Hirshbein L D
University of Michigan Hospitals, Ann Arbor 48109, USA.
J Am Geriatr Soc. 2001 Nov;49(11):1555-60. doi: 10.1046/j.1532-5415.2001.4911253.x.
The aging of the American population has significantly changed medical practice over the last century. As is well known, life expectancy first began to increase dramatically in the late 19th century, but at the same time that the numbers of older people have been increasing, the social and cultural meanings of growing old have also changed. It is likely that different cohorts of older people have had different experiences with old age because of the time periods they lived through. This paper offers one way to look at some of the historical changes that have affected the public and the medical profession on the subject of old age by looking at old age through American popular literature in the first half of the 20th century in three overlapping time periods. In the first three decades of the century, the concept of old age was widely defined, and older people (rather than physicians) were the principal authorities in describing the qualities of old age. In the third and fourth decades of the century, the idea of old age was starting to acquire increasing negative connotations, but chronological age itself did not signal the beginning of old age. However, by the late 1930s and 1940s, old age became widely viewed as a specific social and medical problem to be addressed by professionals, and older people had become a recognizable population, with a variety of groups organized around their care. This paper illustrates changes in American understandings of old age within and without the medical profession and suggests ways in which popular conceptions of old age might continue to shift and affect how physicians take care of their older patients in the future.
在过去的一个世纪里,美国人口老龄化显著改变了医疗实践。众所周知,预期寿命在19世纪末首次开始大幅提高,但与此同时,老年人数量不断增加,变老的社会和文化意义也发生了变化。由于所处的时代不同,不同年龄段的老年人可能有着不同的老年经历。本文提供了一种方法,通过审视20世纪上半叶美国通俗文学中三个重叠时期对老年的描写,来观察一些影响公众和医学界关于老年问题的历史变化。在20世纪的头三十年里,老年的概念被广泛定义,老年人(而非医生)是描述老年特质的主要权威。在20世纪的三四十年代,老年的观念开始带有越来越多的负面含义,但实际年龄本身并不意味着老年的开始。然而,到了20世纪30年代末和40年代,老年被广泛视为一个需要专业人士解决的特定社会和医学问题,老年人已成为一个可识别的群体,围绕他们的护理形成了各种团体。本文阐述了美国医学界内外对老年理解的变化,并提出了老年流行观念可能继续转变以及未来可能影响医生照顾老年患者方式的途径。