A few years ago, she told an emergency doctor that the antibiotic he wanted to prescribe would not counteract the type of urinary tract infection she had.
He wasn’t listening, even when she mentioned her professional references. She asked to see someone else, to no avail. “I was ignored and finally gave up,” said Whitney, who is a lung and urethral cancer survivor and relies on a special catheter to drain urine from her bladder. (An outpatient renal service subsequently changed the prescription.)
Then, earlier this year, Whitney landed in the same emergency room, screaming in pain, with another urinary tract infection and a severe anal fissure. When she asked for Dilaudid, a powerful narcotic that had previously helped her, a young doctor said, âWe do not distribute opioids to people who seek them. Let’s just see what Tylenol does.
Whitney said her pain continued unabated for eight hours.
âI think being an 84-year-old woman alone 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. is like, “Oh, here’s an old man in pain. Well, that happens a lot to the elderly, âshe said.
Whitney’s experiences speak to ageism in healthcare facilities, a long-standing issue that garners attention during the Covid-19 pandemic, which has killed more than half a million Americans aged 65 and over more.
Ageism occurs when people face stereotypes, prejudices or discrimination because of their age. The assumption that all older people are frail and helpless is a common and incorrect stereotype. Stigma can consist of feelings such as âolder people are unpleasant and difficult to deal withâ. Discrimination is evident when the needs of older people are not recognized and respected or when they are treated less favorably than younger people.
In health care settings, ageism can be explicit. One example: medical care rationing plans (âcrisis care standardsâ) which specify treating young adults before older adults. Embedded in these standards, currently implemented by hospitals in Idaho and parts of Alaska and Montana, is a value judgment: Young people’s lives are worth more because they are likely to have more left over. years to live.
Ageism can compromise care
In other cases, ageism is implied. One example is Dr. Julie Silverstein, president of the Atlantic division of Oak Street Health, with doctors presuming that older patients who speak slowly are cognitively compromised and unable to describe their medical problems. If this happens, a doctor may not involve a patient in medical decision-making, which could compromise care, Silverstein said. Oak Street Health operates more than 100 primary care centers for low-income seniors in 18 states.
Emogene Stamper, 91, from the Bronx in New York, was sent to an underfunded nursing home after falling ill with Covid-19 in March. âIt was like a dungeon,â she recalls, âand they didn’t lift a finger to do anything for me,â she said. The assumption that older people are not resilient and cannot recover from illness is implicitly ageist.
Stamper’s son fought for his mother’s admission to an inpatient rehabilitation hospital where she could receive intensive therapy.
âWhen I got there, the doctor said to my son, ‘Oh, your mother is 90 years old,’ as if he was a little surprised, and my son said, ‘You don’t know my mother. You don’t know this 90-year-old man, âStamper said. “It lets you know how disposable they feel to you once you hit a certain age.”
At the end of the summer, when Stamper was hospitalized with an abdominal problem, a nurse and orderly came to her room with papers to sign. âOh, you can write! Stamper said the nurse exclaimed loudly when she put her signature. “They were so shocked I was alert, it was insulting. They don’t respect you,” she added.
Almost 20% of Americans aged 50 and over say they have experienced discrimination in healthcare facilities, according to a 2015 report, and this can lead to inappropriate or inadequate care. A study estimates that the annual health cost of ageism in America, including the over- and under-treatment of common medical conditions, is $ 63 billion.
Nubia Escobar, 75, who emigrated from Colombia almost 50 years ago, wants doctors to spend more time listening to the concerns of older patients. This became an urgent problem two years ago when his longtime cardiologist in New York City retired to Florida and a new doctor struggled to control his high blood pressure.
Alarmed that she might pass out or fall because her blood pressure was so low, Escobar sought a second opinion. This cardiologist “rushed me – he didn’t ask a lot of questions and he didn’t listen. He was sitting there talking and looking at my daughter,” she said.
It was Veronica Escobar, an elderly lawyer, who accompanied her mother to this meeting. She remembers the doctor being abrupt and constantly interrupting her mother. âI didn’t like the way he treated her and I could see the anger on my mother’s face,â she said. Nubia Escobar has since seen a geriatrician who concluded that she was over-medicated.
The geriatrician “was patient. How to put it? She made me feel like she was thinking all the time about what could be best for me,” said Nubia Escobar.
Pat Bailey, 63, receives little of this kind of consideration at the Los Angeles County Nursing Home, Calif., Where she has lived for five years since having a massive stroke and multiple heart attacks. subsequent. âWhen I ask questions, they treat me like I’m old and stupid and they don’t answer,â she said.
Studies show that one in five nursing home residents suffer from persistent pain, and a significant number do not receive adequate treatment. Bailey, whose left side is paralyzed, said she was among them. “When I tell them what hurts, they either ignore it or tell me now is not the time to take pain medication,” she added.
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 speaks to her regularly and makes her feel that she cares about Bailey’s well-being.
“Just because I’m not walking and doing nothing for myself doesn’t mean I’m not alive. I’m dying inside, but I’m still alive,” she said. declared.
Ed Palent, 88, and his wife, Sandy of Denver, 89, also felt disheartened when they saw a new doctor after their longtime doctor retired.
“They went for an annual check-up and all this doctor wanted them to do was ask them how they wanted to die and have them sign all kinds of forms,” ââsaid their daughter Shelli Bischoff, who has discussed his parents’ experiences with their permission.
âThey were very upset and told him, ‘We don’t want to talk about it,’ but he didn’t give up. They wanted a doctor who would help them live, not understand how they were going to die,â Bischoff added. .
The Palents did not return and instead went to another medical office, where a young doctor barely looked at them after performing cursory exams, they said. This doctor failed to identify a dangerous bacterial staph infection on Ed Palent’s arm, which was later diagnosed by a dermatologist. Once again the couple felt neglected and they left.
Now they are with a concierge doctor who has made a sustained effort to get to know them. âIt’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. find, “Bischoff added.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and surveys, KHN is one of the three main operational programs of the KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization that provides information on health issues to the nation.