Volume 12, numéro 1, 2025 Wisdom in Healthcare Sous la direction de Allen Steverman et Sandra Derghazarian

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In this brief personal essay, the author explores her relationship with her two grandfathers, and traces their influence in her path to Geriatric Medicine. She reflects on lessons and stories imparted by her grandfathers, and the wisdom that can be gained from listening to the perspectives of others.

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The topic of wisdom raises questions of its meaning in the clinical setting, examined here by describing three patient experiences over a long career, illustrating the need to weigh equally the biomedical and psychosocial aspects of a patient and his or her illness. The patient stories urge the reader to examine the relationship between the two aspects, the role that patient error can play in evoking wisdom, and the bifold, instructive nature of the doctor-patient relationship, a kind of DNA. Finally, the patient stories raise (but do not answer) a question: can clinical wisdom be taught?

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Caring for persons living with dementia (PLWD) is challenging. Some of the most challenging aspects include managing behavioral and psychologic symptoms of dementia (BPSD). Many patients and families will consider dementia care facilities to better manage BPSD, which can contain design elements that use the physical environment to decrease BPSD by deceiving residents and controlling their behavior—all for their own benefit and safety. This immersive approach to behavior management represents a more holistic way to manage BPSD. Considering the especially vulnerable status of PLWD, these design elements should be thoughtfully implemented, researched post-implementation, and discussed with patients and their loved ones. The design-based approach to managing BPSD demonstrates the obligation healthcare providers and facility designers have to be more holistic in designing care environments for PLWD, especially for those living in dementia care facilities.