Examining physician-patient-caregiver encounters: the case of Alzheimer's disease patients and family physicians in Israel

This study examines the characteristics of physician-patient-caregiver encounters in the presence of dementia and how socio-demographic and professional characteristics of family physicians, and severity of symptoms in patients with dementia affect these encounters. Phone interviews were conducted with 141 Israeli-Jewish family physicians (representing a 66% response rate), who were presented with one of two vignettes describing a 76-year old women with dementia. The two vignettes were identical, except that in the first it was stated that the woman sits quietly and cooperates during the examination whereas in the second she is agitated and uncooperative. Participants were asked to what extent they would ask questions to, inform and involve the patient and caregiver respectively when presented with one of the two vignettes. Findings showed that physicians would address the caregiver more than the patient (both with respect to questions, information and involvement). Moreover, it was found that physicians, who were older and had a higher number of years in the profession, would address the caregiver to a higher degree (compared to the patient) than younger and less experienced physicians. Findings provide direction for understanding medical encounters in the presence of dementia. Theoretical implications for dementia care, for medical encounters, and practical implications are discussed.