Elderhood

by Louise Aronson

  Competence

  competence … capacity American Bar Association Commission on Law and Aging, & American Psychological Association. (2008). Assessment of older adults with diminished capacity: a handbook for psychologists. American Bar Association Commission on Law and Aging & American Psychological Association. (12); Leo, R. J. (1999). Competency and capacity to make treatment decisions: a primer for primary care physicians. The Primary Care Companion to the Journal of Clinical Psychiatry. 1(5), 131–141; Moye, J., & Marson, D. C. (2007). Assessment of decision-making capacity in older adults: an emerging area of practice and research. Journals of Gerontology: Series B. 62(1), 3–11; Silberfeld, M., Stevens, D., Lieff, S., Checkland, D., & Madigan, K. (1992). Legal standards and threshold of competence. Advocates’ Quarterly. 14, 482.

  against their well-being Moye, J., Marson, D. C., Edelstein, B. (2013). Assessment of capacity in an aging society. American Psychologist. 68(3), 158–171.

  mildly disabling hearing loss Cruickshanks, K. J., Tweed, T. S., & Wiley, T. L. (2003). The five-year incidence of progression of hearing loss: the epidemiology of hearing loss study. JAMA Otolaryngology—Head & Neck Surgery. 129(10), 1041–1046.

  Bias

  The White Album Didion, J. (1979). The white album. New York, NY: Noonday.

  demographic groups express distress in different ways Lewis-Fernandez, R., & Díaz, N. (2002). The cultural formulation: a method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly. 73(4), 271–295; Myers, H. F., Lesser, I., Rodriguez, N., Mira, C. B., Hwang, W. C., Camp, C., et al. (2002). Ethnic differences in clinical presentation of depression in adult women. Cultural Diversity and Ethnic Minority Psychology, 8(2), 138–156; Takeuchi, D. T., Chun, C. A., Gong, F., & Shen, H. (2002). Cultural expressions of distress. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. 6(2).

  “the Negro in America” Baldwin, J., & Peck, R. (Writers) & Peck, R. (Director). (2016). I am not your negro. United States: Magnolia Pictures.

  altered mental status was delirium Oh, E. S., Fong, T. G., Hshieh, T. T., & Inouye, S. K. (2017). Delirium in older persons: advances in diagnosis and treatment. JAMA 318(12), 1161–1174.

  research on biases in medicine FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC Medical Ethics, 18(1), 19; Shaband, H. (August 29, 2014). How racism creeps into medicine. Atlantic.

  wouldn’t want to be old Levy, B. R. (2003). Mind matters: cognitive and physical effects of aging self-stereotypes. Journals of Gerontology: Series B. 58(4): 203–211.

  the importance of intersectionality Crenshaw, K., Gotanda, N., Peller, G., & Thomas, K. (1995). Critical race theory: the key writings that formed the movement (6th edition). New York, NY: New Press; hooks, b. (1990). Yearning: race, gender, and cultural politics. Boston, MA: South End; Crenshaw, K. (September 24, 2015). Why intersectionality can’t wait. Washington Post.

  scientifically sound and morally distressing data Goddu, P., O’Conor, K. J., Lanzkron, S., Saheed, M. O., Peek, M. E., Haywood, C., & Beach, M. C. (2018). Do words matter? Stigmatizing language and the transmission of bias in the medical record. Journal of General Internal Medicine. 33(5), 685–691; Haider, A. H., Sexton, J., Sriram, N., Cooper L. A., Efron, D. T., Swoboda, S., et al. (2011). Association of unconscious race and social class bias with vignette-based clinical assessments by medical students. JAMA. 306(9), 942–951; Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, K., et al. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. American Journal of Public Health. 105(12), e60–e76; Hamberg, K. (2008). Gender bias in medicine. Women’s Health. 4(3), 237–243; Jackson, C. L., Agénor, M., Johnson, D. A., Austin, S. B., & Kawachi, I. (2016). Sexual orientation identity disparities in health behaviors, outcomes, and services use among men and women in the United States: a cross-sectional study. BMC Public Health. 16, 807; Scheck, A. (2004). Race, gender, and age affect medical care, so why does bias persist? Emergency Medical News. 26(5), 18–21.

