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Is the Real Issue Age or Competence?

Is the Real Issue Age or Competence?

By Susan Williams

I read a really interesting article in the New York Times recently entitled “When Is The Surgeon Too Old To Operate“. The article highlighted that similar to many other professions, the population of physicians is aging. It then went on to raise the question of how to determine whether an aging physician is still able to practice and what is the best way to evaluate and discuss this.

Right after I read this article, I noticed another article in Forbes on a different but similar topic. It shared the challenges about talking with your elderly parents about whether they should continue to drive or live independently.

Whether we like it or not, the issue concerning at what age someone remains competent to do things is going to become a much larger discussion point. Most often however these types of discussions are extremely sensitive. They can often involve someone’s identity, purpose, mobility and their much guarded independence.

But these situations often involve a much larger issue as well – the potential harm that someone could cause to either themselves or others if we don’t have these conversations.

So what do we need to put in place to protect both the individual and others while at the same time ensuring that we are not taking an ageist approach to these topics?

I think the conversations should strictly stay focused on the discussion of competence and age shouldn’t even be considered. For example, who would you prefer to operate on you – an incompetent surgeon who was 40 years old or a highly competent surgeon at the age of 75?

Just because someone turns a certain age does not mean that they are no longer capable.

There is a great deal of research emerging that shows our biological age is much more critical than our chronological age. We all do not behave the same way at the same age. For example I know some people at 80 that are barely making it through the day and others that are extremely mobile, active and engaged. Same age but living totally different lives.

So when it comes to a service or profession, I think anyone who manages any professional or individual who has a direct impact on the lives of others must have some way to assess the competency of these individuals. Whether it’s through some type of measures, re-certification process, client feedback or other form there needs to be an ongoing method of evaluation. And this assessment should not be based on age.

If someone gets flagged as having a competence issue, then a conversation needs to occur as to what needs to be done to correct the situation. Given the potential impact in these roles, an awkward conversation could be the least of the concerns should someone actually be harmed.

As for having these types of conversations with aging relatives, again rather than age being the trigger point, some assessment of competencies needs to be made.

For instance, Psychology Today published the following eight signs to watch to help you tell whether your elderly parent should consider stopping driving. As I read through the list, I thought age shouldn’t be a factor in this either. I know quite a few young people who should be talked to based on this list;

  1. Hearing and/or sight loss
  2. Minor dents to the car
  3. Easily distracted
  4. Regular alcohol consumption (I would add drugs or medications to this as well that could impair judgement)
  5. Slow reaction time
  6. Poor driving techniques
  7. Multiple tickets
  8. Your nervous in the passenger seat

And as for living independently, again there are also signs to watch for. Again, these are not based on any specific age but focused on capabilities to care for themselves without support.

I think if we are able to have these conversations and frame them in such a way that it’s about caring for the individual and others they may impact, age should never need to even enter into these discussions. As well, we need to also prepare ourselves to be open for others to potentially have these conversations with us at some point.

After all, when we focus on competency – it doesn’t have a best before date.

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