Treat the Patient, Not the Age

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My Pilates teacher is a fantastic person. Seeing her long auburn hair swinging as she walks around a room greeting new students is an inspiring sight. Cate exudes health, is beautiful, and in top condition. She’s also 63 years-old even though she doesn’t look like the antiquated stereotype most people have of a woman that age. But when she suffered a minor back injury on a skiing trip and was sent by her doctor to a physical therapist, her looks and health were discarded and she became simply another ‘senior’ citizen. Her age, not her strength, determined the attitude and the condescension of her physical therapist and his office.

“I was treated like a person who was old and not of any particular value. The therapist had a way of speaking to me that I found insulting. Believe me when I heard him speak to younger patients his whole demeanor and tone were markedly different,” Cate told me. “He used phrases to me such, ‘At your age, you’ll probably have to give up many of your activities’, and ‘At 63, you need to know that you’re not a young woman anymore’. The worst one was, ‘ Tennis?’ Oh, I wouldn’t advise you to do that anymore.’  I was incensed! I’m sixty-three and in perfect health! His treatment of me made me mad.”

Cate did what any self-respecting, intelligent, and mad-as-hell woman would do; she called her doctor’s office and told him what the therapist had said. Her doctor, a man in his 60’s himself, was annoyed at what her therapist had told her.

“You’re healthy and in excellent condition. Let me give you the names of several other therapists in your area. And let me tell you that I am putting a call in to that therapist. He’s treating your age, not you as a healthy, fit patient.”

Cate interviewed the therapists by phone, told them that she wanted to be in charge of her physical therapy, and that her injury, and not her age, was what was being treated.

Within a couple of months, with the kind of excellent physical therapy she expected, she was back to doing everything she loved including tennis and she says,

“The idea that anyone out-of-hand treats the age and not the patient is something that has to be changed and those over 50 have to be the ones to do it.”

Mark Lachs, MD, director of geriatrics for New York–Presbyterian Healthcare System  and author of the book, Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older would have been proud of Cate. He espouses treating the patient and seeing the age as only one of the components which make up the whole. Respect should always be part of the any treatment and when a person is treated solely on the basis of antiquated “age-thinking” there is a problem.

The over fifty set needs to learn how to  navigate a complex and confusing age related health care system and mindset to make the best choices that will that lay the groundwork for a satisfying, active lifestyle that lasts well into the golden years.

It is totally unfair that the culture in the USA tends to define the natural process of ageing in a negative manner. Unfortunately, this definition of ageing widely exists in our health-care system, where “ageist” medicine is, more likely than not, practiced. This attitude often serves to worsen the medical issues rather than helping the patient figure out how to address or avoid them.

Though it seems to be more necessary for those over fifty, we all need an ‘insider’s guide’ to help us stay healthy and demand to have healthcare personnel treat the health problem and not the age. Any woman who is in her child-bearing years knows that any physical complaint she may have is first connected to her menstrual cycle and the possibility of pregnancy. Those factors have nothing to do with over 90% of the cases yet that is the first thing a doctor will suspect in a woman “of that age.”

Medicine and attitudes about treating older Americans need to understand that a 63 year old woman or man of today is healthier, more active, and physically fit than either their parents or grandparents. Nutrition and a healthy lifestyle play an important part in a person’s overall health and that should be taken into consideration when treating the patient. And while age-related problems should definitely be a component of treatment, a person’s age should not define every treatment.

As for Cate, she very subtly made her point about fitness and age. She competed in, and won, a National tennis mixed doubles a year after her back injury. Cate and her male partner were prominently featured in a tennis magazine and she sent the clipping to the therapist who had said a minor back injury was the end of the line for her tennis playing days. Her reward came a week later.

The therapist sent her congratulations and an apology.

© 2013 copyright Kristen Houghton all rights reserved

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