I recently read a remarkable book, Being Mortal, by medical Doctor Atul Gawande. The topic is end-of-life care. Along with the results of major research projects, Dr. Gawande shares distressing anecdotes of patients suffering needlessly due to misunderstanding of their needs. Although written primarily for health-care professionals, I learned important lessons of direct value. I’m using the ideas planning for Kit’s and my declining years, especially in the circumstance of having no children.
- Dr. Gawande explains that most medical physicians are oriented toward cures. And many are reluctant to take away a terminal patient’s or their family’s hope. Physicians can thereby offer unlikely-to-work “lottery chance” treatments that may shorten a patient’s life or ruin their last best days. Dr. Gawande recommends early consultation with geriatric doctors.
- Dr. Gawande makes a strong case that most “assisted living” services have devolved into being little better than nursing homes. He claims that overemphasis on facility safety has taken away a resident’s ability to make choices especially those that involve any risk. Some exceptional facilities are available. The factors to look for in the best arrangements are allowing residents a sense of having one’s own home and a sense of usefulness, perhaps by caring for a pet.
- Dr. Gawande espouses use of hospice services. He urges those continuing cure-oriented treatments to use hospice concurrently.
Most who read this are nudging into older age or have parents who are. A decade ago, Kit and I recognized declines in our physical abilities and initiated a saying. Each day is our last best day. Make the most of it.