Listening and talking to patients. I: The problem.

and conclusions Aged patients with dementia if not stricken by an acute disease sooner or later approach a terminal phase that is distinguished by a failure of spoon feeding.This con- dition induces great anxiety in the workers who care for these patients.The interaction between patient and care- worker during spoon-feeding failure is described by the psychological model of double-binding.Two serious consequences of double-binding are the distancing of the care-workers from the patient and scapegoating among the care-workers.It is essential that the pressure of double-bindings in the wards should be reduced.