In many cultures in the world, elderly people are revered
and their advice is sought and respected. In our culture, the wisdom, the
knowledge and the social skills of the elderly are often overlooked and instead
we focus on the mental and physical deficits of our older generation.
Because of this prevailing attitude, older people are
generally regarded as less valuable than younger people. The younger person has
responsibilities of raising a family, maintaining a career and supporting the
economy. The older person generally has no responsibilities and in addition is
a drag on the economy since a great part of the tax base must go towards the
support of older Americans.
It is inevitable that medical care providers will often have
this same attitude towards their older patients. As a result, if an older
person has a medical complaint and the cause is not readily apparent, a medical
practitioner is more likely to accept the condition as a consequence of old age
and treat the symptoms with medication as opposed to aggressively trying to
identify the problem. In younger people, if the medical complaint is
interfering with normal daily function, typically a more concerted effort will
be made to identify and correct the problem.
Many in the health care profession consider old age to be a
disease itself. Any medical problems are inappropriately attributed to old age
as if it were a medical condition. And since there is no cure for old age,
appropriate tests and treatment are never performed. Thus, medical problems
that may not be related to age and may just as frequently occur in younger
people are often not treated.
Consider the following real-life case as an example of this
attitude.
A 71 year old woman has surgery on her shoulder for a bone
spur that is causing her considerable pain. The surgery is successful and she
goes through several months of physical therapy to help her recover. But she is
not recovering as expected. She continues to experience pain that radiates
through her entire back. Her physical therapist does not know how to help her
and attributes her failure to recover to old age.
She visits her family care doctor at least twice over the
next six months complaining of extreme tiredness and lack of energy. Her skin
color is gray and she does not look healthy. Her doctor tells her that older
people don't recover from surgery as quickly and what should she expect at her
age.
Finally, in frustration, she visits her doctor and insists
he check her for some problem since she is not recovering from the surgery and
she feels awful.
After her insistence, he does a CBC blood lab and discovers
she is severely anemic. He puts her in outpatient care and gives her four units
of red blood cells and puts her on iron supplementation. Within two weeks the
pain has disappeared and within a month she has recovered fully from the
surgery. Numerous tests are done but there is no explanation for the anemia.
Six months later she is healthy and active and her cheeks are ruddy.
When she asks her doctor why he did not suspect anemia, he
tells her that she has never had anemia and based on her history he would never
expect her to develop it. (He has no training in geriatric care.) He then tells
her, in an obvious contradiction of his previous position, that older people
sometimes fail to absorb iron. Ironically, she defends the action of her doctor
and does not feel he acted inappropriately.
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