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Physicians' perspectives on caring for cognitively impaired elders
Wendy L Adams1, Helen E McIlvain, Jenenne A Geske
1Departmentof Geriatrics, Dean East Clinic, Madison, WI, USA.
The Gerontologist
|April 1, 2005
Summary
Caring for cognitively impaired elders presents challenges for primary care physicians, impacting the doctor-patient relationship and requiring a shift in care goals. An expanded care model is needed to address psychosocial and ethical issues alongside medical ones.
Area of Science:
- Geriatrics
- Primary Care Medicine
- Cognitive Impairment Research
Background:
- Cognitive impairment significantly affects elder care.
- Primary care physicians face unique challenges in managing these patients.
Purpose of the Study:
- To understand primary care physicians' perspectives on caring for cognitively impaired elders.
- To identify key issues and challenges in this care setting.
Main Methods:
- Conducted in-depth interviews with 20 primary care physicians.
- Utilized grounded theory analysis for qualitative data interpretation.
Main Results:
- Physicians experienced medical uncertainty and frustration due to patients' limited history-taking and self-care abilities.
- The shift from 'curing' to 'caring' and managing ethical dilemmas related to autonomy posed difficulties.
- Physicians reported feelings of loss and grief as patients' personhood diminished.
Conclusions:
- Caring for cognitively impaired patients necessitates profound changes in the care process.
- An expanded model of care is crucial, integrating psychosocial and ethical considerations with medical management.
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