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Ageism still rampant in health care

A new study looks at ageism in health care. Does an aging population mean older patients will finally get some respect from their doctors? Don't bet on it.
As Canada's population ages, our doctors are spending more of their time with older patients. And according to a troubling new Canadian study, ageism is alive and well among many of them. The research was just published in the Canadian Medical Association Journal.

The study showed that the treatment patients received was influenced by their age.  Researchers looked at the records of close to 1500 patients with spinal cord injuries who are part of the Rick Hansen Spinal Cord Registry.  Of the total, 167 were age 70 or older.  Compared to younger patients with spinal cord injuries, the older ones were more likely to experience delays in treatment. It took twice as long for older patients to go from injury to being transferred to a spinal cord treatment centre. Older patients were less likely than younger ones to have surgery to stabilize the spine.  They were also much more likely to die during their initial stay in hospital.

The study confirms that ageism is a factor in what doctors do and do not offer patients with spinal cord injuries.  Undoubtedly, there are other factors.  For instance, unlike younger patients, older ones have a host of other medical problems like heart disease and diabetes. Sorting those out takes extra time and likely accounts both for some of the delay and for the higher mortality rate. Another reason is that unlike younger patients - who have obviously severe injuries from diving into pools and having high speed car collisions - older people are much more likely to injure the spinal cord by falling.  As a result, to doctors, their injuries appear less severe and therefore in less need of urgent attention. Ageism? You be the judge.

The study once again demonstrates that falls are one of the leading causes of death and injury among older Canadians.  We have to do everything in our power to recognize who is at risk of falling and develop ways of prevention. To not do that is to practice ageism. By the year 2032, the majority of spinal cord injuries will occur in people age 70 and older.  That means doctors will have to think of falls in older people the same way they think of high-speed car crashes in those who are younger.  They're going to have to rewrite the medical playbook to take older patients into account.

There are many examples of ageism in health care.  Older patients are less likely to be offered angioplasty and heart bypass surgery than younger patients. Some would argue it's because older patients have poorer outcomes and more complications than younger patients.  But some of it is ageism.  Older patients admitted to hospital spend more of their time in bed than younger patients. That puts them at risk of suffering a significant deterioration of their ability to live independently.  Canada has fewer geriatricians than many industrialized nations. Until quite recently, geriatrics was considered an undesirable speciality among Canada's doctors.

We reverse this trend towards ageism not by finding excuses and rationalizations but by acknowledging that ageism exists in health care.  We need to debunk the many myths about seniors and health care; for example, that the age of the patient makes it more difficult to operate on them.  What we need is a huge dose of empathy in health care. People who work in health care need to see the system for all its flaws from the point of view of older patients and address those flaws.  And, medical schools need to recruit would be students who love taking care of seniors.

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