The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies

by Muriel R. Gillick M.D.

Overview

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.

Product Details

ISBN-13:	9780674025431
Publisher:	Harvard University Press
Publication date:	10/30/2007
Pages:	352
Product dimensions:	5.50(w) x 8.25(h) x 1.00(d)

About the Author

Muriel R. Gillick, M.D., is Clinical Professor of Ambulatory Care and Prevention at Harvard Medical School. She is a staff physician for Harvard Vanguard Medical Associates, and she is also on the medical staff of Brigham and Women’s Hospital and Faulkner Hospital.

Table of Contents

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

What People are Saying About This

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.

Marcia Angell

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.
— Marcia Angell, former Editor in Chief, New England Journal of Medicine, and author of The Truth about the Drug Companies

George D. Lundberg

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.
— George D. Lundberg, M.D., Editor in Chief, Medscape Core and Medscape General Medicine

Editorial Reviews

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.

People

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.

Hastings Center Report - Harry R. Moody

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.

Harvard Medical Alumni Bulletin - Elissa Ely

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

Tom Graham Book World

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 aging and longevity could be effectively dealt with by informed and intelligent political leadership.

Nature - John Grimley Evans

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.

Age and Ageing - Ros Levenson

This is quite an amazing book. It ranks at the top of my "most important books to read" list—for people of all ages and, most particularly, those with political power. Gillick confronts tough topics with gentle wisdom. Nursing homes, right-to-life issues for the aging, Medicare morass. She lays bare painful situations and moral dilemmas and offers sound, practical advice to the anguished plea, "But what can we do?" All this and it is easy to read...Gillick is on the cutting edge of issues that our entire society must face. For Boomers, for Gen X and Gen Y, for politicians who determine how we spend tax dollars on Medicare and health funding, this is a must-read book.

The Messenger-Press - Joan Ruddiman

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.

Marcia Angell

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.

George D. Lundberg

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

Washington Post Book World - Tom Graham

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.
— Harry R. Moody

Hastings Center Report

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.
— Ros Levenson

Age and Ageing

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.

— Elissa Ely

Harvard Medical Alumni Bulletin

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 aging and longevity could be effectively dealt with by informed and intelligent political leadership.
— John Grimley Evans

Nature

This is quite an amazing book. It ranks at the top of my "most important books to read" list—for people of all ages and, most particularly, those with political power. Gillick confronts tough topics with gentle wisdom. Nursing homes, right-to-life issues for the aging, Medicare morass. She lays bare painful situations and moral dilemmas and offers sound, practical advice to the anguished plea, "But what can we do?" All this and it is easy to read...Gillick is on the cutting edge of issues that our entire society must face. For Boomers, for Gen X and Gen Y, for politicians who determine how we spend tax dollars on Medicare and health funding, this is a must-read book.
— Joan Ruddiman

The Messenger-Press

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

Washington Post Book World

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. (Mar.) Copyright 2006 Reed Business Information.

Publishers Weekly