{"id":31267,"date":"2024-01-26T07:00:49","date_gmt":"2024-01-26T07:00:49","guid":{"rendered":"https:\/\/updates-www.mccdn.io\/vitals\/?p=31267"},"modified":"2024-12-04T00:44:20","modified_gmt":"2024-12-04T00:44:20","slug":"ageism-in-health-care-improving-the-health-and-well-being-of-older-adults","status":"publish","type":"post","link":"https:\/\/updates-www.mccdn.io\/vitals\/ageism-in-health-care-improving-the-health-and-well-being-of-older-adults\/","title":{"rendered":"Ageism in health care: Improving the health and well-being of older adults","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

At MultiCare, we are committed to working toward health equity \u2014 ensuring all people have access to quality health care regardless of age, race, ethnicity, gender identity, religion, sexual orientation, ability, socioeconomic status or location. <\/em><\/p>\n

But we also recognize the reality that longstanding biases and barriers embedded in the health care system, and our society, can prevent people from accessing the care they need. <\/em><\/p>\n

In this series \u2014 inspired in part by society\u2019s growing awareness that not everyone has the same chance to be healthy \u2014 we take a deeper look at the disparities that impact our patients and how we as health care providers and community members can reduce those disparities and improve the health and well-being of all.<\/em><\/p>\n

What is ageism?<\/strong><\/h2>\n

Early in his career, Michael Shannon, MD \u2014 who practiced as an endocrinologist and geriatrician before joining MultiCare Connected Care* as chief medical officer \u2014 took care of a 78-year-old man with end-stage emphysema.<\/p>\n

When the patient ended up in the hospital, he had to decide whether to have a tube inserted into his airway to breathe, an invasive procedure that would slightly prolong his life but not save it.<\/p>\n

\u201cHe had recently gotten remarried to his high school sweetheart,\u201d Dr. Shannon says. \u201cHe told me, \u2018Every day I can be with her is important to me, even if I\u2019m on a breathing tube.\u2019 I found myself having to firmly advocate for this man\u2019s wishes with his hospital care team. I think sometimes ageism can lead us to assume what other people might want or need instead of asking, \u2018What\u2019s most important to you?\u2019\u201d<\/p>\n

Robert Butler, MD, the founding director of the National Institute on Aging<\/u><\/a>, created the term \u201cageism\u201d to describe stereotyping, prejudice, bias or discrimination toward people based on their age.<\/p>\n

In the first of this two-part article, learn about ageism as well as efforts across MultiCare Health System to support the health and well-being of older adults.<\/p>\n

The toll of\u00a0<\/strong>ageism<\/h2>\n

Like racism, sexism and other forms of discrimination, ageism can lead to health disparities, particularly for older adults. A study out of the Yale School of Health<\/a>, with over 7 million participants, found evidence that ageism can shorten life spans, lead to worse outcomes for both mental and physical health conditions, create barriers to accessing care, and lead to inappropriate care.<\/p>\n

Ageism has an economic cost, too \u2014 a study published in The Gerontologist<\/a> found that ageism led to excess health care spending of $63 billion over the course of a single year in the United States.<\/p>\n

Ageism permeates culture at every level \u2014 from our interpersonal interactions to the institutional practices we must navigate to the way we perceive our own self-worth. As activist and author Ashton Applewhite says, \u201cAgeism is prejudice against our own future selves.\u201d<\/p>\n

Age-friendly, all-inclusive care for seniors<\/strong><\/h2>\n

Jessica Van Fleet-Green, MD, and Ramya Kumar, DO<\/a>, sometimes witness the effects of ageism on patients who enroll in Pacific Northwest Program of All-Inclusive Care (PACE) Partners<\/a>.<\/p>\n

PNW PACE Partners, part of MultiCare, extends multidisciplinary, all-inclusive, highly coordinated care to adults 55 and older. Participants meet Washington state\u2019s requirement for long-term care services yet wish to remain at home (or in another community setting) and can do so safely (other criteria apply as well).<\/p>\n

\u201cThere is often an assumption with this population that they\u2019re going to be medically complex,\u201d Dr. Kumar says. \u201cProviders in traditional health care settings can assume they don\u2019t have the time to properly care for them \u2014 and patients pick up on that,\u201d Dr. Kumar says. \u201cWe often have to do a lot of rapport building with a patient at first to show them that we are invested in them as a person.\u201d<\/p>\n

PNW PACE Partners follows the Institute for Healthcare Improvement\u2019s age-friendly health care model<\/a>, which focuses on four key areas: mobility, mentation (cognitive and emotional functioning), medication, and a patient\u2019s own goals and preferences for care.<\/p>\n

\u201cWe frequently see well-intended but misguided care of elders,\u201d Dr. Van Fleet-Green says. \u201cThere can be a tendency to overtreat and under-listen, which can lead to the involvement of multiple specialists, numerous labs and studies, and long lists of medications. It\u2019s evident when you meet many of these patients that what they want is for the health care team to understand what matters to them and take time to hear their story.\u201d<\/p>\n

One of the team\u2019s focus areas is the reduction of inappropriate polypharmacy \u2014 when a person is taking multiple medications. Common among older adults who may have chronic conditions, polypharmacy can increase the risk of adverse drug interactions, cause cognitive impairment and lead to falls, according to the National Institute on Aging<\/a>.<\/p>\n

