Monday, November 10, 2014
Professor Raymond O'Brien, Catholic University Law, and Associate Dean Michael Flannery, University of Arkansas, Little Rock, have collaborated on the latest new classroom text to hit my desk. Published by Foundation Press, "The Fundamentals of Elder Law: Cases and Materials" includes chapters on:
- Elder Estate Planning
- Transfer of Wealth
- Incapacity: Utilization of Powers and Surrogates
- Health Care Decisions
- Social Security, Veterans and Railroad Benefits
- Elder Housing Options
- Payment Options for Elder Housing
- Discrimination and Abuse
Plus, the authors have included text from several key uniform laws as appendices in their book, thus reducing student costs to purchase expensive supllements. I especially appreciate their inclusion of the Uniform Power of Attorney Act, given recent state legislative efforts to provide safeguards connected to use of POAs.By the way, I tried to link to this textbook on the West Academic website here. No luck with searches by author or subject. Is the book too new for the publishers to list? (I've had similar problems before with other title searches on the website, which strikes me as a problem; hopefully one that can be fixed.)
Friday, September 12, 2014
Our friend and health law/elder law rock star, Marshall Kapp, sent me a note about a book review he authored (thanks Marshall) that appears in The Gerontologist Advance Access. The review is of the book, The Rule of Nobody: Saving America from Dead Laws and Broken Government by Phillip K. Howard.
You may be wondering why a blog for elderlawprofs is posting about laws and government regulations. Three words: nursing home regulation. Although a subscription is required to read the full review, an excerpt is available for free, much of which I have reproduced here
The brilliant satirist Jonathan Swift said long ago, “Laws are like cobwebs, which may catch small flies, but let wasps and hornets break through.” (Brainy Quote, n.d.). Swift certainly did not intend that remark as a compliment to either laws or cobwebs. Nonetheless, almost all laws originate to accomplish some reasonably defensible public purpose, even though ... poorly drafted, inconsistently ... enforced, and perpetuated beyond ... their original justification ....
In this latest project, Howard despairs that regulation in the United States has veered far from its proper function as a setter of boundaries or parameters within which individuals are empowered... (end of excerpt).
Since Marshall sent me a full copy of the book review, I can explain further what the abstract does not, how the author uses nursing home regulations as an example. Marshall describes this on page 1-2 of his review
One of the primary examples that author Howard utilizes throughout The Rule of Nobody to illustrate his constructive critique about the largely dysfunctional nature of the contemporary American regulatory situation is the overwhelmingly extensive and complex set of formal command and-control rules we have promulgated on the federal and state levels to govern the operation of nursing homes.
Marhsall offers a bit of history as to why we have so many laws and regulations for nursing homes and suggests that now is "the time to seriously contemplate smarter, rather than just bigger, regulation...." (review at page 2). He notes that the author provides examples of when the regulations don't end up benefitting the residents, with current regulations stifling innovation. (review at 3). Marshall concludes his review with this summary
[T]he Rule of Nobody is noteworthy for the nation generally and for long-term care policy-makers particularly... Settling for being “in the ball park” is damning with faint praise, indeed. The only option for many vulnerable individuals is dependence on the benevolence of nursing home owners and workers and lawmakers’ careful guidance. Society owes them a system of oversight and influence that not only aspires to, but effectively achieves, a much loftier standard.
Another one to add to the reading list.
Monday, September 1, 2014
Washington Post writer Frederick Kunkle profiles Meryl Comer, author of "Slow Dancing With a Stranger," a new book that "offers an unflinching and intimate account about what it means to surrender one's career to care" for a loved one stricken with Alzhemier's. In describing the author and her book, he writes:
"Its a a love stsory without a happy ending, because the ending for Alzheimer's patients can seem more like endless twilight. And it's a call to arms for caregivers such as Comer....
When Alzhemier's took hold, [her husband, chief of hematology and oncology at NIH, Harvey Gralnick] was a fit 56-year-old -- he ran six miles a day -- who dressed impeccably wearing the latest fashions beneath his lab coat.... For a time, he was able to mask his symptoms behind his reputation as a brilliant if eccentric scientist....
