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Rethinking Old Age

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by joe angelelli
Posted on Thu May 24, 2007 at 08:33:18 AM EST

Dr. Atul Gawande is a guest columnist on the New York Times Op-Ed page this month. Today's column is titled "Rethinking Old Age." It's a Times Select piece (i.e., available only to paid subscribers). Here is an excerpt:
At some point in life, you can't live on your own anymore. We don't like thinking about it, but after retirement age, about half of us eventually move into a nursing home, usually around age 80. It remains your most likely final address outside of a hospital.

To the extent that there is much public discussion about this phase of life, it's about getting more control over our deaths (with living wills and the like). But we don't much talk about getting more control over our lives in such places. It's as if we've given up on the idea. And that's a problem.

-- snip --

Certainly, nursing homes have come a long way from the fire-trap warehouses they used to be. But it seems we've settled on a belief that a life of worth and engagement is not possible once you lose independence.

There has been, however, a small band of renegades who disagree. They've created alternatives with names like the Green House Project, the Pioneer Network, and the Eden Alternative — all aiming to replace institutions for the disabled elderly with genuine homes.

-- snip --

"The No. 1 problem I see," Dr. Thomas told me, "is that people believe what we have in old age is as good as we can expect." As a result, families don't press nursing homes with hard questions like, "How do you plan to change in the next year?" But we should, if we want to hope for something more than safety in our old age.

"This is my last hurrah," the woman I met said. "This room is where I'll die. But it won't be anytime soon." And indeed, physically she's done well. All she needs now is a life worth living for.

Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston and a New Yorker staff writer, is the author of the new book "Better."

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Rethinking Old Age (none / 0)

Just ask any hard-working direct caregiver (like myself) who really CARES about the well-being of our Elders, and they will be able to tell you: The answer to how Elders will find "a life worth living" is right before our eyes. And it is indeed so obvious, that apparently we can't see it...

To answer Dr. Thomas' great question, "What Are Old People For?" we need only look beyond our sick modern American culture to those so-called "primitive" cultures who approach their Elders with enduring respect and reverence. Instead of viewing them as the "frail elderly," younger folks in these cultures see their Elders as sacred, deep reservoirs of wisdom gathered from a long life, well-lived. They understand that their Elder's wisdom is essential for their own survival.

Instead of pretending that we adults know what's best for them, and instead of placing our full trust in technology and medicine, we need to replace our American techno-medical arrogance with humble appreciation for the strength and endurance our Elders obviously possess. We need to approach them gingerly, get down on our proverbial (and actual) knees, and sincerely ask for THEIR help. (Anyone who doesn't think we need THEIR help should take a look around and see how frail our own "adult" world is right now)

To begin with, for example, we can ask (the ones who remain) how they survived the Great Depression...this is information that may actually become very useful in the not-too-distant future! Or, we can ask the veterans of wars past, or their wives or mothers, how they feel about Iraq. I have done this many times, and even though we so-called 'professional' adults have labeled them with horribly destructive terms like "Severely demented" or "Cognitively disabled" they mostly still DO respond, IF we are sincere; perhaps because they somehow know we adults are psychologically disabled ourselves! I have personally seen folks who usually (behaviorally) fit the dementia stereotype suddenly come alive and very competently meet the challenge of HELPING ME with my sincere request for assistance with the issues of my day.

I know this works. And I challenge anyone... especially those who sit emotionally protected behind desks and write fancy books about, or prescribe useless and dangerous psychotropic meds for, so-called "dementias"...to leave their assumptions and safe havens aside, and face the whole and real person they seem to be afraid to confront. Behind the labels, these are the most complex and evolved human beings of all, who possess abilities that will amaze us, if we give them half a chance. Ours is the most amazing time in human history; we now have more resources in terms of human wisdom-bearers than ever before!

The life purpose and ultimate meaning that springs from the awareness (followed by ACTION) that I am writing about is hard to over-estimate. If done with the heart more than the head, it may result in not only providing our Elders with a "life worth living"...but also may, as Dr. Thomas wrote, provide an answer for how "Elders Will Save The World."

Try it for yourself. And if you agree that what I propose makes good old-fashioned common sense, please let me know...

Sincerely,

Charles Macknee
macpics11@hotmail.com      


by charlie on Sun May 27, 2007 at 02:13:10 PM EST
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