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How general practitioners perceive the aging trajectory of oldest-old - A qualitative study
Emile Escourrou1,2,3, Thomas Joyeux4, Matthieu Guilhem4
1Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, 133 route de Narbonne, 31400, Toulouse, France. emile.escourrou@dumg-toulouse.fr.
BMC Primary Care
|January 9, 2023
Summary
General Practitioners (GPs) perceive aging as inevitable and unpredictable. GPs adapt care for the oldest-old (90+) by disengaging medically and focusing on essential outcomes like fall prevention.
Area of Science:
- Geriatrics
- Primary Care Medicine
- Qualitative Research
Background:
- The population of the oldest-old (individuals aged 90 and over) is rapidly increasing.
- Caring for the oldest-old presents unique challenges within primary care settings.
- Understanding General Practitioners' (GPs) perspectives on aging and adapting care is crucial.
Purpose of the Study:
- To analyze GPs' perceptions of the aging process in patients reaching very advanced age.
- To explore how GPs adapt their clinical practice for the care of the oldest-old.
Main Methods:
- A qualitative study was conducted in southwest France.
- Data were collected through focus groups and individual interviews with GPs.
- Thematic analysis with researcher triangulation was employed to analyze interview data.
Main Results:
- GPs viewed aging as an individual, unpredictable, and irreversible process.
- The transition to "very old age" was perceived as inevitable, sometimes marked by physical/psychological shifts or self-neglect.
- Care for the oldest-old requires individualized approaches, including medical disengagement and prioritizing essential outcomes like fall prevention and functional decline limitation.
Conclusions:
- GPs recognize an inevitable shift towards very old age.
- A concept of "medical disengagement" was identified in GPs' care of their oldest patients, focusing on less invasive practices and essential outcomes.
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