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Ageism in the healthcare sphere is not just demeaning, but can be dangerous, as it is often the cause for both over- and under-treatment of older adults.
Dr. Robert N. Butler coined the term ageism in 1968 and spent his career trying to eradicate it. Unfortunately, despite his many accomplishments, "systematic stereotyping and discrimination against people because they are old" still occurs today (Achenbaum, 2013).
The healthcare community is not immune to the deleterious effects of ageism. It permeates the attitudes of medical providers, the mindset of older patients, and the structure of the healthcare system, having a potentially profound influence on the type and amount of care offered, requested, and received.
Ageism Among Healthcare Providers
Adults ages 65 and older see doctors on average twelve times per year, and nearly 80 percent see a primary clinician at least once per year (Davis et al., 2011). These visits represent critical opportunities for providers to promote physical and psychosocial health, and patients expect counseling that is individualized for their functional status, life expectancy, and care preferences. Providers' knowledge and attitudes about aging can affect how accurately and sensitively they distinguish normal changes associated with aging from acute illness and chronic disease. Ageism can take the form of a provider dismissing treatable pathology as a feature of old age, or treating expected changes of aging as though they were diseases (Kane, Ouslander, and Abrass, 2004).
Ageism among healthcare providers can be explicit or implicit. The geriatrician and writer Dr. Louise Aronson (2015) describes a disturbing example of explicit ageism in which a surgeon asks the medical student observing his case what specialty she is thinking of pursuing. When she answers, "Geriatrics," the surgeon immediately begins mimicking an older adult complaining about constipation in a high-pitched whine. The attending surgeon had a reputation for being an outstanding teacher, yet repeats this parody throughout the surgical procedure. Another example of explicit ageism involves a respected internal medicine resident flippantly telling her team that she is worried because her patient on morning rounds "looked like this." The resident closes her eyes and opens her mouth with her tongue protruding off to one side. She then says, "But then I remembered . . . I'm on the geriatrics service." The...