{"id":6919,"date":"2022-04-21T07:32:53","date_gmt":"2022-04-21T11:32:53","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=6919"},"modified":"2022-04-21T07:32:53","modified_gmt":"2022-04-21T11:32:53","slug":"covid-spotlights-the-ageism-in-health-care","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2022\/04\/covid-spotlights-the-ageism-in-health-care\/","title":{"rendered":"COVID Spotlights the Ageism in Health Care"},"content":{"rendered":"

The staggering death toll among older people who have contracted COVID has many more people, worldwide, thinking about what needs to change in medical care and elsewhere. In this article for <\/span><\/i>Kaiser Health News<\/span><\/a>, <\/span>journalist Judith Graham reports on new health care strategies being adopted in the United States<\/span><\/i>. <\/span>Her piece was posted on <\/span><\/i>KHN\u2019s <\/span>website on November 5, 2021<\/span><\/i>.<\/span><\/p>\n

Earlier this year, the World Health Organization announced a <\/span>global campaign to combat ageism<\/span><\/a>\u2014discrimination against older adults that is pervasive and harmful but often unrecognized. <\/span><\/p>\n

\u201cWe must change the narrative around age and ageing\u201d and \u201cadopt strategies to counter\u201d ageist attitudes and behaviors, WHO concluded in a <\/span>major report<\/span> accompanying the campaign.<\/span><\/p>\n

Several strategies WHO endorsed\u2014educating people about ageism, fostering intergenerational contacts, and changing policies and laws to promote age equity\u2014are being tried in the United States. But a greater sense of urgency is needed in light of the coronavirus pandemic\u2019s shocking death toll, including more than 500,000 older Americans, experts suggest.<\/span><\/p>\n

\u201cCOVID hit us over the head with a two-by-four, [showing that] you can\u2019t keep doing the same thing over and over again and expect different results\u201d for seniors, Jess Maurer, executive director of the Maine Council on Aging, said in an October <\/span>webinar on ageism in health care<\/a>,<\/span> sponsored by KHN and the John A. Hartford Foundation. \u201cYou have to address the root cause\u2014and the root cause here is ageism.\u201d<\/span><\/p>\n

Some experts believe there\u2019s a unique opportunity to confront this concern because of what the country has been through. Here are some examples of what\u2019s being done, particularly in health care settings.<\/span><\/p>\n

Distinguishing old age from disease.<\/b> In October, a group of experts from the United States, Canada, India, Portugal, Switzerland and the United Kingdom called for old age to be removed as one of the causes and symptoms of disease in the 11th revision of <\/span>the International Classification of Diseases<\/a>,<\/span> a global resource used to standardize health data worldwide.<\/span><\/p>\n

Aging is a normal process, and equating old age with disease \u201cis potentially detrimental,\u201d the experts wrote in <\/span>the Lancet<\/em><\/a>.<\/span> Doing so could result in inadequate clinical evaluation and care and an increase in \u201csocietal marginalisation and discrimination\u201d against older adults, they warn.<\/span><\/p>\n

Identifying ageist beliefs and language. <\/b>Groundbreaking research<\/span><\/a> <\/b>published in 2015 by the FrameWorks Institute, an organization that studies social issues, showed that many people associate aging with deterioration, dependency and decline\u2014a stereotype that almost surely contributed to policies that harmed older adults during the pandemic. By contrast, experts understand that older adults vary widely in their abilities and that a significant number are healthy, independent and capable of contributing to society.<\/span><\/p>\n

Using this and subsequent research, the <\/span>Reframing Aging Initiative<\/a>,<\/span> an effort to advance cultural change, has been working to shift how people think and talk about aging, training organizations across the country. Instead of expressing fatalism about aging (\u201ca silver tsunami that will swamp society\u201d), it emphasizes ingenuity, as in \u201cwe can solve any problem if we resolve to do so,\u201d said Patricia D\u2019Antonio, project director and vice president of policy and professional affairs at the Gerontological Society of America. Also, the initiative promotes justice as a value, as in \u201cwe should treat older adults as equals.\u201d<\/span><\/p>\n

Since it began, the American Medical Association, the American Psychological Association and the Associated Press have adopted bias-free language around aging, and communities in Colorado, New Hampshire, Massachusetts, Connecticut, New York and Texas have signed on as partners.<\/span><\/p>\n

Tackling ageism at the grassroots level.<\/b> In Colorado, Changing the Narrative, a strategic awareness campaign, has hosted more than 300 workshops educating the public about ageist language, beliefs and practices in the past three years. Now, it\u2019s launching a campaign calling attention to ageism in health care, including a 15-minute video set to debut in November.<\/span><\/p>\n

\u201cOur goal is to teach people about the connections between ageism and poor health outcomes and to mobilize both older people and [health] professionals to advocate for better medical care,\u201d said Janine Vanderburg, director of Changing the Narrative.<\/span><\/p>\n

