The preliminary report of this task force appears to lean toward screening of those over 65 as is done for adults with regard to depression. It should be noted that Medicare pays $25 for simple depression screening questionnaires completed in a medical office. The practice begs the question: why no payment for anxiety screenings?

Consider, for a moment, how major healthcare organizations have addressed the question of anxiety disorders in over-65-year-old patients.

Mild anxiety symptoms, according to the Centers for Disease Control and Prevention, steadily increase with age, from about 12% in adults 18 to 29 to 7% in adults 65 and over. The problem is that little research has addressed the incidence of serious anxiety disorders in the older-old population, even among the statistical data supplied by the World Health Organization there’s a gap. How many people in the US are living well beyond the age of 65 these days?

Over 54 million Americans, or roughly 16.5% of the total population, were 65 years of age or older, according to the U.S. Census Bureau. The population aged 65 and above increased by more than a third (34.2% or 13,787,044) over the past ten years and by 3.2% (1,688,924) between 2018 and 2019. Over 56 million Americans — or 16.9% of the country’s total population — were 65 or older in 2020.

The apparent lack of information on this age group is also noted in the National Institute of Mental Health reports, where there is statistical data lacking for those over 65. The lack of data on this age group is, again, noted in the Anxiety and Depression Association of America reports, which primarily show levels of anxiety and depression below the age of 65.

Information on anxiety disorders in general or on specific disorders can be found in other sources. For instance, according to Hopkins Medicine, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, and phobias affect roughly 18% of adults between the ages of 18 and 54 in a given year. Where’s the data on the over-65s? It’s missing.

According to the Anxiety and Depression Association of America (ADAA), social anxiety disorder affects 15 million adults, or 7.1% of the country’s population, whereas panic disorder affects 6 million adults or 2.7%. According to the Centers for Disease Control and Prevention (CDC), Americans aged 45 to 54 had the highest suicide rates in the United States in 2020.

Again, there is no data on the 65 and older individuals who may have committed suicide because of severe anxiety, loneliness, depression, and lack of medical care. Nevertheless, the ADAA statistics do not reveal how many of those people are above 65.

One concern raised by mental health organizations is that people over the age of 65 are less likely to report or seek treatment for depression or anxiety because they prefer to deal with these conditions on their own. This can be because of the stigma still associated with mental health services and treatment. But there is no scientific evidence for this idea; it’s just what most people think.

Although anxiety, in all of its manifestations, can be a serious threat to both mental and physical health, the healthcare sector currently does not. Not only is it unethical, but it could also be dangerous to say that common lifestyle changes cause those worries about the elderly.

Take into account the fact that as one ages, work options diminish. Being a medical consultant for the Social Security Administration, I was aware of the unwritten rule that if you are above 50, you are unemployable. How can someone who doesn’t have enough ways to make money, isn’t working, and is getting worse physically keep from getting nervous or having panic attacks? Anxiety is the outcome of their lack of control over any of this.

Shouldn’t healthcare professionals take a more proactive approach to finding and treating anxiety in their older patients? Indeed, 15-minute sessions don’t provide much time for a thorough examination of something about which the patient hasn’t complained. Should it remain that way forever?

Do we let down our elderly patients? For everything they’ve done for us, shouldn’t they be treated better?

The post People Over 65 Can’t Be Anxious, Right? Wrong. appeared first on Medika Life.

And this deadly disrespect isn’t confined to any one country. The World Health Organization has found it is a global problem where age is not revered but dismissed. Their 2021 report: calls out ageism for what it is: a socially-acceptable form of discrimination that impacts older people’s livelihoods, health, and even survival.

How long are we supposed to abide by these restrictions, a.k.a. biases, in medicine? The time has come to stop it and demand respect and appropriate care rather than resigning older patients to sit in a rocking chair and wait for the Grim Reaper to arrive to collect them.

I recall doing a Google search and seeing a reference to a 2013 statement by a country official who said the elderly should hurry up and die. I suppose that would solve what problem? What about the loss of experience and intellectual capacity, or was consumer product sales the only consideration? A shameful statement at best.

