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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.

1. 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.

2. 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.

3. 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.

Drew