Author: Dennis McCullough, MD
This is a small piece of art, a book that every geriatrician should read. The book talks about the last years of life and how people can prepare for them to be lived peacefully and satisfyingly, both the elderly person and his or her family. Slow Medicine’s strategy of care is to devise ways of coping with the situations that arise over time. The clinical situation of the elderly worsens, dependence progresses, and clinical complications and illnesses complicate their health.
This is an eminently propositional book that exposes situations, analyzes them, and proposes ways to deal with them, from the time when things are relatively well, to the time of bereavement. Dr. Dennis compares the situation of family members caring for their old man to the climb up the mountain in the movie “The Ballad of Narayama,” in which the son carries his elderly mother on his back to the top of the mountain. The essential idea is how to organize the care of the elderly, seeking to integrate family, caregivers, health care professionals, and existing social resources.
The book’s narrative is permeated with numerous cases of patients cared for by Dr. Dennis in his geriatric practice of over 30 years. The “8 late-life stations” described throughout the book are also mirrored in the author’s experience with the end of life of his mother, Bertha.
Once aware of the predictability of the situations that arise, most of them inexorable, caring affectionately, and cautiously take on more relevance than technological interventions. Most of the decisions to be made should be subject to reflection and dialogue between all the people involved in the elderly’s care since true emergencies are rare. The elderly person will certainly benefit from a more thoughtful and careful attitude towards these decisions, which can range from having a more invasive test or not, to undergoing a surgical procedure, to being hospitalized, to being transferred to the ICU, or to a long-stay care facility. The book goes on to address the issues of death and bereavement.
Book review wrote by José Carlos Campos Velho.