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I recently read a wonderful book by Atul Gawande, Being Mortal. Dr. Gawande is a surgeon at Bringham and Women’s Hospital in Boston, a staff writer for The New Yorker and a professor at Harvard’s Medical School and their school of Public Health. Being Mortal discusses growing old and how medicine can enhance the experience or ruin it. In other words, know thyself and know thy parent.
This touched an issue that hasn’t been discussed in these articles – avoidance. No one wants to discuss growing old because after we “grow old” we die. And, although we state “we’re ready” — are we really? I’m not going to answer that question because each one of us has a different answer or feeling but here’s what is true — everyone avoids the issue. We use euphemisms for death: “he passed,” “she’s gone,” “they left us” are a few examples.
We are spoiled today — we think almost every illness can be cured by medicine no matter our age. The truth is there is probably a procedure or a cocktail of pills that can prolong life but what will that life look like after the procedure or medication? Do we tell the elderly patient, the truth about what happens if they choose a “cure”? Rarely. Instead, we’ll operate, radiate and obfuscate the true issue . . . that after the chosen medical course, life as they knew it is not a probability .
As the children of aging parents or loved ones we have to be aware of the fact that the medical profession is going to avoid discussing death as an end game. According to Dr. Gawande, it is not taught in medical school . . . medicine and cures are the emphasis. Doctors (like most of us) don’t want to admit that there isn’t a real cure therefore they offer treatment options. While discussing the options medical professionals rarely state that recovery might alter their lifestyle or that they won’t have their “old” life back. Rarely are the elderly given the choice of a “quality of life” over “duration of life when “treatment options” are discussed. Once again, this is going to be the responsibility of the child or guardian.
My father lived 90 great years, 4 good ones and the last 3 weeks were painful and uncomfortable. Neither his Hospice nurse or his social worker would tell him there were no more options left. It was my brother who broke it to him, “Dad, unfortunately this is how it is now. You have two choices and both bring discomfort. The question is which one are you more comfortable with?”
This is another of the many issues facing us as we ‘parent our parents.’ Therefore we must grasp what the medical professional is telling our loved one and worry about what is best for our seniors — not what the best medicine is.
About Frances Reaves
H. Frances Reaves, Esq. is an estate and Medicaid planning attorney in Miami, FL. She began her career as a litigator/lobbyist. After 15 years in Maryland politics, she moved back to Miami and began her practice, and founded Parent Your Parents, an Elder Advocacy Group. Her inspiration was her parents, whose battle with the ‘elder bureaucratic system’ made clear the pervasive discrimination against elders. Should you have any questions or comments, please contact her at hfrancesr@parentyourparents.
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