Tuesday, September 22, 2015

NYTimes: An Aging Population, Without the Doctors to Match

We talk a lot these days about what constitutes a good way to die. There's also much discussion about the art of healthy aging.

But largely absent from the conversation are all the people between the two. People who aren't dying but who grow more frail. People who have significant health concerns. People who suddenly find themselves in need of care.

People who are, by and large, miserable.

We have a name for this part of life in our family. We call it "the land of pink bibs."

In his 70s, my father, a highly respected orthopedic surgeon, developed Alzheimer's. Later in 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.

We were not prepared to see him like this.

"Oh, not a stroke," the nurse said. "He is fine. He's just on a new drug — a mood stabilizer. He was becoming violent to the aides. Patients often get like this when they have Alzheimer's."

We were suddenly confronted with decisions about his care that we didn't understand. Many families face similar questions: Do we move Mom out of her house to assisted living? Dad is so forgetful and argumentative, does he have dementia? Do our parents have enough money to hire a caregiver — and do we? When should we move them to a nursing home? What kind of care will they need when they get there?

These are difficult questions. Yet when you look around for help, you find there isn't much to be had.

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