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were identified in the service for elderly persons. The most important of thesewere transportation to and from the centre; lengthy waits; interchangeability ofdoctors; dissatisfaction with prescribed treatments, and abruptness or rudenessfrom administrative staff. Each of these problems holds the potential fordegradation to the self-concepts of these patients. However, aspects of the careand service which were potentially depersonalising for these persons appearedto be overridden by the economic advantages of receiving medical treatmentfree or at minimal cost.General passive acceptance and a largely uncritical approach of elderly patientsmay discourage and even inhibit improvements at the centre. This has seriouspractical consequences. It was argued thus, that from a humanistic perspective,the system at the centre could be different for elderly persons who as a result ofthe institutionalised setting, and a combination of advanced age and medicalindigence, have fallen into a state of apathy. This could be effected throughattention on the part of health professionals and the organisation to thepsychosocial needs of elderly patients; through the operation of a rehabilitativemodel of patient care; through socialisation of patients by doctors in thechronic nature of their illnesses; through a reduction in insensitivity to elderlypatients on the part of centre personnel, and through improvements to thephysical and social environment at the settings.Free download from www.hsrcpress.ac.za6.2 Evaluation of the qualitative research frameworkThe qualitative research approach employed in the study succeeded incapturing the essence of the patient world at the setting and depicting the reallife-world situation of medical encounters for elderly patients at the centre. Theapproach and the findings of the study were thus found to offer propositions formitigating some of the shortcomings of earlier, largely quantitative studies onthis subject. Inasmuch as the approach achieved a breadth and depth incoverage of the total experiences of the subjects during their medicalencounters, it also had an exploratory function in identifying areas that couldbenefit from both quantitative and qualitative investigation.One important limitation of the study was the lack of access to consultationswhich restricted the area of investigation and excluded important interactionfrom the research. The study of Stimson, Webb (1975) has shown thatprovided the necessary co-operation can be secured from medical authorities,most patients are willing to allow a researcher to be present duringconsultations and observe interactions between patient and doctor firsthand.The perceptions and interpretations of the researchers may have been biased bypreconceptions. An expanded triangulation strategy could have involvedseveral observers and interviewers which would have served to reduce oreliminate such personal biases.219