Ageism and anti-Ageism
Why doctors don't give proper attention to elderly patients
Elena Almazova, ASI
Participants of the III All-Russian Congress on Geriatrics and Gerontology discussed the main problems of older people.
Ageism – age discrimination – can be observed in any sphere of life. It is especially evident in the doctor–patient relationship, he says Andrey Ilnitsky, First Deputy Director of ANO "Gerontology Research Medical Center", Head of the Department of Therapy, Geriatrics and Anti-Aging Medicine of IPK FMBA of Russia.
"Our doctors do not know how to communicate with elderly people. When such a patient comes to the clinic with complaints, he is often told: "You have the same age, look at your passport. What do you want?" Because of this attitude, the quality of treatment of a patient with pain syndrome is much lower than that of young people, says the expert. – As a result, elderly people often suffer from pain only because they are undertreated. Underestimate the side effects of drugs in older age groups. Also, many people talk to the elderly, as with people with mental disorders or as with young children, but in fact, perhaps a person is just hard of hearing. They are often addressed not by their first name and patronymic, but by "grandmother". And as a result, she is everywhere: in the family, in the store, at the doctor's – grandmother. Because of this, a woman may develop cognitive disorders."
According to the scientist, it has already been proven that aging is associated with a number of disorders: this is a decrease in the number and heterogeneity of the normal intestinal microflora, an increase in the number of pathogenic microorganisms, and the permeability of the intestinal wall. These disorders are accompanied by cognitive deficits, inflammatory reactions develop. The connection between the pathology of the central nervous system and the intestinal microbiota was found.
To control this process, Andrey Ilnitsky suggests eating right.
"It is harmful to eat red meat, we need poultry, more nuts. 500 grams per day of red, yellow, green crispy – vegetables and fruits. This is a fairly simple system for any age," the specialist said, adding that in parallel it is necessary to fight a sedentary lifestyle, obesity, hypertension, diabetes mellitus. There are also other risk factors for the development of senile dementia: middle-aged depression, low level of education, social isolation and lack of active intellectual activity.
Negative stereotypes
Ageism affects people of different ages, but it most adversely affects older people, he believes Olga Startseva, geriatrician, Senior Lecturer at the Department of Social Work, Economics and Bioethics of Yaroslavl Medical University.
"There are the following components of ageism: cognitive (there are prejudices against the elderly and old age), emotional (bias against the elderly), behavioral (discrimination of people by age). Sometimes there are cases when doctors impose expensive medications on the elderly, misdiagnose or, conversely, refuse treatment. In this regard, we decided to study the attitude to old age and aging of junior medical students in Yaroslavl and Minsk, followed by an analysis of gerontological ageism. 158 students took part in the survey."
When asked what age is, 40% answered: this is a period of life, and 36% of respondents believe that this is the final stage of life associated with deterioration of health, progression of diseases, withering of the body. And only 13% answered that old age is a new stage in a person's life. Among the advantages of old age, 42% named retirement, 31% – the appearance of free time, 21% – benefits, discounts, 12% – the opportunity to do what they love, 6% – sleep, rest. Psychological state and senile dementia are the main negative points, which were noted by almost 70% of students.
They were also asked: "Are you afraid of old age?", and half of the respondents (50%) answered positively. Only 34% are not afraid. The remaining 16% found it difficult to answer.
"Working with the elderly is not part of the educational cycle, and little attention is paid to this in universities. We believe that questions on the problems of aging should be introduced into different disciplines from junior courses. This will increase the competence of students in the field of gerontology and geriatrics in senior courses. Now almost no one wants to work in the field of gerontology, everyone wants to be cosmetologists, dermatologists. Working with the elderly is something incomprehensible for them," says Olga Startseva.
Psychology of the proage
Progressive countries have already found a way to overcome ageism. If not so long ago people tried to look younger than their years, now, according to Andrei Ilnitsky, the era of age is coming – for the perception of their age as a new stage in life.
"The anti–ageism movement is being propagandized all over the world," says Andrei Ilnitsky. – His supporters do not specifically dye their hair to emphasize their natural gray hair. But they prove to everyone that old age is not a shame. We still have a lot of age discrimination. Even many doctors do not understand that the syndrome of falls, urinary incontinence, constipation, cognitive disorders are not manifestations of age, but a pathology that needs to be treated. And memory decline is not age, but signs of dementia."
Well, at any age, you need to accept yourself as you are, concluded the geriatrician.
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The III All-Russian Congress on Geriatrics and Gerontology with international participation was held in Moscow on May 16-20. The event brought together leading experts in the field of gerontology and geriatrics from Russia, Belgium, Great Britain, Holland, Israel and other countries, freelance geriatricians of the subjects of the Russian Federation, doctors, representatives of social protection services, non-profit organizations, charitable foundations, the scientific community, social business and the media.
"Today, it is geriatrics that is aimed at a holistic attitude to the elderly, taking into account their needs in a complex. Therefore, support for the development of geriatrics is an important area of the foundation's work. We also support the development of a long–term care system, realizing that long-term support and care of proper quality are possible only at the level of local communities - this allows you to keep a person in his familiar environment. But for this, there should be comprehensive care – both formal and informal – and the development of an interdepartmental, interdisciplinary approach should be continued," she said. Maria Morozova, General Director of the Elena and Gennady Timchenko Charitable Foundation.
According to Olga Tkacheva, president of the Russian Association of Gerontologists and Geriatricians, by 2024, more than 6,000 geriatric beds should open in Russia, 68 corresponding centers in the regions and 2,000 geriatricians should work – this is the first step towards solving the tasks set.
"To implement the project of a long–term care system that requires a clear interaction of medical and social services, we have prepared methodological recommendations for determining the amount of long-term care for a person in need and are starting to implement them together with the Ministry of Labor and Social Protection," the expert stressed.
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