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Physicians' perspectives on caring for cognitively impaired elders
- Authors:
- ADAMS Wendy L., et al
- Journal article citation:
- Gerontologist, 45(2), April 2005, pp.231-239.
- Publisher:
- Oxford University Press
This study aims to develop an in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. In-depth interviews were conducted with 20 primary care physicians in the USA. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis techniques. 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.