The Fast Rise of Slow Medicine - and the Hard Truths about Getting Old
There is a new way of elder care that's increasingly popular with both patients and their families and it's known as Slow Medicine.
I'm sure people working in nursing facilities and assisted living can attest to the amount of ambulances coming in and out on a daily basis, sometimes to take a person in for nothing more than a heavy cold. Why? Because 911 is the only option for many elderly people in facilities or in their homes. There doesn't seem to be a happy medium.
Slow medicine is increasingly becoming a choice for many in their 80s and 90s. Rather that going through heart surgery or other invasive and potentially life-ending procedures at an advanced age, they opt for comfort instead.
By comfort, I don't mean a hospice type setting. Rather, they continue to take medication and otherwise take good care of themselves and see medical professionals, but see little point in major surgeries towards the end of their lives that may cause more harm than good and can completely deplete their savings.
They may have a DNR directive (Do Not Resuscitate) and elect to refuse tube feeds or other life sustaining procedures.
I think I am kind of liking this idea!
In an era where "anti-aging" is a common expression and we all want to "turn back the clock" - the simple fact is that we are all going to get old and die.
I have relatives who survived cancer in their 50 and 60s and are now in their 80s and 90s. They refuse all cancer checkups because they feel great, and have no intention of starting major cancer treatments if they return. Not in their 80s. They want their last years to be about comfort, not sustaining a life that is turning the corner and nearing the end.
This shouldn't sound depressing, even though it probably does! Aging is unfortunate, I agree. At least the creaky, saggy parts! But we better accept it!
And if we want to age with comfort by the time we get to our 80s and 90s, then I say go for it. We have the right to be 100 and refuse open heart surgery!
Tell Us -
What do you think of the notion of Slow Medicine?
If you reach your 80s or 90s, will you want every option for survival or will you bow out with comfort? Can you see yourself getting aggressive cancer therapies or risky surgeries into your 90s?
Comments
My mom just turned 89 and is in independent living (meaning she lives in a studio apt on a 3-level care campus). Cancer in its many forms is our family history.
Mom has a Living Will and DNR instructions are on her refrigerator. When cancer or some other illness decides it is her time she is ready. No tubes or other life sustaining procedures are to be used. In case Assisted Living, Skilled Nursing or Hospice is needed, she has a Long Term Insurance policy to cover costs.
Both my mom and I believe strongly in Slow Medicine, although it is the first time I have heard that term.
Slow Medicine is a practice coming from the Dartmouth Medical School/Dr Dennis McCullough who is a family doctor and gerontologist.
I know a lot of medical professionals don't like his ideas because their job is to sustain life, not help phase it out! But what he says makes sense, at least to me. Many don't fancy the idea of a broken breast bone and fractured ribs from resuscitation when they're 95!
If you would like to look into this more - his book is out:
My Mother, Your Mother
Embracing "Slow Medicine," the Compassionate Approach to Caring for Your Aging Loved Ones. By Dennis McCullough, M.D. HarperCollins. 263 pages. $25.95
And for a New York Times review of the book, click here:
http://www.nytimes.com/2008/02/26/health/views/26books.html
My husband once shared with me something that one of his political science professors said are the three things that all humans need to be mindful of -- responsible birthing, responsible living and responsible death. All three should be considered within the context of quality, Professor Pointy Beard said. It seems to be that Slow Medicine falls into that last category and I'm inclined to follow suit. I know that if I live to be in my 80s or 90s, right now, I'm inclined to think that's enough.
It's interesting that a doctor is turning the concept of surgery on its head. These days, especially with the rise of cosmetic -- aka elective surgery-- there seems to be the mind set that some surgery is not elective -- such as heart surgery in your 80s .... Slow Medicine seems to ask -- as an 90-year-old woman, do you really need that heart surgery -- making a procedure that many would consider basic and necessary seem elective. Thought provoking, for sure.
And bravo, Katharine to you and your mother for being proactive about your health wishes! It's an example I should follow.
should be ours, I believe. I do understand the ethical quandary medical doctors face when a patient's personal wishes diametrically oppose the Hippocratic Oath. Then again, this is why some states acknowledge Living Wills and Trusts.
How very wise of your mother, Katharine, to have taken the difficulty of making decisions out of your hands. I'm still trying to get my very healthy, but nearly 80-year-old mother to do the same.
Heck, I should do this for myself! Thank you for sharing your story.
I object to the following comment that suggests that hospice does not provide medication or allow people to take care of themselves. "By comfort, I don't mean a hospice type setting. Rather, they continue to take medication and otherwise take good care of themselves and see medical professionals" Hospice care is all about people taking care of themselves - living well - but not seeking aggressive curative treatment. Hospice provides aggressive comfort mesures. Slow medicine and hospice have a lot in common.
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