Ageless Wisdom: Reviving the Respect and Care Deserved by Our Elders

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COMMENTARY

Our elderly population, often neglected or avoided as a societal group as their bodies and minds begin to fail, deserve to be treated with the same standard of care and concern as younger generations. As medical technologies continue to advance and as healthy living habits continue to influence our lifestyles, the aging derivative is sure to continue to trend upwards. The 2020 United States Census found that the 65+ population not only had its largest ever 10-year numeric gain (15.5 million) and its fastest ever growth rate (38.6%), but also that 17% of the population was now age 65 or older—a drastic change from the 5% measured 100 years ago.¹

This trend, while encouraging, will ultimately result in adding a level of burden to family caregivers while also surely inducing increases in levels of age discrimination. It becomes increasingly important, as our parents and grandparents age, to remember to provide them with a commensurate level of care and offer them the appreciation and respect they have earned.

I first noticed my uncle’s dementia at my father’s retirement party. It was the first time I had seen him since the start of the pandemic, and I noticed a sudden inability to translate thoughts into words. My aunt often kindly intervened on his behalf in order to save him embarrassment, but it was incredibly disconcerting to me how my once affable and welcoming uncle had become so abruptly remote.

I expressed my concerns to my father about his older brother, and he promptly brushed off my apprehensions as nothing to worry about. My cousin, my uncle’s son, reacted similarly, attributing his father’s cognitive difficulties to the inevitable effects of growing old. With sincere apologies and all due respect to both my father and my cousin, I simply do not accept this. Cognitive impairment should never be considered an inconvenient by-product of aging, and my uncle deserves the same level of attention that would be afforded a person much younger.

Ageism is a subtle but very destructive form of discrimination. The assumption that all older individuals are frail and helpless, and therefore unable to advocate for themselves, is a common, but very damaging stereotype. From a health care perspective, we as physicians need to recognize and respect the rights of all our patients equally and cannot fall prey to the false narrative that young individuals’ lives are worth more because they have more years left to live. This is unfair, inappropriate and, in fact, discriminatory.

The results of many ageism related studies have been published in Contemporary Perspectives on Ageism, and have concluded that “There is ample research evidence demonstrating that age-based discrimination is common and long-standing among health care providers, within health care systems, and in health care policies.”² As examples, the studies referenced the fact that despite the rates of breast cancer being considerably higher in older women, “…only 7% of the physicians participating conducted breast examinations on older female patients on a routine basis.” In addition, these studies found evidence of “…age-related under-treatment of heart attacks relative to national treatment guidelines, with older patients less likely to receive standard diagnostic procedures and recommended treatments.”

While health care is certainly one of the most significant areas in which older adults routinely face ageism, it is hardly the only one. It seems that our elderly individuals are increasingly being pushed to the margins of society, with little or no regard for their contributions. Many of these are from our “Greatest Generation,” individuals who have lived accomplished lives full of service to family, community, and country, but are now open and vulnerable to abuse, neglect, and exploitation not singularly from family members, but also in the workplace, malls, and coffee shops.³

A 2022 study published by the National Institutes of Health (NIH) found that everyday ageism (defined as “…routine types of age-based discrimination, prejudice, and stereotyping that older adults encounter in their day-to-day lives”) was present in a staggering 93.4% of the 2035 United States adults surveyed.⁴

As a member of the medical community, I find this data alarming. As a human being, I find this data appalling, because we are learning that it is not just in clinics, hospitals, and nursing homes where our seniors are receiving such inadequate and unacceptable care. It is across the spectrum of their everyday life.

Of course, the first step in solving a problem is admitting you have one, and clearly we do. The good news is that as individuals we have the capacity to help move the needle towards a more rewarding aging process for our elderly population. Every chance you get, celebrate the achievements and contributions of older individuals and speak up when you hear ageist jokes or comments, while encouraging others to do the same. Advocate for and support policies and legislation that protect the rights of older adults and prohibit age discrimination in employment and housing. Promote and participate in intergenerational programs and initiatives that bring different age groups together to break down stereotypes and foster mutual understanding and respect.

Most importantly, encourage seniors to have regular check-ups and preventive care visits.Routine health screenings and vaccinations can help detect and prevent illnesses before they become more serious and before more serious medical interventions are required. I certainly recognize the fact that there are instances (for all patients) where treatment options may be limited. But the care recommended and ultimately provided by health care professionals should never be based on the age of the patient. To do so is bringing a great disservice to our vocation.

Dr Simone is a psychiatrist in private practice in Los Angeles, California.

References

1. Caplan Z. U.S. older population grew from 2010 to 2020 at fastest rate since 1880 to 1890. Census. May 25, 2023. Accessed October 25, 2023. https://www.census.gov/library/stories/2023/05/2020-census-united-states-older-population-grew.html

2. Wyman MF, Shiovitz-Ezra S, Bengel J. Ageism in the health care system: providers, patients, and systems. In: Ayalon L, Tesch-Römer C, eds. Contemporary Perspectives on Ageism. Springer; 2018.

3. Brokaw T. The Greatest Generation. Random House; 1998.

4. Allen JO, Solway E, Kirch M, et al. Experiences of everyday ageism and the health of older US adults. JAMA Netw Open. 2022;5(6):e2217240.