Skip to main content
SpringerLink
Log in

Dealing with Older Patients: Health and Disease in Old Age

  • Chapter
  • First Online:
The Role of Family Physicians in Older People Care

Part of the book series: Practical Issues in Geriatrics ((PIG))

  • 514 Accesses

Abstract

In this chapter the focus of our attention is on the older person who is not necessarily sick. The key concepts are the subjectivity and personal experiences of the patient. In connection to these perceptions, the patient generates his/her hypotheses of diagnosis and therapy, which he or she then brings to the consultation and that influence his/her relationship with the medical and care staff. We in the medical world must interrogate on ourselves the meaning of healthy elderly person, on how to trace a boundary between the concept of health and sickness in old age, but also the meaning of frailty. The elderly person is immersed in a net of relations, which include those of care, that have been built throughout their whole life and have been moulded through the contact with the health system, doctors and the sanitary consumerism which is typical of our day and age. In this chapter we go further into these ideas with the aid of real stories. The use of these stories allows us to integrate humanities with medical and scientific knowledge. We mention also the educational field and we use stimuli from anthropological and sociological literature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Denjoy N, Why patient-centred approaches are important, OECD Observer N. 3019 Q1 2017:27.

    Google Scholar 

  2. Wenzel M, Complex patients: how healthcare must adapt to their needs, OECD Observer N. 3019 Q1 2017:21–22.

    Google Scholar 

  3. Guria A, Editorial, Our health system must put people at the centre, OECD Observer N. 3019 Q1 2017:3.

    Google Scholar 

  4. Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88(2):251–8.

    Article  CAS  PubMed  Google Scholar 

  5. Byron GJ. Medicine, rationality and experience: an anthropological perspective. Cambridge: Cambridge University Press; 1994.

    Google Scholar 

  6. Claudine H. The individual, the way of life and the genesis of illness. In: Bury M, Gabe J, editors. The sociology of health and illness. NY: Routledge; 2004. p. 27–35.

    Google Scholar 

  7. Middelton J. The exceptional potential of the consultation revisited. J R Coll Gen Pract. 1989;39:383–6.

    Google Scholar 

  8. Parisi G, Demurtas J. The consultation with older patient in primary care: communication, management and clinical reasoning. In: J. Demurtas, N. Veronese (eds.), The Role of Family Physicians in Older People Care. Practical Issues in Geriatrics. Springer Nature Switzerland AG. 2022.

    Google Scholar 

  9. Fulop T, Larbi A, Khalil A, Cohen AA, Witkowski JM. Are we ill because we age? Front Physiol. 2019;10:1508.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Besdine RW. Quality of life in older people. Merk Manual Professional version 2019.

    Google Scholar 

  11. Bowling A, Dieppe P. What is successful ageing and who should define it? BMJ. 2005;E 331:24–31.

    Google Scholar 

  12. American Geriatrics Society. Updated AGS beers criteria® for potentially inappropriate medication use in older adults. JAGS. 2019;67:674–94. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel*

    Article  Google Scholar 

  13. Rowe JW, Kahn RL. Human aging: usual and successful. Science. 1987;237:143–9.

    Article  CAS  PubMed  Google Scholar 

  14. Crowther MR, Parker M, Achenbaum WA, Larimore W, Koenig HG. Rowe and Kahn’s model of successful aging revisited: positive spirituality—the forgotten factor. The Gerontologist. 2002;42(5):613–20.

    Article  PubMed  Google Scholar 

  15. Parsons T, Turner BS. The social system, (Preface to the New Edition) First published in England 1951 by Routledge & Kegan Paul Ltd New edition first published 1991 by Routledge 11 New Fetter Lane London EC4P 4EE.

