Just a spoon full of medicine…is not helping the elderly
John Sloan is a physician who has practised for 30 years with the frail elderly. He describes the elderly as people that the medical system has failed and people that are destroying our medical system by accessing unproven and unhelpful preventative and heroic drugs, surgeries and tests.
He argues that emergency and preventative care are usually detrimental to the frail older person, causing more problems than they cure. The kind of care the medical system currently offers has little chance of extending life, reduces quality of life and causes side effects worse than the cure. It hurts the individual patient and blocks access to care for other patients.
Sloan argues that since the frail elderly have such a broad range of medical concerns and require special assistance with daily functioning, they cannot be comprehensively studied. He says there is no evidence-based information for the treatment of the unique frail elderly person. Instead, they require personalized, individual treatment that prioritizes the patients' values and choices, enabling them to live a comfortable daily life rather than simply trying to extend life.
Much of the book contains stories of Sloan's patients and their caregivers, whom he portrays compassionately and honestly. He is open about his own mistakes and struggles when trying to treat his patients. He models a treatment approach of intent, listening to his patients and their families and supporting his patients to live and die in comfort and with maximum function in the areas of life they value, for example in such 'simple' activities as sewing or choosing what to eat.
This book is a challenging read for all of us as we look towards old age, but particularly for the elderly and their caregivers. It is a must read for health care providers. For Christians who live daily knowing the life and death of Jesus, this book will challenge us to accept the dying we see in our own bodies and our elders physical bodies and to consider how and when it will be time to stop fighting death using last measures medical treatment.
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