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No room at the inn: How ageism and sexism drive health care for elderly women

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Woman's feet under a rumpled sheet on a stretcher in an emergency department.

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"No room at the inn" could easily be the title of an article I would write, as a street nurse, about overcrowded homeless shelters and people forced to sleep outside in dangerous situations or in church basements across the country. "No room at the inn" could also be about the intentional withdrawal of government funding to life-saving social programs such as shelters or the federal government's non-funding of the upstream solution -- a national housing program.

But it's not. Instead, I'm using the phrase that a vibrant and active elderly woman, who I'll call Maggie, used to describe her experience with the health care system in a rare time of need: "No room at the inn."

There was "No room at the inn" for Maggie when she fell at home and was taken by ambulance to the local emergency department to rule out a hip fracture. No room on the second trip to emerg either. No room on the third ambulance trip. Not even room on the fourth trip when a triple pelvic fracture was finally diagnosed two weeks after her initial fall. On each visit Maggie's children advocated for her to be admitted for medical investigation to determine the root cause of the fall, for proper diagnostic tests, pain management and convalescence. They were repeatedly told, "we have no beds" and to follow-up with the family doctor. Maggie was essentially discarded. After each visit she went downhill. Her family was alarmed and desperate.

But the story, as many of you will know, is not just about the mantra of "we have no beds". The new norm is crowded emergency rooms where the elderly may be left in wheelchairs in a drafty waiting room wearing only a thin hospital gown or left to lie in the hallway on a stretcher for hours or days. In some hospital emergency departments, no meals are provided unless the individual is admitted, which can take days.

For the elderly and particularly for elderly women, who are facing the consequences of pelvic or hip fractures, the writing is on the wall. Ageism dominates the direction of care. Sexism closes the deal.

I've long been aware that vulnerable populations suffer disproportionately within the health care system. I'm also personally aware of the role sexism plays in medical care and choices for women. Look at how long it took for the medical establishment to realize that women experiencing cardiac problems did not receive the same level of cardiac interventions as men.

Canada has an aging population. Elderly women are more likely to experience skeletal fragility and pelvic fractures in a fall. They are also more likely to suffer complications resulting in both a diminishment of their quality of life, their independence and significantly their lifespan. Yet they remain shunned and ignored in a health care system that makes no room for them, that trivializes their pain and that ignores their mobility, rehabilitation and convalescent needs.

So, what to do? Help make healthcare a federal election issue this year. Maggie could be your mother.

Join and donate to the Canadian Health Coalition or its provincial or local counterpart.

Photo: by Cathy Crowe

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