Listen to a short interview with Dr. Muriel Gillick
Host: Chris Gondek | Producer: Heron & Crane

You've argued politics with your aunt since high school, but failing eyesight now prevents her from keeping current with the newspaper. Your mother fractured her hip last year and is confined to a wheelchair. Your father has Alzheimer's and only occasionally recognizes you.

Someday, as Muriel Gillick points out in this important yet unsettling book, you too will be old. And no matter what vitamin regimen you're on now, you will likely one day find yourself sick or frail. How do you prepare? What will you need?

With passion and compassion, Gillick chronicles the stories of elders who have struggled with housing options, with medical care decisions, and with finding meaning in life. Skillfully incorporating insights from medicine, health policy, and economics, she lays out action plans for individuals and for communities. In addition to doing all we can to maintain our health, we must vote and organize--for housing choices that consider autonomy as well as safety, for employment that utilizes the skills and wisdom of the elderly, and for better management of disability and chronic disease.

Most provocatively, Gillick argues against desperate attempts to cure the incurable. Care should focus on quality of life, not whether it can be prolonged at any cost.

"A good old age," writes Gillick, "is within our grasp." But we must reach in the right direction.

From diets to cutting-edge diagnostic technology, Americans spend billions of dollars, not to mention untold hours of anxiety, staving off the aging process. In this readable examination of growing old and learning to live with it, Gillick, a Harvard Medical School associate professor, is pitiless as she critiques the current medical mantra of 'health maintenance,' observing that warding off death via endless testing and dangerous invasive procedures is 'a hopeless and counterproductive aim' hurting, rather than helping, the elderly. She persuasively argues for 'intermediate care,' 'a middle ground between maximally aggressive care and exclusively comfort-oriented care' involving, among other things, less expensive screening for some ailments after a certain age and, when possible, treating patients at home. This means fewer trips to the emergency room and fewer admissions to hospitals, which, in addition to being the most expensive means of delivering health care, also have proven to be places where the elderly actually suffer unnecessarily and often die prematurely. Gillick concludes that 'a good old age is within our grasp,' provided we rethink our approach to urgent or acute care, provide compassionate support to the elderly, and accept the fact that no one lives forever.

Americans, [Gillick] asserts, squander resources on quackery and on futile but expensive treatments for people approaching the end of their lives, and risk not leaving enough money for more beneficial care....Gillick's book raises important issues in a lucid and accessible style. The reader cannot help feeling that the problems of ageing and longevity could be effectively dealt with by informed and intelligent political leadership.

Finally, a book that tells the truth about aging, starting with the fact that eating right and exercising will not prevent it. Dr. Gillick provides a fascinating guide for the journey into old age, and shows us how to make the best of it. Boomers (and most other grown-ups) will find her book right on target.

Get real. You are going to get old and die, if you don't die young first. Face it. Prepare for it. Gillick teaches us how to age with grace, spend healthcare money wisely, retire productively, and die with dignity. It's a great achievement.

Blame it on graying boomers, medical advances or Hollywood: Americans are spending billions a year trying to stay young. Snap out of it, urges Dr. Muriel R. Gillick, and focus on things like overhauling Medicare. Read it before scheduling that facelift.

[Gillick] challenges her generation to embrace the inevitability of aging and to make the most of it.

Gillick's reasoning is so efficient and well placed, and she illustrates it so well with cases...Her detailed descriptions are dazzling in their sensibleness...[She] is the informed, compassionate, realistic gerontologist you want for your grandmother, your mother, and eventually--if she is not too old by then--yourself.

Americans, [Gillick] asserts, squander resources on quackery and on futile but expensive treatments for people approaching the end of their lives, and risk not leaving enough money for more beneficialcare....Gillick's book raises important issues in a lucid and accessible style. The reader cannot help feeling that the problems of ageing and longevity could be effectively dealt with by informed and intelligent political leadership.

It is not easy to review a book that is as good as this one as there is so much to say that is positive about this book and almost nothing by way of criticism. ...[T]his humane and compassionate book captures and retains the reader's interest throughout. It examines the denial of ageing and the associated "dangerous fantasies": if we continue to deny the realities of old age, we will, as a society, put our money into futile and expensive treatments, and will not have money left over to provide the beneficial care that older people actually need. It goes on to look at all the things that can contribute to a best possible old age, including appropriate medical care, housing support, a sense of purpose and meaningful activities. It does this for each segment of the older population, comprising "the robust, the frail and the dying." Best of all, it does all this with an impeccable blend of analysis, hard evidence and narrative about the lives of real people...In sum, this is a book that should be read by everyone who is interested in old age, and particularly, by those who allocate resources or deliver care.

Gillick’s book could not appear at a better time. We should send a copy to every member of Congress, as well as to all those doctors peddling bogus antiaging remedies. Readers need her message more than ever, but, alas, they seem unlikely to hear it at all as they rush to pick up prescriptions for human growth hormone, antioxidants, or other “dangerous fantasies” that Gillick decries.

'Muriel R. Gillick, M.D.is Associate Professorof Ambulatory Care and Prevention at Harvard Medical School. She is a staffphysician for Harvard Vanguard Medical Associates, and she is also on the medicalstaff of Brigham and Women\'s Hospitaland FaulknerHospital.'

Prelude

1. An Ounce of Prevention?
2. When Less Is More
3. Doing the Right Thing Near the End
4. The Trouble with Medicare
5. Is a Nursing Home in Your Future?
6. Assisted Living: Boon or Boondoggle?
7. The Lure of Immortality
8. Making the Most of the Retirement Years
Finale

Appendix: Resources and References
Notes
Acknowledgments
Index