Age Discrimination In Healthcare-Untreated Depression

Age discrimination in medicine is real and it can affect someone you love. Our society holds physicians in high regard. People tend to trust a doctor for a lot of reasons, one of which is the extent of their education. But they’re human and they certainly make mistakes. We are hopeful that with artificial intelligence, there will be progress over symptoms ignored or overlooked, as multiple sources of information can be immediately available. But meanwhile, we see all too many errors, particularly with aging adults who suffer from depression. Symptoms are frequently not addressed.

Case study: Disabled Elder With Leg Fracture

Wheelchair User, (WU), age 65, had an accident on a bus, in her wheelchair, which was not properly secured by the bus driver. She went flying when there was a sudden stop. She fractured her leg. Normally, a person would be in a cast and then get some physical therapy after it healed. Her M.D. saw that the fracture was repaired. He seemed totally unconcerned that she normally used crutches and could walk in her apartment and a little outside, apart from the wheelchair use. He never bothered to order physical therapy. Apparently, her regaining her limited walking was not of interest to the physician. She got depressed being stuck in her wheelchair. Her crutches were unused. She was outraged, and had to advocate hard to get what she needed. That is particularly difficult when one is depressed. She did not like arguing with her doctor, but she had to do so. This looked like age discrimination.

Case study: Elder With A Psychiatric Emergency

A 90 year old woman, (9W), seriously depressed, threatened her family that she wanted to die. She grabbed a sharp knife. They took it away. She then got ahold of a bottle of pills and tried to open it, saying she was going to end things by taking the whole bottle. They got that away from her too. They rushed her to a large, supposedly “senior friendly” hospital emergency room. In her state, as in most, there is a law that allows healthcare providers to hospitalize a suicidal person for 48-72 hours on a psychiatric hold. This can be done without patient consent. Did the hospital staff respect the urgent need for evaluation and treatment of a depressed 90 year old? No. They told the family members there was nothing wrong with her and to take her home. (They refused). This looked like age discrimination too! If it had been a 30 year old, the outcome would likely have been very different.

Case Study: A Fall In The Dark

Caregiver sister (CS), age 80, who lived in the same building as her older brother, was heading downstairs to attend to him one night. The light on the stairwell was out, and she tripped in the dark and fell. She got banged up and was in pain. She was angry and also depressed. She saw her doctor after the fall, and reported the pain and feeling sad and hopeless. Her M.D. told her “You’re just getting old”. He told her to take Ibuprofen and ignored her depression. Age discrimination once again! Only when she had an advocate to help her get anti-depressant medication and therapy, which Medicare covered, did she obtain necessary treatment.

The Conclusions

We are not a society that broadly demonstrates deep respect for aging people. Stereotypes are common. This pervasive, dismissive attitude creeps into medical practice. All too often, complaints of elders are ignored, particularly when it comes to mental health issues. The “you’re just getting old” message is unfair. Depression is not a normal part of aging that we have to just shrug our shoulders and accept.

The message here is that if you have an aging parent who has issues and presents them to the treating doctor, you need to see to it that available treatment is offered. On their own, the aging loved one might accept whatever the doctor says. Here at AgingParents.com, where we consult with families of elders, we often hear that the aging parent has depression and is not getting any care for it. If the elder is willing to accept help so they can feel better, it may be up to family members to advocate for them to get what their aging parents need. Elders are all too often unwilling to disagree with a doctor. Too much blind faith in physicians is a hallmark of their generation.

Steps To Take: Advocate For Your Loved One

First, it is helpful to have your aging loved one give you permission to speak to the treating M.D. You get that either by being appointed at the agent on your parent’s Advance Health Care Directive, or with a privacy release. The privacy form is called a HIPAA release, governed by Federal law. It’s free on the internet. With either form, signed by your parent, you can speak to your aging parent’s healthcare providers and you can obtain their medical records.

Next, if you have a concern with what looks like an aging parent’s depression, observe details in your aging parent’s behavior. Do they say they feel hopeless and helpless? Do they have chronic pain? Do they withdraw from all the things they used to enjoy? These are just some of the symptoms. All these, in detail, should be reported to the M.D. Doing so in a letter or email creates a record. Ask to speak to the doctor about these things and ask for referral to a mental health provider. Medicare does cover psychotherapy, as well as appropriate medication to relieve the feelings of distress.

Finally, understand as many people do, that depression feels miserable. No doctor should ignore it just because a person is old. Every elder, including your own aging loved ones, deserves relief if such relief is possible. A caring family member or friend needs to speak up, make specific requests to doctors and do all that is possible to get care for your loved one, no matter how old they are. Your own awareness of the age discrimination issue can help. Many physicians do not discriminate based on age, but there are plenty more who unconsciously do.