Old Age, Disease, and the Discourse on Risk: Geriatric Assessment in U.S. Health Care

Abstract

This article explores one way in which medical practice confronts old age, disease, and conceptions of risk through an examination of geriatric assessment, a recently created health care modality in the United States. The process of geriatric assessment is shown to extend medicine's gaze to all aspects of bodily, mental, and social existence, thereby contributing to widespread cultural confusion about the equation of old age with disease. Geriatric medicine's representation of old age and disease is embedded in a risk discourse permeating contemporary society. An analysis of geriatric assessment conferences suggests that the old become the field on which the imperative to reduce risk by behavior modification and supervision competes with the deeply held value of autonomy. Medicine is assumed to be the appropriate institution for managing both the risks associated with aging and disease and the conflict between surveillance and care on the one hand, and freedom and neglect on the other.