  two patients of the same age and grooming and class Kaul, P., Armstrong, P. W., Sookram, S., Leung, B. K., Brass, N., & Welsh, R. (2011). Temporal trends in patient and treatment delay among men and women presenting with ST-elevation myocardial infarction. American Heart Journal. 161(1), 91–97; Liakos, M., & Parikh, P. B. (2018). Gender disparities in presentation, management, and outcomes of acute myocardial infarction. Current Cardiology Reports. 20, 64; Vaccarino, V., Rathore, S. S., Wenger, N. K., Frederick, P. D., Abramson, J. L., Barron, H. V., et al. (2005). Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. New England Journal of Medicine. 353, 671–682.

  primary language is English Nguyen, M., Ugarte, C., Fuller, I., Haas, G., & Portenoy, R. K. (2005). Access to care for chronic pain: racial and ethnic differences. Journal of Pain. 6(5), 301–314; Campbell, C. M., & Edwards, R. R. (2012). Ethnic differences in pain and pain management. Pain Management. 2(3), 219–230.

  when they began dialysis Grubbs, V. (2017). Hundreds of interlaced fingers: a kidney doctor’s search for the perfect match. United States: Amistad.

  8. Adult

  Oblivious

  The Unknown Profession Campbell, J. Y., Durso, S. C., Brandt, L. E., Finucane, T. E., & Abadir, P. M. (2013). The unknown profession: a geriatrician. Journal of American Geriatrics Society. 61(3), 447–449.

  Calling an older person cute Whitbourne, S. K., & Sneed, J. R. (2004). Chapter 8: The paradox of well-being, identity processes, and stereotype threat: ageism and its potential relationships to the self in later life. In T. D. Nelson (Ed.), Ageism: stereotyping and prejudice against older persons. (247). Cambridge, MA: MIT Press.

  “does not fit the speaker’s stereotypes about old” The Old Women’s Project. (n.d.). Real-life examples of ageist comments.

  Language

  “If I’m ninety and believe I’m forty-five” Le Guin, U. K. (2017). No time to spare: thinking about what matters. (193). Boston, MA: Houghton Mifflin.

  “Old age is for” Le Guin, U. K. (2017). No time to spare: thinking about what matters. (201). Boston, MA: Houghton Mifflin.

  “to tell me I don’t exist” Le Guin, U. K. (2017). No time to spare: thinking about what matters. (243). Boston, MA: Houghton Mifflin.

  a metaphor for happiness Sontag, S. (1972). The double standard of aging. Saturday Review. 29–38.

  “ ‘Old’ means you’re past your prime” Morris, W. (July 19, 2017). Jay-Z and the politics of rapping in middle age. New York Times.

  illness metaphors Sontag, S. (1979). Illness as metaphor. (3). New York, NY: Vintage Press.

  Vocation

  Dr. Ken Brummel-Smith’s Kemp, B., Brummel-Smith, K., & Ramsdell, J. (Eds.). (1990) Geriatric rehabilitation. Austin, TX: Pro-Ed Press.

  medical training doesn’t just erode doctors’ empathy Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2005). Medical student distress: causes, consequences, and proposed solutions. Mayo Clinic Proceedings. 80(12), 1613–1622; West, C. P., Huschka, M. M., Novotny, P. J., Sloan, J. A., Kolars, J. C., Haberman, T. M., & Shanafelt, T. D. (2006). Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 296, 1071–1078.

  Greek words for old age physician Nascher, I. L. (1909). Geriatrics. New York Medical Journal. 90(17), 358–359; Nascher, I. L. (1914). Geriatrics: the diseases of old age and their treatment. Philadelphia, PA: P. Blakiston’s Son & Co.

