You are old, ill, in pain, and your doctor asks you what you want to do about it. You may be uncertain but you're definitely not alone. By the year 2020, some 50 million Americans will be over sixty-five, and as the nation ages we must all ask what we ought to do about the health and medical care of our elderly. Our response will have profound consequences, not just for individuals and families, but for society as a whole. This book helps us start to form an answer. To make decisions about medical care in old age, we need to know more about the reality of being elderly and sick, and Choosing Medical Care in Old Age gives us the opportunity. Muriel Gillick, a noted physician who specializes in the care of the elderly and in medical ethics, presents a panoply of stories drawn from her clinical experience. These encounters, with the robust and the frail, the demented and the dying, capture the texture of the experience of being old and faced with critical medical questions. From the stories of older people struggling to make choices in the face of acute illness, stories that are often poignant and sometimes tragic, Gillick develops broad guidelines for medical decisionâe"making for the elderly. Within this framework, she confronts particular concerns and questions. When are certain procedures too burdensome to be justified? What are unacceptable risks? Should family members serve as exclusive spokespersons for relatives who can no longer speak for themselves? Gillick's bold and personal prescription for medical care for the elderly calls for a change in the way medicine is understood and practiced, as well as for changes in the institutions that serve the elderly, such as hospitals and nursing homes. An intelligent and deeply compassionate inquiry into the difficult issues and realâe"life dilemmas raised by current practices, her book offers a first step toward those changes.
Since the introduction of Medicare and Medicaid in 1965, the American health care system has steadily grown in size and complexity. Muriel R. Gillick takes readers on a narrative tour of American health care, incorporating the stories of older patients as they travel from the doctor's office to the hospital to the skilled nursing facility, and examining the influence of forces as diverse as pharmaceutical corporations, device manufacturers, and health insurance companies on their experience. A scholar who has practiced medicine for over thirty years, Gillick offers readers an informed and straightforward view of health care from the ground up, revealing that many crucial medical decisions are based not on what is best for the patient but rather on outside forces, sometimes to the detriment of patient health and quality of life. Gillick suggests a broadly imagined patient-centered reform of the health care system with Medicare as the engine of change, a transformation that would be mediated through accountability, cost-effectiveness, and culture change.
A specialist in elder care, Dr. Muriel Gillick examines the complications of lives lived far longer than ever before. This book aims to help the frail elderly and their families cope with the often unforeseen dilemmas of aging: the most common chronic ailments, the acute problems, and their impact on living options. Tracing the stories of four people, Dr. Gillick highlights the various challenges and decisions that arise when frailty develops and discusses the importance of prevention and social responsibility in assessing, treating, and living with frailty. " G]ives me hope that if the worst should come, there is help to be found and meaning to be derived." John Kotre, author of "Make It Count
Since the introduction of Medicare and Medicaid in 1965, the American health care system has steadily grown in size and complexity. Muriel R. Gillick takes readers on a narrative tour of American health care, incorporating the stories of older patients as they travel from the doctor's office to the hospital to the skilled nursing facility, and examining the influence of forces as diverse as pharmaceutical corporations, device manufacturers, and health insurance companies on their experience. A scholar who has practiced medicine for over thirty years, Gillick offers readers an informed and straightforward view of health care from the ground up, revealing that many crucial medical decisions are based not on what is best for the patient but rather on outside forces, sometimes to the detriment of patient health and quality of life. Gillick suggests a broadly imagined patient-centered reform of the health care system with Medicare as the engine of change, a transformation that would be mediated through accountability, cost-effectiveness, and culture change.
