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Tuesday, December 08, 2015

Preserving Dignity and Quality of Life in Our Later Years

Amazingly, it was my twenty-seven year old son who recommended Being Mortal by Atul Gawande, a book that was #1 on the New York Times bestseller list for several weeks. A compelling read, I was unable to put it down until I read the last word.

Gawande is renowned as a surgeon, public health researcher and author. He is a general and endocrine specialist at Brigham and Women’s Hospital, as well as a Harvard professor in both its Department of Surgery and Department of Health Policy and Management.During a previous Leading Age conference, guest speaker Gawande was inspirational as he described how medical systems are broken, needing re-examination and change to produce better outcomes for its users. As keynote speaker at LeadingAge2015 in Boston, Gawande discussed quality of life in later years, a fundamental focus of his latest book, Being Mortal.

I found this book thought-provoking not only from my perspective as a provider, but as the family member of a current consumer and an eventual consumer of senior living services. Gawande highlighted successes in improved quality, independence and increased autonomy in the senior living and health care areas. He also described the failures of our health-oriented models, which tend to place safety over that of satisfaction in life. Then I realized why this book might have appealed to my twenty-seven year old:he had a front row seat during our own family’s senior safety saga.

Wheelchair IndependenceMy family and I moved in with my mom during her terminal months, as she was suffering from colon cancer. Mom became frailer and less functional, and my concerns grew about her stability and safety. We had the infamous parent-child conversation about moving to a bedroom downstairs (she had always had an upstairs bedroom). After a heated discussion, she said to me, “It is my life, and if I want to live upstairs at the expense of shortening my life by weeks or months, that is my right to do so.” Being the obedient child, I shut up.Later, she was to decide for herself to move downstairs.

Gawande is sensitive to the balances: safety/satisfaction; quality/quantity. The ultimate storyteller, he describes real life situations in which our senior living communities provided one at the cost of the other. Extrapolated against those failures, he cites places that succeed in valuing both sides of that equation.

For us as providers, we might ask, “How might I or my community adapt in order to enhance lives rather than restrict and diminish them?”  As Retirement DYNAMICS’ summarized in this book review of Being Mortal.

“While this book at times comes across a challenge to history and current practices in some communities and services, it is another guidepost to creating services, programs and communities that truly make lives better in all aspects versus just trying to focus on physical health.” Let’s hope that many accept that challenge.


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