THE GENERAL-PRACTITIONER AND OLDER-PEOPLE - STRATEGIES FOR MORE EFFECTIVE HOME VISITS

This paper is based on findings from a pilot research project funded b y the Primary Health Care Development Fund in Scotland. The researcher 's remit was to examine home visiting patterns by general practitioner s (GPs) to older people on Tayside following the community care reform s. Fieldwork was conducted in three general practices on Tayside, usin g an anthropological perspective. This research confirms that communit y care changes have not to date effected a significant shift in GP per ceptions, which are that the probable destiny of frail older people is to enter some kind of residential setting. The researcher examines ho w and why GPs label certain patients as a 'problem' and uses this cate gorization process to suggest that such patients are seen by GPs as ha ving a 'moral career'. It is argued that GPs may also see some older p atients as a 'problem', the solution to which may be to recommend that the patient enter residential or nursing home care. The research iden tifies a point in the career of the older 'problem' patient at which d octors could usefully refer to other agencies. A model for communicati on or collaboration is posited as a way of enabling GPs to continue to provide sensitive and individually appropriate care for frail older p atients in collaboration with appropriate others. Funding has been obt ained to pilot this model in selected general practices on Tayside in 1996/97.