An indispensable, comprehensive reference for family caregivers. Caregivers hold the key to the health, well-being, and happiness of their aging relatives, partners, or friends. The Caregiver's Encyclopedia provides you with all of the information you need to take the best care of your loved one—from making major medical decisions to making sure you don't burn out. Written by Muriel R. Gillick, MD, a geriatrician with more than 30 years' experience caring for older people, this book highlights the importance of understanding your friend's or family member's overall health. With compassion and expertise, this book will help you "think like a doctor." The content • helps you navigate the health-care system • shares important information about treating basic geriatric syndromes, including delirium, dementia, and falls • teaches you about preventive care options • enables you to manage medical decisions related to both acute and chronic conditions • discusses what Medicare covers—and what it doesn't • guides you through different approaches to care • weighs the risks and benefits of hospital vs. home, nursing home, or hospice care • provides a detailed list of medical supplies that you might want to keep on hand • offers you additional resources and emotional support Throughout, Gillick provides helpful information and concrete concepts that caregivers can put into practice today. Authoritative, comprehensive, holistic, and highly illustrated, The Caregiver's Encyclopedia will help you figure out how to be the best caregiver you can be.
Once They Had a Country conveys well what it was like to establish a new life in a foreign country--over and over again and in constant fear for one's life. The book draws from a remarkable set of primary source materials, including letters, telegrams, and police records to relate the story of two teenage refugees during World War II.
You’ve argued politics with your aunt since high school, but failing eyesight now prevents her from keeping current with the newspaper. Your mother fractured her hip last year and is confined to a wheelchair. Your father has Alzheimer’s and only occasionally recognizes you. Someday, as Muriel Gillick points out in this important yet unsettling book, you too will be old. And no matter what vitamin regimen you’re on now, you will likely one day find yourself sick or frail. How do you prepare? What will you need? With passion and compassion, Gillick chronicles the stories of elders who have struggled with housing options, with medical care decisions, and with finding meaning in life. Skillfully incorporating insights from medicine, health policy, and economics, she lays out action plans for individuals and for communities. In addition to doing all we can to maintain our health, we must vote and organize—for housing choices that consider autonomy as well as safety, for employment that utilizes the skills and wisdom of the elderly, and for better management of disability and chronic disease. Most provocatively, Gillick argues against desperate attempts to cure the incurable. Care should focus on quality of life, not whether it can be prolonged at any cost. “A good old age,” writes Gillick, “is within our grasp.” But we must reach in the right direction.
A specialist in elder care, Dr. Muriel Gillick examines the complications of lives lived far longer than ever before. This book aims to help the frail elderly and their families cope with the often unforeseen dilemmas of aging: the most common chronic ailments, the acute problems, and their impact on living options. Tracing the stories of four people, Dr. Gillick highlights the various challenges and decisions that arise when frailty develops and discusses the importance of prevention and social responsibility in assessing, treating, and living with frailty. " G]ives me hope that if the worst should come, there is help to be found and meaning to be derived." John Kotre, author of "Make It Count
You’ve argued politics with your aunt since high school, but failing eyesight now prevents her from keeping current with the newspaper. Your mother fractured her hip last year and is confined to a wheelchair. Your father has Alzheimer’s and only occasionally recognizes you. Someday, as Muriel Gillick points out in this important yet unsettling book, you too will be old. And no matter what vitamin regimen you’re on now, you will likely one day find yourself sick or frail. How do you prepare? What will you need? With passion and compassion, Gillick chronicles the stories of elders who have struggled with housing options, with medical care decisions, and with finding meaning in life. Skillfully incorporating insights from medicine, health policy, and economics, she lays out action plans for individuals and for communities. In addition to doing all we can to maintain our health, we must vote and organize—for housing choices that consider autonomy as well as safety, for employment that utilizes the skills and wisdom of the elderly, and for better management of disability and chronic disease. Most provocatively, Gillick argues against desperate attempts to cure the incurable. Care should focus on quality of life, not whether it can be prolonged at any cost. “A good old age,” writes Gillick, “is within our grasp.” But we must reach in the right direction.
Authoritative, comprehensive, holistic, and highly illustrated, The Caregiver's Encyclopedia will help you figure out how to be the best caregiver you can be.
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