    Google Scholar 

  16. Freidson E. Client control and medical practice. Am J Sociol. 1960;65(4):374–82.

    Article  Google Scholar 

  17. Searle JR. Mind, language and society. Philosophy in the real world. Basic Books; 1998.

    Google Scholar 

  18. Freidson E. Professionalism. The third logic. UK: Polity Press; 2001.

    Google Scholar 

  19. Gherardi S, Strati A. Learning and knowing in practice-based studies. UK: Edward Elgar Publishing inc; 2012.

    Google Scholar 

  20. Kleinman A. The illness narratives: suffering, healing, and the human condition. New York, NY: Basic Books; 1988.

    Google Scholar 

  21. Anecdotes and empiricism, Editorials, British Journal of General Practice, November 1995: p 571–572.

    Google Scholar 

  22. Schön D. The reflective practitioner: how professionals think in action. New York: NY Basic Books; 1983.

    Google Scholar 

  23. Knock; ou, le triomphe de la médecine. J Remains The Triumph of Medicine, J Remains 1923—traduced and acted by Trento’s school of general medicine in 2006.

    Google Scholar 

  24. Merleau-Ponty M. Sense et non-sense. Ed. Gallimard 1966.

    Google Scholar 

  25. Foucault M. The birth of the clinic. New York: Pantheon Books; 1973.

    Google Scholar 

  26. Quality improvement in practice care: lesson from project in general practice in Improving patient care in primary care in Europe, editors M. O’Riordan, L. Seuntjes, R. Groll, EQuiP 2004:8–13.

    Google Scholar 

  27. Evans DA, Glymour C, Penrose AM. Evaluation, goals and discourse in clinical decision. 1985, (Trad. It a S.Bernabè, The Italian Journal of Clinical Pharmacy, 1992 Vol 6, N.2, p 63–75).

    Google Scholar 

  28. Bothelo RJ. A negotiation model for the doctor-patient relationship. Family Practice. Oxford University Press; 1992. p. 210–8.

    Google Scholar 

  29. Greenhalgh T, Hurwitz B. Narrative based medicine. Dialogue and discourse in clinical practice. BMJ Nooks; 1988.

    Google Scholar 

  30. Schelling T. The strategy of conflict. Cambridge: Harvard University Press; 1960.

    Google Scholar 

  31. Parisi G, Caimi V, Valcanover F. La continuità̀ relazionale in Medicina Generale—the long-term doctor-patient relationship in general practice. Osp Maggiore. 2002;94(3):275–80.

    Google Scholar 

  32. Greenhalgh T. Intuition and evidence—uneasy bedfellows? Br J Gen Pract. 2002;52:395–400.

    PubMed  PubMed Central  Google Scholar 

  33. Baron R. We must learn to hear our patients as well as their breath sounds, after all, what are we listening for?, an introduction to medical phenomenology. Ann Intern Med. 1985;103:606.

    Article  CAS  PubMed  Google Scholar 

  34. Poweley E, Highson R. The arts in medical education. A practical guide. UK: Radcliff Pub. Ltd; 2005.

    Google Scholar 

  35. Edelman GM Tononi G. A universe of consciousness. How matter becomes Imagination. Basic Books 2000., Reprint edition 2001.

    Google Scholar 

  36. Gear S. The complete nMRCGP study guide, Radcliffe P. 2008 2008:1.

    Google Scholar 

  37. Determining the harm-benefit balance of in intervention: for each patient, Prescribe International, Nov 2014/Vol 23 N° 154:274–277.

    Google Scholar 

  38. Lee OL, James P, Zevon ES, Kim ES, Trudel-Fitzgerald C, Spiro A 3rd, Grodstein F, Kubzansky LD. Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women. Proc Natl Acad Sci U S A. 2019;116(37):18357–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Valcanover F, Sartori N, Colorio P. Simulated patient: a holistic approach like a bridge between theory and practice in medical education. Poster, Wonca Europe Conference 2009.

    Google Scholar 

  40. Weick C. Sensemaking in organization. Sage Publication, Inc; 1995.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. CLIPSLAB-IT, Trento, Italy

    Norma Sartori & Fabrizio Valcanover

Authors
  1. Norma Sartori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabrizio Valcanover
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fabrizio Valcanover .

Editor information

Editors and Affiliations

  1. Primary Care Department USL Toscana Sud Est, Grosseto, Italy

    Jacopo Demurtas

  2. Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    Nicola Veronese

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sartori, N., Valcanover, F. (2022). Dealing with Older Patients: Health and Disease in Old Age. In: Demurtas, J., Veronese, N. (eds) The Role of Family Physicians in Older People Care. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-78923-7_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-78923-7_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78922-0

  • Online ISBN: 978-3-030-78923-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation