On Being Mortal

My husband and I just finished reading Being Mortal by Atul Gawande and found it extremely thought-provoking. It should be a “must read” for anyone over 50 and anyone with parents who are aging. We all want the best possible quality of life for our parents and ourselves in the declining years, but how do we go about assuring it?  Gawande provides a lot of context, raises a lot of questions, and provides some answers.
 
According to the book’s description, “Modern medicine has transformed the dangers of birth, injury and disease from harrowing to manageable.” But when it comes to the inescapable realities of aging and death, medicine often does the opposite of what it should be doing. Calling on both research and compelling, moving stories of his own patients, Gawande reveals the suffering caused by the lack of attention to what people really want as they age. To find that out, doctors and we all need to ask questions and have some tough discussions, but by-and-large we haven’t been doing that. We fail to realize the choices we’re making, or that are being made for us, because the doctors are not really talking to us, and we’re not asking the right questions. If we want not only a good death but a good life, both sides need to start talking honestly about realities and choices.

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Gawande also looks carefully at how medicine frequently prevents the dying from facing reality about their condition, either because doctors fear the conversation, something Gawande confesses he’s experienced, or because they view the disease as an enemy that must be fought to the end, failing to see how extreme treatments and last-ditch efforts destroy the quality of a patient’s remaining life.

He looks in-depth at the cultural evolution in assistance and care for the aging and details in fascinating terms the whole evolution of “retirement living” and assisted care. And we discover that while some facilities have beautiful lobbies and fancy brochures, they frequently play on the guilt of children in marketing and many are little more than glorified nursing homes. After reading Being Mortal, I have a lot more questions I would ask of a facility before choosing it for myself or a loved one.
 
Personal autonomy is frequently the primary desire for aging folks and it’s frequently the first thing diminished in an institution for the aging. When it’s lost, physical decline can rapidly set in. Yet when institutional decisions are made or seemingly some simple changes implemented to improve autonomy and surroundings, patients generally improve both physically and emotionally, leading to less depression and less medication, leading to much better quality of life. A riveting, humane and very honest book, Being Mortal shows how our ultimate goal should be a good life to the very end.
 
The book is not just for those of us who are aging or have aging parents--it should really be mandatory reading for ALL of us. If enough people start asking the right questions, perhaps we can change the national conversation about aging and dying and vastly improve the quality of life for millions of aging Americans.

A graduate of Stanford University, Mary Waldmann and her husband Raymond raised three children who are now independent, well-adjusted and happy young adults. Before becoming a mother, she was a successful real estate broker, political consultant and public relations executive, and worked as a part-time communications consultant when her children were young. Mary is the author of Six-Word Lessons on Winning with Today's Media , Six-Word Lessons for Intentional Parenting, and Six-Word Lessons for Compelling Speeches.

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