  “senility and its diseases apart from maturity” Nascher, I. L. (1909). Longevity and rejuvenescence. New York Medical Journal. 89(16), 794–800.

  the state of being old Dodd, Mead, & Co. (1916). The new international encyclopaedia. (703). New York, NY: Dodd, Mead and Co.; Ozarin, L. (2008). I. L. Nascher, MD (1863–1944): the first American geriatrician. Psychiatric News. https://doi.org/10.1176/pn.43.22.0024.

&nb
sp; “have never been numerous or powerful” Thane, P. (1993). Chapter 46: Geriatrics. In W. F. Bynum & R. Porter (Ed.), Companion Encyclopedia of the History of Medicine (1092). London, UK; New York, NY: Routledge.

  “The conservation of old people … has been neglected” Freeman, J. T. (1950). François Ranchin contributor of an early chapter in geriatrics. Journal of the History of Medicine and Allied Sciences. 5(4), 422–431; Thane, P. (2005). A history of old age. Oxford, UK: Oxford University Press.

  gérocomie (Greek: geron—old man; komeo—to take care of it) Bynum, W. F., & Porter, R. (Eds.). (1993). Companion encyclopedia of the history of medicine: volume 2. (1095). London, UK; New York, NY: Routledge.

  the lack of lectures about old patients Freeman, J. T. (1961). Nascher: excerpts from his life, letters, and works. Gerontologist, 1, 17–26.

  the first geriatrics lecture Burstein, S. R. (1946). Gerontology: a modern science with a long history. Postgraduate Medical Journal.

  “a reaction against the belief” Howell, T. H. (1975). Old age: some practical points in geriatrics (3rd edition). London, UK: H. K. Lewis. (101).

  medical care harms and kills Gabow, P. A., Hutt, D. M., Baker, S., Craig, S. R., Gordon, J. B., & Lezotte, D. C. (1985). Comparison of hospitalization between nursing homes and community residents. Journal of the American Geriatrics Society. 33(8), 524–529; Graham, J. (December 8, 2016). You’re not just “growing old” if this happens to you. Kaiser Health News; Piers, R. D., Van den Eynde, M., Steeman, E., Vlerick, P., Benoit, D. D., & Van Den Noortgate, N. J. (2012). End-of-life of the geriatric patient and nurses’ moral distress. Journal of the American Medical Directors Association. 13(1), 7–13; Pijl-Zier, E., Armstrong-Esther, C., Hall, B., Akins, L., & Stingl, M. (2008). Moral distress: an emerging problem for nurses in long-term care? Quality in Ageing and Older Adults. 9(2), 29–48; Span, P. (June 22, 2018). Breathing tubes fail to save many older patients. New York Times; Tedeschi, B. (March 28, 2018). With the help of a loved one, a family finds what is essential in the end. STAT.

  Distance

  “an old person in a nursing home” Lynn, J. (2008). Aging America: a reform agenda for living well and dying well. Hastings Center Bioethics Agenda 08: America Ages.

  Values

  physician career satisfaction Leigh, J. L., Kravitz, R. L, Schembi, M., Samuels, S. J., & Mobley, S. (2002). Physician career satisfaction across specialties. Archives of Internal Medicine. 162(14), 1577–1584; Leigh, J. P., Tancredi, D. J., & Kravitz, R. L. (2009). Physician career satisfaction within specialties. Biomedical Central Health Services Research. (9, 166); Siu, A. L., & Beck, J. C. (1990). Physician satisfaction with career choices in geriatrics. The Gerontologist. 30(4), 529–534.

