NURS 445 Week 3 Discussion Board Forum 2 Example

Discussion Board Forum 2: Recognizing Ageism in Everyday Nursing Care

NURS 445 Contemporary Issues in Nursing and Healthcare, Discussion Board Forum 2

Thread by [Student Name]

The clinical examples and classmates are composites; the textbook and journal articles cited are real.

Last week I walked into the room of an 84-year-old man recovering from pneumonia, smiled at his daughter and asked her, "How's he doing today?" He answered before she could: "He is doing fine, and he can talk." He was right, and I was embarrassed. His daughter laughed and said, "He's been telling everyone that all week," which told me I was not the first to make the mistake. Reading this week's chapters, I realized I had done something many nurses do without noticing.

Mauk (2018) describes how negative stereotypes of aging, the assumptions that older adults are frail, confused, unproductive or unable to decide for themselves, shape the attitudes of health care workers as well as the public, and how gerontological nursing requires recognizing and countering them. When I looked at my own practice, I found at least four ways those stereotypes show up. I sometimes speak to family members instead of the patient. I use terms like "sweetie" with older women that I would never use with a 40-year-old. I have heard colleagues, and occasionally myself, describe new confusion as "just his age" instead of a change to assess for delirium. And I rarely ask older patients what matters most to them about their recovery, even though I ask younger patients about returning to work.

Aydin et al. (2026) interviewed 18 nursing students working on a palliative care unit and described how ageism appeared in clinical care, including in how older patients were communicated with and cared for, and how the students' experiences prompted self-awareness about their own attitudes toward old age. Attitudes are not fixed. Nehls et al. (2026) studied 247 undergraduate and graduate students who completed an intergenerational service-learning experience in nursing facilities and found significant improvements in aging awareness and attitudes, fall prevention skills and workforce readiness. Spending time with older adults as people, not only as patients, seems to change how students think about them, and I suspect the same is true for practicing nurses who rarely see older adults outside a hospital bed.

Ageism also has consequences beyond hurt feelings. When new confusion is dismissed as normal aging, delirium goes untreated; when an older patient's goals are not asked about, care plans may aim at outcomes the patient does not want; and when patients sense they are being talked around, they may stop reporting symptoms. Each of the habits I noticed in myself carries one of these risks. I plan to adopt three habits. I will greet the patient first and ask whether they want family members to answer for them. I will call patients by their preferred names. And I will treat any new confusion as a finding to report, not a feature of age. Ageism in nursing rarely sounds cruel; it usually sounds kind, which is why it is so easy to miss.

Reply to Rebecca

Rebecca, your description of a nursing assistant who spoke to a resident in a sing-song voice, "Are we ready for our bath?", is a textbook example of elderspeak. It often comes from affection, but residents can hear it as treating them like children. Mauk (2018) emphasizes respect for the older adult's dignity and autonomy as central to gerontological nursing, and the tone of everyday speech is one of the most visible ways that respect is shown or withheld. I wonder whether your unit could address elderspeak in a short huddle without shaming anyone, perhaps by asking residents what they prefer to be called and posting it in their rooms. When I tried asking patients directly, several were surprised to be asked, and one woman told me no one had called her by her name, rather than "honey," in weeks. Have any of your residents commented on how staff speak to them? Their answers might make the most persuasive case to your coworkers, since staff tend to listen when residents speak for themselves.

Reply to Marcus

Marcus, you described a 79-year-old woman who refused to use a walker after a fall and the frustration of the team, who labeled her "noncompliant." Her choice may be risky, but it may also reflect what matters most to her, such as feeling independent or not looking frail in front of her neighbors. Aydin et al. (2026) found that nursing students who examined ageism in practice became more aware of how their own assumptions about old age shaped their care, and I think "noncompliant" is sometimes one of those assumptions in disguise. Respecting autonomy does not mean ignoring safety. It could mean asking her what she fears about the walker, offering a cane or physical therapy and documenting that she understands the risks. Did anyone on the team ask her why she refused? Sometimes the answer is practical, such as a walker that does not fit through her bathroom door, and the solution is easier than the label suggests.

References

Aydin, M., Yarar, Y. A., Kaçan, N., & Çakmak, M. (2026). Experiences of ageism in palliative care: Nursing students' perspectives. Nurse Education Today, 168, 107410. https://doi.org/10.1016/j.nedt.2026.107410

Mauk, K. L. (Ed.). (2018). Gerontological nursing: Competencies for care (4th ed.). Jones & Bartlett Learning.

Nehls, M. S., Michalik, J. L., Pipgrass, K. D., Clough, B. M., Crandall, K. J., & Ickes, M. J. (2026). An intergenerational service-learning project improves attitudes and awareness toward aging, fall prevention skills, and workforce readiness among undergraduate and graduate students. Gerontology & Geriatrics Education. Advance online publication. https://doi.org/10.1080/02701960.2026.2737860