When television and film actress Sarah Jessica Parker, who turns 57 in March, dared to display her naturally gray hair in public, she was trolled and made fun of by lots of people in social media. “What am I going to do about it,” Parker quipped in response, “stop aging? Disappear?”
In this youth-focused society, the demand for cosmetic procedures and anti-aging products is strong. The current $194.4 billion global anti-aging market is expected to grow to $422.8 billion by 2030, according to market insights provided by P&S Intelligence. Instead of treating older adults with admiration and respecting their wisdom, we too often discount this population with ageist attitudes and behaviors.The harsh reality is that Americans 50 and older are depicted in ads and commercials as having nothing better to do than deal with hearing, gastric, or mobility issues, and their voices and lived experiences are usually ignored – even and especially at the doctor’s office.
As a licensed clinical social worker in the field of aging with vast experience attending to the non-medical needs of patients of diverse backgrounds, I can tell you this reality is a significant problem for ageing adults.
The quality of health care received, and therefore the quality of life and longevity to be gained, could be significantly improved when the voices of older adults are incorporated into treatment plans. This information is important to keep in mind, given that Americans are living longer. Per the Population Reference Bureau, the average U.S. life expectancy increased from 68 years in 1950 to 78.6 years in 2017, in large part due to the reduction in mortality at older ages. At the same time, older Americans are living with a myriad of chronic health conditions caused by biological factors, and environmental, social, and cultural factors can further complicate their care, according to the National Institute on Aging. Older Americans have greater health needs and in order to provide them the care they need to reduce health disparities, they must be engaged, heard and ready to talk about more than just symptoms. This is what we call in the business, patient-centered care.
Patient-centeredness opens the door for older persons to express what is important to them when seeking care; what are their preferences, needs, beliefs, and goals. Those are important factors that influence their decision-making. For example, while some would be okay with western medicine, others might prefer to resort to other remedies. While some might only work with physicians, others might want to involve folk or spiritual healers. If the price of a medication or treatment seems prohibited, you might want to say that. This requires that older adults feel comfortable and even empowered to freely express what matters most to them. Since the average doctor’s appointment lasts 13-15 minutes and families might want to or need to be involved in treatment plans, older adults might struggle to report something other than what’s ailing them.
Today, patients should arrive at the doctor’s office ready to express the types of treatments they prefer and why. And professional healthcare providers should take notes on older patients and their perspectives, hopes, and dreams. To be sure, this new way of interacting with doctors may be intimidating for some older adults because, across cultures, it is unusual for lay people to question healthcare providers. The problem with taking a passive stance is that the focus will be on what’s the matter and what matters becomes irelevant and completely ignored.
Age-Friendly Health Systems seek to provide the best care possible to older adults through evidence-based practices addressing four key components of care, known as the 4Ms: Medication (making sure that medication lists are reviewed frequently and that these don’t interfere with what matters to the older adult), Mentation (preventing, identifying, treating, and managing depression, dementia, and delirium), Mobility (ensuring the older person moves safely each day to maintain function), and What Matters. The latter is what guides all other components and what puts the older adult at the center of care.
There are tools that have been developed to assist older adults voice their desires, concerns, preferences and goals. From workbooks to prepare for these conversations to mini-clip videos to document what the older person would like to say to their families about their care and future plans, there are tools that can be used.
Older patients need to be reassured that their voice matters and that if they are not heard properly, they should speak up.