clinical focus
that [cause them to] try to delay being
discharged from facilities they’re in
because even though they may be critical
at times of the facility, they’re not alone
there. [Because] they feel contained
there, we get some unfortunate somatic
symptoms, somatic complaints or requests
for medical intervention that may be
much more about a wish to prolong the
stay in hospital than they are about any
organic condition.
The trouble is the patient does feel the
pain; they’re not making it up, it’s a matter
of emotional distress being expressed
as a physical concern. And because
the patient is elderly, everyone worries
terribly about it being an organic disorder,
so specialists are called in, and physicians
are called in. Even surgeons, sometimes.
[Ultimately a] diagnosis may be made
– not necessarily accurately – on the
basis