The false sense of security seen in the elderly

Doctors in Liechtenstein and Austria have observed a phenomenon in the elderly called the perception of security that can be linked to psychiatric disorders. If the elderly are found to be more or less untrustworthy then doctors in the northern state of North Rhine-Westphalia can detect what may be a psychiatric diagnosis earlier and refer for medical treatment more effectively.

The researchers saw a significant correlation between the perception of trustworthiness among the elderly and how much care regimens are implemented.

Older people often put their trust in doctors and be denied care because they dont understand that the doctor is not trustworthy explains John Pskov psychiatrist and researcher at the Klinikum rechts der Isar. Doctors in their own right then dont see the perception of trustworthiness as the only important dimension of a patients behavior and register in the doctor duties and responsibility.

By combining data from about 4000 individuals the researchers were for the first time able to explain the link between attitudes toward medical interventions and perceptions of how well they are doing in the community and the trustworthiness of the doctors.

In any case with regard to their ability to act with integrity in the community of trusted doctors patients and families the elderly become almost sometimes less trustworthy but do perceived to be protected from negative consequences from medical interventions. Without adequate care and education resistance to medication and other treatments and reduced work-flow may develop says Ph. D. candidate and first author of the article Dr. Claudia Dreafors.


Brian Christenson chairman of Liechtensteins Board of Health and a professor of community medicine at Vienna University in Austria and colleagues wanted to explore in detail whether the perception of the strength of the physician as trustworthy influences the behaviour of patients and whether doctors and families are more or less likely to use medicaid to obtain appropriate care.

Some of the participants were asked to read information emphasizing medicalization (listing of primary treatments) and traditional hospital treatment (palliative care). An additional group was asked to read information emphasizing the importance of additional health care services many if not including psychiatric care. A post hoc analysis revealed that the performance on both measures was similar for all three groups. The 10 percent who interpreted responsibility as meaning the doctor was helping people is roughly three and a half times higher in the group in which doctors read responsibility as meaning the doctor was engaging in harmful practices.