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Jane Giddan and Ellen Cole Headshot

Ageism in the ER

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I am 72 years old, and yesterday I fell off my bike. I wish I could tell you that I was popping a wheelie or going too fast, because that might have been thrilling and would be a better story. I was standing still. Actually, I had stopped just before a steep downhill, planning to walk the bike down. I put one foot on the ground and then started to bring my other leg over the seat. My husband has told me a thousand times to tilt the bike so it's not such a big stretch, but I never do. Well something got caught on something, I toppled over and so did the bike -- on top of me. I landed hard on my left jaw bone and heard it crack, or so I imagined, but at least I knew right away that my right hip was fine. Now this is important, because exactly a year ago I had a total hip replacement. I also felt my teeth, and they were intact. I could live with a broken jaw -- in fact, I giggled picturing myself with a gauze bandage starting under my chin, with a bow at the top of my head.

It did hurt, though, and my neck and jawline started to swell right away. (FYI, I was wearing a helmet. The injury was at the strap line.) My husband drove me to the ER, because even though a broken jaw would, we assumed, likely require ice and ibuprofen, both of which we had had home, it didn't seem like a good time to be cavalier. Picture us: We walked into the hospital wearing our sweaty biking clothes -- shorts and t-shirts, a couple of reasonably-fit septuagenarians. After three and a half hours of tests and questions by a variety of cordial health care workers and mostly being left alone, I learned happily that nothing was broken, my diagnosis was bruising, and my prescription was... ice and ibuprofen. So far, pretty good.

The check-out nurse handed me a sheaf of papers and said, "I see you've requested information on fall prevention." Really? I don't think so. I could use information on bike safety, getting on and off, braking, yes I really could use a bike-riding class designed for women in their 70's, but fall prevention? I read the handout. The last line said, "You should make small changes to your home to keep from falling. You could add a tub mat to keep you from slipping. You can also fix loose carpeting and rugs so you won't trip." The prior two pages had equally incongruous advice: "Do not rush to answer the doorbell or the phone. Take your time." Honestly, I didn't know whether to laugh or cry. I fell off my bike on a bike path, for pete's sake.

Now, I do not want to minimize or trivialize the importance of these instructions. Falling is a risk for older women. According to the Centers for Disease Control and Prevention, each year in the United States, one in every three people 65 and older falls. Falls are the most common cause of nonfatal injuries and hospital admissions for trauma in this age group, and they can also lead to death.

Specifically, according to a 2003 study from the Journal of the American Geriatrics Society, "more than 1.8 million adults, age 65 and older, were treated in emergency departments for fall-related injuries." I do want to know about home safety and fall prevention. But...I do not need grab-bars next to my toilet yet, and I pride myself on running up the stairs, not even touching the handrail. Whoever thought I needed these instructions at this particular time stereotyped me as a 72 year old statistic.

The ER and the world at-large seem to be in accord in categorizing us as universally retired (in fact, I am working more hours now than ever and think of myself as being in many ways at the top of my game) and frail (in fact, I'll race you up that staircase). Some of us are retired and/or frail. Many are not. Being handed instructions to be sure to have your cane, walker or other assistive device "inspected regularly," even when you can still play tennis, ride a bike and walk many miles unaided is really not appropriate. I wish the hospital personnel had treated me as a woman who fell off a bicycle, validated me as someone who is healthy, albeit perhaps even somewhat accident-prone, rather than stereotyping me by just my age. And I wish this was true more broadly, as well.