Embracing "Slow Medicine" as Compassionate Care for the Elderly

My Mother, Your Mother is an excellent common-sense book that addresses the inevitable decline and aging of one’s parents. It is both a sobering and encouraging read, especially if one is fortunate enough to absorb its advice early on in the aging process.

The project proposed by McCullough, a geriatrician and the son of a nonagenarian, is to combat the present healthcare system of emergency room medicine with a more tempered approach of “slow medicine." As a specialist to the elderly and caretaker of an aged mother, the author has seen first-hand, repeatedly, that modern-day Americans do not treat advanced age as a stage of life with its own predictable ebbs and flows; as a result, those who are fortunate enough to live into their eighties and beyond endure “crisis cycles of hospital-rehabilitation-nursing home stays [which] are often repeated many times over.” (Pg. 10).

“Slow Medicine” is not the systemization of yet another process, but the recognition of and insistence on the need for relationship. McCullough strives to be a gentle soul, but the core of his message is rather blunt: your parent is at some point going to die; prepare yourself, and plan to walk with your mother or father on this bittersweet path. (The reader is forced to endure repeated metaphors of life’s journey and autumn leaves and climbing the last mountain of life; the main message is, however, a sound one.)

McCullough presents this journey as a series of seven Stations—an image which can be interpreted spiritually (the stations of the cross, the seven Sufi stations of enlightenment) or metaphorically (train stops on the journey to the final destination), depending upon one’s perspective. These stages are: Stability (“’Everything is just fine, dear’—Mom”), Compromise (“’Mom’s having a little problem’—Dad”), Crisis (“’I can’t believe she’s in the hospital’—Sister”), Recovery (“’She’ll be with us for awhile’—Rehabilitation Nurse”), Decline (“’We can’t expect much more’—Visiting Nurse”), Prelude to Dying (“’I sense a change in her spirit’—Nurse in long-term care’”), Death (“’You’d better come now’—Hospice nurse”), and Grieving/Legacy (“’We did the right things’—Brother”).

The heart of McCullough’s message is the inviolable dignity not only of elders, but of the family that surrounds them. He is encouraging adult children to reacquaint themselves with their parents--to go back to the nest and not only rediscover, but intimately care for the ones they have most likely left behind. The answer may not be for mother to move back in with her children; however, children must familiarize themselves with the way mother lives in a day-to-day fashion, whom she relies upon as friends and intimates, how she views life and what awaits her after, what she wants for herself and why. As a geriatrician, McCullough is able to provide the reader with the red flags of breakdown that occur at various stages of aging, how to address setbacks, and how to advocate for the aging in a system which values efficiency over quality of life. Throughout the book he pleads for thoughtful deliberation and patience in considering options for one’s parents, as a restive society and a faceless medical bureaucracy pressure the elderly into nursing homes.

McCullough’s main objective—one he is hoping the reader and, eventually, the medical community at large will share—is to provide the elder with a fruitful end of life and a peaceful death at the heart of a loving family community. His book is an invaluable guide for adult children who wish to face their parents’ end, and eventually their own end, with empathy and peace.

Colet C. Bostick is the mother of two children and resides in Falls Church, Virginia. See theomamagy.blogspot.com.