General


Doctors Die Differently

Many years ago, my late father received a recommendation for carotid artery surgery. He had no symptoms, but his physician was concerned about kinking and possible narrowing of the artery. I described the situation to a vascular surgeon colleague. He thought the recommendation was questionable. I encouraged my father to talk further with his physician about […]

“Mommy’s” Long Life with Alzheimer’s Disease

My dear 99 year old stepmother, Virginia, has just been discharged from the supplemental hospice care program within her Alzheimer’s care facility.  Why? Because she has survived for almost two years beyond the six month prognosis for survival required for inclusion. She has not died and is considered stabilized. Her advanced Alzheimer’s disease is now […]

Social Security: Should the Over-55 Be Protected?

As Congress and the President begin to grapple with the looming “fiscal cliff,” the topic of Social Security reform could receive renewed attention as part of any effort to address the long-term budget deficit.  Some have asked whether policymakers considering Social Security changes could learn anything from recent state and local pension reforms.  One of […]

Do Not Transfer

They finally signed a “Do Not Transfer” order. The patient’s family had been reasonable enough, but they lacked medical expertise, and no one at the nursing home ever mentioned that an acceptable option could be to let a 92-year-old man live out his days, unencumbered by transfers to the emergency room for every attack of […]

Learning from my Mother’s Hospice Care

My mother has been in hospice care for the past five months, after three months of almost daily visits with doctors and recurrent visits to the emergency room, and pointless hospital admissions fraught with tests designed to diagnose problems which would require surgeries that she could never survive.

Do We Need Less Technology, or More?

As a practicing outpatient geriatrician, I generally embrace the principle that less is often more. But is this the approach we should take towards technology and the health care of older adults?

I’m Over 65 and Counting the Money

Not long ago, I retired from the clinical practice of psychiatry. One of the factors that comforted me in making that decision was that I was eligible to receive Medicare, so I wouldn’t have to try to obtain some sort of expensive private health insurance or COBRA to tide me over. Actually, I was 66, […]

Death with Dignity: A Response to Daniel Callahan

As someone who strongly supports the proposed Death with Dignity Act that will come before Massachusetts voters on November 6th and that is virtually identical to the law that has been in effect in Oregon for nearly 15 years and in Washington state for four years, I would like to respond to Dan Callahan’s arguments […]

Should We Accept Kidney Donations from our Children?

I’ve been looking into the phenomenon of organ donation from children to parents. Since I believe our national approach to Medicare injures future generations on behalf of us in the over 65 cohort, I wanted to see how we’re dealing with the most tangible form of intergenerational transfer – organ donation.