Dr. Dennis McCullough gave a boost to the Slow Medicine Movement when he wrote “My Mother, Your Mother: Embracing ‘Slow Medicine,’ the Compassionate Approach to Caring for Your Aging Loved Ones.”
Slow Medicine is common sense and kindness, grounded in traditional medicine while open to alternative practices, as well. Slow Medicine for Elders is a measured treatment of less-is-more that improves the quality of patients’ extended late lives without bankrupting their families financially or emotionally.
In 2008, Dr. McCullough wrote in the alumni magazine of the Geisel School of Medicine at Dartmouth College that: “The vast machinery of modern medicine, which can be heroically invoked to save a premature baby, when visited upon an equally vulnerable and failing great-grandmother, may not save her life so much as torturously and inhumanely complicate her dying.”
In his book, Dr. McCullough focuses on the fastest-growing group of elders: those over age 80. This group is particularly important because they have more interaction with the medical system and use more resources per capita than any other age group, a number that is about to double with a spiraling demand for health services. Diseases that once ended lives relatively quickly have been changed into chronic illness, chronic debilitation and extended years of decline.
In “My Mother, Your Mother,” he wrote: “Slow Medicine is not a plan for getting ready to die. It is a plan for understanding, for caring and for living well in the time that is left.”
Gentle Decisions
The concept of Slow Medicine is about learning to slow down when a loved one is in the later stages of life, typically age 80 and beyond. Taking more time for reflection, asking questions, having conversations with family and friends, and researching to help understand options and potential outcomes, is important before making decisions.
One example of practicing this concept is reassessing medications. The value of a medication can change over time. What was wise and useful to take when a person is younger in hopes of a healthier future, can change as we age.
Dr. McCullough points out that instead of a yearly mammogram, a manual breast exam may suffice for the very old, and home tests for blood in the stool may replace the draining routine of a colonoscopy. The high-blood-pressure pills that are lifesaving at 75 may cause problems at 95.
Another example of Slow Medicine is taking time to discuss and think about recommended tests and procedures. Often a doctor will recommend a series of tests, not considering how the test or procedure itself will affect the older adult. Is it worth the potential discomfort, anxiety and time? What is the goal of the test or procedure? If you find out your 95-year-old mother has colon cancer, will treatment be started?
Expensive state-of-the-art medical interventions do not necessarily deliver superior outcomes, Dr. McCullough says. Gentle, personal care often yields better results, not only for elders in late life, but for the families who love them.
In the late stages of life, older adults begin to slow down, not only physically but in almost every other aspect of life. Interests in the world around them lesses; life becomes greatly simplified. Reassurance that everyone and everything is okay can be so important at this late stage. Learning to slow down and embrace slow medicine for our elderly is something worth learning and talking about, not only for your elderly loved one but also letting others know what is important to you as you age.
Jennifer Beach is an Advanced Aging Life care Professional. She established Advocate for Elders (advocate4elders.com) in Rocky River and has 25 years of experience working with and advocating for older adults and their families.
