General


The Elderly not Resting on their Laurels

On the morning of Wednesday, November 20th, 2013, I was beginning to peruse the article by Dan Gorenstein in the New York Times, “How Doctors Die: In Coming to Grips With Their Own Mortality, They Are Showing the Way for Others”. CNN was on the TV in the background. On came the presentation of the […]

Dogs and the Elderly

As an only child growing up in New York City, I hounded my parents for a dog.  They held fast. Then, in the eighth grade, playing stickball with friends after school, I came upon a mutt tied to a barbershop pole. The barber told me the dog had been wandering around on its own. Did […]

Exercise for the Elderly

The past year has seen mounting evidence of the strong cumulative benefits from physical activity at every age, not least for persons over 65. Yet as the time for New Year’s resolutions rolls around once again, we see the same bleak media predictions of how few people, among all those who resolve to begin a […]

Going South

I was 68 and long since retired when I had the pleasure of being an “accompanying spouse” on a junket to a Caribbean island where my wife was attending a business conference. During her meetings I whiled away the time on the beach and simply fell in love with the climate. It was reliably sunny […]

On Aging and Writing a Hard Book

I recently finished a biography of Bertrand Russell, a major 20th century British philosopher who, as his career moved along, shifted heavily toward personal involvement in international political and cultural affairs, most notably arms control and nuclear weapon reduction—but meanwhile, as a kind of relaxation, continuing to turn out a stream of philosophy books. He […]

Update on LTCI in Massachusetts: Law Passed, Implementation Stalled

The Affordable Care Act has been front-page news from well before its passage in 2010 up through its present turbulent phase of getting up and running.  Questions, concerns, and controversies have abounded and continue to do so.  What impact will it have on benefits?  On premiums?  On cost to the taxpayer?  Similar questions are commonplace […]

Aging Well

My mother will turn 88 in a few weeks. According to the definition of successful aging put forward by Rowe and Kahn nearly 16 years ago, she is aging quite well. Her kidneys, lungs, and heart work fine. She is still very active—she teaches a French class once a week at the local senior center, […]

Surrender at the End of Life

First, the problem “Do not go gentle into that good night… Rage, rage against the dying of the light.” So wrote the Welsh poet, Dylan Thomas. Working intensively over the past seven years in end-of-life care, I have often seen this attitude as a response by good people to the bad things that are happening […]

Aging in Place in a Bleak Landscape

Somewhere near the middle of Alexander Payne’s new movie Nebraska, a young boy rides up on a bicycle to take a photo of Woody Grant for the local newspaper.  Woody has, or so he believes, won a million dollars in a merchandising sweepstakes. He has become a celebrity in Hawthorne, the small fictional Nebraska town […]

Proust on Treating Chronic Illness

The need to control health care cost is a central challenge for health and economic policy. Other than the high prices we pay in the U.S., chronic illness is a main driver of cost escalation, especially for Medicare.  Seventy-six percent of Medicare spending is on patients with five or more chronic diseases, including heart disease, metabolic syndrome, […]