Intended for healthcare professionals

News Roundup

Age discrimination difficult to identify, says King's Fund guide

BMJ 2003; 326 doi: (Published 15 February 2003) Cite this as: BMJ 2003;326:355
  1. Sarah Macdonald
  1. London

    Older people may be missing out on vital health and social care services because age discrimination is not being identified, according to a guide published by health policy organisation the King's Fund.

    The guide blames a lack of expertise in recognising ageism as the problem. Its author, Ros Levenson, says, “Tackling age discrimination is too low on the agenda for many health and social care organisations. But ageism is a serious equality issue.” Older people “must be able to access services on the basis of clinical need and on equal terms with younger people.”

    The guide says that a lot can be achieved if older people are treated with dignity. If things are to change, “older people must be involved in the process in a continuous way. Their knowledge and experience of using … health and social care services cannot be second guessed by anyone else.”

    Unlike discrimination relating to race, sex, and disability, ageism is not yet the subject to antidiscrimination legislation in the United Kingdom. This will change when European Union laws come into place in 2006, but until then ageism remains difficult to define.

    Compiled from research carried out by groups in Leeds, Cambridgeshire, and Sussex, the guide says that direct ageism is rare. An example that the researchers came across was the case of a neurology nurse whose remit was to provide care only for people aged under 65. However, it cites many cases of indirect ageism, including difficult access to buildings, lower referral rates, and early discharge without supporting services.

    Ageist attitudes that undervalue older people are also common. It is often assumed that older people are a homogeneous group and diversity and individuality are not recognised. Similarly, old people may often be referred to as “dear” without ascertaining their preferences.

    The guide offers strategies for dealing with age discrimination, while recognising that many obstacles need to be overcome. “Staff and older people may have ageist attitudes,” it says. And it can be difficult to identify age discrimination because not everyone is familiar with the concept.

    Scrutiny groups set up to identify and eliminate age discrimination in health and social care should involve older people, not just a “token” older person. Older people should be supported in coming to meetings and given briefings before meetings, and the use of jargon should be avoided. Group members should also be given the chance to get to know one another.

    Other methods suggested for representing older people's views include setting up older people's forums and telephone conferences.

    Auditing Age Discrimination: A Practical Approach to Promoting Equality in Health and Social Care is available from the King's Fund bookshop (tel 020 7307 2591;, price £15.