I’ve never been a passive adult patient. I refuse to accept the medical preconception of my body as a vesicle-in-waiting for disease. I never accept a quick prescription symptom fix in lieu of thorough exploration and diagnosis from the doctor. I have more experience than I ever wished for in advocating for myself within our health care system. So naturally, when my 89-yr-old mother developed debilitating pain in her back, I took it upon myself to be by her side as she pursued diagnosis and care of her health condition. I’m getting an eye-opening and in some ways troubling introduction to health care from the perspective of the elderly.
After a diverse array of scans, x-rays, and pathology tests, doctors still cannot explain my mother’s pain or the fact that her lung keeps filling up with fluid. In just 3 weeks, mom’s lifestyle and personality have seemingly flashed ahead from that of a healthy and vibrant 89-yr-old to a fearful, pessimistic, and quickly declining 90-yr-old.
Quite recently, mom divided her time between photography, crafts, gardening, volunteering in the community, writing and church involvement. Just one week ago, the new version of mom had abandoned all her beloved hobbies and social activities and decided she was ready for assisted living. I was shocked. How could a chest pain that she easily manages with steroids bring about such a drastic change in her attitude? Or was it something else?
Imagine being told by your PA that a diagnosis of the source of your chest pain may not be important given the limitations of treatment for someone your age. In other words, at 89-yrs-old, there’s no helping you anyways, so why wonder about the source of your pain. Doesn’t “89 years old”say it all? Down, down, down you go….
I’m not only shocked and bothered by the attitude of some of my mother’s health care providers, but also how quickly her feisty, stubborn, determined, and always positive perspective has been replaced by this same idea that any health condition at age 89 means one thing. The door is closing - fast, too fast for enjoying living.
Diagnosis - old age. And yet “old” is oh so relative. So it’s not just my 89-yr-old mother who is a potential victim of ageism, a term coined in 1968 by Robert N. Butler, MD, author of the book ‘Why Survive? Being Old in America‘ and founding director of the National Institute on Aging and the first department of geriatrics at Mount Sinai School of Medicine. After all, how old was the last medical student internist you saw? A lot younger than me.
Becca Levy, PhD of the Yale University School of Public Health has spent the last decade researching the impacts of ageism on both quality and quantity of life in the U.S. She has found strong correlations between negative self-perceptions of age and increased risk of elevated blood pressure, hearing decline, poor memory performance, and shorter lives.
After some reflection, I can in some ways understand mom’s doctor’s frank reluctance to dig deeper into the source of her lung pain. The fact is, at age 89, my mother couldn’t undergo a surgical lung biopsy. If it’s cancer, she really doesn’t have the same treatment options as a 60-yr-old. Her options are in fact limited and the medical objective would in all honesty be minimizing her suffering, possibly extending her life a bit, but not a cure. That’s the physiological reality, but what about mom’s mental/emotional/spiritual reality?
Up until 3 weeks ago, I would say my mom lived each day like it was her last. Now she seriously contemplates moving into an assisted living facility and has lost all interest in living life like the healthy, spiritual and social 89-yr-old she was just 20 days ago.
I think the following book excerpt says it all….
“Morris says to his doctor, ‘My right knee hurts.’
‘How old are you now, Morris?’ asks the doctor.
‘I’m 101,’ he replies.
‘Well, what do you expect at your age?’
Morris pauses for a second then rises in anger.
‘The problem with that, Doc, is that my left knee is also 101, and it doesn’t hurt at all!’ ”
(Excerpt from ‘Treat Me - Not My Age’, book written by Mark Lachs, MD, quote from Robert N. Butler, MD, founding director, National Institute of Aging, International Longevity Center.)