  elder-friendly hospitals American Geriatrics Society Expert Panel on the Care of Older Adult with Multimorbidity. (2012). Journal of American Geriatrics Society. 60(10), E1–E25; Capezuit, E. A. (2015). Geriatrics models of care: bringing “best practice” to an aging America. New York, NY: Springer; Coleman, E. A., & Boult, C. (2003). Improving the quality of transitional care for persons with complex care needs. Journal of the American Geriatrics Society. 51(4), 556–557; Counsell, S. R., Holder, C. M., Libenauer, L. L., Palmer, R. M., Fortinsky, R. H., Kresivic, D. M., et al. (2000). Effects of multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. Journal of the American Geriatrics Society. 48(12), 1572–1581; Fulmer, T., & Berman, A. (November 3, 2016). Age-friendly health systems: how do we get there? Health Affairs; Meier, D. E., & Gaisman, C. (2007). Palliative care is the job of every hospital. Medscape General Medicine. 9(3), 6.

  to what they are Sandberg, S. (2013). Lean in: women, work, and the will to lead. New York, NY: Alfred A. Knopf; Mody, L., Boustani, M., Braun, U. K., & Sarkisian, C. (2017). Evolution of geriatric medicine: midcareer faculty continuing the dialogue. Journal of the American Geriatrics Society. 65(7), 1389–1391.

  “not equally been extended” Nascher, I. L. (1914). Geriatrics: the diseases of old age and their treatment. (XV) Philadelphia, PA: P. Blakiston’s Son & Co.

  “The cause of this neglect” Nascher, I. L. (1914). Geriatrics: the diseases of old age and their treatment. (V) Philadelphia, PA: P. Blakiston’s Son & Co.

  “treatment of diseases in senility” Nascher I. L. (1909). Longevity and rejuvenescence. New York Medical Journal.

  “those who are economically worthless” Nascher, I. L. (1914). Geriatrics: the diseases of old age and their treatment. (VI). Philadelphia, PA: P. Blakiston’s Son & Co.

  “a ton of problems” Higashi, R. T., Tilack, A. A., Steinman, M., Harper, M., & Johnson, C. B. (2012). Elder care as “frustrating” and “boring”: understanding the persistence of negative attitudes toward older patients among physicians-in-training. Journal of Aging Studies. 26(4), 476–483.

  Truth

  interact with other parts Steel, N., Abdelhamid, A., Stokes, T., Edwards, H., Fleetcroft, R., Howe, A., & Qureshi, N. (2014). A review of clinical practice guidelines found that they were often based on evidence of uncertain relevance to primary care patients. Journal of Clinical Epidemiology, 67(11), 1251–1257; Jansen, J., McKinn, S., Bonner, C., Irwig, L., Doust, J., Glasziou, P., et al. (2015). Systematic review of clinical practice guidelines recommendations about primary cardiovascular disease prevention for older adults. BMC Family Practice, 16, 104; Upshur, R. E. G. (2014). Do clinical guidelines still make sense? No. Annals of Family Medicine, 12(3), 202–203.

  clinicians struggle to personalize Bodenheimer, T., Lo, B., & Casalino, L. (1999). Primary care physicians should be coordinators, not gatekeepers. JAMA. 281(21), 2045–2049; Wenrich, M. D., Curtis, J. R., Ambrozy, D. A., Carline, J. D., Shannon, S. E., & Ramsey, P. G. (2003). Journal of Pain and Symptom Management. 25(3), 236–246.

  social services that might improve their lives Bradley, E. H., Canavan, M., Rogan, E., Talbert-Slagle, K., Ndumele, C., Taylor, L., Curry, L. A. (2016). Variation in health outcomes: the role of spending on social services, public health, and health care, 200–209. Health Affairs. 35(5), 760–768; Schneider, E. C., & Squires, D. (2017). From last to first—could the U.S. health care system become the best in the world? New England Journal of Medicine. 377, 901–904.

  falls have innumerable causes Delbaere, K., Close, J. C., Brodaty, H., Sachdev, P, & Lord, S. R. (2010). Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. British Medical Journal. 341, 4165.

