Many people living with chronic pain have at some point felt dismissed by medical professionals—and for older individuals experiencing pain, their age often becomes an additional barrier when they seek out medical help. When older patients’ pain is overlooked because of their age, it can affect quality of life and even life expectancy.
Telehealth technology has been a positive change for many—but for some, it is not a workable solution, whether because of an unfamiliarity with the tools or the absence of a hands-on diagnostic approach. This may significantly impact individuals with limited mobility, hearing, or vision, also common as people age.
Lindsay Clarke, senior vice president of health education and advocacy at the Alliance for Aging Research (agingresearch.org), notes that telehealth can be particularly challenging for aging individuals. “More than 60% of adults over the age of 65 are smartphone owners, and many are very adept at using them,” Clarke says. “However, providers should consider font size, volume controls, ease of use, and other accessibility standards when designing and offering telehealth and other health care technologies.”
Transportation can be a challenge as well. Not every person can drive or has a caregiver to bring them to appointments. The physical and financial cost of ride-sharing and public transportation limits some individuals’ options even further. Clarke suggests contacting the local Area Agency on Aging to ask about local organizations that can help with rides.
Ellen Lenox Smith and Stu Smith, co-directors of Medical Cannabis Advocacy for the U.S. Pain Foundation, offer insight from an advocacy standpoint. And with their own health issues—Ellen lives with Ehlers-Danlos syndrome and sarcoidosis, and Stu has Parkinson’s disease—they have firsthand experience when it comes to health care disparities, including those related to age.
Ellen identifies another challenge for seniors: traveling longer distances to get to appointments. For individuals living with pain who can’t find help from a nearby physician, options may be limited. Traveling to find second opinions or doctors specializing in certain conditions can cause a significant physical, mental, and financial burden.
“Traveling to the right medical specialist [that may be out of state] isn’t always covered [by insurance],” Ellen shares—and many older individuals are not able to travel long distances to find the right specialist because their medical conditions or pain make the trek impossible. “Adding [medical] complications to aging becomes a real problem.”
When pain is brushed aside
Some individuals living with pain are incorrectly told they are overreacting or that pain is a natural part of aging. For people with serious underlying conditions, hearing the words “you’re fine; you’re just getting older” from a physician can cause feelings of helplessness and belittlement.
“If you have any symptoms as you get older that are getting misinterpreted as being old and whiny, doctors won’t search for a solution,” Ellen says. “It’s really hard to fight the battle, and if you don’t have the type of personality where you stand up for yourself, you get lost in the system.”
For those who may struggle to even get to an appointment, having their pain be dismissed due to their age shows how badly the current health care landscape is failing aging people with pain.
“Older adults are less likely to report their pain because they may not want to be perceived as complaining, or they may believe that it’s an unavoidable part of their disease or disease treatment, that there are no treatments for their pain, or that their pain is a part of aging that can’t be changed and must instead be accepted,” Clarke shares. “More training for clinicians on treating pain in older patients could help increase self-reporting and lead to more effective treatment plans.”
Creating a clinical environment in which individuals feel comfortable speaking about their ailments and pain is vital, Ellen adds: “Many elderly people find it embarrassing to bring these issues up that probably should be spoken about.”
Sometimes, this leads to incorrect diagnoses or incomplete treatment plans. Lack of communication can also cause serious issues with medication interactions.
“[Doctors] have an obligation to present the best plan for people,” Stu says. “I’m not sure they do that with elderly people. … When you have a special condition, it’s very difficult to get the amount of time you need.”
Advocating for equitable care
As a physical therapist assistant with 22 years of experience, 19 of those providing care to seniors, Teresa Gardner has seen firsthand the struggles and disparities many aging individuals face. Her place of employment offers assistance with telehealth and transportation. “If it were not for our employees helping, many would not be able to be seen,” she says.
Gardner encourages open communication between individuals and their health care providers as they work to find an effective treatment plan, using trial and error to find what helps with pain and what does not.
“Never stop being your own advocate,” Gardner advises. “Push for the medications that help, push for the therapy to help with pain, learn alternative approaches to pain, practice self-care, learn your limits.”
Urging health care professionals to treat aging people with respect and empathy, Ellen and Stu note that older patients are not looking for a cure-all, but rather belief, understanding, help, and direction: “Doctors need to remember that it is OK that you can’t fix us.” But aging patients with chronic conditions still deserve the best quality of life medicine can provide. •