{"id":5848,"date":"2019-12-13T07:55:44","date_gmt":"2019-12-13T12:55:44","guid":{"rendered":"http:\/\/www.silvercentury.org\/?p=5848"},"modified":"2019-12-13T14:43:46","modified_gmt":"2019-12-13T19:43:46","slug":"health-care-is-failing-older-people","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2019\/12\/health-care-is-failing-older-people\/","title":{"rendered":"Health Care Is Failing Older People"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Treating patients slowed by Parkinson\u2019s, geriatrician Louise Aronson, MD, sings a chorus of \u201cHappy Birthday\u201d in her head to make sure they have enough time to respond. I\u2019d love a doctor this humane as I head into old age, not to mention this expert. But she lives across the country and I\u2019ll bet there\u2019s quite a waiting list, so I\u2019ll have to settle for her as an ally\u2014and what an important ally she is. &nbsp;&nbsp;<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Elderhood<\/span><\/i><span style=\"font-weight: 400;\">: <\/span><i><span style=\"font-weight: 400;\">Redefining Aging, Transforming Medicine, Reimagining Life<\/span><\/i><span style=\"font-weight: 400;\"> (2019), Aronson\u2019s urgent, eloquent new book, catapults her to the front line of those calling for culture change around aging in general and health care in particular. It\u2019s an expertly argued takedown of a system that:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">makes it far easier for people to see doctors than get the social services that would improve their lives;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">punishes doctors, instead of rewarding them, for tackling the complex needs of older people in a humane, holistic fashion. Many burn out, including Aronson herself, a painful process she chronicles in the book;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">prioritizes the high tech over the human, those in midlife over the young and the old, and curing over caring;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">typically treats the chronic conditions that accumulate over time without taking quality of life into consideration, making more years of debility more likely;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">makes a good death harder to achieve by forcing many people to go on longer than they would like.&nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The list goes on.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Innovations are underway, but most medical schools have yet to question the profession\u2019s entrenched bias and assumptions. Olders are either undertreated (deprived of treatment that would probably help them) or overtreated (with drugs and regimens that don\u2019t take age into account). Both approaches, Aronson bluntly observes, \u201care forms of ageism.\u201d So is the omission of older people from clinical trials, which Aronson calls \u201cridiculous,\u201d likening age limits in osteoporosis studies to \u201cstudying menopause in thirty-year-old women.\u201d So is the lack of interest in why men live less long. Again, the list goes on.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Why don\u2019t clinicians spend more time studying the people and complex conditions that require the most medical attention\u2014and health care dollars? Because, Aronson explains, \u201csocial forces and cultural rationales determine what doctors study and value.\u201d Left behind are not only the nonyoung but the nonmale, nonwhite, and non-\u201cable-bodied,\u201d and, as she comments tartly, \u201cWhen people are defined by what they are not, we are in trouble.\u201d Medical advances have very different consequences in a world of much longer lives, yet most institutions ignore those consequences. The result is vast waste and immense suffering.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">What we need, Aronson argues, isn\u2019t better medical science and technology, but a profound shift in the underlying culture around age and aging.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Biology matters, but it\u2019s only one part of a far more complex equation that includes attitude, behaviors, relationships, and culture. That\u2019s a terrifying thought in a culture where ageism is more common than sexism or racism, and most people of all ages see old age through a window rendered dark and dirty by negative stereotypes. But there\u2019s hope\u2014beliefs have frequently changed through history, and for individuals, they can change at any age. And when beliefs about elderhood change, the culture and experience of old age, in life and in medicine, will change too.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For Aronson\u2019s blueprint for the necessary, innovative, structural changes to our health care system, read her book. (Read it also for the moving portraits and splendid prose; Aronson is also a gifted writer.) For the necessary shift in our attitudes and beliefs about aging, read mine\u2014<\/span><i><span style=\"font-weight: 400;\">This Chair Rocks: A Manifesto Against Ageism<\/span><\/i><span style=\"font-weight: 400;\"> (2019). And look in the mirror.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The culture change that both of us demand requires a grassroots social movement, like the women\u2019s movement, to raise awareness of ageism and make it as unacceptable as any other form of prejudice. That change begins in each of us, as we confront our own internalized age bias, begin to unlearn it\u2014and take that shift out into the world. For starters, if your doctor or your parents\u2019 doctor says, \u201cWhat do you expect at your age?\u201d call him (or her) on it\u2014and find a new doctor.<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Treating patients slowed by Parkinson\u2019s, geriatrician Louise Aronson, MD, sings a chorus of \u201cHappy Birthday\u201d in her head to make sure they have enough time to respond. I\u2019d love a doctor this humane as I head into old age, not<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"http:\/\/78.142.243.82\/~silvercentury\/2019\/12\/health-care-is-failing-older-people\/\">Read more <span class=\"screen-reader-text\">Health Care Is Failing Older People<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":3,"featured_media":5849,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":null,"_FSMCFIC_featured_image_hide":null,"footnotes":""},"categories":[79,1],"tags":[],"class_list":["post-5848","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-voices-views"],"cc_featured_image_caption":{"caption_text":"","source_text":"","source_url":""},"wps_subtitle":"","_links":{"self":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/5848","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/comments?post=5848"}],"version-history":[{"count":3,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/5848\/revisions"}],"predecessor-version":[{"id":5891,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/5848\/revisions\/5891"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media\/5849"}],"wp:attachment":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media?parent=5848"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/categories?post=5848"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/tags?post=5848"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}