ventilator to an older adult or a younger person, with people using ageist attitudes to argue that older adults should make a ‘sacrifice,’ and a younger person should always receive improved medical attention due to increased viability, length of life, and a greater perceived likelihood to make a full recovery [1]. Ageist attitudes such as these are not only impacting the mental and physical health of our elderly, but are actively killing them in such severe situations, indicating the gravity of addressing ageism in healthcare and general life.
With regards to the growing elderly population and the need to prioritize older adults’ well-being, interventions need to be put in place to combat this intense ageism. These can range from acknowledging the prevalence of ageist attitudes, laying out specific anti-ageist policies, training nurses and doctors to actively work against ageist tendencies, training professionals to communicate effectively, patiently, and respectfully with older adults, bringing in more geriatric specialists, and creating an individualized, person-centered treatment plan in order to provide effective and valuable care to older adults. This includes preventative care, which can be implemented to increase their physical and mental well-being as well as increase trust between providers and older adults [5]. Overall, ageism in healthcare negatively impacts the health, well-being, and lifespan of older adults, and needs to be acknowledged and treated seriously as it determines the fate of a large percentage of our nation.
References:
American Psychological Association. (2020, May 6). Ageism and COVID-19. Retrieved from https://www.apa.org/topics/covid-19/research-ageism
Ben-Harush, A., Shiovitz-Ezra, S., Doron, I., Alon, S., Leibovitz, A., Golander, H., Haron, Y., & Ayalon, L. (2016). Ageism among physicians, nurses, and social workers: findings from a qualitative study. European Journal of Ageing, 14(1), 39–48. https://doi.org/10.1007/s10433-016-0389-9
Colenda, C. C., Reynolds, C. F., Applegate, W. B., Sloane, P. D., Zimmerman, S., Newman, A. B., Meeks, S., & Ouslander, J. G. (2020). COVID-19 Pandemic and Ageism: A Call for Humanitarian Care. The American Journal of Geriatric Psychiatry, 28(8), 805–807. https://doi.org/10.1016/j.jagp.2020.04.005
Graham, J. ., (2021, October 17). Seniors decry ageism in health care settings. Retreived from https://www.cnn.com/2021/10/17/health/age-discrimination-khn-partner-wellness/index.html
Regis College. (2019, December 24). Understanding Why Ageism in Health Care Is a Serious Concern. Regis College Online. https://online.regiscollege.edu/blog/why-ageism-in-health-care-is-a-growing-concern/
World Health Organization. (2021, March 18). Ageism is a global challenge: UN. . Retrieved from https://www.who.int/news/item/18-03-2021-ageism-is-a-global-challenge-un