Being Mortal -- Take 2

I have gotten very behind on my posts.  The consequence of that is that many of my memories of books read and movies watched are fading, and for that I apologize.  Nevertheless, I will do my best to share my thoughts about my recent (and not-so-recent) selections.

First up, Being Mortal.  I had heard generally positive things about Atul Gawande's many books, but had never previously read any of them.  I found Being Mortal to be a very easy read.  Rather than being overly preachy about the importance of end-of-life planning, those lessons come in the context of stories -- many of them personal stories about his own parents.  There are also some good, practical questions that we should all think through, even if we are not planning on needing end-of-life care in the near future.  It's better to think about these critical issues when the situation isn't critical.

Perhaps my favorite part of the book, though, was the historical context in which he places these questions.  At the beginning, people just didn't live that long, so these questions didn't need to be answered.  Then, once they did start living longer, we didn't know what to do with them so we put them in nursing homes, which generally were pretty horrid, jail-like places.  Following that, the assisted living revolution came along.  Where it still truly is "assisted living," it is an improvement over the prior situation.  However, many facilities that call themselves assisted living are no better than the original nursing homes they were meant to replace.  The latest shift is in favor of hospice or palliative care -- for both cost and preference reasons.  It is more important than ever (for a variety of reasons) for people to feel that they can remain independent, even with some limitations, and the costs of assisted living facilities or nursing homes are more than many can afford, especially in light of how much longer people are living.

Even since I finished reading this book a couple of months ago, I have seen some stories about user-friendly approaches to end-of-life care, especially for patients with dementia. One is a completely enclosed village in Holland; one in Cleveland is designed to look like a small town from the 1930s or 1940s, to remind people of where they grew up.  How neat is that?  As a bit of a dovetail, there was also recently an episode of Hidden Brain called "The Bomb That Didn't Explode: Why Our Fears About Population Growth Didn't Come True."  One of the many reasons that nursing homes took off like they did was that people were having fewer children -- one of the subjects covered by this podcast, although it also goes into other issues such as government support payments to the elderly and the significance of immigration into countries with a low birth rate.

Overall, I found the book informative and easy to read; recommended for everyone, however difficult the content may be.