Specific features of interaction between doctors and elderly patients in rural areas (a case study of the Leningrad region)

The article deals with care for older people in rural areas as part of communication between doctors and patients, including during appointments. Care is analyzed from two positions (from the position of rural doctors and the elderly themselves), their differences are analyzed. Basing on interviews conducted in the Luzhsky district of the Leningrad region, the paper makes an attempt to contextualize views on professional care from both sides. The article examines how, in the context of the «dense texture» and importance of rural communities, doctoral care for older people becomes more personalized and what features of such care affect the professional autonomy of doctors, the communication of older rural residents with medical professionals. The separation of care and autonomy raises the question of the role of rural doctors in the rural community as well as the specific features of care, which is more personalized and shown by paramedics at rural outpatient clinics or first aid stations. The paper concludes that within the framework of doctor - patient communication, when doctors and patients interact, doctors consider care as an instrumental opportunity to establish more trusting communication, interaction with the elderly. However, the elderly themselves remain dissatisfied with this form of care. More personalized care is provided by rural paramedics and doctors, who are most integrated into the rural community and are an important part of it, which determines the specific features of care for older people provided by different professionals.