Talking With Your Older Patient: A Clinician's Handbook by National Institute of Aging - HTML preview

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foreword

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c h a p t e r 1

Considering Health Care Perceptions

The best way to learn what is and is not acceptable is to communicate directly with patients and caregivers.

“I’m 30 . . . until I look in the mirror.”

Mrs. Hill is an 85-year-old nursing home resident. She has lived in a facility since advanced heart disease made it impossible for her to live independently. Her adult children feel that life in a nursing home must be a nightmare. They want to do something, but they don’t know what. Moving her to one of their homes isn’t an option; visiting her makes them feel depressed. One day, her doctor chats with Mrs. Hill about life in the home. She tells him that this is one of the best times of her life—people prepare and deliver her meals, she has a comfortable room with a view of the gardens, and the place is very peaceful. Mrs. Hill is quite happy and has no desire to move.

For Mrs. Hill, a life her children fi nd unacceptable is, in fact, just fi ne with her. What seems intolerable to a 40-year-old may actually be preferred by a 90-year-old.

In the past century, the nature of old age has changed dramatically. In the early 1900s, the average life expectancy was about 49 years—today, it is nearly 80 years. With longevity, however, comes the sobering news that older considering health care perceptions