Ageism in Health Care - Essay Example

Ageism in Health care Name Institutional Affiliation Ageism in health care The elderly patients also known as geriatrics present some challenges in the provision of care. The aim of the study is to help create an understanding of the impact of ageism in health care by analysing the effect that ageism has on the delivery of nursing care. The need has been created by a notion that elderly patients do not receive the same type of care as young patients despite having an equal need as the latter. Different theories concerning the geriatrics relevant to health care will be discussed to aid in the research. Also, the behaviour of registered nurses, who are the care providers, will be discussed about health care provision among the aged. 1) Definition of ageism and adapting it to health care of an elderly person. Inequality in health care provision exists in different perspectives. One aspect of inequality is discrimination on the basis of age. As governmental and non-governmental bodies strives towards ensuring equality and equity in health care, various situations where discrimination based on the patient’s age has been considered. Common areas where age influences the quality of care provided include primary care, social care and also mental care (Williams & Wold, 2016). Ageism and age discrimination are used together although they are different in their meaning. The difference between ageism and age discrimination is that ageism is a set of beliefs held among the elderly patients that their age limits their capability of receiving equal care as young patients whereas age discrimination is behaviour that leads to aged patients being treated unequally on age basis (Gullette, 2011). Ageism is thus seen as a contributing factor to age discrimination making it evident the belief of inequality does not only lie within the care providers but also among the elderly patients. Several theories make ageism play a crucial factor in determining the quality of health care offered. Several decisions in the health sector are made based on the age whereby more priority is put on the younger patients as compared to older patients. Health utilitarian ageism, that argues that younger people should be prioritized when it comes to decisions for maximizing the life years since they have a greater life expectancy (Williams & Wold, 2016). Young patients are also more productive, both socially and economically, prioritizing them in productivity ageism. Some studies identify ageism as beliefs based on prejudice whereas age discrimination influences the behaviour of treating older patients in a manner different from that of younger patients, is based on the knowledge that age difference demands varying treatments (Buttaro & Barba, 2012). Age discrimination can take a direct or an indirect form depending on the direction adopted by the care provider. Discrimination on age basis can take a direct approach in those instances where treatment to an elderly patient could have taken an equal manner as that of a younger patient but failed due to the difference in age. Such an act is treated as direct age discrimination when the inequality cannot be justified. On the other hand, indirect age discrimination occurs when a neutral situation that should have been favourable for any patient disadvantages the elderly patient (Robnett & Chop, 2010). Such an instance can be supported by the response of the aged patient, defined in most states as 65 years aged patients and beyond, to a medication expected to treat a particular condition putting them in more danger as compared to younger patients. In short, age discrimination can occur when patients from different ages having equal needs are treated differently, making it direct discrimination, and also when the said patients, with different needs based on the age, are treated equally, disadvantaging the elderly patients taking a more indirect approach. Either of the acts violates the provision that health care should reflect health equality and equity respectively (Boltz, 2012). The lacks of agreed framework provide challenges for measurement of age discrimination in the different levels of care. In England, the Department of Health has adopted a mechanism that can be used to measure the inequality (Tabloski, 2014). The areas targeted in the program include social care, primary and acute care by use of benchmarking tools. Contained in the tools are such details as the number of procedures based on the age of the patients, and the number of the patients that aid in determining the rates of the service provided for the various age groups under consideration. 