Older adults spend the majority of health dollars in the US. So you’d think that doctors and other health-care professionals would treat these individuals—their best customers—with lots of care and respect. But that’s often not the case…and the consequences can be catastrophic.
Important new finding: When researchers from Yale School of Public Health and Yale School of Medicine looked at national data to assess the health effects of ageism (which their study defined as prejudice against people age 60 and older), the results were eye-opening.
Over one year, ageism played a role in more than 17 million cases of eight health conditions, including cardiovascular disease, diabetes, chronic respiratory disease and musculoskeletal disorders such as arthritis, according to their research, which was published in The Gerontologist. Ageism is estimated to drive up health-care costs by an astounding $63 billion a year.
The good news is, there’s plenty you can do to protect yourself—or a loved one—from the perils of ageism.
A Dangerous Blind Spot
Most Americans have a blind spot when it comes to ageism. People usually don’t recognize when they’re being ageist…or when ageism is happening to them. What to watch out for—in others and yourself…
• Second-rate treatment. Age discrimination often shows up as inferior medical treatment. Example: When you describe a new health problem, the physician says: “It’s just your age” or “That’s a normal sign of aging”—and doesn’t adequately investigate or treat your problem.
A personal story: Not long ago, my mother—who is 65—was walking around for several months with severe pain in her upper thigh.
The doctor she talked to about the problem didn’t believe she was in as much pain as she said she was. He chalked it up to arthritis and prescribed a course of steroids. Finally, she went to the emergency room—where X-rays showed that she had a broken femur (thighbone)!
• Harmful stereotypes. In the health-care setting, ageist stereotypes—that is, negative beliefs about an older person or older people in general—can be the driving force behind disrespectful treatment from doctors and other medical personnel. Example: A doctor thinks all older people are somehow impaired in mind and body—and talks to you in a patronizing way, speaking in high-pitched, loud tones as if you were a child.
This type of treatment is more than a mere annoyance. In a study published in Psychology and Aging, people age 61 and older who were subjected to patronizing speech performed more poorly on a cognitive test and had higher levels of cortisol, a stress hormone that can trigger high blood pressure, headaches, weight gain and insomnia.
• Negative self-perceptions. Surprisingly, older adults often view old age and the aging process negatively themselves. Example: You think aging—including your own old age—is inevitably associated with forgetfulness, incompetence, decline and disease. And there’s significant harm associated with that mind-set.
What the research shows:In a series of studies, people with self-directed ageism were found to be twice as likely to develop cardiovascular disease…have poorer day-to-day function…be less likely to follow health-promoting practices such as eating a balanced diet, exercising regularly and taking prescribed medications…be less likely to seek care for debilitating back pain…and be at greater risk for depression.
Put a Stop to Ageism
Even though health-care ageism is usually deeply ingrained, there are ways to counter it. Once you recognize that older adults are likely to encounter biases when interacting with health professionals, you’ve taken the first step to overcoming it. Additional steps…
• Be honest about your own attitudes. Are you guilty of self-directed ageism—for example, do you assume, on some level, that disease and decline are just a “normal” part of aging? If you do, you need to know that such assumptions may not be true, particularly with the advances of modern medicine. Even though health problems are more common in older adults, when you have a condition that interferes with a full, active, fulfilling life—get the care you need and deserve.
• Stand up for yourself. Older adults should never be submissive at the doctor’s office or the hospital. Don’t seek conflict—but don’t avoid it either. Give yourself permission to challenge health-care providers who are not meeting your needs. And if a concern you’ve raised is dismissed, say something like: “This one thing is really important to me, so I want to make sure we discuss it.”
• Find the right advocate. Whether you’re going for an annual physical, major surgery or anything in between, get an advocate to go to the appointment with you. This will help ensure that you get top-notch treatment.
Helpful: Be choosy about your advocate. You want someone who is dependable, conscientious, loyal and sharp. Before an appointment, ask this person to help you practice the story you plan to tell the physician about your health problem and the questions you’ll ask. And don’t be shy about telling your doctor any details (even embarrassing ones) that might help you get the best care.
• Don’t wing it. Many people don’t take their doctor appointments seriously enough. You should always ask questions and, of course, write them down in advance. Examples: What are my treatment options, and which one do you think is the most effective? What are the benefits, risks and side effects of the medicine you are prescribing? Are tests necessary? What will they show and how will they affect treatment? What costs can I expect, and does insurance cover them? If there is no one to take notes, you may want to record the conversation during a doctor appointment on your smartphone. If you do, just be sure to ask the doctor first.
• Think ahead. Before you leave any medical appointment, make sure you know the next steps for your care. Ask questions such as: How long should it be before my next visit? Are there symptoms that mean I should return sooner than planned? How will I know whether this medication is working? What is the best way to reach you if needed?
• Make sure you’re seeing the right type of doctor. After age 65, your primary care provider should be a geriatrician—a specialist in aging. This doctor will coordinate your care with other specialists, such as a cardiologist or neurologist. The geriatrician also may oversee your care in a hospital setting if he/she has privileges at the hospital.
Ask for a reference from your primary care physician. Or consult the American Geriatrics Society’s HealthinAging.org website to find a geriatrician in your area.
