Rural Physiciansʼ Attitudes Toward the Elderly

Abstract

Rural elderly patients receive health services primarily in the outpatient setting, with their primary care provider often serving as their only point of contact with the health care system. Little is known however about the attitudes of physicians, and more specifically attitudes of those practicing in rural locations, toward differing age groups of the elderly. The current study was undertaken to examine the perceptions and attitudes of rural Florida physicians who routinely provide care for the elderly. We utilized an existing and validated survey instrument designed to measure the perceptions and attitudes of health professionals toward 3 different cohorts of elderly people: the elderly population in general, the elderly population older than 85 years, and the nursing home population. The study provides evidence that physicians who routinely provide care for the elderly in rural Florida demonstrate ageist perceptions, especially against those older than 85 years and the nursing home population. The trends identified are important because they may directly influence the quality of care that this population receives.

Researching Ageism in Health-Care and Long Term Care

“…Examples include doctors in primary health care, where ageism is related to clinical decision-making Arber et al 2006), physicians in hospital in their recommendations for physical activity among individuals with arthritis (Austin et al 2013), unfair judging by Florida physicians of older adults simply because of their advanced age (Gunderson et al 2005). Other examples are physicians deciding on access to critical care that is influenced by age against older people (Hubbard et al 2003), and significant differences in access to treatment, depending on the patients' chronological age and prescribing chemotherapy less frequently as the patients' chronological age increase (Protiere et al 2010).…”

“…We were able to identify only one study focusing on ageism in health care that explicitly considers positive stereotypes about ageing (Gunderson et al 2005). Research on long term care more often recognizes the positive aspect of ageism (Lagacé et al 2011;Natan et al 2013;Wells et al 2004) although it rarely takes a central place in the analysis.…”

“…Common methods of survey administration include telephone-based (Austin et al 2013;Jerant et al 2004), mail-based (Kearney et al 2000;Protiere et al 2010) and direct distribution to participants (Kydd et al 2014). Virtually all quantitative studies on ageism in long-term care rely on validated scales of ageism for data collection, while in the literature focused on health care a mix of ad-hoc survey instruments (Bouman and Arcelus 2001;Gunderson et al 2005) and validated instruments is used (please refer to the next section for an overview of the main scales used to measure ageism). While sample sizes and response rates vary widely, in relation to the specific participant population targeted, numerous studies draw on small samples (less than 100 respondents), pointing to a necessity to replicate and reconfirm these findings in other settings and on larger groups in order to establish to what extent their results are generalizable.…”

“…To the best of our knowledge, only Bodner et al (2011) use a multi-setting data collection approach including individuals living in the community and in sheltered housing arrangements. In studies focusing on ageism in health care a similar imbalance is evident with regard to the over representation of specialist and high intensity care services, in the detriment of primary care based studies Arber et al 2006;Gunderson et al 2005). Most commonly, the study focus is further narrowed with reference to a specific disease or pathology: diabetes mellitus (Cruz-Jentoft et al 2013), arthritis (Austin et al 2013), cardiovascular disease (Bond et al 2003), spinal cord injury (Furlan et al 2009), ischemic heart disease (Gnavi et al 2007), colorectal cancer (Jerant et al 2004), psychosis (Mitford et al 2010), lung cancer (Peake et al 2003), brain injury (Pedersen andMehlsen 2011), breast cancer (Protiere et al 2010), stroke (Rudd et al 2007).…”

Catering to Love, Sex and Intimacy in Residential Aged Care: What Information is Provided to Consumers?

“…This is important, as health care professionals themselves have been found to hold negative attitudes towards the expression of sexuality in older people [24], particularly against the very old and those living in the residential care setting [25]. In this setting, sexual behavior is rarely seen as beneficial and something to be promoted [26,27].…”