Age-inclusive health care – Are you ageist?

By: Melanie Bower, Education, Engagement & Communications Manager, Collaborative Care Seniors Health, Horizon Health Network.

This article aims to bring increased awareness of ageism, how it operates, and how we can begin to address it.

New Brunswick’s older adult population is growing fast. Seniors currently make up 22.8 per cent of our population, and by 2038 this number will surpass 30 per cent. Older adults have a wealth of experience, insight, and wisdom and their many contributions are valuable to our communities. However, there is still an implicit bias against older adults in our society, which leads to inequities in our health care system – the very system we count on to keep us well.

What is ageism?

Ageism is stereotyping, prejudicing, and discriminating based on age. As with any identity-based prejudice, it is unjust and limits opportunity. Ageism suggests that it is possible to judge someone knowing one thing about them – in this case, their age, and it has a detrimental impact on our quality of life, health, and economy.

Ageism is widespread in Canada. Research tells us that one in two Canadians is ageist while six-in-ten seniors say they have been treated unfairly or differently because of their age, and nearly eight-in-ten seniors shared that a health care professional dismissed their complaints as an inevitable sign of aging. The majority of Canadians associate aging with negative outcomes such as being alone and losing independence, yet older Canadians are more likely than all other generations to say that ‘age is just a number.’ In fact, 40 per cent of those 66 years of age and older say they believe the “best is yet to come.”

Health care

We all inadvertently contribute to ageism. A person’s age, rather than their overall health status, can often influence medical decisions about diagnostic tests or treatments. Many physicians, as well as older adults themselves, believe pain, fatigue, depression, and dependency are a ‘normal’ part of aging. Older patients are less likely to seek health care, and if they do, risk being undertreated. Studies show health care providers communicate differently with older adults than with younger adults and can be less patient, less engaged and provide less information. As a result, treatable conditions like chronic pain or arthritis are too often dismissed as just a part of old age.


Although ageism is very common, some hopeful signs of change are slowly emerging, and by working together we can reduce its prevalence in society. Hospitals across Canada are implementing a Senior Friendly Care (sfCare) Framework, emphasizing holistic approaches and what matters to the older adult, who must be afforded dignity and respect. By changing the way health practitioners engage with older adults, patients will be empowered to use their skills and confidence to take responsibility for their health and wellness. An effective strategy is awareness and education. The following tips can help you reduce ageism:

  • Educate yourself on ageism and identify when it is happening. Seek training that dispels negative assumptions and increases awareness of how to appropriately respond to the aging process.
  • Reframe your language. Certain terms and communication approaches are often associated with – and reinforce – negative stereotypes about older people that result in stereotyping and discrimination. Our language and the stories we tell can make a difference in reducing ageism. Instead of saying elderly, aging dependents, consider using seniors or older adults.
  • Communicate with the older person directly, even when they are accompanied by a support person at their medical visit. One of the most common ageist practices is directly communicating with the support person, even if the patient is fully competent. This behavior can lead to disengagement from health and health practices, can negatively impact self esteem and dignity, and in some cases may even deny seniors autonomy and basic rights. Take the time to compensate for hearing deficits by speaking slowly and clearly and facing the patient directly. Older adults can especially benefit from having written notes to refer to that summarize major points from the visit. Try to make these notes simple and clear, avoiding ambiguous and complicated language. 
  • Practice patient-centered communication and care. Actively listen and try not to assume you already know what is being said. Listen with empathy – try to put yourself in the patient’s place and understand their position. Try to find common ground. We tend to forget that seniors were once young and share our similar life experiences. Pause to take a moment to reflect on what you are hearing.
  • Be aware of ‘elderspeak’ among all office staff. This refers to the way we sometimes speak to older adults, especially those with Alzheimer’s disease or another kind of dementia. Elderspeak involves speaking slowly, using a high-pitched voice, using terms of endearment such as “honey” or “sweetheart,” and speaking to the adult as if he was an infant or young child. For that reason, elderspeak is also described as using communication that “infantilizes” the adult. Research tells us that elderspeak can cause an older adult to feel incompetent, lower their self-esteem and promote depression and cause them to withdraw.


To learn more about ageism and what you can do to reduce ageism in your practice, please check out the following resources:

[5] Revera Inc. (2012). Revera report on ageism. Available at: