Interacting with the Elderly Patient, Family, and Referring Physicians

  • Dennis W. Jahnigen

Abstract

The relationship of the physician with an elderly patient involves more than simple application of the most current diagnostic and therapeutic information. Knowing this is necessary but not sufficient to ensure an optimum outcome. It also requires recognition of the differences and similarities between the patient and the physician. It requires sensitivity to age-related changes that may increase the anxiety associated with illness for the patient and that may increase the difficulty of obtaining accurate historical and physical information for the physician. It also involves appreciation of differences in the values among elderly patients and a willingness to negotiate what may be medically indicated or medically possible, with what is most desirable from the patient’s frame of reference. The goals of therapy for an elderly person may lie in relief of symptoms rather than a cure, preservation of independent living rather than returning to employment, and easing suffering at the end of life rather than fighting death.

Keywords

Elderly Patient Elderly Person Truth Telling Community Dwelling Elderly Person Medieal Decision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Strange GR, Chen EH, Sanders AB. Use of emergency departments by elderly patients: projections from a multicenter data base. Ann Emerg Med 1992;21:819–824.PubMedCrossRefGoogle Scholar
  2. 2.
    Singal BM, Hedges JR, Rousseau EW, et al. Geriatric patient visits. Part I. Comparison of visits by geriatric and younger patients. Ann Emerg Med 1992;21:802–807.PubMedCrossRefGoogle Scholar
  3. 3.
    Sanders A, Morley J. The older person in the emergency department. J Am Geriatr Soc 1993;41:880–882.PubMedGoogle Scholar
  4. 4.
    Ettinger W, Fried L, Harris T, et al. Self-reported causes of physical disability in older people. J Am Geriatr Soc 1994;42:1035–1044.PubMedGoogle Scholar
  5. 5.
    Fahs M. Primary medical care for elderly patients II. J Commun Health 1989;14:89–99.CrossRefGoogle Scholar
  6. 6.
    Gastei B. Working With Your Older patient: A Clinician’s Handbook. Bethesda, MD: National Institute on Aging, National Institutes of Health, 1994.Google Scholar
  7. 7.
    Adelman R. Green M, Charon R. Issues in physician-elderly patient interaction. Ageing Soc 1991; 2: 127–148.CrossRefGoogle Scholar
  8. 8.
    Anderson L, Zimmerman M. Patient and physician perceptions of their relationship and patient satisfaction: a study of chronic disease management. Patient Educ Counsel 1993;20:27–36.CrossRefGoogle Scholar
  9. 9.
    Beisecker A, Beisecker T. Patient information-seeking behaviors when communicating with doctors. Med Care 1990;28:19–28.PubMedCrossRefGoogle Scholar
  10. 10.
    Green M, Adelman R, Charon R, Friedman E. Concordance between physicians and their older and younger patients in the primary care medical encounter. Gerontologist 1989;29:808–813.CrossRefGoogle Scholar
  11. 11.
    Haug MR (ed). Elderly Patients and Their Doctors. New York: Springer, 1981.Google Scholar
  12. 12.
    Beisecker AE. Aging and the desire for information and input in medical decisions: patient consumerism in medical encounters. Gerontologist 1988;28:330–335.PubMedCrossRefGoogle Scholar
  13. 13.
    Branch L, Nemeth K. When elders fail to visit physicians. Med Care 1990;23:11.Google Scholar
  14. 14.
    Carlson M, Jahnigen D. The hospital gown. J Am Geriatr Soc 1991;38(8):A30.Google Scholar
  15. 15.
    Glasser M, Prohaska T, Roska J. The role of the family in medical case-seeking decisions of older adults. Family Commun Health 1992;15:59–70.CrossRefGoogle Scholar
  16. 16.
    Haley W, Clair J, Saulsberry K. Family caregiver satisfaction with medical care of their demented relatives. Gerontologist 1992;32:219–226.PubMedCrossRefGoogle Scholar
  17. 17.
    Jahnigen DW, Schrier RW. The doctor/patient relationship in geriatric care. In: Jahnigen D, Schrier RW (eds) Issues in the Care of the Elderly, vol 2. Philadelphia: Saunders, 1986:457–464.Google Scholar
  18. 18.
    Drickamer MA, Lachs MS. Should patients with Alzheimer’s disease be told their diagnosis? N Engl J Med 1992;326:947–951.PubMedCrossRefGoogle Scholar
  19. 19.
    Americans View Aging. Alliance for Aging Research, 1991.Google Scholar
  20. 20.
    Miller D, Jahnigen D, Gorbien M, Simbartl L. Cardiopulmonary Resuscitation: how useful? Attitudes and knowledge of an elderly population. Arch Intern Med 1992;152: 578–582.PubMedCrossRefGoogle Scholar
  21. 21.
    Murphy D, Burrows P, Santilli S, et al. The influence of the probability of survival on patients’ preferences regarding cardiopulmonary resuscitation. N Engl J Med 1994;330: 545–549.PubMedCrossRefGoogle Scholar
  22. 22.
    Fabiszewski K, Volker B, Volicer L. Effect of antibiotic treatment on outcome of fevers in institutionalized Alzheimer’s patients. JAMA 1990;263:3168–3172.PubMedCrossRefGoogle Scholar
  23. 23.
    Quill T. Utilization of nasogastric feeding tubes in group of chronically ill, elderly patients in a community hospital. Arch Intern Med 1989;149:1937–1941.PubMedCrossRefGoogle Scholar
  24. 24.
    McCann R, Hall W, Groth-Juncker A. Comfort care for terminally ill patients: the appropriate use of nutrition and hydration. JAMA 1994;274:1263–1268.CrossRefGoogle Scholar
  25. 25.
    Fabiszewski K, Volicer B, Volicer L. Effect of antibiotic treatment on outcome of fevers in institutionalized Alzheimer patients. JAMA 1990;263:3168–3172.PubMedCrossRefGoogle Scholar
  26. 26.
    Miller D, Gorbien M, Simbart L, et al. Factors influencing physicians in recommending in-hospital cardiopulmonary resuscitation. Arch Intern Med 1993;153:1999–2003.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Dennis W. Jahnigen

There are no affiliations available

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