Elderly patients facing informed consent (IC): Issues associated with aging

The elderly patient is becoming (and the patients’ relatives are becoming themselves) more and more informed on any health issue, both at scientific and at legal levels, which implies a transformation of the traditional ways of approaching the patient-doctor relationship: what they are all looking for is no longer a qualified ‘technician’ but a passionate ‘supporter’ and a ‘caretaker’. Any success by the physician in dealing with problems surrounding the patient's informed consent is always central to the strength of the physician's relationship with the patient (Stanley et al. 1884). With the elderly patient, the doctor must have some sensitive specialized knowledge together with a particularly strong psychological background, an in-depth knowledge of the main communicative and relational mechanisms (both verbal and non-verbal, cognitive and emotional) and a holistic vision of illness, a deep understanding of the varied signs and expressions of human discomfort (Stacey et al. 2010) and full consciousness of the criticality of information transmission for decision making. Our study is aimed at describing the revised role of the third millennium practitioner in supporting the elderly patient facing the IC issue: far from being a mere informant and a scientist, he/she must be also a good communicator and an expert both in medical and ethical issues , as many cases of patient-doctor interactions in managing elderly patients demonstrates. In the past centuries, from Gregory (1770, 1795) to Percival (1803) and Hooker (1849), literature on the topic shows that the doctor, far from being a mere informant and a scientist, must be a good communicator and a ‘caretaker’