As his condition worsened, Comer, too, gave up her career -- and she adds with a note of bitterness, her 'prime.' In her blunt-talking manner, she acknowledged that she did so not entirely out of devotion but because doctors told her more than once, wrongly, that the progress of her husband's disease would not be long.
Finances, too, were a factor. It was almost impossible to find care that she felt would be satisfactory for her husband and yet affordable. Her burden intensified even further when her mother, too, developed Alzheimer's; her mother now shares the same home with Comer and her husband."
The book is meant to make people mad -- and more realistic and focused -- about the need for solutions. The article quotes George Vradenburg, a co-founder with Comer of the nonprofit group USAgainstAlzheimer's, who hopes that Comer's book will stir conversations about a disease many prefer not to think about. "I hope America gets mad," Vradenburg is quoted as saying.
For more, see "Alzheimer's -- Thief and Killer," in the Washington Post.
Tuesday, August 5, 2014
The Law and Ethics of Dementia, co-edited by Israel Doron, Charles Foster and Jonathan Herring, recently released in hardback by Hart Publishing and available for e-readers in September, is definitely on my "must read" list. Followers of this Blog will certainly recognize Issi Doron, from the University of Haifa, who has long exercised an international, comparative perspective on issues in ageing. Professor Foster is a practicing barrister and a fellow at Green Templeton College, University of Oxford, which is also the working home of prolific writer and Law Professor Herring.
The book is organized into five parts, Medical Fundamentals, Ethical Perspectives, Legal Perspectives, Social Aspects, and Patient and Carer Perspectives. As part of the first section, physicians and researchers Amos Korczyn and Veronika Vakhapova co-author "Can Dementia be Prevented?" a question we all hope will be answered in the affirmative. Not surprisingly, given the title of the book, the section on ethical perspectives promises to be especially fascinating, offering multiple views on ethical components of decision making and care. To suggest the scope, Andrew McGee's chapter is on "Best Interest Determinations and Substituted Judgement," while Leah Rand and Mark Sheehan tackle the challenge of "Resource Allocation Issues in Dementia."
In the Social Aspects section, I notice that Syracuse Law Professor Nina Kohn has a chapter on "Voting and Political Participation," while Chinese (and University of Pennsylvania) health care scholar Ruijia Chen and colleagues address "Physical, Financial and Other Abuse."
With more than forty individual chapters and dozens of international writers, this book promises to be a key guide for the future.
Wednesday, May 14, 2014
It occurs to me that what I'm about to write here is a mini-review of a mini-book. Slightly complicating this little task is the fact that I count both authors as friends and mentors.
The latest edition of Elder Law in a Nutshell by Professors Lawrence Frolik (University of Pittsburgh) and Richard Kaplan (University of Illinois) arrived on my desk earlier this month. (As Becky might remind us, both are definitely Elder Law's "rock stars.") And as with fine wine, this book, now its 6th edition, becomes more valuable with age. This is true even though achieving the right balance of simplicity and detail cannot be an easy task for authors in the intentionally brief "Nutshell" series. Presented in the book are introductions to the following core topics:
- Ethical Considerations in Dealing with Older Clients
- Health Care Decision Making
- Medicare and Medigap
- Long-Term Care Insurance
- Nursing Homes, Board and Care Homes, and Assisted Living Facilities
- Housing Alternatives & Options (including Reverse Mortgages)
- Alternatives to Guardianship (including Powers of Attorneys, Joint Accounts and Revocable Trusts)
- Social Security Benefits
- Supplemental Security Income
- Veterans' Benefits
- Pension Plans
- Age Discrimination in Employment
- Elder Abuse and Neglect
The authors describe their anticipated audience, including "lawyers and law students needing an overview of some particular subject, social workers, certain medical personnel, gerontologists, retirement planners and the like." Curiously, they don't mention potential clients, including family members of older persons. I suspect the book can and does assist prospective clients in thinking about when and why an "elder law specialist" would be an appropriate choice for consultation. This book is a very good starting place.
