Refashioning the uneasy relationship between older people and geriatric medicine

Perspectives and experiences of the first geriatricians trained in Canada

Many Canadian-trained geriatricians from the subspecialty's first decade of existence continue to practice today. The objective of this study was to examine the experiences and perspectives of the earliest cohort of geriatricians in Canada. Using qualitative description method, we conducted semi-structured interviews to explore participants' experiences in training and practice. We included geriatricians who trained in Canada between 1980-1989 and were in active clinical practice as of October 2021. Each transcript was coded independently by two investigators. Thematic analysis was used to develop key themes. Fourteen participants (43% female, mean years in practice 35.9) described their choice to enter geriatric medicine, their training process, the roles of a geriatrician, challenges facing the profession and advice for trainees. Two themes were developed from the data: (i) advocacy for the older adult and (ii) geriatrics as "the road less taken". Advocacy was described as the "core mission" of a geriatrician. Participants discussed the importance of advocacy in clinical practice, education, research and disseminating geriatric principles in the health system and society. "The road less taken" reflected the challenges participants faced during training, which led to relatively few geriatricians for the growing number of older adults in Canada. Despite these challenges, participants described rewarding careers and encouraged trainees to consider the profession.

Don't call me elderly: a review of medical journals' use of ageist literature

PURPOSE

Older people do not want to be called 'elderly' (Falconer et al. in BMJ 334: 75-88, 2007). The UN Committee on Economic, Social and Cultural Rights of Older Persons agreed in 1995 that the term 'older persons' is preferred over 'elderly' 'seniors' and 'the aged'. Medical literature may lag behind this trend and continued to refer to older adults by nomenclature that they find stigmatising. We examined the use of stigmatising language in two medical journals.  METHODS: All articles published by Age and Ageing and European Geriatric Medicine from January 2018 to December 2020 were reviewed. The articles were searched for the use of the words 'elderly', 'senior', and 'the aged' as well as 'older'.

RESULTS

383 articles were published in the EGM and 511 in Age and Ageing. In the EGM, 80 articles (20.8%) used stigmatising language. In Age and Ageing, 90 (17.6%) used stigmatising language.

CONCLUSION

While progress has been made in reframing the language used in journal articles compared to previous studies (Lundebjerg et al. in J Am Geriatr Soc 65: 1386-1388, 2017), more can be done to ensure our compliance with addressing older adults by their preferred terminology.