Auais: How to fight ageism in health care through the power of stories

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Since the beginnings of human civilization, storytelling has been a powerful way to bridge gaps and bring people together. I believe stories also hold the key to addressing ageism in healthcare — to building personal connections between health professionals and their older patients.

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Ageism is a negative attitude, stereotyping or discrimination against older adults. In our health-care system, research shows ageism associated with worsened disability and poorer health. That means seniors being under-treated or misdiagnosed for common conditions, ignored, subjected to paternalism or having decisions forced upon them. The pandemic has only amplified this trend.

Better health care starts with better health education; instructors must find compelling and innovative ways to change hearts and minds. That’s why my team developed a podcast research project at Queen’s University to determine whether storytelling can motivate students to care for older patients.

Negative attitudes about older adults also mean that students — our future health-care providers — aren’t interested in working with this rising population. In Canada, just over 300 physicians specialize in older adult care. We now have more than seven million seniors; that’s an average of only one specialist for every 23,000 older people. This is a widespread problem, not limited to any health profession.

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To address this issue head-on, we launched a unique storytelling initiative in a gerontology course that I teach for future physical therapists. Stories connect us; they can provoke interest, empathy and understanding. Could my students’ attitudes be changed by hearing authentic stories from older adults?

We chose a podcast format to make it easier to record and share patient interviews. (Emerging research also shows that students prefer podcasts to textbooks for learning.) Every Gerocast episode featured one senior’s powerful story and included student reflection questions and a related group assignment. What we ended up with was an interactive experience, where students take their “lessons learned” and apply them in practice.

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The themes of the episodes ranged from social isolation, to experiences with substitute decision-making and legal guardianship, to caring for someone with dementia.

For example, my students heard a patient named Sheila share her experience as an older adult with urinary incontinence — from how it affects her day-to-day life to her interactions with different health professionals.

They listened to the story of Adrienne and her late husband, Ron, who lived together for 56 years. Adrienne took my students on a journey to understand what it meant for her husband to live with serious disease and how he arrived at the difficult decision to undertake assisted dying.

When we surveyed students who took part in our research pilot, most said the podcast was an effective strategy for learning about older adults and increased their understanding of the issues facing them.

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I believe that it was the deeply personal nature of the episodes that resonated with students. They noted that they were able to “hear the emotions” of the senior. As one student put it, “Listening to these seniors makes you feel their story and see their struggle.” Tellingly, many of my students reported they were newly considering the possibility of working in a geriatrics setting when they graduate.

This initiative could easily be implemented in other courses, programs and institutions to train health professionals.

My biggest takeaway for health education: listening to seniors’ stories is important. It turns out that it a sense of connection can really change people’s minds. And in turn, this has the power to change our health-care system and change the outcomes of our most vulnerable patients.

I dream of health-care settings where all older adults feel respected, connected with the health-care team, prioritized and cared for with empathy and compassion. And I know that we can do this … one story at a time.

Mohammad Auais is an assistant professor in the School of Rehabilitation Therapy at Queen’s University. Watch his Research Talk: healthsci.queensu.ca/5a7