Dr. Ross Colt performs a surgery in Iraq.

The American healthcare system has a serious problem with ageism, and it’s costing patients their lives. But given the challenges facing healthcare workers who are caring for elderly patients, particularly throughout the pandemic, how can we even begin to make real change?

I know from experience that it can be done — and as a retired Army colonel my military background gave me the experience I need to pivot quickly, think creatively and provide compassionate, holistic care. In other words, the Army has helped me fight ageism in the medical system, one person at a time.

Ageism is an institutionalized form of prejudice deeply ingrained in our healthcare system. Overwhelmed providers use cognitive shortcuts to automatically stereotype seniors as frail, helpless, cognitively impaired or even childlike.

We see it in medical professionals who frequently address older patients in “elderspeak” –slow, high-pitched, exaggerated tones and volumes, somewhat like baby talk — hesitate to offer technology-forward solutions to older patients, and overtreat or undertreat seniors simply because of their age without looking for other underlying causes.

This has a real cost. Overtreatment of illnesses in seniors costs our healthcare system $158 billion to $226 billion every year, while putting patients through unnecessary pain and mental anguish. Conversely, undertreatment often leads to advanced disease or conditions that force patients to move into a nursing home or result in hospitalization or death.

Elderly patients who internalize the ageist attitudes they may encounter are also less likely to seek medical care or engage in preventive behaviors like eating healthily and exercising.

We need broad, systemic change in multiple areas of our society, including how we train our medical professionals, to ensure that seniors are treated like the valuable human beings they are. I’m proud to be a part of this effort through my current role with Gary & Mary West PACE in San Marcos — and my military service gave me the skills I needed to do so.

As a geriatric medicine specialist and medical director at West PACE, I oversee a unique service that provides more than just medical care to older adults. West PACE is part of the nationwide PACE network, whose acronym stands for Program of All-inclusive Care for the Elderly. It enables seniors of all income levels to preserve their dignity, quality of life and independence with comprehensive, affordable, high-quality health and support services all in one place.

PACE participation, which is 40 percent less expensive for taxpayers than nursing home care under Medicaid, has been shown to reduce emergency room visits, unnecessary hospital admissions and long-term nursing home placements for older adults.

From Combat Zone to Exam Room

Before coming to PACE I spent 24 years on active duty in the Army and had the honor of doing two combat tours in Iraq. Being an Army physician in a combat zone requires quick thinking and the ability to rapidly change plans depending on the situation. I drew directly from this skill set when the COVID-19 pandemic hit and the West PACE Day Center was forced to close for socialization visits and only allow medical and rehabilitation appointments.

We quickly pivoted to an in-home focused model of care, providing many of our participants with easy-to-use tablets to help them stay socially engaged and connect directly with our medical staff.  We also brought on a field nurse to provide home wellness visits to our seniors who were isolated at home. When vaccines became available, I worked with our diverse team of medical professionals, therapists, and logistics managers to organize a vaccine clinic with transportation provided.

The unique camaraderie that came with my Army experience also taught me the value of viewing yourself on the same team as your patients, instead of adopting an “us vs. them” mindset. You might have noticed by now that I refer to each person we serve at West PACE as a participant, not a patient, because this automatically acknowledges their ability to participate in their care plan.

I continue to draw from the attitude I learned in the military with our now reopened Day Center, prioritizing ways to give our participants safe opportunities for connection and social engagement on top of medical care, because research shows that prolonged social isolation is as bad for a person as smoking 15 cigarettes per day.

Older individuals have so much to offer. I consider it a true honor to serve them, just as I considered it an honor to serve my country in the Army — an experience that gave me the skills and flexibility to treat our seniors with dignity and respect that they deserve.

Dr. Ross Colt is the medical director for the Gary and Mary West PACE, an innovative, nationwide model of care for vulnerable seniors with chronic care needs offering high-quality, comprehensive and coordinated healthcare, social services and support to enable them to successfully age in place.

Show comments