What's the right thing to do for mom and dad as they get older?
Thanks to advances in science and medicine, more of our parents are living longer than ever before. And though we are rewarded with more time with the people we love, we are also faced with new sets of complications—more diseases, more disability, more need for support and careful judgments. Yet while our health care system may help people live to an older age, it doesn't perform so well when decline eventually sets in. We want to do the best thing but are overwhelmed with the staggering choices we face.
Geriatrician Dennis McCullough has spent his life helping families to cope with their parents' aging and eventual final passage, experiences he faced with his own mother. In this comforting and much-needed book, he recommends a new approach, which he terms "Slow Medicine."
Shaped by common sense and kindness, grounded in traditional medicine yet receptive to alternative therapies, Slow Medicine advocates for careful anticipatory "attending" to an elder's changing needs rather than waiting for crises that force acute medical interventions—an approach that improves the quality of elders' extended late lives without bankrupting their families financially or emotionally. As Dr. McCullough argues, we need to learn that time and kindness are sometimes more important and humane at these late stages than state-of-the-art medical interventions.
My Mother, Your Mother will help you learn how to:
—form an early and strong partnership with your parents and siblings; —strategize on connecting with doctors and other care providers; —navigate medical crises; —create a committed Advocacy Team; —reach out with greater empathy and awareness; and —face the end-of-life time with confidence and skill.
Although taking care of those who have always cared for us is not an easily navigated time of life, My Mother, Your Mother will help you and your family to prepare for this complex journey. This is not a plan for getting ready to die; it is a plan for understanding, for caring, and for helping those you love live well during their final years. And the time to start is now.
I picked up this book to see if I could/should recommend it to my Mom who is knee-deep in Mother care issues - her own Mom, my Grandma, just lost her brother/roommate and is now living alone and stubborn out of town and her partner's Mom is advancing further into dementia. It's a testament to the sad state of America's healthcare that I won't be sending it to my Mom because so much is concerned with the issues of paying for care, what insurance might not cover, how to afford a dying relative. My Mom and Grandma live in Canada so roughly one-half of the stresses faced in this book are not applicable to them. Thank god, what he has to say is very scary. Emotionally there are some good tips but the author seems to have the perspective that all elders are kind and stoic individuals that you don't have any kind of complicated feelings about and who don't get drunk and yell at you and hate your boyfriend like, uh, my Grandma does to my Mom. Maybe I should write a book for that niche audience.
3,5 stars; practical nuts-and-bolts pointers on how to organize for yourself and your loved ones for the inevitable end; in particalur liked the mentioning of the 'covenant relationship' characterization of the patient-doctor relation; analagous to the 'good neighbourly care' coined by Kathryn Montgomery in her excellent How Doctors Think: Clinical Judgment and the Practice of Medicine.
"In reflecting on the decades of work I’ve done as a clinician, I see that my primary role might best be described as “physician friend.” Ethicist William May’s concept of the “covenantal relationship” is another way of thinking about this doctor-patient alliance. In such partnerships, the doctor expressly becomes the designated “agent” of the patient and family and maintains a covenant, unspoken and unwritten, to be there in time of need."
"Modern medicine has complicated the situations of elders’ late life by offering better and more technological means of extending the length of human life while not necessarily greatly improving its quality."
Good but also incredibly overwhelming. McCullough gives a very helpful overview of the stages of life that are typical for people in "late" old age, so 80+. And by "typical" it just means he lays out some common experiences, challenges, and problems. This was useful as I've seen these stages now extremely compressed in the case of one parent, and in another parent who is currently working through them more slowly. Aging has many wildcards, but this book is useful in getting across the bigger picture of the process from aging to decline to death in a way that can make things seem less alarming (as in, "this is how life is, don't freak out") along with many suggestions to help make things as comfortable as possible for the elder. But it's those many, many, MANY suggestions that became completely overwhelming to me, to the point I had to take a break from the book for a few days. I had to keep reminding myself that the author is a geriatrician, and therefore deals with all of this as his job and calling. If someone were to take on even half of the suggestions that McCullough provides, that person wouldn't be able to hold a job much less care for other family members. Luckily I'd read two other books prior to this one that offered a more realistic approach for the caretaker ("How to Care for Aging Parents" by Virginia Morris and "A Bittersweet Season" by Jane Gross.). So from McCullough's book I gained a better sense of the overall process of aging amongst the oldest and an emphasis on caring that is focused on comfort and not cure. That's useful.
