ELDERLY PATIENTS, CAREGIVERS, AND PHYSICIANS - THEORY AND RESEARCH ONHEALTH-CARE TRIADS

Consumerism in doctor/elderly patient relationships and physician supp ort for the caregivers of such elderly patients are discussed as two a pparently unrelated issues that affect health outcomes. The first is b ased on a theoretical stance that physicians' power flowing from their specialized knowledge can be countered by methods of enhancing patien t power, so that an egalitarian or a negotiated approach in the relati onship will ensue. The caregivers' need for support from physicians is based on the stress-support-health paradigm, and views the caregiver as a ''hidden patient'' of the elderly patient's own physician. The ef fects of cohort differences, changes in public education, the inherent uncertainties in medical practice, and the potential impact of techno logy are among the issues addressed. The argument that patient power a nd ''hidden patient'' support needs may constitute an oxymoron is conf ronted in this essay, which attempts to show how the two theoretical a pproaches may be consistent.