2. What's "embarrassing" about the progress of medicine and public health?
3. After age 85, __% of people in industrialized countries are toothless. (4, 20, 40)
OR, Around age 80, we lose up to __% of our muscle weight. (10, 25, 50)
OR, By age 85, __% of us have textbook dementia. (10, 20, 40)
OR, By age 50, __% of the average person's hairs have gone gray. (20, 40, 50)
4. The newest view is that we age due to random wear & tear, genetics, or what?
5. Is there (according to Silverstone) a single common cellular mechanism to aging?
6. What is "defrailulation"?
BONUS: What's "the prevailing fantasy," and how do geriatricians contradict it?
BONUS: What kinds of courses would Chad Boult like to establish in every med school, nursing school, school of social work, and internal-medicine training program?
Spotted yesterday at Parnassus Books in Nashville-
Everybody, please post at least one and be prepared to say a few words about it.
1. Would you personally rather have "the bottom drop out" at the end of a long and satisfying life, or experience a vertiginous descent such as depicted in the graph on p.27 or a "long slow fade" (28) ("instead of delaying the moment of the downward drop, our treatments can stretch the descent out...")? If the former, is this an argument for allowing elective euthanasia?
2. Do you dread becoming a needy nonagenarian who can't run a marathon (etc.)? Or do you accept the inherent restrictions and limitations of aging, and look forward to your rocking chair? (Think about Alice's typical day, 39... ALSO: see the cartoon I posted Sunday night. Is it funny to you, or sad, or what?)
3. If "the story of aging is the story of our parts," will the development of prosthetic enhancement technologies rewrite the story of our biological/cultural transformation? Or is this dream just another form of denial about our limitations?
4. Given the "normal" phenomenon of brain shrinkage and a corresponding decline in judgment and memory (etc.), should our culture be less indulgent of older people's stubbornness regarding their living situation in later life?
5. Do you agree with Montaigne and Gawande that aging is "unnatural"?
6. "Doctors don't like taking care of the elderly." (36) How do you feel about that? Is this an attitude medical training should challenge and try to eradicate? How?
7. What do you make of the high incidence of falling accidents among the elderly? (40) (In Let Me Be Frank With You Richard Ford wonders about this. "How bleeping far are these people falling?!")
8. With the higher risk of fatality among elderly drivers (53), why shouldn't everyone over age 75 be required to pass an annual driving test behind the wheel?
1. Who called old age a "massacre"?
2. What happened to Bella that severed her connection to Felix?
OR, What move restored a sense of control to Felix and Bella?
3. What is a "continuum of care" community?
4. What happened in 1935 to introduce greater security in the lives of ordinary Americans?
5. Who was Harry Truman? (Not Harry S...)
6. What was the original rationale for nursing homes, if not to help old people face dependency and manage their lives more effectively?
BONUS: AG says the goal that matters most to older people is what?
1. "We do not like to think about" losing our independence in old age, and so we tend not to prepare for it. What kinds of preparations would you advise, for yourself and your patients?
2. What impairment associated with aging do you think would be hardest to cope with, or create the most difficulties for continued quality of life?
3. "It means something when you can move in and see all your things in their own places..." (60) What kinds of"things" can you not bear to imagine parting with, ever? The silver in your kitchen drawer, for instance? Shouldn't we all make an effort to simplify our material lives as we age?
4. Given the historical prevalence "poorhouses" (and their persistence in much of the world), should modern old age homes - even at their worst - be perceived as "frightening, desolate, odious" etc.? It could be worse, after all. Is this an insensitive thing to say?
5. Is it reasonable of old people to expect a lot more of life's last chapter than mere safety? (Friendship, purpose, freedom...) Can an institution ever really be a home?
6. Will you be a "feisty" old person? (75)
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|Atul Gawande (@Atul_Gawande)|