Posted on in General

Hazel McCallion, the mayor of Mississauga, is 91. On New Year’s day,  she strapped on her skates to dazzle her fans.

Sidney Bacon has come to dinner at our house at Easter and Christmas for the last 25 years. He is now 102 years of age. Aside from his hearing issues, he can still keep you entertained for hours with detailed stories about his life’s adventures.

We no longer have to retire at 65.  That’s the law.

But world class academic researchers at the “advanced” age of 65 are having their research funding cut to zero even if they are healthy, vigorous and fully engaged at work.

So why would a 59 year old male patient with cirrhosis of the liver from hepatitis C and who needs a liver transplant not get on the transplant list?

And why would an active and alert bridge playing 78 year old female who is in kidney failure not get dialysis?

Could this be ageism?

Let’s explore that thought.

Ageism is discrimination against a group or person because of their age.

Unfortunately, when clinical decisions are made, age is a factor. Why perform heart surgery on an 85 year old when they can muddle along with medications? Ageism is subtle but ever present.

When I toured the Kaleida Health system in Buffalo, it was apparent that the cardiac surgeons were treating patients into their late 80’s and early 90’s.  Ageism was not a factor.

So how does ageism impact clinical decision making? It is subtle but real.

When confronted with the accusation of ageism, there is denial. But it is real.  Ask the patients and their family members.

Here is what Canadian legislation says about providing healthcare for older persons.

Under the Ontario Human Rights Code, older persons have the right to be free from discrimination in health care.  This right applies to health care services and facilities including hospitals, clinics, community care access centres, long-term care facilities, home care and health care programs.

As well, the Supreme Court of Canada has made it clear that those who are responsible for health care services must take positive steps to ensure that disadvantaged persons (including the elderly) benefit equally from those services.

This requires designing services and facilities to be inclusive and barrier-free from the start, for example by ensuring that a health clinic is accessible to older persons.  It also means taking special needs into account such as using good communication techniques with older clients.

So the legislation creates a level playing field for older persons. Now we have to teach older persons and their family members that they  have the right to the same treatment as younger persons.

So much for ageism.