What to do if you encounter it

WEYMOUTH – At 94, Muriel Savoy Moloney has gotten used to medical caregivers who sometimes assume she can no longer do certain things for herself because of her age.

Her own doctor is definitely not one of them. “My primary care doctor is terrific,” she said. “He listens to you, talks to you like you are a person, explains things and knows my medical history.

“But when I’ve been in the hospital, people will come in and say, ‘Now, who does your medicines at home for you?’ I’ll tell them I do my own medicines. And they say, ‘You do? You’re 94!’

And I’ll say, ‘Yes but my brain is still good.’ I’ll make a joke out of it, to let them know I’m not offended.”

Savoy Moloney remembers that when she was 15, living in Jamaica Plain, her paternal grandmother died at age 70. “People said, ‘She lived a good long life,’ and in that day, the mid-1940s, she did,” Savoy Moloney said. “Today, things are different.” Several of her friends are also in their 90s and late 80s and they often talk about their medical issues.

More:At 80, I ride my bike 80 miles a week in season. I fell. A doctor told me to stop. Not yet

Six examples of how age can affect health care

Savoy Moloney is one of five seniors, each one a member of a different health care network, who were asked if they believe age has affected their health care.

Ageism in medicine has become a concern as more people live longer and face different and more complicated health care choices than previous generations did.

The American Medical Association, AARP, and other elder advocacy groups have worked to raise awareness of the issue. Health care providers may include doctors, nurses, nursing assistants, social workers and lab technicians.

Age may be inappropriately influencing a patient’s care if the medical provider:

• Has low expectations about what an older patient can do just because of their age
• Is less likely to recommend a treatment because of a patient’s age
• Does not offer, or restricts, information about possible medical treatments
• Shows little interest in, or appears bored by, an older patient’s questions or interests
• Decides that screening or further treatments aren’t worthwhile solely because of age
• Assumes that with advanced age, a patient is likely to be cognitively impaired or gives over-simplified answers or explanations

In some cases above, a medical provider’s judgment may be reasonable, but elder advocates say that some discussion should take place.

Nearly 20 percent of older adult patients reported experiencing medical ageism in health care encounters, according to a recent survey by the American Medical Association. Nearly one in five of older adults reported that a health care provider had ignored or dismissed treatable concerns like falls, joint pain and hearing or vision loss.

More:10 awesome stories of seniors showing age is just a number. Biking, running and loving it

Be on the lookout for ‘elderspeak’

“Elderspeak” is a term used by some advocates and medical groups to refer to a certain way of speaking to older people that is in general demeaning and a not-so-subtle put-down. Visiting Angels offers suggestions of how to correct elderspeak on its website, www.visitingangels.com/.

• Speaking to a patient in a condescending way, possibly more slowly than usual, or over-doing the repeating of words and phrases
• Using over-simplified sentences or explanations
• Acting impatiently or showing a lack of respect
• Excluding an older patient from making their own medical decisions by asking close-ended questions that have only a “No” or “Yes” answer or using “we” and “us” instead of “you.”
• Speaking to family members rather than directly to the patient
• Using false affection terms like “sweetie,” “honey,” or “dear”

‘I was very disappointed. The nurse didn’t ask any questions’

Dot Anderson, 95, of Weymouth, takes no medicines and is unusually active for a near-centenarian. She swims, kayaks, goes walking most every day and cross-country skis. Her friends often remark that she is a standout example of healthy aging.

Yet she recently encountered what she sees as ageism of a less obvious kind – an apparent lack of interest.

“I was very disappointed,” Anderson said, when she had her annual Medicare wellness check and the nurse practitioner showed no apparent interest or curiosity in how she was doing. “She didn’t ask me any questions, and I don’t think she even took my blood pressure, maybe because I don’t take any medications.”

Anderson rarely needs to go to the doctor and wondered, “Maybe they expect older people to be on medications and figure you are fine if you aren’t. She told me to go to (the pharmacy) to get my vaccines and that was it. And nothing was said about good eating and exercise.”

She plans to write her concerns on the patient review form that Medicare sends out after annual wellness visits.

At 69, retired scientist feels he was told ‘You’re too old’

At 69, retired scientist Brad Barr, of Hanover, has felt dismissed as an older person, not offered treatments he believes younger people with similar chronic health conditions might receive.

“Based on my own experience, ageism by the medical community is a serious problem,” Barr said.

To counteract the negative attitudes, he has stepped up his fitness routine, swims daily, watches his diet and hopes his generation will help change entrenched attitudes about aging.

“Too often, we ‘of a certain age’ are dismissed or written off as too old to bother offering treatment that doctors would more routinely recommend for younger people,” he said. “As the U.S. population ages, this may change, but only if we advocate for ourselves and not just go along with or overlook this misguided perception.” 

Barr noted that his parents’ generation ‘didn’t make this kind of intentional effort to exercise and to find ways to reduce stress,” Barr said. “To ignore that is simply repeating the mistakes of the previous generation.

“Today’s seniors may then need less care and demonstrate to the medical community that they are taking personal responsibility for their health and well-being.”

5 ways to prevent or change ageism in health care

Some suggestions on what you might do to prevent or counter-act ageist attitudes or actions in your health care:

• Arrive for your appointment with a list of top three or top five issues or questions you have. It’s good to think about them beforehand and be prepared to help guide the conversation to what is most meaningful to you..
• Take a family member, friend or other advocate with you to make sure you hear everything and to help present your case. Cynthia Roche-Cotter a family nurse practitioner in Quincy, advises: “Whenever possible, bring a trusted friend or partner with you to most appointments unless it is a simple follow-up with no real concerns. It is so important to hear everything your provider is saying during the visit and we all miss a few things that our partner will pick up. Also this person may ask questions you haven’t thought of.”
• State at the beginning that you want to and are capable of understanding what the doctor or nurse may recommend you do. Savoy Moloney follow this practice now.
• Have an up-to-date list of your medications. Think about any questions you have about how they work, possible interactions with other medications, whether they are affordable, usual doses.
• If you don’t want to be called by your first name (or terms of endearment) and are, speak up. Voice your preferred form of address.

Roche-Cotter, the family nurse practitioner, also suggested finding a primary care provider with some geriatric training, if possible. There is a shortage of geriatricians but she believes the effort is worth making.

“If you need to find a new provider for primary care, you would be wise to find a geriatrician who should be expert in the care of older patients and willing to listen and care about keeping you healthy and happy after 65 years of age,” she said.

Lois Murphy, who is 93, has spoken with Roche-Cotter, a neighbor and a friend, about such issues. Murphy has one resource not available to most people. When she needed to go to the hospital, one of her granddaughters, who is a nurse, was working there and was able to check daily on her progress.

“I didn’t have the feeling they were pushing me off at all,” Murphy said. “Everyone was very kind, very thorough.”

Mary Fallon, of Weymouth, who is 89 and has chronic medical conditions, has felt very satisfied with her care. Fallon, who worked in the field of hospital medical records for 20 years, feels that she knows her way around the health care system.

When a doctor told her that she was “a boring case,” she understood that the doctor meant that Fallon was managing her conditions well. “I have no complaints,” she said.

Reach Sue Scheible at sscheible@patriotledger.com.

No Byline Policy

Editorial Guidelines

Corrections Policy

Source