Your doctor dismisses your health concerns as a normal part of aging. They only speak to the adult child accompanying you, as if you weren’t even in the room. You leave with yet another prescription to treat symptoms, rather than learning the root cause of your complaint.
Sound familiar? Your doctor could be ageist.
Ageism in healthcare is often an overlooked form of discrimination, yet its effects can significantly impact the quality of care older adults receive. This bias is pervasive, and ageist assumptions—often unrecognized—can hinder diagnoses, compromise treatment plans, and undermine the dignity of patients. As the population ages, it is increasingly vital to address this issue head-on, according to Mark Brennan-Ing, director of research and evaluation at the Brookdale Center for Healthy Aging, City University of New York.
“it’s really robbing that older person their autonomy and their sense of agency and contributing to a sense of loss of control as they’re getting older,” he says.
Ageism in health care is a hidden epidemic
Research suggests that health care disparities, including those due to age discrimination, can lead to billions of dollars in additional healthcare costs annually, according to Marilyn Gugliucci, director of geriatrics education and research at the University of New England College of Osteopathic Medicine and president of the Gerontological Society of America. She cites studies conducted by the Yale School of Public Health, that estimated an additional $63 billion a year is spent on health care for eight expensive conditions due to ageism, including diabetes, heart disease, and cancer.
Andrew Steward, an ageism researcher and licensed clinical social worker at the University of Wisconsin, Milwaukee, points out that ageism rears its head in many ways, which may go unnoticed by even the most well-meaning health providers:
- Dismissal of symptoms: Patients often hear, “That’s normal for your age,” leading to the under-treatment of legitimate medical issues.
- Over-treatment: Conversely, some doctors err on the side of excessive caution, making paternalistic assumptions about older adults’ fragility.
- Patient invisibility: Doctors may direct questions and explanations to family members rather than addressing the patient directly.
- Elderspeak: Patronizing language, including terms like “sweetie” or “dear,” diminishes a patient’s agency.
- Time disparity: Research shows that physicians spend less time with older patients and are less likely to refer them to specialists.
These patterns not only affect the patient experience but also lead to measurable disparities in care quality. Numerous studies and reports show that physicians are less likely to order diagnostic tests for older patients, opting instead to prescribe medications without comprehensive reviews.
The roots of ageism
Ageist attitudes often stem from stereotypes ingrained early in life. Research by gerontologist Tracey Gendron and others finds that children as young as three or four begin internalizing negative perceptions of aging through media and cultural narratives. Stories like Hansel and Gretel or Little Red Riding Hood perpetuate portrayals of older adults as cruel, frail, or foolish.
These negative stereotypes can lead to profound health consequences for older adults. Negative perceptions of aging are linked to:
- Shortened lifespans
- Increased dementia risk
- Reduced physical functionality
- Higher rates of PTSD
- Slower recovery from disabilities
Conversely, individuals with positive attitudes toward aging tend to live 7.5 years longer on average and show a nearly 50% reduced risk of dementia. These findings emphasize the urgent need to challenge ageist beliefs, both within the health care system and society at large.
Systemic challenges
Ageism isn’t confined to individual biases; it’s deeply embedded in the structure of health care. The huge shortage of geriatricians is a prime example, according to Gugliucci.
“Geriatrics is among the least financially rewarding medical specialties, leading to a significant shortage of professionals trained to address the complex needs of older patients,” she says. Medical students and residents view older patients as “challenging” due to communication barriers, perceived non-compliance, or complexity. This can deter them from pursuing geriatric care. Currently, there’s about one geriatric specialist for every 10,000 patients over 65—a situation that will only worsen as the population continues to live longer.
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Internalized ageism can reduce life expectancy, increase suicide risk—particularly among men over 85—and worsen depression and cognitive decline, Gugliucci notes. By confronting these biases, she says we can improve health outcomes and quality of life for older adults.
Yet, most health professionals, regardless of specialty, receive little to no training about older patients, or how to become more self-aware about their own possible age bias. “It goes back to just our kind of societal view of aging and our own fears of aging and our own misunderstandings of aging,” Steward says.
While systemic change is essential, individual patients can take steps to advocate for better care. Steward partnered with several community organizations to pilot a 10-session anti-ageism peer support program for adults over 50. It aimed to reduce internalized ageism and enhance self-efficacy, social connectedness, and cognitive function among older adults. “We found that there was a significant reduction in relational ageism, which is defined as concerns about being judged by others based on your age,” he says.
Steward suggests taking these steps the next time you see your doctor:
- Be prepared: Document symptoms, questions, and concerns before appointments. This ensures clarity and focus during discussions.
- Bring an advocate: A trusted friend or family member can provide support and help ensure your voice is heard.
- Speak up: If a provider dismisses your concerns, assert yourself by saying, “I’d like to explore this issue further.”
- Request support services: Social workers and ombudsmen can advocate on your behalf within healthcare systems.
- Educate about ageism: Address patronizing behavior respectfully. For instance, you might say, “That comment feels dismissive. Can we focus on my concerns?”
- Seek a second opinion: Switch providers if you feel undervalued or dismissed.
- Know your rights: Familiarize yourself with patient rights and anti-discrimination laws.
- Cultivate self-efficacy: Grow your confidence in your ability to manage your health can help counteract the effects of ageist assumptions.
