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Ageism in healthcare is evident in many areas of the field whether it be blatant or inconspicuous in the practice. An example that I have found to show obvious ageism is when taking an admission assessment that includes the lifestyle and health practices assessment. Intimate subjects that involve sexual intercourse are often glossed over and filled in as nonapplicable or marked "not sexually active" without having asked the questions. By making this assumption simply based on the patient's age, healthcare workers can miss key components of a full health history of the patient. Chronological age is typically one of the first things seen on the chart or asked of the patient to disclose in health history, but it is not an accurate gauge to decide about the patient's lifestyle and habits in any area (Miller, 2023).
Ageism has a negative effect on older adults, especially the psyche. The older adult can oftentimes sense that discrimination is present when certain topics are not being covered that were once a part of their assessment or when a healthcare provider will only look towards caregivers or significant others for responses during their assessments. Being a complex and cognitively functional older adult, this would lead to feelings of poor self-esteem and invalidation. This can be attributed to the stereotype that aging automatically means deterioration (Miller, 2023).
There are many nursing interventions that can lead to better care for the older adult. The first step that must be taken by the nurse is to assess their own feelings towards aging and recognize any prejudices or preconceived notions that they might have about the older adult. Addressing the patient directly and only looking to family members when necessary is a key component to establishing a trusting rapport with the patient. Promoting environmental modifications to suit the level of activity of the patient can be incorporated into the health history to reduce falls or improve genitourinary health (Miller, 2023). Ageism cannot be stopped entirely, and there are many additional health assessments and screenings that must be used and accounted for when participating in care for the older adult. I feel that assessing one's own feelings and building a working knowledge base of the older adult is the most effective way to greatly reduce ageism in healthcare.
Long-term health care costs in the United States fall on many shoulders. Most directly, it falls at the foot of the patient and their family to cover their expenses (Miller, 2023). There are many programs that can be utilized to aid with this large fee, but there is rarely enough assistance to cover all of the financial burden. One avenue that is utilized is the Medicare and Medicaid systems that aid in healthcare expenses of the older adult based upon qualifications for their services. The money dedicated towards these programs is generated through taxes. The most visible and known area of deduction from U.S. citizens can be seen on pay stubs as deductions devoted to Medicare/Medicaid, but this is just one of the many places that the money for funding older adults comes from (Cussen, 2022). These sources are not well known for their great reimbursements and have limitations on care that you can receive as opposed to private insurance which is much more costly to the individual. Germany offers a public health care system that requires citizens to pay a proportionally small amount of money based on wages and their employers as well. The government plays a small part in financing the healthcare system, and it works out to where there are minimal out-of-pocket costs to consumers, including the older adult needing long-term care. Private insurance is also an option for citizens and allows doctors to set their appointments ahead of those using the public healthcare system, but when it comes to patients and older citizens in need of care, there is little healthcare needs that are deemed "unaffordable" (Edwards & Dunn, 2019).