Excellent read for those of us with elderly parents or siblings. Stress is on "slow medicine" vs the fast medicine of current health system. Slow medicine emphasizes keeping elder as close as possible in familiar settings with support group of care-givers including family, neighbors, health practicioners, etc. A very wise and practical book based on author's personal expereince with own mother and others in his care as a doctor in Vermont. Author was mentioned in recent NYT article (July 2008)on caring for elderly.
While packed with information and helpful how-to suggestions, this book left me overwhelmed with ideas and practices that just don't apply to my parents or family. Many parents will not share with their adult-children their financial information or detailed health status, rendering much of this guide meaningless.
Anyone that has parents that are living really need to read this book. It is a wake up call and will make you think about what you want to do for yourself as you age and how it will effect your kids.
One of my highest words of praise for any book is "lyrical." Dennis McCullough's My Mother, Your Mother is lyrical, meditative and compelling. Dr. McCullough dissects the current state of medical care for Seniors with authority: he is a family physician and geriatrician in practice for over 30 years, faculty at Dartmouth Medical School, and doctor at Kendal at Hanover continuing care retirement community. He writes about Eldercare medicine as a healer and as a son: he interweaves his experiences with his patients with his experiences caring for his mother, who passed away at age 92.
Quietly, calmly and forcefully, Dr. McCullough denounces the modern American trend of commercializing medicine, extending quantity of life without necessarily extending its quality. He advocates a return to "Slow Medicine," a conscientiously chosen path of honoring aging for its inevitability, to allow Elders to adjust to their changing circumstances and needs as gradually, completely and carefully as possible.
For example, take longer to ask your parents "How are you?" Let them take longer to answer. Let them be as independent as possible in their homes, maybe with some housekeeping assistance and physically modified household aids like grab bars in the shower, instead of rushing them to an assisted living facility with their first serious illness. Help them, if you can, to talk with their doctors: be a scribe and an interpreter who insists on "plain English" conversations. Resist profit-oriented tests and procedures and quick fixes with a multitude of medicines. Find trustworthy friends, community and service providers to supplement your own and your parents' efforts.
This is only a glimpse at the depth of this book. It is worth reading.
Lauren Williams, Certified Professional Organizer(R), Owner, Casual Uncluttering LLC, Woodinville, WA USA
This book requires you to think about your own parents aging, so inherently a challenging topic to read about. The concept of ‘slow aging’ is not common in the US and is something I want to take with me as a practitioner and caregiver of aging parents.
The advice provided is clear, reasonable, and made me think about elements of care that I never considered. Overall it helped me reframe my future role in these inevitable health transitions. However the structure was hard to follow. They had overall themes (stability, crisis, decline, death) for each chapter with paragraph long sub themes within that. It felt a little jumpy for me and I think it would be hard for me to reference the advice I want to find in the future.
This book gets a little boring sometimes, but there's no denying the good intentions of the author. Even if they skim some pages, baby boomers and others who have parents nearing the final stages of life will find lots of good information and comforting philosophy.
I was recommended this book by a friend. It advocates a 'slow medicine' approach to caring for the elderly, as opposed to the over medicalised, quick fix approach that often dominates this field. I have spent more than two decades working with elderly people and their families in the UK, and a lot of this book made sense and would be a helpful read for those who have loving caring families and are in a position to support their elderly relatives. It is a U.S. book, so the detail of cost and access to medical care, and dealing with the system, is not the same as the UK, but the broad principles of the book about how to approach things remain useful for either context.
My biggest gripe about this book, in common with some other reviewers below, is that it gives no recognition at all of how complicated family relationships can be, and the kind of dynamics that might exist where there has been, say, childhood abuse, domestic violence, estrangement, or toxic relationships driven by manipulation and control, guilt and duty. There needs to be another very different book for sons and daughters who find themselves living with these very different dynamics. For many people I have worked with over the years, this book would bring only undeserved guilt, pain, sadness and frustration, and I would not recommend it, in fact I would give it a serious health warning.
