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 a thorough exploration and diagnosis from the doctor. I have more experience than I could ever wish for in advocating for myself within our health-care system. So naturally, when my eighty-nine-year-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 why that her lungs keep filling up with fluid. In just three weeks, Mom’s lifestyle and personality have seemingly flashed ahead from that of a healthy and vibrant eighty-nine-year-old, to a fearful, pessimistic, and quickly declining ninety-year-old.
Until 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 her had abandoned all of 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? Was it something else?
Imagine being told by your physician assistant 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 eighty-nine years old, there’s no helping you anyways, so why wonder about the source of your pain? Doesn’t “eighty-nine 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health-care providers, but also by how quickly her feisty, stubborn, determined, and always-positive perspective has been replaced by this idea that any health condition at age eighty-nine means one thing: the door is closing fast—too fast to enjoy living.
Diagnosis: old age. And yet “old” is oh so relative. So, it’s not just my eighty-nine-year-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? Most likely, a lot younger than I am.
Becca Levy, PhD, of the Yale University School of Public Health, has spent the last decade researching the impacts of ageism on both the quality and quantity of life in the United States. 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 my mother’s doctor’s frank reluctance to dig deeper into the source of her lung pain. The fact is, at age eighty-nine, my mother couldn’t undergo a surgical lung biopsy. If it’s cancer, she really doesn’t have the same treatment options as a sixty-year-old would. Her options are in fact limited, and the medical objective would in all honesty be to minimize her suffering, and possibly extending her life a bit—but not a cure. That’s the physiological reality, but what about her mental, emotional, and spiritual reality?
Up until three 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 eighty-nine-year-old she was just twenty days ago.
I think the following book excerpt says it all:
“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.)