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Ageism in Health Care Is Really Hidden Rationing

Editor's Note: Editor's Note: The following article is reprinted from the Toronto Star, September 26, 2003, courtesy of Torstar Syndication Services.

It's been almost two years since my mother woke up one autumn morning in the apartment we shared and said she didn't have the strength to move. It was a couple of months before her 96th birthday, and her dementia and frailty had been getting worse.

I took her to a downtown hospital and, after a night on a stretcher in the emergency room, she was transferred to a room on the geriatric floor.

I knew, of course, that she might never come home again. But I also knew that she would choose not to go gently into the night, that the same fierce will to live that had sustained her for 95 years, including 90 winters on the Prairies, would be a force to reckon with.

What I didn't know was how horrific the last six weeks of her life would be in the hospital as she fought to live--or that the health system to which I'd entrusted her would not always be her ally in that fight, but would declare it to be over well before she had given up.

David Globerman, who is 51 and trained as a social worker, knows what can happen to the elderly when they become patients in Ontario hospitals or nursing homes.

He talks about withholding of tests, about "passive euthanasia through omission--what we're talking about are not errors." And he refers to "horrific acts of dehydration, lack of feeding, lack of attention to bed sores, allowing people to lay in vomit and feces, using drugs to dope people."

This week, the Running To Daylight Foundation, which Globerman founded five years ago, co-sponsored a forum at the St. Lawrence Centre on Ageism in Health Care. It took place on the 7th anniversary of his father's death, at age 85, in an Ottawa hospital after a stroke that was not diagnosed because a CT scan was not deemed necessary, despite the family's pleas.

When Globerman surveyed people at the forum--about 85 attended including hospital reps, health care professionals, elderly people, and family members of elderly patients--100 percent responded affirmatively to the question: "Do you believe that some health care providers would have treated you (or a senior you know) better if you or they had been younger?"

At the forum, they talked about what Globerman calls "age-inappropriate care" at best and "conscious neglect and elder abuse" at worst.

I call it unacknowledged rationing in an underfunded health system.

"It is rationing," Globerman agrees. "At a time of scarce resources, the elderly fall to the bottom of the barrel. It's a glaring double standard.

"There's huge abuse and neglect going on in health care institutions, and it should be addressed by all those existing initiatives that currently deal with elder abuse. It's plain dangerous to go into hospital if you're elderly. And it can be dangerous and a threat to health if you go into a long-term care facility."

One speaker at the forum talked about a 79-year-old woman with Alzheimer's whose broken arm wasn't set properly, and the bone finally protruded, causing a life-threatening infection. "No doctor visited the patient throughout the hospitalization," recounts Globerman.

Other speakers talked of substandard care in nursing homes, with elderly relatives left to lie in their own waste or vomit and going for days or even weeks without baths or showers.

In some, if not many cases, the care and treatment of elderly people in hospitals and nursing homes "is not meeting acceptable standards," he says.

"If it were a child receiving the same care, there's no way that people would accept it."

He says, "There is no mechanism to ensure accountability."

Globerman's goal for Running To Daylight is not only to continue questioning standards for the care and treatment of elderly people, but also to provide independent patient advocates for them.

He can be reached at 416-782-3249 or at rtdlf @ aol.com