Elderly patients, caregivers, and physicians: theory and research on health care triads.

Consumerism in doctor/elderly patient relationships and physician support for the caregivers of such elderly patients are discussed as two apparently unrelated issues that affect health outcomes. The first is based on a theoretical stance that physicians' power flowing from their specialized knowledge can be countered by methods of enhancing patient power, so that an egalitarian or a negotiated approach in the relationship will ensue. The caregivers' need for support from physicians is based on the stress-support-health paradigm, and views the caregiver as a "hidden patient" of the elderly patient's own physician. The effects of cohort differences, changes in public education, the inherent uncertainties in medical practice, and the potential impact of technology are among the issues addressed. The argument that patient power and "hidden patient" support needs may constitute an oxymoron is confronted in this essay, which attempts to show how the two theoretical approaches may be consistent.