‘Ageism’ in medical care is a term for stereotyping elderly patients that result in (mostly unintentional) preceived discrimination & bias simply because they are old. It’s very deeply ingrained in healthcare and like this 2023 article states – “Ageism is so structurally integrated and normalized in US health care that it is generally unnoticed by clinicians“.
It is true that structural and functional changes occur in us with age, but not everyone ages the same. Many are still ‘young at heart’ with good healthspans despite longer lifespans. Throwing all elderly patients in the same basket & making presumptions about their priorities & wishes devalues them and their healthcare experience. It also tarnishes their opinion and confidence in you. I have been unintentionally guilty myself, but now I watch myself more mindfully. For starters, I am mindful of empathy and always ask respectfully how would they like to be addressed name-wise. The delivery matters. No “honey” or “dear” or other baby-talk with elderly people!
Here are some examples of healthcare workers engaging in ageism:
– Looking & talking to family members instead of your elderly patient
– Assuming cognitive deficits if they are slow and tired to respond
– Talking slow & loud to a person just because they look old
– Telling people their condition is due to their age
– Broaching the topic of palliative care without establishing a proper diagnosis first
So why should avoiding ageism be on your radar? Older people are well aware of their age and how it affects their health, energy & outlook. Magnifying & reflecting it back on them just makes their own outlook and feeling of helplessness worse, worsens negative attitude to self, and can negatively impact health outcomes – as shown in publications like these in 2009, 2020 & 2022. Hopefully, in the future, elderspeak will be another cultural fossil that we look back on and cringe about!
P.S: Ageism goes both ways. Younger & Trainee physicians often experience the “You look young ! Are you a doctor ?” question!
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