That is not to invalidate the importance of the message of this book in the midst of today's money-driven, time-limited, medical services. Indeed, for those brave enough, it may be a useful read to help us better ready ourselves for our own later lives.
This is a decent “how to”, or rather, “this is how others have done it” guide to caring for aging parents and facing aging oneself. Its subtitle is “Embracing ‘Slow Medicine’, the Compassionate Approach to caring for Your Aging Loved Ones”.
The “slow” and “compassionate” part is the hook the author sets to distinguish his ideas from the mainstream. He advocates much less medical testing, treatment, and interventions. Instead he favors community based care, relationships, autonomy for as long as possible, and a peaceful death.
Many little “case studies” of Bertha or John, etc. pad out the book. Sometimes these didn't help the narrative flow or the overall thesis that much -- this book was not a compelling read as I went along. However, it does fairly well serve to illuminate how elders do better with more choices and slower, more reflective assessments, plans, and choices.
Very scary, but important, book. A must read for anyone with elderly parents and/or in-laws. Dr. McCullough goes into great detail about the reality of aging in America and it's not pretty. It's downright terrifying to think of not only parents going through this but your spouse, yourself...
He nails the experience of growing old. I found myself reading many passages out loud to my husband and we were nodding in recognition.
A lot of the advice in the book we can't use yet but will be helpful down the road. I plan to buy this book (got this copy from the library) and hold on to it for future use.
I read the introduction, started the first chapter, realized we left that stage behind a couple of years ago, and wound up moving forward to the final few chapters, "Decline" and beyond. I found this book affirming and thoughtful, and will recommend it to my sisters as we try to support our recently widowed father. I also found it interesting that a reviewer whose elders live in Canada thought this book emphasized affording health care; as an American I thought it glossed over financial issues too much!
This book is an essential read for all of us whom have aging parents and want to assist them in their latest stages of life. Written by a geriatrician who is a member of the Dept of Community and Family Medicine at Dartmouth Medical School, this book outlines the stages of later life and how we, as caretakers, can advocate for and assist our loved ones by following a "slow medicine" approach. McCullough's anecdotes are powerful, and his advice, practical and, hopefully, doable. This book will serve as a guide for me and my sister for the next months/years.
Written by a surgeon/psychiatrist who says that medicine only can stabilize but the patient and support system do the healing. Takes one through 5 'stations' of dealing with an elder's health problems. I really appreciated his acknowledgment of the many limitations of the medical system - and how to deal with them. This should be required reading for anyone hoping to be prepared for helping their aging parents or loved ones.
Very thorough instructions about how to care for aged folk, and how to recognize the milestones of decline. I learned a lot from it and hope I needn't apply any of it for decades yet.
Recommended, but don't do what I did and read it the day after your parents leave for their home thousands of miles away.
This had a lot of specific & useful information, plus a wonderfully sympathetic approach to the very elderly (over 85 or so). That said, I found it rather depressing because so many of its idealistic techniques are simply unattainable. It would've been nice, though, to have this information when my own mother was in her last years.
Very useful guide, especially advice about thinking well ahead and forming a care team. One caveat: it glosses over those who might have difficult relationships with parents or siblings, nor does it fully acknowledge that there are elderly people who weren't so great when they were younger and offer thoughts about that. But still an extremely useful, thoughtful book
Facing life's inevitable crises, especially in advanced age, is made better by loving relationships. Slow down, take time to adjust to changes, create circles of care. All we have is each other. Author argues effectively for a social model of care for ourselves and our elders.
This kind doctor wants to guide folks through old age and dying in the sense of navigating the medical system and being prepared before crisis. A helpful resource for anyone. I gave him 3 stars for being a bit repetitive, but I did like the book.
Not an easy book to read, but a worthwhile one for someone whose parent(s) are in "late life" - late 80s or older, mapping out both the practicalities and the emotional difficulties of the various stages our elderly parents go through.
Interesting. Second reading two years later and I am even more exhausted by his caregiver as SAINT approach — coordinator of social interactions, reminiscing over old photo albums, massaging dry skin with lotion, singing along to the oldies. WTH. WHO are these saint-like caregivers?
A must read for anyone with parents over 80. McCullough's book details a way to look at the frail elderly and their choices for care in a way that is sensitive and no-nonsense.