Physicians' perspectives on caring for cognitively impaired elders

Wendy L. Adams, Helen E. McIlvain, Jenenne A. Geske, Judy L. Porter

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Purpose: This study aims to develop an in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis techniques. Results: A patient's impaired ability to provide an accurate history and to participate in self-care hindered the usual process of care, often resulting in greater medical uncertainty and feelings of inadequacy and frustration for the physician. Shifting the goal of care from "curing" the patient's illness to "caring" for the patient's quality of life was also problematic. The doctor-patient relationship changed dramatically as others became involved in care, often with attendant ethical dilemmas related to patient autonomy and the locus of decision making. Many physicians described a deep sense of loss and grief as the personhood of patients faded. The increased complexity and prominent social and emotional issues were difficult to manage in the context of the current model of practice. Implications: Profound changes occur in the process of care with cognitively impaired patients. The increased complexity mandates an expanded model of care that addresses the prominent psychosocial and ethical aspects of care as well as the medical ones.

Original languageEnglish (US)
Pages (from-to)231-239
Number of pages9
JournalGerontologist
Volume45
Issue number2
DOIs
StatePublished - Apr 2005

Fingerprint

Physicians
Primary Care Physicians
Patient Care Planning
Personhood
Aptitude
Frustration
Grief
Self Care
Uncertainty
Decision Making
Emotions
History
Quality of Life
Interviews

Keywords

  • Cognitive impairment
  • Geriatrics
  • Primary health care

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Cite this

Physicians' perspectives on caring for cognitively impaired elders. / Adams, Wendy L.; McIlvain, Helen E.; Geske, Jenenne A.; Porter, Judy L.

In: Gerontologist, Vol. 45, No. 2, 04.2005, p. 231-239.

Research output: Contribution to journalArticle

Adams, Wendy L. ; McIlvain, Helen E. ; Geske, Jenenne A. ; Porter, Judy L. / Physicians' perspectives on caring for cognitively impaired elders. In: Gerontologist. 2005 ; Vol. 45, No. 2. pp. 231-239.
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