Questionnaires designed to test attitudes toward old people were given to both the freshman class and the senior class of students in the University of California School of Medicine. Results of the study showed that these two groups shared most of the general societal conceptions and misconceptions about the aged. In addition, these students adhered to a set of medical stereotypes about aging to a degree surprisingly unmodified by the much-vaunted medical socialization process; freshmen and seniors agreed on many aspects of the subject. The results of this attitudinal status were manifested in a medical prejudice against old patients, as expressed in the replies given to the questionnaire. How much of the difference observed between the attitudes of the freshmen and the seniors was due to non-medical acculturative influences (such as the demographic characteristics unique to each group) and how much to the medical socialization procedure, was difficult to ascertain. More significant, however, was the lack of difference between the two student classes and the failure of three years of medical education to mitigate factors injurious to a major and growing segment of the population-aged patients.An extensive review of the current literature supports the contention that the medical care of aged patients in the United States (though not uniquely here) is characterized by negativism, defeatism, and professional antipathy. This state of affairs, opposed to ethic, and patently unacceptable in any other medical situation, is somehow complacently received and even considered somewhat justified in dealings with the old. The result is that therapy for the aged sick is often little better than palliative procrastination (1,2).The attitudes of the doctor and of the doctor-in-training toward the old
The major psychiatric illness is depression. In the elderly this may be precipitated by internal psychic problems, but external complications can be added by ineffectual attempts to help by inadequately trained health professionals. The low utilization of psychiatric services by the aged may be explained on the basis of the attitudes of both patients and clinicians. Three main factors determine the patient's decision to consult a physician. The patient must recognize that: 1) a psychiatric disturbance is present, 2) that this disturbance is alien, and 3) that help is available. When such services are offered, the elderly will recognize their need for them. Two specific areas of clinical practice with geriatric patients are stressed; these involve drug problems and sexual problems. When stereotyped attitudes are replaced by attention to the underlying pathology, and treatment goals are formulated in the context of good psychiatric practice, the elderly will profit by psychiatric therapy and have a better life in their remaining days. The rates of success in treatment are just as high as with younger patients.The emotional disturbances to which our population is heir, are not limited to people
This article describes a seminar series for general practice residents dealing with communication, interpersonal relations, self-image, and patient-dentist interactions. Objectives, content, and methods of evaluation are presented.
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