Slow medicine for the old

Time to "rescue the elderly from standard medical care"? Geriatrician Dennis McCullough says it is in his new book, My Mother, Your Mother. Embracing "Slow Medicine," the Compassionate Approach to Caring for Your Aging Loved Ones. I haven't read the book but the New York Times review makes me want to.

The book is aimed at children and relatives who, McCullough says, are the best medicine--along with a slower, simpler, less expensive, family based approach to medical care. In interacting with the medical system, frail older people need an advocacy team of friends and relatives for protection and moral support.

Among the changes to consider for people at advanced ages: manual breast exams instead of mammography, stool tests for blood instead of colonoscopy, revisiting hypertension medication that works differently in the very old, companionship instead of antidepressants.

Reviewer Abigail Zuger, also a physician, calls the book valuable, "chilling and comforting in equal measure."

The topic is especially timely as we think about our July member meeting. We'll be building on the dialog with discharge planners in January. This time, we'll be considering how family members can talk about "advance directives" that go beyond end of life hospitalization. As McCullough says, hard conversations about topics like when to stop driving and what to do when you can't manage at home anymore need to start early, while the parent is still vital and lively.

It's about anticipatory guidance. The Library Journal's review says that the book will help readers:

—form an early and strong partnership with your parents and siblings;
—strategize on connecting with doctors and other care providers;
—navigate medical crises;
—create a committed Advocacy Team;
—reach out with greater empathy and awareness; and
—face the end-of-life time with confidence and skill

Please let us know your experiences and thoughts about how professionals in aging might help families talk about and plan for all of the transitions from fully independent to needing a wide circle of concern and care!