Caregiving issues in the geriatric medical encounter.

Families provide much-needed care for dependent older persons, which can be both burdensome and stressful. In addition to providing personal care, families often are essential for optimal chronic disease management. Thus, two critical functions of the medical encounter are to provide empathic support to family caregivers and to provide education about chronic diseases and their management. Concomitantly, a conscious effort must be made to not compromise the doctor-older patient relationship, insofar as possible. Managing the doctor-patient-family caregiver relationship is challenging, especially in the settings of cognitive impairment and end-of-life care. In these circumstances in particular, both older patients and their families need the care of their physicians.