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AGEISM

AGEISM. “A process of systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish with skin color and gender.” Robert Butler, MD (1975): Why Survive? Being Old in America. AGENDA: LARGE GROUP. Skit 1: Emergency Room

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AGEISM

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  1. AGEISM “A process of systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish with skin color and gender.” Robert Butler, MD (1975): Why Survive? Being Old in America

  2. AGENDA: LARGE GROUP • Skit 1: Emergency Room • Skit 2: Internist’s Office • Discussion: Doctor-Older Patient Communication • Geriatrics Pearls

  3. AGENDA: SMALL GROUP • Review • Enhanced Social History • Geriatrics Screen • Communication Checklist • Break into groups • Interview/Assess older patient • Discussion • Evaluate morning

  4. GERIATRICS PEARLS • Effective communication can improve health outcomes. • Ageism is prevalent and can interfere with effective communication. • A thorough psychosocial history is essential in geriatric medicine. • Assessing and maintaining function and independence is a major goal of geriatric medicine.

  5. COMMUNICATION and the MEDICAL INTERVIEW • Age-heterogeneous patient populations recall about 50% of what their doctors say. • Prevalence of low health literacy in > 60 age group is > 80%.1 • Physicians who communicate better will have patients who understand more about their illness and will be more likely to adhere to regimens.2 1 Weiss B et al.(1995); 2Grueninger U et al

  6. THE THIRD PERSON in the MEDICAL INTERVIEW • Older patients often referred to as “he” or “she.” • Older patients raise fewer topics in triads than dyads. • Older patients less assertive in triads than dyads. • Less shared laughter in triads. Adelman R, Greene M, Ory M ( 2000)

  7. IMPORTANCE of a COMPLETE HISTORY • About 75% of diagnoses can be made by the history alone. • In 70% of interviews, physicians interrupt patient history after 18 seconds. • In 77% of interviews, patient’s problems not fully elicited.

  8. ENHANCED PSYCHOSOCIAL HISTORY • Thoroughly assessing psychosocial issues can improve accuracy of diagnosis. • Thoroughly assessing psychosocial issues may lead to interventions that can affect morbidity and mortality.

  9. IMPORTANCE OF ASSESSING FUNCTION • Predicts outcomes • Allows physician to monitor response to treatment • Helps in making diagnoses • Communicates about the patient • Helps to determine level of care needed

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