Perspectives of a Geriatrician on Aging

By Eunice K. Neubauer, CSA

Elderhood Perspectives of a Geriatrician on Aging Twin Cities MNMaybe you’ve read or heard this anecdote before.   A 97-year-old goes to the doctor because his left knee is bothering him   The Doctor takes a history and does an exam.  There’s no sign of trauma and he says “Hey, the knee is 97 years old, what do you expect?”  But the patient says, “But my right knee is 97 and it doesn’t hurt a bit.”  That’s ageism.  Dismissing an older person’s concerns, simply because they are old.     It happens all the time in the medical field and it hopefully will improve.

Imagine a better way. Older adults would be seen as “different than,” not “less than.” The phases of later life would be mapped and expertise in aging would be valued. With the growth of the elder population, it’s time for this to happen, argues Dr. Louise Aronson, a geriatrician and professor of medicine at the University of California-San Francisco, in her new book, “Elderhood.”

Elderhood is the third major stage of life, lasts for 20-40 years depending on how long we live.   Medicine pretends this stage of life isn’t different from early adult hood or middle age, but it is.  Elderhood, unlike early childhood doesn’t go through set stages; baby, toddler school age etc, rather, its stages are very different for different people.    Some age slowly, others more aggressively and others may go back and forth in how they feel in this stage due to a cancer diagnosis and treatment as an example.    Decline and improvement can both occur in the third stage.

The focus this Dr. Aronson takes with her patients are to focus on 5 Ps.

  • The whole person not the disease.
  • Prevention. It is true that some exercise until you are 100 will benefit your heath.
  • Purpose. What makes you happy and gives you a reason to get up every day.
  • Priorities. What are things they know they want to get done yet.
  • Perspective. How are they adapting to aging and are they flexible in making changes.

What can people do if they feel ageism is a factor from a doctor?  Dr. Aronson advises this approach.   Don’t be defensive or you won’t get anywhere.  You may say something like this in your most gentle and friendliest way possible:

“I picked you for my physician because I know you’re a wonderful doctor. But I have to admit, I’m pretty disappointed by what you just said, because it felt to me that you were discounting me. I’d really like a different approach.”

Doctors are human beings, and we live in a super ageist society. They may have unconscious biases, but they may not be malicious. So, give them some time to think about what you said. If after some time they don’t respond, you should definitely change doctors.

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