Ageism & Me: An Evolving Perspective

By Laura Gwynn, PT
FOX Regional Director

Ageism: prejudice or discrimination based on a person’s age and a tendency to regard older persons as debilitated, unworthy.

In other words, ageism is not a concept I would ever accept. At least that is what I thought.

I’d never call myself a prejudiced person. But, I’ve committed ageism more times than I would care to admit, especially as a physical therapist.

Over the years, prior to joining FOX Rehabilitation, I would make the treatment sessions easier for the “elderly.” I’d decrease the number of repetitions or sets in an exercise program. I’d reduce the level of time I would work with an “elderly” individual.

I would talk to “them” in a more infantile, slower, and louder voice, as if understanding was poor. If that person’s balance was poor, I would not advance the assistive device from a walker, to a cane, to no assistive device. I’d think, “There is no way someone 92 years old can advance to a cane. They will fall.”

I was treating the age, not the functional deficits.

Then, in September of 2015, I found a work environment where “older adults” were viewed much more positively and age was just a number: FOX. What a difference a culture makes!

This had been the first time in my 25-year career as a PT I heard and put into practice the concept of anti-ageism.
To intellectually understand a concept is one thing. To viscerally and emotionally understand and accept that concept, that’s something quite different.

One of my first patients with FOX was, I thought, a 76-year-old woman. She had a progressive fear of falling. She also was having more difficulty getting up from a chair.

After a few sessions, I looked more closely at the age during the progress note. I realized, to my surprise, she was 96!

Afterwards, the patient stated, “This is the easiest session I have had so far with you. I am not even tired. I wish you had known I was 96 sooner!”

Without awareness, I had committed ageism.

That experience, luckily early in my FOX career, has shaped how I treat every patient I meet now. Now, I focus on the functional deficits and abilities alongside of a lack of interest in the age.

It was difficult enough for me to put my beliefs into action. The only way I knew to start educating was to give visual examples. Once the family, patient and physician realized the patient’s potential and abilities, then verbal education could continue, and the acceptance became easier.

The example below is a perfect springboard. ​

One special patient, 91 now, suffered from two very serious falls. She suffered cervical and lumbar fractures and an exacerbation of the symptoms from a previous stroke one year before.

When I took over the case, the patient was wheelchair-bound, presented with severe extensor tone in sitting and required two people to assist with all transfers, toileting, and bed mobility.

She was living with her daughter and son-in-law. The dining room was her makeshift bedroom with a bedside commode and hospital bed.

“I want to die. I can’t live like this and I will never get any better. I am too old at this point. I am a burden to my family, and I will never walk again,” were her first comments to me during every visit for the first two weeks.

We worked every week on shifting her negative thoughts into positive actions. We also focused on what made her happy and gave her purpose – not her age.

She wanted to go back to Puerto Rico to visit her home if she could.

After intensive rehabilitation, she was walking with a cane for 2,000 feet with minimal assistance. She was going up and down steps to prepare to live in her upstairs bedroom and bathroom. She could get in and out of a car.  So, the medical transport staff could be discontinued she went to a medical appointment.

She has caught that plane to Puerto Rico with her family and has taken 10 trips around the country since then.

The focus was driven by functional abilities, not by age. She, her family, and the physician were reminded over and over again that age is just a number.

I, too, have grown personally by knowing no matter how old one is, our determination and spirit can promote unbelievable function and independence.

I approach my patients with a renewed sense of promise. I also address all older adults with dignity and respect.

I realize that anything is possible to achieve no matter what your age.

The FOX patient and clinician featured in this image are not referenced in this article.