Add new comment

I heard your rerun of the interview with Jane Gross today. Her New Old Age blog was a landmark column and most helpful to read given the work I do. Another contributor, Paula Span, also articulates problems and issues that families encounter with clarity and compassion (and conflict).

As a geriatric care consultant I help families the sometimes lengthy process of assessing an elder's health issues and needs and the accompanying care plans which change as illness and abilities change. This is especially true regarding chronic illnesses that progress and dementia that can take many unexpected turns.

We talk about getting old as a boon. "Look at us we're so much healthier than our parents and WE'RE leading healthier lives"...until the unexpected happens; loss of memory being one of the most shocking health crises that take families (and individuals) aback. And we know now that noone is exempt - people in their 30's and 40's can be affected by dementia, leaving spouses still raising children having to deal with what becomes a very complicated picture. Or leaving single adults to find the ways to be cared for.

We live in a time of fast medicine - quick decisions to cure, make better, " stabilize" conditions; but this can be at the expense of the whole picture. Just read Michael Wolff's "A Life Worth Ending" to get an idea of how difficult it is when the medical community push for "life" and children, already in a state of anticipatory grieving, may not able to make clear judgements in the moment, but determined to do the best, if not the right, thing.

The book,"My Mother, Your' Mother" by Dr. Dennis McCullough provides a very different and consoling perspective. We can't help or change the length of an illness but we can start early by thinking about what we want, if and when; true for children and parents. He suggests the idea of "slow medicine" which refers to viewing a family member's health and abilities over a long period of time. More than a primer it helps organize an acceptable way for us to look, plan,and talk so that when health decisions must be made, it can be accomplished with less guilt, less angst and some sense (if not a complete plan) of how to proceed.

There will never be a fix for people who refuse to discuss the measures they do and do not want if they are no longer able to make decisions but family members who observe over a long time can help may learn indirectly what their family member might accept. This is true even when families don't agree or noone has power of attorney because once they learn that without consensus the legal machinery may take over and assign guardianship. Most families don't want that.

Families who struggle with one another benefit from talking with objective professionals who assist by putting together a picture based on talking with all involved to glean what their family member would want and help execute those wishes.

Your programs on aging and dementia have been good to get these conversations started. Thank you for your efforts and keep these topics at the top of your to-do lists. As the boomers age, the more information, the more the information is repeated, the better off we will all be.

~ Ruth Rothbart-Mayer, LCSW
Geriatric Care Consultant