  Biology

  seven stages Shakespeare, W. (1963). As you like it. H. H. Furness (Ed.). New York, NY: Dover Publications.

  losing the ability to self-regulate Cristofalo, V. J., Allen, R. G., Pignolo, R. J., Martin, B. G., & Beck, J. C. (1998). Relationship between donor age and the replicative lifespan of human cells in culture: a reevaluation. Proceedings of the National Academy of Sciences of the United States of America. 95(18), 10614–10619; Cristofalo, V. J., Gerhard, G. S., Pignolo, R. J. (1994). Molecular biology of aging. Surgical Clinics of North America. 74(1), 1–21; Cristofalo, V. J., Lorenzini, A., Allen, R. G., Torres, C., & Tresini, M. (2004). Replicative senescence: a critical review. Mechanisms of Ageing and Development. 125(10–11), 827–848.

  autolysis Morales, A. (2016). The girls in my town. (92). Albuquerque, NM: University of New Mexico Press.

  single-celled populations are immortal Masoro, E. J. (Ed.). (1995). Handbook of physiology Sect 11: Aging. (3–21). Oxford, UK: Oxford University Press.

  gradually deteriorate from maturation Finch, C. E. (1990). Longevity, senescence, and the genome. Chicago, IL: University of Chicago Press.

  human body as it ages Benetos, A., Okuda, K., Lajemi, M., Kimura, M., Thomas, F., Skurnick, J., et al. (2018). Telomere length as an indicator of biological aging. Hypertension. 37, 381–385; Epel, E. S., Blackburn, E. H., Lin, J., Dhabhar, F. S., Adler, N. E, Morrow, J. D., & Cawthon, R. M. (2004). Accelerated telomere shortening in r
esponse to life stress. Proceedings of the National Academy of Sciences of the United States of America. 101(49), 17312–17315; Harley, C. B., Futcher, A. B., & Greider, C. W. (1990). Telomeres shorten during ageing of human fibroblasts. Nature. 345(6274), 458–460; Marniciak, R., & Guarente, L. (2001). Human genetics: testing telomerase. Nature. 413(6854), 370–371, 373; Rudolph, K. L., Chang, S., Lee, H. W., Blasco, M., Gottlieb, G. J., Greider, C., & DePinho, R. A. (1999). Longevity, stress response, and cancer in aging telomerase-deficient mice. Cell. 96(5), 701–712.

  Evolutionary theories Bowles, P. J. (1986). Theories of human evolution: a century of debate, 1844–1944. Baltimore, MD: Johns Hopkins University Press.

  life expectancy is nearly ninety years Central Intelligence Agency. (2017). Country comparison: Life expectancy at birth. World Factbook; The US Burden of Disease Collaborators. (2018). The state of US health, 1990–2016: Burden of diseases, injuries, and risk factor among US states. JAMA. 319(14), 1444–1472

  “it’s a massacre” Roth, P. (2006). Everyman. New York, NY: Houghton Mifflin.

  communities also support healthy options Ehrenreich, B. (March 31, 2018). Why are the poor blamed and shamed for their deaths? Guardian.

  “This is what 40 looks like” Savan, S. (2006). Slam dunks and no-brainers: Pop language in your life, the media, business, politics, and like, whatever. New York, NY: Vintage.

  Outsourced

  living meaningful lives American Geriatrics Society Geriatrics Healthcare Professionals. (2017). AGS extends hip fracture co-management program that sees geriatrics mending more than bones; Friedman, S. M., Mendelson, D. A., Kates, S. L., & McCann, R. M. (2008). Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population. Journal of American Geriatrics Society. 56(7), 1349–1356.

  transfers to nursing homes Burke, R. E., Lawrence, E., Ladebue, Ayele, R., Lippman, B., Cumbler, E., Allyn, R., & Jones, J. (2017). How hospital clinicians select patients for skilled nursing facilities. Journal of American Geriatrics Society. 65(11), 2466–2472.