July 2008 - Preserving Sanity and Dignity with "Slow Medicine"

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Recently, PBS aired a documentary titled "Caring for Your Parents." The subject matter hit close to home-not just for me, but also for many of my friends. The program did a good job portraying the struggles, challenges and conflicts families often experience when trying to provide the best care possible for their aging parents and loved ones while maintaining their own families, careers and friendships. It's a full time job. I would have loved to have seen an African-American family profiled, but the commonality of the experience-regardless of ethnicity - is universal. The double crisis is providing quality care for the elderly while also offering support and relief to caregivers.

Not only are the elderly victims of the maladies of old age-failing minds and bodies - but are also victims of a social and health care system ill-equipped to support them. Fortunately and mercifully, a new approach to treating ailing seniors is emerging. Slow Medicine is a new term that embraces and activates old concepts: nature knows best, less is more and life is always best lived with dignity.

How often have we witnessed the frail elderly - already afflicted with multiple chronic and age-related illnesses like heart disease, diabetes, dementia, incontinence, hypertension and so on, subjected to an ever-increasing number of invasive and complicated medical procedures designed to prolong life indefinitely? The cycle of diagnostic testing followed by surgeries and restorative therapies is both frightening and exhausting for the patient and the patient's loved ones. Surely, long life is something we all want, but at what expense and what kind of life are we speaking of?

The Slow Medicine approach shifts medical intervention with the elderly down to the lowest gear. Its first objective is not the extension of life, but rather the maintenance and comfort of the patient in whatever state of health he or she is in. The patient's comfort, and dignity are the goals. Medical crises that once would have meant a trip to the emergency room followed by more hospitalization and new rounds of testing and evaluation are now handled in a patient's home by trained professionals. There are no more diagnostic tests with the Slow Medicine model. There are no invasive surgeries or extensive rounds of rehabilitation therapies. Elderly patients are treated with the best medicines available to control their condition and relieve discomfort - nothing more.

This shift is a blessing for patients and caregivers. The locus of care remains the familiar surroundings of a patient's own home. Professional help is brought in instead of unsettling the patient by sending them out to hospital. Caregivers need not be trained in new medicine regimens or spend countless hours outside intensive care units. The path of least resistance is the chosen path of Slow Medicine. The patient's peace and dignity and the family's sanity are all preserved. While patients still receive treatment, Slow Medicine allows nature to take its own course.

Eventually, all journeys must come to an end. Fighting nature at any stage of life is not wise, nor is it welcomed or warranted when both heaven and earth have decided life should be winding down.

With you on your Journey to Wellness,
Dr. Mary S. Harris

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