A Pervasive Problem
Ageism is pervasive in our society. At its core, ageism is discrimination against older adults based on negative and inaccurate stereotypes. When it shows up in our healthcare system, it can cause real harm.
By fostering underlying bias, ageism quietly works to invalidate older adults’ experiences, putting them at risk of being deprioritized — even overlooked — when timely care is critical.
This article outlines practical actions you can take to help address ageism on the frontlines of healthcare by reframing aging. Adopting this approach does not require longer visits. It relies on accurate assumptions based on individual needs. Avoiding age-based shortcuts often saves time by reducing missed diagnoses, return visits, and prolonged boarding.
Language Matters
Words shape our perceptions. They frame how we view ourselves in relation to others, and can ultimately influence clinical practice and policy. Certain language used to describe older adults creates a false sense that they are part of a separate group, one that lacks nuance and individuality. In reality, we are all aging, and we all have unique clinical needs.
Phrases like “seniors” and “elderly” generalize older adults and carry negative connotations, reinforcing the faulty notion that they require a one-size-fits-all approach to care. Symptoms like pain, frailty, or confusion may be falsely attributed to “normal aging.”
Shifting how we speak about age can directly impact how care is delivered in the ED and beyond.
Choosing the Right Words
Here are some practical ways to reframe aging through neutral, inclusive, and accurate language.
Avoid This
- Terms that work to “other” older adults: “seniors,” “elderly,” “they,” “them”
- Language implying that health outcomes are due to individual decisions: “choices,” “planning,” “control”
- Catastrophic terms that frame aging as a crisis in the healthcare system: “tidal wave,” “tsunami”
- Metaphors that associate aging with conflict: “battle,” “struggle,” “fight”
Try This
- Neutral, inclusive terms: “older adults,” “older Americans,” “we,” “us”
- Language that recognizes aging as a shared experience: “solutions that help us all thrive as we age”
- Phrasing that affirms a growing older population: “As more Americans lead longer and healthier lives…”
- Language that reframes aging as personal growth : “a dynamic process that leads to new abilities and knowledge”
Avoiding Ageism in Patient Interactions
When speaking with older adult patients, consider the following best practices. They’re designed to help you create a comfortable, age-friendly clinical environment.
- Sit down at eye-level
- Ensure the patient is comfortable
- Speak plainly to the patient as a fellow adult; avoid baby talk
- Communicate face-to-face; avoid turning your back while typing
- Keep a calm and comfortable pace – do not rush the patient
- Be sensitive to the patient’s personal goals and expectations
- Print off important takeaways
For more tips on communicating with older patients, review this article from the National Institute on Aging (NIA).
Keep Learning and Advocating
Confronting ageism requires both individual awareness and system-level support. To help you continue advocating for age-friendly care in the ED, we’ve included additional resources from our colleagues at the National Center to Reframe Aging (NCRA). Explore and share them with your team.
From Awareness to Action
Creating meaningful change is an ongoing effort. While making deliberate shifts in language can help is the first step in addressing ageism in healthcare, you can go further by taking the following actions:
- Notice when problematic patterns influence care; are patients being triaged according to clinical needs, or based on age alone? Don’t call out anyone in particular. Observe these moments and raise them through thoughtful, constructive communication.
- Encourage needs-based evaluations over age-based assumptions. Ask whether symptoms are truly the result of aging, or if they point to a specific clinical cause that can be treated.
- Share knowledge about age-friendly care. Best practices around geriatric needs assessments and screening should be widely accessible. For more on this, explore our toolkit on boarding in the geriatric ED.
Addressing Boarding in the Geriatric ED
Toolkit
This toolkit provides tools, recommendations, guidelines, and educational resources for EDs to implement processes that address the problem of boarding. It contains essential background and real-world examples of successful boarding protocols and a slide deck presenting the financial and patient-centred benefits of boarding reduction practices.