PHYSICIAN AND FAMILY CAREGIVER IN THE MEDICAL SETTING - NEGOTIATION OF CARE

Forty clinic visits with physician, older patient, and family caregiver were audio-taped and analyzed for topical themes and exchanges of meaning. The extent to which the caregivers contributed to traditional physician domains of care during the visits [diagnosis, interpretation of symptoms, treatment recommendations) was unexpected. This presentation of self as a practitioner by the caregiver differed from the physician's view of the caregiver as a patient-substitute. In addition to Health Care, the problem situations most often discussed were Eating, Moving Around and Risk. In general, the participants in the clinic visit-physician, caregiver and patient-brought very little of the social context of the illness and care into the medical visit.