Attitudes to the Elderly
Podiatric students generally have a lack of interest in treating older patients – this may be because they hold inaccurate perceptions of older people and they have perceptions about the lower status within the profession of those who treat older persons compared to the more “glamorous” subspecialities.
Society, in general, tends to hold negative attitudes to the elderly, and it is assumed that health professional attitudes reflect those of society in general. These attitudes have the potential to contribute to the older persons receiving suboptimal levels of health care. Laurent (1990) identified attitudes that pervade the National Health Service in the UK so that services for the elderly are based on deep seated stereotypes of what older people are like – “stupid, decrepit, feeble, or unusually eccentric, wise or sweet natured, and in any event to be patronised”. It was suggested by the author that the elderly are ‘fobbed off’ by health professionals because of their age as being responsible for their ills and because caring for the elderly is low status work. The elderly should be given the same time and consideration as patients of any age. Age should not be a reason for not using a particular therapeutic intervention (ie ageism).
Within physiotherapy the decision not to work with older people was largely influenced by the perceived lack of status or prestige, perceived inadequate remuneration, poor working conditions, and the limited opportunities for advancement opportunities with geriatric practice . This was despite the growing need for physiotherapists skilled in geriatrics. Chumbler et al (1996) showed that those students who entered podiatric medicine for extrinsic rewards (eg income, prestige and financial security) were more likely to display negative attitudes to treating older patients whereas those who entered for intrinsic rewards (eg to help others, enjoyment of working with people) were less likely to have negative attitudes to older patients. Student’s attitudes toward the older person have been shown to improve following direct contact with positive older patients . Landorf (1997), in a focus group interview with male podiatry students found that they thought working with older people was unsatisfying; they believed the health of all older people deteriorated after the age of 65; they were concerned what other people would think if they did specialise in the area; and they have little desire to work with older people.