\u201cMany patients don\u2019t even know why they are on particular medications \u2014 and sometimes the reason is not even clear to us,\u201d Dr. Kumar says. \u201cWhen we carefully manage the number and types of medications patients are taking, they tend to have a much better quality of life.\u201d<\/p>\n

Following an initial assessment of each patient\u2019s personal and medical needs, the PACE team \u2014 which includes nurses, nurse practitioners, social workers, therapists and physicians \u2014 develops a customized care plan and coordinates service delivery out of the PNW PACE Partners Center in Tacoma (or in some cases a patient\u2019s home). Services include nursing, primary and specialty care, transportation, appointment scheduling, social work, prescriptions and more.<\/p>\n

Drs. Van Fleet-Green and Kumar also see education as an important part of their work \u2014residents from MultiCare Tacoma Family Medicine<\/a> and MultiCare East Pierce Family Medicine<\/a> gain valuable experience in delivering age-friendly care at PNW PACE Partners.<\/p>\n

\u201cWe are very intentional about having residents at PACE,\u201d Dr. Van Fleet-Green says. \u201cWe want the next generation to learn what age-friendly care is and how to provide it in any type of medical setting.\u201d<\/p>\n

2023 CEO & President\u2019s Award winners <\/strong><\/p>\n

PNW PACE Partners and the Veteran Advocacy Program at Yakima Memorial are both winners of 2023 CEO & President\u2019s Awards. This annual award series honors excellence and achievement at MultiCare.<\/p><\/blockquote>\n

Equitable access to care for veterans<\/strong><\/h2>\n

Delivering age-friendly care isn\u2019t just about what happens during a medical encounter \u2014 it\u2019s also about ensuring equitable access to services and benefits. Yakima County is home to about 11,000 veterans of the U.S. Armed Forces, and more than 50 percent of those veterans are 65 and older.<\/p>\n

In 2019, Matthew McCay helped establish the Veteran Advocacy Program at MultiCare Yakima Memorial<\/a>. A key part of the program is educating veterans about their medical and disability benefits through the Department of Veterans Affairs (VA) and helping them overcome barriers to using those benefits.<\/p>\n

\u201cSometimes veterans don\u2019t know that they\u2019re eligible for benefits through the VA,\u201d says McCay, manager of the program. \u201cSome veterans, particularly those who are older, may not use the internet or email, or they may struggle with the sheer complexity and bureaucracy of the systems they must navigate to get what they need.\u201d<\/p>\n

Each day, McCay rounds on veterans admitted to Yakima Memorial, identifying specific needs they have and talking with them about their benefits. He may guide them through filling out and submitting medical paperwork or help them call the VA to clear up an issue.<\/p>\n

\u201cSometimes older veterans will ask me to listen to phone calls or voicemail messages from people pretending to be the VA and asking for money,\u201d McCay says. \u201cScammers target this population and it can be hard for patients to tell what\u2019s legitimate and what\u2019s not.\u201d<\/p>\n

Another important aim of the Veteran Advocacy Program is improving outcomes for veterans, specifically reducing average length of stay in the hospital and the rate of rehospitalizations, which both tend to be higher for veterans than nonveteran populations, according to McCay.<\/p>\n

One way they do that is by maintaining the visibility of veterans \u2014 identifying them at patient registration and noting their veteran status in electronic medical records and displays at nurses stations.<\/p>\n

\u201cKnowing a person is a veteran informs the way care is delivered,\u201d McCay says. \u201cDr. Stephen Hunt, a well-known VA clinician and researcher, has found that veterans as a people group have trends in health care. For example, they may be more likely to have certain diseases and injuries or experience exposure to certain chemicals.\u201d<\/p>\n

Many veterans also see both a VA provider and a civilian provider, making it important to reconcile medication lists to avoid potentially dangerous duplications.<\/p>\n

McCay, a veteran himself, also arranges trainings for clinicians and support staff about caring for veterans and keeps team members up to date about veteran-related legislation or changes in VA protocols.<\/p>\n

\u201cI\u2019m proud of the work I do,\u201d McCay says. \u201cYet I think there is still more to be done when it comes to removing unnecessarily complex barriers to care for older patients \u2014 veterans and nonveterans.\u201d<\/p>\n

In the next of this two-part series, we\u2019ll dig deeper into the effects of ageism and highlight additional efforts across MultiCare to support healthy aging and equitable access to services.<\/p>\n

*MultiCare Connected Care<\/strong> is MultiCare\u2019s accountable care organization (ACO)<\/a>. An ACO is a clinically integrated network of hospitals, doctors, advanced practice providers and specialists who assume responsibility for a designated population of patients and work together to keep them healthy.<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"

At MultiCare, we are committed to working toward health equity \u2014 ensuring all people have access to quality health care regardless of age, race, ethnicity, gender identity, religion, sexual orientation, ability, socioeconomic status or location. But we also recognize the reality that longstanding biases and barriers embedded in the health care system, and our society, […]<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"author":367,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[15,155],"tags":[],"class_list":["post-31267","post","type-post","status-publish","format-standard","hentry","category-community","category-health-equity"],"acf":[],"yoast_head":"\nTackling ageism in health care - MultiCare Vitals<\/title>\n<meta name=\"description\" content=\"Ageism, or discrimination based on a person\u2019s age, is particularly harmful for older adults, leading to shortened life spans, adverse health outcomes and inappropriate care.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/updates-www.mccdn.io\/vitals\/ageism-in-health-care-improving-the-health-and-well-being-of-older-adults\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tackling ageism in health care - 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