Aging is what all of us, who live long enough, will face. But ageism shouldn’t be mandatory.
In ancient times, elders were revered for their wisdom and experience. Today, that respect has been lost in many areas of life.
In a recent large-scale national study conducted by the University of Oklahoma, more than 93% of older Americans between the ages of 50 and 80 frequently experience everyday ageism interactions and experiences. Everyday ageism was described as minor comments, interactions and exposures that suggest that aging is undesirable. It’s also when older adults tend to believe some of these assumptions and prejudices about older adults themselves.
Our approach to the healthcare of our aging population is no exception. With the heightened focus on health equity and disparities in access to care and treatment, older adults are an element of diversity that often get left out of this conversation. It’s striking that despite the exponential growth of our aging population—there are more than 1 billion people globally who are 60 years of age or older, and nearly 75 million in the U.S. alone—we, as a society, often don’t give older generations the support they need. And that applies to how we think about their healthcare.
Several studies have validated the challenge this age bias presents in every aspect of healthcare from diagnosis to treatment to prognosis.
In hematology, which is currently my area of focus, the average age of people diagnosed with multiple myeloma is 70. But often patients aren’t diagnosed quickly or accurately because their symptoms are attributed to the natural aging process. I have the opportunity to meet patients regularly and learn about their journeys and stories. One patient who was in her 60s shared with us that she initially shrugged off her symptoms as back pain from a previous injury. It took multiple visits to the emergency room and to specialists before she eventually was diagnosed with stage 3 multiple myeloma.
Another blood cancer, myelodysplastic syndromes, also often goes undiagnosed as the symptoms, such as fatigue or paleness resulting from anemia, may be misinterpreted as common and expected parts of aging.
When we talk about inclusivity today, we need to be mindful of bias when treating our older adults. These biases are also something older adults tend to believe about themselves, so they may write off certain symptoms as just signs of aging.
I first became aware of ageism through a personal experience with my grandmother, with whom I was extremely close.
When I was younger and living in Spain, my granny had a debilitating rheumatologic condition and was taking medication that helped her pain and mobility. However, when she was 85, the doctor stopped prescribing her medication because it was too expensive for somebody her age. We fought to keep her on the medication as she said it really helped her. Despite our pleas, she was taken off the medication.
Shortly after stopping the medication, she started to lose mobility and was in great pain. Six months later, she was in a wheelchair. She had always been a very strong and stoic woman and although she never said it aloud, she was very sad. I could see it in her eyes. Losing her mobility and independence made her realize she was entering the last stage of her life.
She lived until 100 years of age, and looking back, I know the last 15 years of her life could have been happier and more comfortable if she had stayed on the medicine that helped with her pain and mobility. The difficulty of my grandmother’s last days and her sense of powerless and sadness have stayed with me. Since then, I have been committed to doing what I can to ensure that other individuals are not denied treatment and suffer because of their age.
So, what can we do? Of course, the needs of older patients are broad, but there are several measures we can take to start addressing the problem as an industry.
Diversity of viewpoints. We can start by building diverse teams. As the leader of U.S. hematology at Bristol Myers Squibb, one of my priorities is to build a diverse organization, based not only on ethnicity, race and gender, but also on diversity of experience (including skills, proficiencies, capabilities and life experience). Where are you on the tenure track? What point of view do you bring? With a diverse team that is operating in an inclusive way, we can better understand the patients we serve and engage them in more meaningful ways. In fact, we have five generations in our work force. This concept of multigenerational and diverse teams can also be applied when putting together a patient’s care team. By pulling from the perspectives of different team members, we have a better chance of coming up with the best approach to caring for the patient in a more holistic way.
Listen. The healthcare industry is made of up a complex ecosystem, and we all have a role to play in addressing ageism. Really listening to patients and their caregivers to understand their holistic health, socioeconomic needs and quality of life choices is a must. We need to be careful not dismiss their symptoms. We also need to acknowledge that many older adults do not have family or a traditional support network, and we might need to delve deeper to understand who, if anybody, comprises their support system.
Advocate. Support and develop programs to raise awareness about health disparities so patients can be diagnosed earlier and receive the appropriate treatments that can help them live better, live longer.
I’m hopeful. For one, I’m encouraged by the launch of the United Nations Decade of Healthy Aging, a global collaboration, aligned with the Sustainable Development Goals. This initiative brings together governments, civil society, international agencies, professionals, academia, the media and the private sector to improve the lives of older people, their families and the communities in which they live.
As we have throughout history, we can and should honor our elders by focusing more on promoting healthy aging that enables them to continue contributing to society—doing things that are important to us and to them rather than just responding to their diagnoses. Doing so enriches their lives and ours.
Ester Banque is the senior vice president and general manager of U.S. hematology at Bristol Myers Squibb.