Good Medical Care for the Elderly and How to Get It

Consider the Conversation

A new documentary is available to the public on DVD to help patients and their families talk with their physicians about end-of-life care. Following a model I’ve seen on Aging with Dignity website,  "Consider the Conversation" is a documentary available to the public on DVD to help patients and their families talk with their physicians about end-of-life care.  The documentary film will be available on PBS television this Spring and is also available for purchase on Amazon.com. Made in a volunteer effort and funded entirely by donations, the producers explain the film as follows:

“The bottom line is that Consider the Conversation does not seek to hand down answers.  Rather, it provides something far more important - the questions all of us need to contemplate.  That being said, the producers have three goals for this film: 1) to change the current American attitude from one that predominantly views end-of-life as a failed medical event to one that sees it as a normal process rich in opportunity for human development, 2) to inspire dialogue between patient and doctor, husband and wife, parent and child, minister and parishioner on end-of-life issues, and 3) to encourage medical professionals, healthcare organizations and faith leaders to take the lead in counseling others.”

Talking about End-of-Life Care

Thanks to my friend, Wendy Harpham, author of Happiness in a Storm and Only 10 Seconds to Care, for bringing to my attention a new guide for patients and their loved ones helpful to families and patients who are coping with final illness. Written by Paula Span, author of When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions, “Advanced Cancer Care Planning: What Patients and Families Need to Know About Their Choices When Facing Serious Illness” may be downloaded free of charge from the American Society of Clinical Oncology’s website.

I read the guide and believe it may be useful in any kind of situation—not just when a final illness is cancer. Using language that if both compassionate and direct, the booklet is easy to read. It explains, for example, that the word “advanced” is synonymous with 'end-stage' or 'terminal,' and that this doesn’t mean that an advanced illness is untreatable or that death is imminent. It also explains that choices for care relieving pain and discomfort remain when cancer is progressing even though a patient is receiving the best available anti-cancer therapies.

Making Decisions about When to Stop Driving

Jane Gross wrote in the New York Times recently about the angst primary care doctors face when   confronting a patient and family about whether an aging patient should still be driving. Questions raised are:

When is it time for someone with physical or cognitive problems to give up the car keys?

Who makes that decision?

How can it safely and compassionately be enforced?

Gross provided a link to a comprehensive and thoughtful handbook published by the American Medical Association in collaboration with the National Highway Traffic Safety Administration. Recently updated, the “A.M.A. Physician’s Guide to Assessing and Counseling Older Drivers” can be accessed by doctors and also family caregivers.