Friday, May 25, 2012

Age's Stealing Steps

Michael Wolff has written a gripping but narrative-heavy article about the troubles he has experienced in addressing his mother's worsening dementia. It is hard not to feel for him and his family. Still, I think there are two perspectives which his piece underemphasized:

1) Many debilitated but cognitively intact individuals do have a good quality of life. For example, in a recent survey of 62 seniors with an average of 2.4 daily living dependencies and fairly good cognitive well-being (≥ 17/30 on the MMSE), 87% reported that they had a quality of life somewhere in the fair to very good range. I consider this to be a testimony to the resiliency of the human psyche. Also, it makes me worry that people will read the article and think that LTC insurance is only useful for those with dementia, which Wolff implies, when that is far from the case.

2) Why is it that many of the doctors depicted his story seem so unhelpful? There's little doubt that fear of litigation plays a role. For example, in a Mar '12 study, over half of the 600+ palliative care physicians surveyed reported being accused of euthanasia or murder within the past five years. In many respects this is a legislative issue, and I wish his article had discussed that angle more.

Many pointers in this post go to the excellent blog GeriPal