Age Discrimination within the Health Care System toward the Young and the Elderly Patients - Research Paper Example

Introduction The elderly are the backbone of the society, yet they are poorly treated and are discriminated while seeking health care. Large numbers of elderly Americans receive either second or third class health care services because the professionals in the health care service are not trained to care for them, or simply because the provider does not feel that old person health care is important. Ageism, is a wide spread practice among the Americans- it affect over 50% of the household in American with older people. Ageism and age discriminations The term age discrimination and ageism are interrelated in one way or another. Ageism is an altitude of the mind that may lead to age discrimination. The term is used to refer to the stereotype and the prejudice held about older people. Age discrimination on the other hand, refers to action whose outcome may be assessed, measured, and compared (Whitley 210). It refers to the behavior where either older people are treated unequally- directly or indirectly- based on their age. Ageism is a set of belief that relate to the aging process. It generates a fear and denigration of the ageing process and stereotyping the assumptions regarding competence and the need for protection. Particularly, ageism legitimizes the use of chronological age mark out a category of people who are systematically denied the opportunities and resources that other people enjoy. Ageism is a broader term than age discrimination. It includes deep-rooted negative beliefs about older people and the process of ageing, which in turn brings about age discrimination. Some authors view age discrimination as the sub branch of ageism. Ageism has three main components namely- behavioral component (discrimination); affective component (feelings) and cognitive components (stereotypes and beliefs). Any unjustifiable difference treatment based on the age is age discrimination. Age discrimination may be direct or indirect. Direct age discrimination occurs when a direct difference treatment based on age cannot be justified. Indirect age discrimination on the other hand, occurs when a natural measure or practice has an adverse repercussion on a person. Direct age discrimination takes place where people with comparable needs are treated differently based on their age (Whitley 120). Whereas indirect discrimination take place where people of different age groups are treated in the same manner, the need of an older person not being fully met. Other writer has distinguished ageism from age – differentiated behavior, considering ageism to be based on stereotype and prejudice where as age- differentiated is based on a properly developed understanding of difference in age. Therefore, Ageist behavior is because of the stereotypes, prejudice, and stigmatization. However, the age differentiated behavior is a function of the age of the target person, based on the understanding of the development and thoughtful recognition of difference in age. What element in the society promote ageism Ageism prevails and continues to rise in the society that lacks the following basic requirement: 1) A comprehensive national health insurance and pension system. In this condition employer, confront the high cost that increase as worker grows older by restraining from hiring and retaining old workers. 2) Secondly, in the absence of lifelong continued education that promotes development of new skills that meets the requirement in the job market, in this it become difficult for old workers to acquire the necessary skill (Todd 130). 3) In the absence of proper national health promotion and disease prevention program and adequate investment in behavior research, condition like dementia and frailty result among the elderly resulting in avoidance and uneasiness about old age, reinforcing stereotypes. Ageism is also seen in a society where member of society are constantly stereotyping the elderly, in a society that refuse to accept the reality of aging and constantly use language that replete with negative reference like ‘dirty old man’ or ‘greedy miser’. Measuring ageism and age discriminations Ageism as the altitude of the mind can be measured using the psychometric tests. These kinds of measure find that ageism reduces, as people get older. This measure has also indicated that men are more ageists than women are. Age discrimination is easier to measure and observe. Practically age discrimination cannot be measured directly. This is because ideally there is no level of prescribing and treatment for a person in a specific age group with a particular condition living in a particular place. There are no agreed standards against which to measure the treatment level. Forms and level of discrimination Ageism is grouped into four broad categories: institutional, personal, intentional and unintentional. Ageism or age discrimination that rises from the policies, structure, and system of the health service is said to be institutional. Institution ageism is rule, mission, and practices that tend to discriminate against individual because of their old age. Examples of this include devaluing of older individuals in cost benefit analysis, mandatory retirement among many others. This kind of discrimination may occur in policy at political, national, and or overall sartorial level. Institutional or systematic age discrimination includes the imposition of explicit age limit for the provision of service or access of a particular facility (Whitley 139). This kind of discrimination is easy to control as it involves formulating the right policies. Observing whether such policies are being followed is also fairy easy. Personal ageism: these are individual altitude ideals, and beliefs that are biased against individuals based on their age. Discrimination at individual or clinical level is much more difficult to control. This is because at this level, discrimination is likely to be covert and may be subconscious. In other word, because a clinical judgment is meant to involve the holistic assessment of individual needs, it is therefore very difficult to assess how age is viewed at this level. Those concerned in reduction of age discrimination cannot therefore take refuge in decision-making. At this level, even though age discrimination is there, it is hard to challenge it. Some examples of personal ageism are physical abuse of the old, negative stereotype against old people, ignoring of older people among many others Intentional ageism entails rule, ideals altitude, and practice that are carried out with knowledge that they discriminate the older persons (Sinclair 150). Examples are targeting older person in a financial swindle and denial of job opportunity based upon the age of the individual. Unintentional ageism constitutes rules, ideas, altitude, and practices that are carried out without the ideal