Author/Editor		Petek-Šter, Marija; Kersnik, Janko
Title		Obravnava starostnika v družinski medicini
Translated title		Family practice approach to elderly patients
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 10
Publication year		2004
Volume		str. 767-71
Language		slo
Abstract		Background. The number of elderly patients, i.e. people over 64 years, is growing. With longer life span the proportion of elderly people will be even higher Elderly patients are a heterogeneous group of patients with considerable differences in health status, functional capacity, emotions, fears, beliefs and views. Health care of elderly patients in primary care is a responsibility of family doctors. One third of all family practice consultations are in the age group over 64. A consultation in the elderly is different from a consultation in younger patients. The consultation length in those patients is longer and the office visits of elderly are more frequent If we want to deliver a quality care for the elderly, we have to care for them and manage their illness in psychological, physical, family and social context, which is a core stone of biopsychosocial model of medical practice. Besides medical knowledge and patient participation, all these elements make a foundation of the holistic approach. In elderly a special attention to their attitude towards aging, dying, loneliness and to the fears connected to those issues should be taken into account Coordination with other services and with patients' families is also necessary. Family physician is in the best position to recognise abuse, neglection or limitations in patient autonomy. We should be aiming to achieve a connection between the doctor and the patient through continuity between the doctor, the patient and his/her family. Good connection will make management of elderly patients more effective and the patients will accept and follow therapeutic plan.
Summary		Izhodišča. Delež oseb, starih 64 let in več, ki sodijo v skupino starostnikov, je vse večji in se bo ob podaljševanju življenjske dobe še povečeval. So heterogena skupina z velikimi razlikami v zdravstvenem stanju, funkcionalnih zmožnostih, socialnih okoliščinah, vrednotah, razumevanju bolezni, pričakovanjih, občutkih, strahovih, pogledih na življenje in smrt ter verskem prepričanju. Za zdravstveno varstvo starostnikov na primarni ravni skrbimo zdravniki družinske medicine. Pregledi starostnika danes predstavljajo tretjino vseh pregledov v dejavnosti splošne medicine. Obravnava starostnikov se razlikuje od obravnave mlajše populacije po vsebini, čas posveta je daljši, obiski v ambulanti pa so pogostejši. Da bo obravnava starostnika uspešna, moramo bolnika in njegovo bolezen upoštevati v okviru posameznika, družine in okolja, kar je bistvo biopsihosocialnega modela obravnave. Za celovito oceno bolnikovega stanja je potrebno upoštevati biomedicinski vidik, psihosocialni vidik, socialno okolje, bolnikove vrednote, razumevanje bolezni ter pričakovanja. Celostna obravnava starostnika od zdravnika družinske medicine poleg dobrega kliničnega znanja in poznavanja osnov geriatrije zahteva tudi poznavanje socialnega okolja, bolnikovega odnosa do zdravja in zdravnika, bolnikovega razumevanja bolezni, pričakovanj, občutkov, strahov ter sodelovanje s strokovnjaki drugih strok in bolnikovo družino. Zdravnik družinske medicine ima tudi ključno vlogo pri prepoznavanju kratenja pravic starostnikov, kot so, omejevanje bolnikove avtonomije, različne oblike zlorabe in zanemarjanja. Obravnava starostnika bo uspešna takrat, ko bo bolnik sprejel predlagani terapevtski načrt, kar dosežemo z medsebojno povezanostjo med bolnikom, njegovo družino in zdravnikom skozi dolgotrajen odnos.
Descriptors		FAMILY PRACTICE CHRONIC DISEASE SOCIAL PROBLEMS MENTAL DISORDERS PHYSICIAN-PATIENT RELATIONS AGED FAMILY HEALTH DEMENTIA PHYSICIAN'S ROLE