TAKING CARE OF YOUR HEALTH... AND OF AGING.

Ageism in healthcare 

In the context of an aging population, the health care system must adapt to ensure access to care and social services, regardless of our age and physical and mental condition. Over the last few decades, substantial financial, material and human resources have been mobilized to enable us to meet the challenges that lie before us. This being said, ageism can unfortunately find its way into elder care.

Is aging a disease?

The quality of care we receive is much more than just a matter of structures and policy decisions. Unfortunately, like any environment that welcomes different generations, the health care environment is not free of ageism. Studies show that ageism occurs in health centres (CLSC, CHSLD) and private clinics as well as in home care services. Ageism is at work, for example, when caregivers use infantilizing and even disrespectful language in their interactions with older adults. This behaviour stems from deep-seated prejudices, and results in older adults being approached as necessarily slow, rigid, irritable, fragile and confused. Moreover, aging is sometimes considered a disease rather than a state of change. Indeed, older adults’ health priorities (autonomy, capability, absence of suffering, etc.) are often quite different from the goals of health professionals (reducing disease and prolonging life).

Different manifestations and different causes

Research shows that age discrimination can occur during a diagnosis when physical or psychological symptoms described by older adults are automatically attributed to old age, whereas they may require intervention, i.e., health care or social services that have nothing to do with age. Ageism is thus responsible for late detection and delays in treatment, which can cause irreparable harm to individuals and their families. The World Health Organization furthermore deplores the exclusion of older adults from many clinical research protocols and the lack of interest in gerontology and geriatrics among students.

Ageist stereotypes, prejudices and discrimination are largely due to a lack of training of health care personnel. The work environment is also believed to be a determining factor, including the unfavourable opinion of colleagues, lack of time for care, shortage of human resources, and unsatisfactory working conditions, among other things, that tend to increase the risks of discrimination. 

In this context, it is important to be aware, both individually and collectively, of ageism in health care. Breaking with ageism can help avoid worsening the psychological distress and isolation of older adults as well as the view of aging as an disease.

The COVID-19 pandemic has not only had a devastating impact on the lives of many older adults who have been victimized by the disease, but furthered stereotypes, prejudices and discriminatory behaviours associated with age and aging. According to the WHO, the health crisis has highlighted the problem of ageism in the very organization of health care and social services in many countries around the world.

References

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Bodner, E., Palgi, Y., Wyman, M. F. (2018). Ageism in Mental Health Assessment and Treatment of Older Adults. In L. Ayalon & C. Tesch-Römer (Ed.), Contemporary Perspectives on Ageism, Cham, Springer, 241-262.

Chester Evans, S. (2018). Ageism and Dementia. In L. Ayalon & C. Tesch-Römer (Ed.), Contemporary Perspectives on Ageism, Cham, Springer, 263-275.

Cohen, A. A., Levasseur, M., Raina, P., Fried, L. P. & Fülöp, T. (2020). Is Aging Biology Ageist? The Journals of Gerontology: Series A, 75(9), 16531655. https://doi.org/10.1093/gerona/glz190

Conseil des aînés du Québec (2010). Avis sur l’âgisme envers les aînés : état de la situation, Conseil des aînés.

Fialová, D. Kummer, I., Držaić, M., Leppee, M. (2018). Ageism in Medication Use in Older Patients. In L. Ayalon & C. Tesch-Römer (Ed.), Contemporary Perspectives on Ageism, Cham, Springer, 213-240.

Kergoat, M. J. (2009). La personne âgée admise à l’hôpital est-elle victime d’âgisme? Vie et vieillissement, 7(2), 41-47.

Lagacé, M. (2015). Représentations et discours sur le vieillissement – La face cachée de l’âgisme? Ste-Foy, Presses de l’Université Laval.

Lagacé, M. (2010). L’âgisme : Comprendre et changer le regard social sur le vieillissement. Ste-Foy, Presses de l’Université Laval.

OMS (2021). Global Report on Ageism.

Plamondon, L. (2009). L’âgisme peut-il être meurtrier? Vie et vieillissement, 7(2), 49-60.

Wyman, M. F., Shiovitz-Ezra, S., Bengel, J. (2018). Ageism in the Health Care System : Providers, Patients, and Systems. In L. Ayalon & C. Tesch-Römer (Ed.), Contemporary Perspectives on Ageism, Springer, 193-212.