Monday, November 18, 2013

More Book Reviews!

My Mother, Your Mother: Embracing ‘Slow Medicine,’ the Compassionate Approach to Caring For Your Aging Loved One, Dennis McCullough, MD

I really enjoyed this book, once I relaxed into his slower pacing and relaxed style, which I suppose reflects what the book is trying to say.  McCollough acknowledges first of all that we are, in fact, heading towards a geriatric/dementia based crisis because of advances in science and medicine, which has allowed our elders to live longer than ever before.  He contends that the care model we have been using is broken and a stop-gap and that something new needs to be created.  Using his own family experience, and stories from many of the families he has either treated or been in contact with, McCullough argues that families can create a more relaxed foundation for how to deal with the last years of their loved ones’ lives.  By being prepared in advance for the almost-inevitable illness, decline and death; by gathering information and having plans in place; and by fostering awareness and communication, not only throughout the family unit, but also into the patient’s medical and care community. 

McCullough takes the reader through a stage by stage outline, made up of what he calls the Eight Stations of Life.  The Stations start at Stability, make their way through Compromise and Crisis to Decline, Death, and Grieving.  Each Station describes the decline of a loved one, with a problem or issue to prepare for followed by solutions, information, and ways to arrange care and support.  He argues that, in this way, a crisis will never truly arise, because plans and back-up plans will have been made and people are prepared, for the most part, for what is coming.  I really enjoyed the comprehensive-ness of each Station and how neatly he has divided up each stage of life.  I also liked that he referenced the major illnesses and/or physical problems that occurs with age, giving us a short medical lesson.

I can really appreciate his viewpoint, because if there’s one thing my family didn’t do – which is the thing I urge everyone else to do – is be prepared in some small way for what you know is coming.  Gather information ahead of time, plan ahead, give yourself some options before you ever need them.  Even if your loved one is in denial and fiercely negative of the situation, you will have armed yourself with a few preparations.  In addition, try to start having those difficult conversations now – we all know what the future holds for us, and we have allowed issues like aging, illness, how we want our affairs handled, and how we want to die to become taboo, difficult issues, when they don’t have to be.

While I think McCullough can be a little optimistic on how easy it is to form a community of helpers, including how much family, friends, and neighbors will want to be involved; and he can gloss over how difficult having these conversations, and making these decisions and changes can be – I do believe he has the right idea and is on the right track.  He advocates a measured, prepared, hopefully crisis-free approach, which I think could be achievable given enough advance warning and thought.

 The Long Hello, Cathie Borrie
This is not your run of the mill dementia memoir and I should know because I’ve read a lot of them.  Borrie has chosen to style her book almost as memoir in poetry form – using short essays and very descriptive passages to convey events, conversations, and memories – both her own and her mother’s.  She weaves those memories together until it becomes almost her family’s memoir, not just hers or her mothers’.

Borrie combines elements of her own childhood and adult memories with conversations she and her mother had during the final years of her dementia.  Borrie recorded these conversations or wrote them down, conversations in which she asks her mother questions about what she remembers or feels.  Borrie also records questions that her mother asks her, and her mother’s response to her answers.  Her mother’s responses are often nonsensical, sometimes sad, but almost always poetic and touching.  The reader is left wanting more information about what were obviously terrible and impactful events, but the shortness of each essay provides only so much and no more.

Borrie’s recollections of her own life experiences, especially those that involve mother and her mother’s second husband act as a foundation to explain the loving, complex, and melancholy relationship she and her mother share, and the emotional bond that still persists into cognitive decline.  She manages through short exchanges and paragraphs to convey her love for her mother, the events surrounding the difficulty of dementia, as well as the relationships she has during her mother’s illness.  

Many reviewers called the book lyrical, which I would definitely agree with.  I don’t think it’s the right book for a caregiver with very little time, who is seeking immediate support and information – there are many other memoirs I would recommend in that case.  But the book isn’t terribly long and if you’re in the mood to wander through a story for a little while, this might be a good choice.

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