Ageism in Healthcare: Stopping Discrimination in Its Tracks

Ageism is the practice of discriminating against individuals based on their age, including both implicit and explicit forms of discrimination. As the baby boomers continue to retire and the elderly population increases exponentially over the next few decades, care providers will likely spend a great deal of their time caring for older adults.

The healthcare industry is not immune to ageism. Tending to the needs of older patients can lead to issues of discrimination in the workplace. Care providers can easily make assumptions about their patients based on their age, reducing the overall quality of care these patients receive.

See how ageism can affect the healthcare industry overall, including your ability to care for your patients and properly diagnose their symptoms.

Caring for the Elderly

Aging slowly wears away at our physical health. Older patients are more likely to visit their doctor or primary care provider than younger patients. Adults ages 65 and older see doctors on average twelve times per year, and nearly 80% see a primary clinician at least once per year.

However, care providers can easily misinterpret the aging process as evidence of chronic conditions and vice versa. Older patients tend to have more aches and pains than younger patients, which can lead to instances of over- and under-treatment.

• Over-treatment

If an older patient comes in with various symptoms and concerns, the provider may be more likely to diagnose the patient with a chronic condition based on their age. Approximately 80% of older adults have at least one chronic disease, and 77% have at least two, but just because a patient is of a certain age doesn’t mean they necessarily have a chronic condition. Providers may be quick to jump to this conclusion if they overlook additional factors, such as the patient’s functional status, comorbid conditions, and individual preferences.

Common examples of over-treatment among the elderly include:

• Universal prostate-specific antigen screenings for prostate cancer, which can result in the over-diagnosis of benign or slow-growing tumors.
• Excessive treatment with surgery that can cause unnecessary harms like urinary incontinence following surgery
• Intensive end-of-life care that disregards patient preferences
• The use of tests and procedures lacking evidence of benefit

Each year, more than 4 million major operations are performed on patients ages 65 and older in the United States, some of which may not be medically necessary or lead to negative consequences such as incontinence or limited mobility.

Under-treatment

Older patients can also be vulnerable to instances of under-treatment. In this situation, a patient may come in complaining of aches, pains, and other symptoms, but the doctor will dismiss their symptoms as a natural part of the aging process. According to a study of community-dwelling older adults ages 60 to 93, 43% of respondents reported that “a doctor or nurse assumed my ailments were caused by my age,” and 9% said they were “denied medical treatment because of age.”

In another recent study of physicians, nurse practitioners, and physician assistants, 64% of participants agreed with the statement, “Having more aches and pains is an accepted part of aging.” In addition, 61% agreed with the statement, “The human body is like a car: when it gets old, it gets worn out.” Furthermore, 52% agreed that one should expect to become more forgetful with age, and 17% agreed that “mental slowness” is “impossible to escape.”

These assumptions can lead to the under-diagnosis and treatment of conditions that do not have an association with age. It can also lead to issues of medication noncompliance.

The Growing Need for Geriatric Care Providers

Caring for elderly patients doesn’t always have the same appeal as caring for younger patients in the healthcare community. For some care providers, saving the life of a young mother of three may be more rewarding than saving the life of a 90-year-old man. These trends have led to a growing shortage of care providers that specialize in caring for the elderly.

Geriatricians are medical doctors who specialize in evaluating and managing the unique health care needs and treatment preferences of individuals aged 65 and older. As the elderly population grows over time, the U.S. is poised for a widespread shortage of geriatricians. According to the U.S. Department of Health and Human Services, demand for geriatricians is projected to exceed supply, resulting in a national shortage of 26,980 full-time equivalents (FTEs) in 2025.

Ageism in the Workplace

Ageism can also affect care providers themselves. Older nurses, assistants, and physicians may feel discriminated against in the workplace. A recent report from AARP shows that around 20% of American workers are over the age of 54, 64% of workers say they have seen or experienced ageism in the workplace, and 58% believe ageism begins when workers reach their 50s.

When ageism is present in the workplace, patients may disregard the findings or recommendations of older care providers. Additionally, younger staff members overlook the contributions of older care providers, putting them at a disadvantage in the workplace.

As we can see, ageism is all too common in the healthcare industry. Older workers should be able to enjoy the same rights and privileges as their younger colleagues, and older patients shouldn’t have to live in pain or over-pay for care because of their age. Providers should get in the habit of diagnosing the whole patient, instead of letting the patient’s age dictate their findings.

No one is immune to ageism. As a care provider, keep an open mind when caring for elderly patients, and listen to and heed their concerns and individual preferences when recommending care.