that they discriminate a group based on their age. Ageist stereotypes and language A study conducted in 2001 revealed that 80% of Americans are subjected to ageist stereotypes. The stereotypes can be found in media, workplace, education or the health care. The bottom line massage of many of these ageist stereotypes is that older individual are incompetent, lack self reliance and that, they are worthy only at our pity Ageist altitude in health care Concerning altitudes and view of older people, research indicates that the elderly lay much attributes to the health care rationing. A random sample of 1321 person aged sixty years and above interviewed in England in year 2007 indicated that, 51% of the old people believed that health care professional dismiss symptom as just old age while 53% believed that there is no dignity for old people in health care. Altitude of the medical staff: There is evidence of the presence of ageist altitude among the medical staffs in the health care sector. Doctors are more ageists among the medical staffs. Some of the ageist languages applied by the medical community are, GOMER (get out of my emergency room), bed blocker (refers to hospitalized patient with long-term care needs who await transfer to nursing home) A study carried out in 2003 of all staff in Wirral hospital indicated that of all the hospital staffs, doctors did not view the older as having the need to access the health care. Other studies show that 35% of the doctor erroneously considers an increase in blood pressure to be a normal process of ageing (Macnicol 128). There is an ideal that the old age is associated with the high cost. The age and disease association with the health cost is a shift forward in time. Illness and death are common among the elderly. In fact disease and death has been deferred so that eighty percent of death occurs after the age of 60. Areas of discrimination in the treatment Oncology (cancer) is more common later in life. Research has shown that one third of the cancer diagnosis are made to people that have attained the age of 70 years. The percentage of People that are 70 years and above constitute only 7% of the world’s population. A study carried out at region cancer center in year 1999 in England showed that most Oncology medical practitioners have a negative attitude toward older people. A study on old cancer patient showed that fewer diagnostic and staging procedures and less treatment are carried out with advancing age and that cancer specific survival rate decline with age. Screening programs- early diagnostic and referrals from primary care is key to successful cancer treatment. There is evidence that cancer screening do not meet the demand of elderly people. The upper age limit of 69 and 64 for bowel cancer and cervical cancer screening respectively, are observed, despite the fact that most of the deaths are in people above the age of 70 years. These facts are a clear indication that there is a reduction in the investigation and treatment of cancer with the increasing age. Cardiology: There is strong evidence that elderly people attending a hospital with heart diseases are less likely to be investigated and less likely to be treated. A study in year 2003, in a district general hospital in US involving 712 patients with ischaemic heart disease and angina pectoris found that older patient received lower proportional of investigation, and although not discriminated against for the indicated treatment, they received lower treatment because of not having been investigated. There are clear evidence of discrimination in hospital in term of investigation and treatment of heart diseases and investigation of secondary prevention regimes. Other diseases where evidence of age discrimination is overwhelming are: transient ischaemic attack and stroke, diabetes, osteoporosis, osteoarthritis, Parkinson’s disease. Clinical trials A large number of studies has pointed out that one of the primary problem for the prescribing of medication to elderly people is that older people has a changed physiology and often with associated polypharmacy have in the past been excluded from the drugs trials. Commonly, drugs trial excludes those above 70 years. Many medical practitioners do not prescribe the medication to those excluded age groups due to lack of age relevant data. The reasons given for this exclusion are increased cost, desire to keep the test simple, and change of metabolism observed in elderly people and the desire to protect older people from vulnerability of the tests. A continued misrepresentation of the older people from the clinical trial is a clear form of age discrimination. The cost of ageism The impact of ageism to a country is considerable. Older people are also capable of playing a vital role in social economic development. When old people are discriminated, they are denied an opportunity to make a positive contribution toward improvement of the economy. Education and training There is a general agreement that key to eradicating age discrimination among the health sector, is appropriate education and training. As it seem, the root cause of the ageism in the health care sector is the effect of ageist altitudes among the national health sector (Lievesley, 2009). There is therefore, a need for a work based training to include a team of nurses, doctors, health care assistants, therapy technicians, and mangers to act as older people champions and advise others. In addition, the training and education of all medical professionals need to change to reflect what their daily activity will include among other, the care of older people with long-term conditions. Conclusion The direct age discrimination is the most common type in the health sector. It often occurs through the provision of in adequate services because of the ageist altitude of the national health staffs. Evidence of cardiology is so widespread that one can conclude that the ageist altitude among the medical professionals is having an overall effect on investigation and treatment levels. Ageism and age discrimination in the health sector reflect ageism and age discrimination in the entire society. To root out this altitude among the health sector staff, a review of medical school curricula and training courses for medical staff to ensure an in-depth coverage of needs of the older people is necessary. Appropriate awareness of ageism and direct and indirect age discrimination should be created. Works Cited Macnicol, John. Age Discrimination: An Historical and Contemporary Analysis. UK: Cambridge University Press, 2006. Sinclair, Smith. How to avoid unfair discrimination against disabled patients in healthcare resource allocation. Journal of Medical Ethics.38.3 (2012): 158-62. Todd, Nelson. Handbook of Prejudice, Stereotyping, and Discrimination. New York: CRC Press, 2009. Whitley, Bernard. The Psychology of Prejudice and Discrimination. New York, NY: Cengage Learning, 2009. Read More