“The COVID hits us at a rate of 2 by 4”: urgently addressing the issue of age discrimination

“The COVID hits us at a rate of 2 by 4”: urgently addressing the issue of age discrimination


Earlier this year, the World Health Organization announced a A global campaign against age discrimination — Discrimination against the elderly is widespread and harmful, but it is often not recognized.

The WHO concluded in a report: “We must change the narrative about age and aging” and “take strategies to combat” age-discriminatory attitudes and behaviors. Main report Accompanied by election campaigns.

Several strategies endorsed by the WHO — educating people about age discrimination, promoting intergenerational contacts, and changing policies and laws to promote age fairness — are being tried in the United States. But experts suggest that given the alarming death toll of the coronavirus pandemic, including more than 500,000 elderly Americans, there needs to be a greater sense of urgency.

“The COVID hit us in the head at a rate of 2×4, [showing that] Jess Maurer, executive director of the Maine Commission on Aging, said in a statement that you can’t do the same thing over and over again and expect different results for older people. October webinar on age discrimination in healthcare Sponsored by KHN and John A. Hartford Foundation. “You have to address the root cause-the root cause here is age discrimination.”

Some experts believe that because of what the country has experienced, there is a unique opportunity to deal with this concern. Below are some examples of what is being done, especially in a healthcare environment.

Distinguish old age from disease. In October, a group of experts from the United States, Canada, India, Portugal, Switzerland and the United Kingdom called for the exclusion of old age as one of the causes and symptoms of the disease. The 11th revision of the International Classification of Diseases, A global resource for standardizing global health data.

Experts wrote that aging is a normal process, and equating old age with disease “may be harmful.” LancetThey warned that doing so may lead to inadequate clinical evaluation and care, and increase “social marginalization and discrimination” against older people.

Identify age-discriminatory beliefs and language. Groundbreaking research A study published in 2015 by the FrameWorks Institute, an organization that studies social issues, showed that many people associate aging with deterioration, dependence, and decline-a stereotype that will almost certainly contribute to policies that harm older people during a pandemic. In contrast, experts have learned that the abilities of the elderly vary greatly, and a considerable number of people are healthy, independent and able to contribute to society.

Using this research and subsequent research, Reinvent the aging initiative, In order to promote cultural change, training organizations across the country have been working to change the way people think about and talk about aging. It does not express the fatalism of aging (“a silver tsunami sweeping society”), but emphasizes originality because “if we are determined to do this, we can solve any problem,” project director and vice president Patricia Said Patricia D’Antonio. Policy and professional affairs of the American Academy of Gerontology. In addition, the initiative promotes justice as a value, such as “We should treat the elderly equally.”

Since its inception, the American Medical Association, the American Psychological Association, and the Associated Press have adopted unbiased language on the issue of aging, and communities in Colorado, New Hampshire, Massachusetts, Connecticut, New York, and Texas have signed contracts to become Partner.

Address the issue of age discrimination at the grassroots level. In Colorado, a strategic awareness campaign “Change Narratives” has hosted more than 300 seminars in the past three years to promote the language, beliefs, and practices of age discrimination to the public. Now it has launched a campaign to call attention to age discrimination in healthcare, including a 15-minute video that will premiere in November.

“Our goal is to let people understand the link between age discrimination and poor health outcomes, and to mobilize older people and [health] Professionals advocate for better healthcare,” said Jenny Vanderbilt, director of the change narrative.

Faced with the terrible effects of the pandemic, the Maine Commission on Aging was launched earlier this year The power of aging The project is sponsoring a series of community dialogues around age discrimination and requires organizations to adopt “Anti-age discrimination oath. “

The goal is to educate people about their own “age biases”—mainly unconscious assumptions about aging—and help them understand how “age biases affect everything around them,” Maurer said.For those interested in assessing their own age bias, a test comes from The Harvard University Project Implied Often recommended. (Log in and select “Age IAT” on the next page.)

Changing the education of health professionals. Two years ago, Harvard Medical School began to integrate the education of geriatrics and palliative care in its curriculum, realizing that it was not doing enough to train future doctors to care for the elderly. According to the latest data from the Association of American Medical Colleges, despite the rapid growth of the elderly population, by 2020, only 55% of American medical schools will require geriatric education.

Assistant Medical Professor Dr. Andrea Schwartz directs Harvard’s work, which teaches students everything from places where older people receive care (nursing homes, assisted living, family-based programs, community-based environments) to how to manage common problems. Old age syndromes, such as falls and delirium. In addition, students learn how to talk to elderly patients about what is most important to them and what they want most from their care.

Schwartz also chaired an academic project committee in geriatrics, which recently issued an update Minimum ability in geriatrics Any medical graduate should have it.

Change professional requirements. Dr. Sharon Inouye, a professor of medicine at Harvard, has proposed other ways to promote better care of the elderly. She said that when doctors seek professional board certification or doctors, nurses or pharmacists renew their licenses, they should be required to demonstrate training or ability in “basic knowledge of geriatrics.” And more clinical trials should include a series of representative elderly people in order to establish a better evidence base for their care.

During the pandemic, geriatrician Inouye was particularly shocked when doctors and nurses failed to realize that elderly people with COVID-19 had “atypical” symptoms in hospital emergency rooms, such as loss of appetite and delirium. She said this “atypical” manifestation is common among older people, but these older people are not tested or treated for COVID, but are sent back to nursing homes or community settings, where they help spread the infection.

Introduce professional knowledge of geriatrics. If there is a silver lining to the pandemic, it is that medical professionals and health system leaders have witnessed the ensuing problems and realized that older people need special consideration.

Dr. Rosanne Leipzig, professor of geriatrics at the Icahn School of Medicine at Mount Sinai in New York City, said: “Everything we as geriatricians have been trying to tell our colleagues has suddenly become the focus.”

Now, more Mount Sinai surgeons are asking geriatricians to help them manage elderly surgical patients, and orthopedic experts are discussing the establishment of a similar project. “I think the value of geriatrics has risen because institutions see how we care for complex elderly people and how this care can improve outcomes,” Leipzig said.

Establish a health system that cares for the elderly. “I believe we are at a turning point,” said Terry Fulmer, chairman of the John A. Hartford Foundation, which works with the American Hospital Association, the American Catholic Health Association, and the Institute for the Improvement of Healthcare. (The John A. Hartford Foundation is a funder of KHN.)

More than 2,500 health systems, hospitals, medical clinics, and other healthcare providers have joined this movement, which has identified four priorities for caring for the elderly (“4Ms”): taking care of their mobility, medication, and spirituality Status (cognitive and mental health) and what is most important to them is the basis of people-centered care.

Even in the face of great uncertainty in the past few years, creating a standardized framework to improve elderly care will help healthcare providers and systems know how to proceed. “We believe [the pandemic] It will slow us down, but in most cases, we find that the opposite is true-people can stick to 4M and have a sense of control and accomplishment in such a chaotic period,” Fulmer said.

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

This story first appeared in Caesars Health News.

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