A new political anatomy of the older body? An examination of approaches to illness in old age in primary care

Abstract

ABSTRACTThis paper examines the new approaches to older bodies found within primary care, with the purpose of determining whether they represent a significant disjunction from established approaches in geriatric medicine. A genealogical review of clinical approaches to certain conditions commonly found in old age is undertaken utilising (a) key texts of pioneering British geriatricians and (b) three editions of a key textbook of general practice, published between 1989 and 2009. The discourses and practices established by the Quality and Outcome Frameworks in England are then examined, focusing on evidence-based guidance for these same conditions. Following this excavation of written texts, empirical data are analysed, namely the accounts of general practitioners and practice nurses regarding application of the technologies associated with chronic disease management to older patients. Continuities and changes identified by these practitioners are explored in terms of three specific consequences, namely conceptualising and treatment of older bodies and interaction with patients. The paper's conclusion considers whether these changes are significant enough to warrant describing them as representative of an epistemic rupture or break in the way older bodies are perceived, both in medicine and also in society more generally, and thus of constituting a new political anatomy of the older body.