It’s a well known fact that America is collectively getting older, with one-in-five Americans expected to be above 65 years of age by 2040 according to one estimate. As birth rates continue to drop while older adults live longer, what will the aging of the country mean for Utah’s health care system—and how can we ensure every person receives high-quality care at any age?
On Tuesday of last week, amidst the fourth MEDiversity Week programming, Sharon A. Brangman, MD, delivered the Week’s keynote address, discussing what it means to deliver quality care for patients at any age. An award-winning physician with decades of experience working within geriatrics, she currently is a SUNY distinguished service professor and serves as the inaugural chair of the Department of Geriatrics at SUNY Upstate Medical University. She is also the director of the Upstate Center of Excellence for Alzheimer’s Disease, and the Medical Director of the Transitional Care Unit on the Upstate Community Campus.
Brangman’s presentation, “Ageism: The -Ism We All Share” aimed to illustrate just how large the issue of ageism is (or will be) in medicine within the next few years and why we should care. “[In the near future] every specialty will be working with this population—including pediatrics, because there are an increasing number of grandparents taking care of their grandchildren.” Brangman pointed to how widespread the problem of ageism is now by using a number of pop culture examples, including one well known New Yorker magazine cover from October of this year. It showed political candidates racing while using walkers, suggesting that their age and infirmity meant “they really shouldn’t be in leadership roles.”
“That’s a very offensive cover when you look at it,” Brangman said, “it’s the epitome of ageism, … when you think of a person’s age as the only determinant of their functionality.”
Brangman also discussed the many ways that ageism can manifest in medicine—from the use of derogatory language or thinking, to the dismissive treatment of patient concerns and the use of reflexive prescriptions for older patients. Thankfully, she pointed out, there are some best practices for delivering quality care. The first involves the realization that “aging is not a disease” and the de-stigmatization of growing older. Brangman says that in several cases, healthcare practitioners merely assume that a change in performance, mobility, and/or function are part of the aging process for older patients—and this assumption ignores the experiences of these patients and assumes all aging is the same. As Brangman points out, this sort of neglect only diminishes older adults and reinforces the idea that age is naturally about loss.
The keynote also went on to discuss the ways ageism affects our ability to perform high-quality research with broadly applicable results—and the way limitations in instruction also limit geriatric skill in medical school, ensuring ageism is passed from one generation to the next. In each case, Brangman made sure to present a number of practical steps we could take “to limit the impact of ageism in medicine”—from increasing access to geriatric training and patients in medical school, to implementing requirements for diverse older subjects in research pools.
Timothy W. Farrell, MD, the interim clinical co-chief of the U’s Age-Friendly Care at the Division of Geriatrics emphasized how fortunate the University of Utah was to have the chance to hear from a nationally recognized scholar in the field with such valuable experience. To learn more about Sharon A. Brangman’s practice, readers can visit her page on the Upstate University Hospital website—and to learn more about this year’s MEDiversity programming, visit the MEDiversity Week website.