How to Improve Health Inequities Among Marginalized Elders

• Nurse practitioner education doesn’t spend a lot of time on the elderly population’s unique needs or health inequities. 
• However, there are opportunities in these faults. 
• Their long lives have afforded them the opportunity to see and experience a lot – these stories are important.   

In my schooling to become a nurse practitioner, we did not spend a great deal of time focused on the elder population and their unique social needs and health inequalities. Instead, our education largely highlighted their many complicated health conditions.  

These patients are often complicated because they have lived long lives, often acquiring many comorbidities. We do not, however, learn about social isolation and loneliness and its impact on our aging patients. In my experience as a provider, our medical system tends to lean more toward “problem focused,” care and, until recently, social isolation, loneliness, and community (or lake thereof) were not considered priorities in treating patients.  

As our population ages and life expectancy increases, the social implications of living a long life should be evaluated as it relates to our healthcare system. Social isolation has been proven to decrease longevity and quality of life, but this is not at the forefront of our minds when managing patients, and it really should be, as the authors of one study argue. 

Opportunities to Address Health Inequities 

I see opportunities in these faults. Particularly, when discharging these patients from the hospital, we are not making the necessary level of adjustment to their care plans to reflect a need for increased support in these areas. Many organizations strive to connect our elders with others to decrease social isolation and to provide them with services necessary to thrive in the community.  

The detriment of fractured care and poor attention to our aging population doesn’t appear to be a result of age bias from healthcare workers. It does, however, appear to be a larger problem that negatively impacts the care due to the lack of societal infrastructure to support these individuals, as a study in the International Journal of Environmental Research and Public Health explains.  

The COVID-19 pandemic shed light on the growing needs for community in all age populations. However, no age demographic was hit harder from this perspective than our elders. We should use the knowledge gained from the pandemic to better tailor our approach; we should use it to help trainees do better. What should this look like? More resources, better planning, more engagement with our elders.  

There are some nurse care managers in the community, that generally focus on planning at this stage of life, aging at home, and advanced care directives. There is much to navigate. This is a great start, but the scope should be broadened to include touchpoints in various care settings.  

The Bottom Line

In my experience, our elders should be venerated; they are an untapped resource. If you spend time with an older adult, asking real questions about their life experiences, they often are full of wisdom. Their long lives have afforded them the opportunity to see and experience a lot – these stories are important.  

I had one patient, let’s call her Louise, who had a lengthy and diverse career working in many different places. She was 96 years old when I took care of her. She had worked in factories, in autobody shops, research facilities, often the only woman in the place. And she did all of this while being a mother.  

Things are different now, we should utilize our elders to further our own experiences, to understand where we come from, and where we can go. 

Read More