2) Theories and principles that are relevant to ageism, nursing care and health care environment. Important to consider is the different forms that age discrimination occurs in the various levels of health care environment. Age discrimination can take the form of institutional age discrimination, and it may exist as policy in the different levels such as political level, national, societal or individual level. At the societal or institutional level, discrimination can take the shape of restriction of patients aged 65 and above to some services due to their old age (Gullette, 2011). Health institutions face difficulty in dealing with institutional age discrimination at the individual level as the patients ignore their need for certain medical services by their age. It is challenging to eliminate such type of discrimination as patients have to want to receive care for them to be treated. Also, under institutional age discrimination are decisions relevant to the clinical practice. At a clinical level, some services may be limited to some patients on grounds of their age leading to making essential clinical judgments. After an assessment is carried out by a professional, some limitations may be requested by the care provider by the age of the patient, and arrival at that kind of decisions is what is known as clinical judgment (Tabloski, 2014). In England, the Department of Health, by use of National Health Service Trust, identified the most common areas where age discrimination occurs in the secondary care. The most common areas where such discrimination occurs include mental care and screening programmes such as Gastroenterology, Osteoporosis and Breast and Cervical cancer screening (Vivien et al. 2011). The usual conditions where such discrimination occurs were published in the National Service Framework for Older people in the year 2001 as a pledge by the government to increase medical services for the aged (Pope, 2012). It also resulted in raising awareness among the staff and patients leading to a decline in age discrimination. There are some factors, known as the guiding principle that facilitates nursing care for the older persons. They are used together with the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives dictating the factors necessary for quality care for the elderly patients (In Mauk et al. 2014). These principles are split into four namely the core belief of a person, environment, health, and nursing. The health practitioner providing care to the elderly possess the belief that every patient possesses some worth and value that are different from another’s. They also have a broad range of capabilities as well as requirements that they look forward to their fulfilment and can be physical, spiritual and social (Whitbourne, 2016). Another core belief about the person is that the individual and his/her carer should be used as the unit of care thus can be used to make essential decisions about all the aspects of care involving the elderly patient. The registered nurse should also ensure that the environment, either in long-term care or acute hospital, is flexible supporting the necessary care (Whitbourne, 2016). Essential to achieving best outcomes is teamwork and health practitioners should ensure that type of an environment is supported. An environment that protects the patients from any kind of abuse, physical, social, spiritual and psychological should also be established. Other principles necessary for the care include the belief that health take not only the physical form but also include psychological, spiritual and social well-being (Liu & While, 2013). The patient and the carer are also entitled to defining their desired quality of health. While nursing the elderly patients, the type of care that should be provided should be non-discriminatory on age basis but also taking into concepts the needs and requirements of the elderly. 3) The impact of registered practitioner’s ageist behaviour: On older patients in their care, Safety and quality of the nursing care of an older patient and colleagues from the health care team. Registered nurses provide care to the elderly patients at all level of care including hospitals, nursing homes, at their homes sand in the long-term care facilities. The increased life expectancy has meant an increase in the number of geriatric patients and consequently, growth in care provided to the elderly patients (Liu & While, 2013). The perception of the type of care that old persons should receive in a health care setting influences the behaviour of the registered nurse. Since geriatric patients are the primary users of health care services, nurses play various crucial roles in ensuring the continued survival of such patients. In many countries across the globe including Australia, older patients prefer from the comfort of their homes where they spend more time with their families (Liu & While, 2013). Geriatric patients living at homes, the most preferred by many patients, requires professional assistance from nurses to help them in achieving independence. Such can be attained through empowering the patients, coming up with flexible and suitable responses to their range of needs, and even offering support, mostly through training to their careers (Whitbourne, 2016). Patients may also reside in long-term residential care when they fail to achieve such level of independence essential for living at home. It may be influenced by such conditions as the patients being disabled, regularly illness therefore, demanding close watch by registered nurses or even due to lack of formal carers. In spite of the dependency of care of the elderly patients on nurses in all aspects of care as explained, ageism attitude among nurses is still evident in the modern society. It deprives the geriatric patients of their rights to equal care as the younger patients. An example of stereotypes adopted that eventually reflect in their behaviour include that some treatable conditions they may be suffering from are part of the ‘normal ageing process’ (Liu & While, 2013). It ends up creating a notion that the elderly do not deserve health care and their treatment is seen as a waste of resources that could be used on younger patients. The misconception has also affected the patients compelling them not to communicate the symptoms they may be experiencing. Such beliefs have taken a centre stage in the modern society and are based on misinformation that age limits the health and participation that elderly people can make in the community. The misconceptions have themselves played a huge role in limiting active participation of the aged towards the development of the society (O’Sullivan, 2012). Another common stereotype among the nurses and other health practitioners that influence their behaviours is that old persons are ‘past their sell dates’ (Schermer & Pinxten, 2013). It can in another way be interpreted to mean that they are past their prime. The belief has led to increased cases of abuse, either intentional or as an act of neglect both in nursing homes and acute hospitals. As the geriatrics patients try to regain their independence in health care facilities, several researchers have identified the poor quality of care that instead of promoting independence, by disempowering the aged patients. Although old age is associated with conditions such as neurological deficits, leading to the reduction in the functioning of the sensory system, some nurses confuse it with disability (Schermer & Pinxten, 2013). Other colleagues from the health care team have also adopted the perception, and many patients complain of being treated as goods when in hospitals. An example of an action that dehumanizes the aged includes moving of old patients from one bed to another like parcels, as many patients put it (Nelson, 2011). The routines in the wards also limit the independence of the patients as they do not make decisions regarding the actions they want to take. The handing over process of schedules from one profession to another is in most cases poorly planned thus more discrimination. Patients also express concern where, when visiting a doctor, he addresses the caregiver instead of the provider (Nelson, 2011). Old age does not affect reasoning and also do not necessarily mean mental illness. When asking questions to the patients essential for collecting medical information, the practitioner should give more reaction time to enable the processing of the questions instead of shutting them out of the conversation. 4) Two strategies essential in addressing ageism in health care One strategy is to engage in effective communication with the geriatric patient during the medical encounters. Many of the challenges that affect geriatric care are brought about by miscommunication between the practitioner and the patients. The loss of high and low-frequency audition as the age progresses and the perception of aged persons as incapable of effective communication by the nurses have resulted in the miscommunication (Robnett & Chop, 2010). Practitioners should understand that sensory deficit doess not necessarily lead to functional impairment. Failure by patients to report symptoms due to the thought that the illness is typical for the aged can also be corrected through engaging in effective communication. Another important strategy is the education of geriatric care in both formal and non-formal education. All students taking medical courses should take subjects addressing geriatric care as mostly they end up encountering elderly patients during their practice (Robnett & Chop, 2010). Informal education is also necessary for removing the misconceptions held by the caregivers and the patients thus the stereotypes. Conclusion Ageism as discussed in the paper is seen as a contributing factor to age discrimination. These stereotypes and prejudices that the age of a patient influences the quality of care pose a great danger to the various principles of nursing that relate with treatment of the aged. When the beliefs are held by registered nurses, they end up influencing their behaviour in many ways as outlined in the paper. To deal with the issue, effective communication between the practitioner and the geriatric patient in the healthcare setting should be established. Resources should also be set aside to aid in developing awareness both in formal and non-formal education. References Boltz, M. (2012). Evidence-based geriatric nursing protocols for best practice. New York: Springer Pub. Co. Buttaro, T. M., & Barba, K. A. (2012). Nursing Care of the Hospitalized Older Patient. New York, NY: John Wiley & Sons. Gullette, M. M. (2011). Agewise: Fighting the new ageism in America. Chicago: University of Chicago Press. In Mauk, K. L., In Harvey, A., Parker, K. E., & Amann, C. A. (2014). Gerontological nursing: Competencies for care. Liu, Y. E., Norman, I. J., & While, A. E. (2013). Nurses’ attitudes towards older people: A systematic review. International Journal of Nursing Studies, 50(9), 1271-1282. Nelson, T. D. (2011). Ageism: The strange case of prejudice against the older you. 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Exeter: Learning Matters Ltd. (Williamson & Jenkinson, 2010) Williams, P., & Wold, G. (2016). Basic geriatric nursing. Read More