Read this book My Mother, Your Mother: Embracing “Slow Medicine,” the Compassionate Approach to Caring for Your Aging Loved Ones
and your perspective on aging will be forever changed! You will no longer wonder and worry about what you’ll do as your aging parent grows frail and dependent. By the time you finish this book, you’ll have a foundation with which to build a process to determine what is best for your parent (you and your family) in each stage of later life.
The author, Dennis McCullough (a geriatrician), writes of his own personal journey in medicine and in caring for his mother throughout her life. He writes about his philosophy of patient-centered “slow medicine” and its importance in the lives of the elderly. He believes we should focus on the “central issues of caring with patience and a sense of shared humanity, forgiving one another for what cannot be changed, bending flexibly at times of need, and holding firmly to shared values”. Our goal should be to understand, to support, to heal and to care for those in a way that we would want to be cared for.
Certainly everyone’s journey with their aging parent will be unique, and we will make different choices. But, we can all find peace and wisdom in our choices if we hold true to this underlying philosophy.
McCullough has identified 8 phases in late life and describes the “texture of life” commonly experienced in each of the phases by the elderly and their families. He writes about the issues and opportunities unique to each phase and makes suggestions for questions to ask and conversations for the whole family to have.
Here are those 8 phases and my key take-aways:
1. “Stability” -
Our aging parents seem fine. “Why not let sleeping dogs lie?” This is the stage in which we should be learning about aging and start actively participating (a 3 day visit to just observe our aging parents). Get to know members of their community. Engage the family and physician, building an advocacy team. McCullough suggests seeking out a “physician friend”, an valuable resource for the coming years.
2. “Compromise” -
“A time of vigilance and ready attendance”. Watch, analyze and communicate. Learn about and choose medical and social resources for your aging parent. At this stage, the goal is to postpone as long as possible any decline in function. He describes the two models of care: the social model and the medical model. This is an incredibly important part of the book as he points out the major concerns in acute care hospital. This information will help you be vigilant and proactive when your parent is admitted to a hospital. This is the stage in which “careful attending and prompt intervention can make the greatest and longest lasting difference”.
An excellent suggestion is to separate aging, disease and illness in your mind.
3. “Crisis” -
At the point of first crisis, jump into action. Let go of the “why’s and what if’s and focus on “what now”. He walks you through the ER and nonemergency hospital admissions. Then he recommends gathering the whole family together to review the crisis and prepare for the next one. He talks about how to partner with the hospital staff. Involve your advocacy team – “you can’t do this alone”. Learn about the 3 Ds – depression, dementia and delirium.
4. “Recovery” -
This is a relatively peaceful phase, either at home or in a facility. Understand the difference between repair and healing. Look ahead to new financial costs and become familiar with reimbursement processes. He describes the concept of “Circle of Concern”, those family and friends who can offer insight and perspectives on your loved one. Focus on mobility, a key factor in continuing strength and good health. Periodic review of medications and preparation of an emergency information pack are also important. Unfortunately, you are preparing for the next crisis.
5. “Decline” -
Caused by strokes, cancer, physical fraility, dementia. This is where families need to balance quality of life with further medical treatment. Consider long-term care options and PACE.
Engage in watchful waiting and active listening. Encourage your parent to share his/her “life story”. Seek consensus from the many doctors treating your parent. It’s not uncommon for a patient to be on 12 different drugs for various conditions.
6. “Prelude to Dying” -
Learn about the late “near the end” stages of common terminal illnesses. Keep your parent moving. Use lotion to give a little massage. Embrace palliative and hospice care. You may have heard about these two terms but read this section to gain an understanding of all it will offer your parent. Be certain you have a copy of all advance directives.
7. “Death” -
He describes the “slow shutdown” and “inviting celebration”.
8. “Grieving/Legacy” -
He talks about “carrying forward the essence of an elder’s life… into the future”. The importance of reaching out to others.
Throughout the book, McCullough uses his mother’s life and journey as an example in his writing. I felt as if I had walked along beside him. This book has certainly made me consider my philosophy and perspectives as I walk beside my elderly mother.
For those of you on the journey with your aging parent, is there any one lesson you have learned that you would like to share with others? Please comment.
