• Out of sight, out of mind. Fear and misperceptions ultimately fuel a lack of attention to older adult health, but keeping aging "off the radar" does little to remedy impediments to health as we grow older.In light of this, we are qualifying the AMA recommendation for referring to a person's age. Specifically, JAGS will require that authors use the term "older adult" when describing individuals aged 65 and older. Authors will also
The Beers Criteria are a valuable tool for clinical care and quality improvement, but may be misinterpreted and implemented in ways that cause unintended harms. In this paper, we describe the intended role of the 2015 AGS Beers Criteria, and provide guidance on how they should be used by patients, clinicians, health systems, and payors. A key theme underlying these recommendations is to use common sense and clinical judgment in applying the 2015 AGS Beers Criteria, and to remain mindful of nuances in the criteria. The criteria serve as a “warning light” to identify medications that have an unfavorable balance of benefits and harms in many older adults, particularly when compared to pharmacologic and non-pharmacologic alternatives. However, there are situations in which use of medications included in the criteria can be appropriate. As such, the 2015 AGS Beers Criteria work best not only when they identify potentially inappropriate medications, but when they educate clinicians and patients about the reasons those medications are included and the situations in which their use may be more or less problematic. The criteria are designed to support, rather than supplant, good clinical judgment.
In the early 1990s, visionary leaders at the American Geriatrics Society and The John A. Hartford Foundation recognized that the marked and growing shortage of geriatrics healthcare professionals would lead to a U.S. healthcare system ill prepared to provide optimal care for the ever-increasing number of older Americans. Led by the late Dennis W. Jahnigen, MD, they set forth a plan to address this shortage by collaborating with surgical and related medical specialists to create a series of programs to foster the highest quality care of older adults. Their unique programmatic vision was that every physician, not just geriatricians, would have basic knowledge and skills in geriatric care, because geriatricians cannot and should not meet the need alone.
The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought to the forefront of the collective public consciousness at different points throughout history. The COVID‐19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID‐19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well‐documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism.
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