Physicians and Family Caregivers
A Model for Partnership
- Council on Scientific Affairs
Abstract
Primary care physicians need a strong and effective model to guide their relationships with family caregivers, key resources for the frail elderly. Caregivers provide a significant proportion of the home care needed by the rapidly growing number of frail elderly living in the community. Caregiving exacts a physical, psychological, social, and emotional toll that no intervention strategies have proven powerful enough to offset. An effective relationship model would acknowledge the key linkage role of the primary care physician, recognize that caregivers and patients form interdependent units, and affirm a care partnership between the physician and caregiver. In this model, the physician conducts periodic assessments of the caregiver as well as the patient; uses a comprehensive home-based approach to care and services; provides training to caregivers, particularly in managing difficult behavior; validates the role of caregiver; and acts as case manager. Educational opportunities and reimbursement structures should be modified to encourage physicians to use the partnership model.
(JAMA. 1993;269:1282-1284)
Footnotes
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The recommendations of this report were adopted by the House of Delegates of the American Medical Association at the Interim Meeting, December 1991.
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This report is not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns of practice evolve. This report reflects the scientific literature as of December 1991.
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Members of the Council on Scientific Affairs include the following: Yank D. Coble, Jr, MD, Jacksonville, Fla, Vice-Chair; A. Bradley Eisenbrey, MD, PhD, Grosse Pointe Woods, Mich, Resident Representative; E. Harvey Estes, Jr, MD, Durham, NC, Chair; Mitchell S. Karlan, MD, Beverly Hills, Calif; William R. Kennedy, MD, Minneapolis, Minn; Patricia Joy Numann, MD, Syracuse, NY; William C. Scott, MD, Tucson, Ariz; W. Douglas Skelton, MD, Macon, Ga; Richard M. Steinhilber, MD, Cleveland, Ohio; Jack P. Strong, MD, New Orleans, La; Christine C. Toevs, Greenville, NC, Medical Student Representative; Henry N. Wagner, Jr, MD, Baltimore, Md; Jerod M. Loeb, PhD, Chicago, Ill, Secretary; and Robert C. Rinaldi, PhD, Chicago, Ill, Assistant Secretary. Invited authors were Joseph M. Keenan, MD, and Kenneth W. Hepburn, PhD, both from Minneapolis, Minn.
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Reprint requests to the Group on Science, Technology, and Public Health, American Medical Association, 515 N State St, Chicago, IL 60610 (Jerod M. Loeb, PhD).