A 2020 report by the United National General Assembly noted that in their report, the independent experts stress(es) the lack of comprehensive and integrated international legal instrument for the promotion and protection of the rights and dignity of older persons has significant practical implications given that a) existing regulations do not cohere, let alone conceptualize regulatory principles to guide public action and the policies of government; b) general human rights standards do not consider the recognition of rights in favor of older persons; c) it is difficult to clarify the obligations of states with respect to older persons; d) procedures for monitoring human rights treaties generally ignore older persons; and e) current instruments do not make the issues of aging visible enough, which preclude the education of the population and with it, the effective integration of older persons.

If the world’s populations are not sufficiently educated regarding the rights and dignity of older persons, doesn’t it follow that it has worked its way into the practice of medicine? Undoubtedly, anyone older than 65 or 70 has faced that ignorance, bias, or whatever you want to call it when receiving medical care. It is not-so-hidden dismissive behavior.

Publications have indicated a disturbing occurrence related to elderly patients who leave hospitals sicker than when they were admitted. Research shows that about one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived.

One paper outlined reasons for improper or poor care of elderly patients (they failed to mention bias), which read: Poor management of the complex problems of the frail elderly can be summarized as follows:(1)inappropriate (2) incomplete medical diagnosis, (3) poor coordination of community support services, (4) overprescription of medications, and (5) underutilization of rehabilitation. The question of beliefs in medicine was addressed in another publication. Succinctly, it stated that positive beliefs=better outcomes.

I don’t care how many “training sessions” on experiencing the difficulties of the elderly are run in schools. Putting on padding, gloves, or special glasses is a momentary thing that doesn’t necessarily carry over to overt beliefs and behaviors with the elderly. It’s a lark for the attendees, not a change of view.

I’ve heard physicians remark how “old patients have a certain smell, don’t they?” Smell? Well, I suppose they can’t afford your cologne, after-shave, or taking their clothes weekly to the dry cleaners, doc.

A word to the elderly patients: Learn to dress for success, even if you can’t afford it and have to skimp on meals or medicine. Better-dressed patients are perceived as more worthy of care. Yes, I am being facetious, but it’s a fact.

I recall standing in a major New York City hospital hallway while a quite elderly man in a hospital gown was seated on a gurney waiting for a procedure. He was entirely alone in the room and without glasses.

A quite young staffer approached, pushed a clipboard and pen in his direction, and asked him to sign a release to participate in a research protocol. The man was confused and wanted to know what it was for, and the staffer, in a state of annoyance, told him he needed to sign it. Signing without knowing what he agreed to seems unethical to me. In “good patient” mode, the man signed on the dotted line, not knowing in what research he would participate.

The hospital, undoubtedly, makes a great deal of money and produces many professional papers, so getting subjects for clinical trials is of paramount importance. Forget about the patients; get them to sign.

Other older patients with Medicare coverage regularly are told, “Well, Medicare won’t cover this procedure, so if you want it, you’ll have to pay.” The “pay” part isn’t usually provided, and the patient must produce a credit card before leaving. Where’s the medical empathy about the issue? It’s missing.

Most of the time, the procedure might be “cosmetic,” like an ugly mole, an enormous cyst, or distressing marks. I suppose that means elderly patients shouldn’t care how they look and how it might affect both their self-respect and how they are treated? Thank you, Dr. Pimple Popper, but who pays your fees? Is it Medicare or Medicaid or the TV show’s producers?

We know that Medicare won’t pay for more than ONE hearing aid. How many people need only ONE hearing aid? Do they pay for more than ONE lens in eyeglasses?

Medicare is just as biased as those providing the services. And Medicare won’t pay for dental care, and we know that can play a role in various illnesses, including cardiac disorders. Are all the elderly on their own here, and should they let all their teeth fall out?

Are we reaching the point where the elderly patient in medical care no longer expects respect? Should they begin committing suicide, as has been reported happening in Japan during the lockdowns and loneliness of the pandemic?

The post Too Old to Live? The Scourge of Ageism in Medicine Cannot Be Denied appeared first on Medika Life.