(July 21, 2008) Hear the audio version

Like many baby boomers, I’ve been helping to care for my parents just as my kids are leaving home. Some older people, like small children, require a lot of medical care. Bones break, systems fail after eight or nine decades of use. The inclination is to do anything possible to fix whatever’s broken. After all, we have modern medicine. We did that for my mother for most of the last year of her life, until, while lying in the ICU, she looked up at her favorite surgical resident and said clearly and with a sound mind, “Enough. No more operations. Take me off life support and let me go home to die.” Which Mom did, with dignity and the chance to say goodbye to those she loved.

Now I’m trying to care for my dad with my mom’s wisdom. It hasn’t been easy, especially after Dad had a heart attack. The chaotic pace during a four-day stay in our local, high-tech university hospital made me dizzy. Eventually, however, his daily report changed from “lousy” to “pretty good, thank you.”

That’s when the time came to s-l-o-w d-o-w-n the specialists eager to perform follow-up tests and procedures. Some geriatricians call it slow medicine – that is, the practice of not doing everything we can just because we can, and because older people can pay for it, for they’re covered by a great government-funded universal health insurance program, Medicare. Dad’s internist, a perceptive physician I’ve worked with the past year, prefers to call it “thoughtful medicine.” What are the real goals? The benefits? Side effects? Potential harm? Why subject Dad to a complicated procedure if we could not – or would not – do anything about what we might find out? What if doing so caused new complications? Deciding not to do something is a decision in itself. Dad, after all, is feeling “pretty good.” We need to listen to him instead of focusing on how long we might be able to get him to live.

My father’s 83. He’s slowing down. When I take him somewhere he’ll tell me to run along ahead of him. “Nope, Dad,” I say. “I’m right here beside you, all the way.”

With a Perspective, I’m Debbie Duncan.

In loving memory of my dear mother, Lavon Elaine Johnson Duncan, July 24, 1925 – February 15, 2008. I miss her every day. She was my biggest fan.