Grim Reaper

New Yorker October 6, 2015

When it comes to end-of-life care, perhaps we do need a bigger hammer

 by Richard Sontheimer.

While sitting one evening with my terminally ill elderly mother, she again asked me to help her end her suffering.  This time it was, “Could you just go get the hammer and hit me in the head?” Her previous requests had included “Son, you are a doctor, can’t you do something to help me with this?”  And then, “They treat animals better than this.”

On previous occasions, I had to remind my mom that we lived in one of the 48 states in the USA that does not have a death-with-dignity euthanasia law.  Her response was, “Then can you move me to Oregon or Washington?”

Rick Sontheimer is an old friend of mine.  His article is well-written, deep and important.  You can access it at Kevinmd.com.

Escape From the Land of the Pink Bibs

This is the story of Narcy Houle’s father, a highly respected orthopedic surgeon, developed Alzheimer’s.  During the course of the disease, he broke his hip. One day when we visited him at the nursing center, about six months after his accident, we found him sitting in a row of patients all wearing pink bibs, left on after they had finished eating. Like the others, his head was bent toward his lap; though his eyes were open, they were not focused on anything. His shoulders slouched, like a rag doll’s, and his mouth hung slightly ajar.

What he needed was a geriatrician.  Most health care professionals have had little to no training in the care of older adults. Currently, 97 percent of all medical students in the United States do not take a single course in geriatrics.

Recent studies show that good geriatric care can make an enormous difference.  Older adults whose health is monitored by a geriatrician enjoy more years of independent living, greater social and physical functioning and lower presence of disease. In addition, these patients show increased satisfaction, spend less time in the hospital, exhibit markedly decreased rates of depression and spend less time in nursing homes.

See:  An Aging Population, Without the Doctors to Match by Marcy Cottrell Houle (NY Times, September 23, 2015)