Friday, January 6, 2012

2011 Top 10: A Bittersweet Season

First in a series of reviews of my 10 favorite books read in 2011, presented in alphabetical order.

A Bittersweet Season by Jane Gross, ©2011

Excerpted [with some paraphrasing] from the book's section on a geriatrician’s presentation to healthcare policymakers:

“How many of you expect to die?”
[All members of the audience eventually raised their hands.]
“Would you prefer to be old when it happens?”
All hands flew up in unison.
Who would choose cancer as the way to go?
Just a few.
“What about chronic heart failure or emphysema?”
A few more.
“So all the rest of you are up for frailty and dementia?”

This outstanding book -- part memoir, part instruction manual, part expose on eldercare and financing -- is a sort of documentary about that third route. Cancer deaths come relatively early (age mid-60s) and with a rapid decline for 20% of Americans, and organ failures follow a decade later, via lengthier up-and-down declines, for another 25%. But it’s frailty and dementia -- “a drawn-out and humiliating series of losses for the parent and an exhausting and potentially bankrupting ordeal for the family” -- that lead to 40% of deaths.

The topic may be heavy but the treatment is extremely readable, accessible (suspenseful and fascinating, even), and packed with useful information. New York Times writer Jane Gross uses her mother’s decline as a springboard to present statistics and discuss issues, for example:
• elder housing (“assisted living is a social, rather than a medical, model of long-term care”);
• elder care (home care, nursing homes, physicians, hospitalizations);
• private savings and public financing (“assume that whatever it is you need, Medicare won’t pay for it”);
• family relationships and responsibilities
• end of life.

Gross gathers dozens of resources into a useful appendix, and the blog she launched (The New Old Age at the NYT) remains active although with new contributors. Her mother’s 2001 decline prompted this book, but Gross incorporated up-to-date research when she wrote it in 2010. It was published when my 92-year-old mother was a couple of years into her decline into frailty, and I read it in a cycle of putting it aside and then invariably being fascinated to find recognition and comfort when I picked it up again; I finished it a month before she died.

Of the many books now about caregiving and elder care, I recommend this single volume. It’s one to read for your parents’ aging and then again for your own.

(Review based on an advance reading copy provided by the publisher.)

1 comment:

  1. The book is for everyone who has parents or is a parent. It's about how families can take care of aging parents and how we can arrange ourselves so that our children need to care for us as little as possible. It's part memoir, part how-to, part policy analysis. The author worked for the New York Times for 30 years and has been nominated for 13 Pulitzer Prizes. Her expertise as an investigative journalist is in health and aging. Therefore, the fact that even she was ill-equipped to care for her aging, ailing mother was a huge wake-up call to her and she wrote this book to help the rest of us.
    As I was reading it, I kept finding myself wanting to immediately email various friends the news that I'd found a book that provided answers to the very same issues with which they were currently struggling. Share the book with your parents or kids, too - it will be the starter to the conversation that's been too tough to have. I've shared it with my family - I don't want to be the only one in this situation equipped with the crucial information and insights.
    Jane's tone is that of a wise, witty, warm, humble friend who happens to be an expert. You'll laugh and cry. It's not a bleak or dry read. It is, however, a must-read, in my opinion. Why reinvent the wheel at the expense of you, your parents', your kids' health, finances, and well-being? Just read this book.