Day 323 of 365 - Normal Aging?

I'm reading what will probably the last book about aging that I report on in this daily blog series, though there will be more than one post.  The book is called Elderhood and is written by Louise Aronson, who is a geriatrician.  It's very well written, containing lots of personal stories from her own family life and medical training and practice experience, case histories, and the historical and cultural patterns around getting older.

Here is a poignant quote from the book - "the experiences of older people in our health care system are indicative of how current medical care is broken for all of us.  We have created a society where we do everything possible to stay alive, yet dread being old, a culture that discards people who don't fit the latest human 'product specification', and a health care system in which the work of medicine is often incompatible with both care and health."

In her many examples throughout the book, Aronson points out how only until very recent years, the training of doctors has left them ill equipped to deal with the complexities of older patients.  This is partially due to old age actually being the most varied time of our life.  The point between middle age and old age is hard to pin down.

People of the same age can range from being independent and self-sufficient to totally dependent on others for their care.  People can also move back and forth between these and other stages due events like illness, injury, recovery and the kind of environment in which they live.

When it comes to 'normal' related to medical care for older people, standards have been based on what is normal for middle aged people.  There are more factors to consider for older people such as increased sensitivity to medications and the like.  In many cases the health care system focuses on what is needed to get patients through a medical crisis in the acute phase and fails to consider the wider scope of supports which might help a person regain their independence.  Many people who end up in nursing homes might actually have been able to return home with adequate support and a broader perspective of medical care rather than being rushed out of the hospital care setting to 'some other place'.

Aronson also broaches the often avoided discussion of end of life care, giving various case scenarios to illustrate outcome variability when patients preferences were determined directly from them or from family members, versus the medical system just charging ahead with the usual treatment strategies.  As she says 'most illnesses raise existential issues as we get older'.

This post is just a little taste of the content of the book.  I look forward to sharing more related to what I learn from it as I make my way through.


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