The elderly sick role: an experimental analysis

Spotlight on Age: An Overlooked Construct in Medical Sociology

Medical sociology gives limited attention to age-a surprising observation given the aging of the population and the fact that age is among the strongest determinants of health. We examine this issue through an analysis of articles published in Journal of Health and Social Behavior (JHSB) and Sociology of Health & Illness (SHI) between 2000 and 2019. One in 10 articles focused on age or aging, with attention increasing over the period. However, the journals differed. More JHSB than SHI articles addressed it, but fewer focused on the latest life stages when frailty often appears. We discuss three dimensions of age that would enrich medical sociology: as a dimension of inequality akin to race and gender with similar health effects, as an institution interacting with the medical one, and as an identity-again, akin to race and gender-through which people process their experiences in ways that affect health.

Consequence of Patient Accident Reports for the Frail Elderly

The study employs the "labeling" framework to study accidents among elderly patients in an acute care hospital. A content analysis of 392 accident report descriptions was conducted and 51 elderly accident victims were interviewed. In addition, case records of 39 restrained elderly patients were examined. The content analysis revealed that most descriptions contained too little information to determine whether an accident had taken place. Most patient accidents described in these reports appear to be relatively insignificant events in which patients were not injured. Patients'versions of their accidents were generally consistent with the accident report descriptions. Accidents among elderly patients appear to be associated with a cycle of stigmatization and restraint.

Congruence of health and treatment perceptions among older patients and providers of primary care

High utilization of primary health care services by older adults, and factors which promote discrepancies between personal and professional health judgments, create a need for effective communication between providers and patients. The present study was designed to extend existing reports on the congruence of health ratings among older adult patients and their primary care physicians and nurses. Congruence ranged from 29 to 69 percent across fourteen health and treatment questions (N = 108 patient/provider pairs). Patients appeared to be more favorable on most questions, and questions with a present orientation exhibited greater congruence than those with a future orientation. Few variables predicted congruence. Providers' ratings were associated with congruence more strongly than were patients' ratings. Further research should examine the uniformity of content and structure in patient/provider communication both across providers, and with their individual patients.