Faced with the pandemic\u2019s horrific impact, the Maine Council on Aging earlier this year launched the <\/span>Power in Aging Project,<\/span> which is sponsoring a series of community conversations around ageism and asking organizations to take an \u201c<\/span>anti-ageism pledge<\/a>.<\/span>\u201d <\/span><\/p>\n

The goal is to educate people about their own \u201cage bias\u201d\u2014largely unconscious assumptions about aging\u2014and help them understand \u201chow age bias impacts everything around them,\u201d said Maurer. For those interested in assessing their own age bias, a test from <\/span>Harvard University\u2019s Project Implicit<\/span><\/a> is often recommended. (Sign in and choose the \u201cage IAT\u201d on the next page.)<\/span><\/p>\n

Changing education for health professionals.<\/b> Two years ago, Harvard Medical School began integrating education in geriatrics and palliative care throughout its curriculum, recognizing that it hadn\u2019t been doing enough to prepare future physicians to care for seniors. Despite the rapid growth of the older population, only 55 percent of US medical schools required education in geriatrics in 2020, according to the latest data from the Association of American Medical Colleges.<\/span><\/p>\n

Andrea Schwartz, MD, an assistant professor of medicine, directs Harvard\u2019s effort, which teaches students about everything from the sites where older adults receive care (nursing homes, assisted living, home-based programs, community-based settings) to how to manage common geriatric syndromes such as falls and delirium. Also, students learn how to talk with older patients about what\u2019s most important to them and what they most want from their care.<\/span><\/p>\n

Schwartz also chaired a committee of the academic programs in geriatrics that recently published updated <\/span>minimum competencies in geriatrics<\/span><\/a> that any medical school graduate should have.<\/span><\/p>\n

Altering professional requirements.<\/b> Sharon Inouye, MD, also a professor of medicine at Harvard, suggests additional approaches that could push better care for older adults forward. When a physician seeks board certification in a specialty or doctors, nurses or pharmacists renew their licenses, they should be required to demonstrate training or competency in \u201cthe basics of geriatrics,\u201d she said. And far more clinical trials should include a representative range of older adults to build a better evidence base for their care.<\/span><\/p>\n

Inouye, a geriatrician, was particularly horrified during the pandemic when doctors and nurses failed to recognize that seniors with COVID-19 were presenting in hospital emergency rooms with \u201catypical\u201d symptoms such as loss of appetite and delirium. Such \u201catypical\u201d presentations are common in older adults, but instead of receiving COVID tests or treatment, these older adults were sent back to nursing homes or community settings where they helped spread infections, she said.<\/span><\/p>\n

Bringing in geriatrics expertise.<\/b> If there\u2019s a silver lining to the pandemic, it\u2019s that medical professionals and health system leaders observed firsthand the problems that ensued and realized that older adults needed special consideration.<\/span><\/p>\n

\u201cEverything that we as geriatricians have been trying to tell our colleagues suddenly came into sharp focus,\u201d said Rosanne Leipzig, MD, a professor of geriatrics at the Icahn School of Medicine at Mount Sinai in New York City.<\/span><\/p>\n

Now, more Mount Sinai surgeons are asking geriatricians to help them manage older surgical patients, and orthopedic specialists are discussing establishing a similar program. \u201cI think the value of geriatrics has gone up as institutions see how we care for complicated older adults and how that care improves outcomes,\u201d Leipzig said.<\/span><\/p>\n

Building age-friendly health systems.<\/b> \u201cI believe we are at an inflection point,\u201d said Terry Fulmer, president of the John A. Hartford Foundation, which is supporting the development of age-friendly health systems with the American Hospital Association, the Catholic Health Association of the United States and the Institute for Healthcare Improvement. (The John A. Hartford Foundation is a funder of KHN.)<\/span><\/p>\n

More than 2,500 health systems, hospitals, medical clinics and other health care providers have joined this movement, which sets four priorities (\u201cthe 4Ms\u201d) in caring for older adults: attending to their mobility, medications, mentation (cognition and mental health) and what matters most to them\u2014the foundation for person-centered care.<\/span><\/p>\n

Creating a standardized framework for improving care for seniors has helped health care providers and systems know how to proceed, even amid the enormous uncertainty of the past couple of years. \u201cWe thought [the pandemic] would slow us down, but what we found in most cases was the opposite\u2014people could cling to the 4Ms to have a sense of mastery and accomplishment during a time of such chaos,\u201d Fulmer said.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Earlier this year, the World Health Organization announced a <\/span>global campaign to combat ageism<\/span>\u2014discrimination against older adults that is pervasive and harmful but often unrecognized. <\/span><\/p>\n

Read more COVID Spotlights the Ageism in Health Care<\/span> ›<\/span><\/a><\/div>\n

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