What's missing from the overview? Not a lot, although I find it interesting that despite solid coverage of the basics of Medicaid, and even though it is unrealistic to expect exhaustive coverage in a mini-book, the authors do not hint at the bread and butter of many elder law specialists, i.e., Medicaid Planning. Thus, there's little mention of some of the more cutting edge (and therefore potentially controversial) planning techniques used to create Medicaid eligibility for an individual's long-term care while also preserving assets that otherwise would have to be spent down.
Modern approaches, depending on the state, may range from the simple, such as permitted use of assets to purchase a better replacement auto, to more complex planning, as in states that permit purchase of spousal annuities or use of promissory notes, allow modest half-a-loaf gifting, or recognize spousal refusal. Even though the federal Deficit Reduction Act of 2005 succeeded in restricting assets transfers to non-spouse family members, families, especially if there is a community spouse, may still have viable options. Without appropriate planning the community spouse, particularly a younger spouse, may be in a tough spot if forced to spend down to the "maximum" permitted to be retained, currently less than $120,000 (in, for example, Pennsylvania). See, for example, a thoughtful discussion of planning options, written by Elder Law practitioners Julian Gray and Frank Petrich.
Perhaps the Nutshell omission is a reflection of the unease some who teach Elder Law may feel about the public impact of private Medicaid planning?
May 14, 2014 in Advance Directives/End-of-Life, Books, Cognitive Impairment, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid, Medicare, Property Management, Social Security | Permalink | Comments (0) | TrackBack (0)
Wednesday, April 30, 2014
Another book recommendation, courtesy of my Penn State colleague, neuropsychologist Claire Flaherty. The book is "The Banana Lady and Other Stories of Curious Behavior and Speech," by Andrew Kurtisz and first published in 2006. Professor Flaherty accompanied this recommendation with the note that the book presents "truth is stranger than fiction" tales of changes in personality, behaviors and relationships, including the gradual loss of language that can occur even in one's "middle" ages.
The author's bio is also interesting:
Dr. Andrew Kertesz is professor of Neurology in the Department of Clinical Neurological Sciences at the University of Western Ontario. He is Director of Cognitive Neurology and Alzheimer's Research Centre at St. Joseph's Health Care London and former Chief of the Department of Neurology. He graduated from Queen's University in Kingston, Ontario, studied neurology in Toronto, and behavioral neurology in Boston. His publications deal with the classification, localization and recovery in aphasia, as well as alexia, apraxia, visual agnosia and dementia. His books include Aphasia and Associated Disorders by Grune and Stratton (1979), Localization and Neuroimaging in Neuropsychology by Academic press (1994), and his most recent book, co-authored by Dr. David Munoz, is entitled, Pick's Disease and Pick Complex by Wiley-Liss Inc. (1998). Recent research projects are the experimental treatment of Alzheimer's disease, mild cognitive impairment, vascular dementia, primary progressive aphasia, and frontotemoral dementia. He has standardized a Frontal Behavioral Inventory for the diagnosis of Frontotemporal dementia and is active in clinical trials.
Thanks, Claire, for helping to keep our summer reading lists well filled.
Thursday, April 24, 2014
My Penn State colleague from Hershey Medical Center, Dr. Claire Flaherty, has shared with me a another fascinating resource, "What If It's Not Alzheimer's?: A Caregiver's Guide to Dementia," by Gary Radin and Lisa Radin.
The first chapter provides "The ABCs of Neurodegenerative Dementias," including frontotemporal dementia (FTD), Lewy Body Dementia, vascular dementia, as well as Alzheimer's Disease. Key chapters including "finding the A Team" of specialists, and a guide to therapeutic interventions.
The book reminds us that with some forms of dementia, particularly early onset dementias such as FTD, changes in personality or executive function may be the first signs, and easily misunderstood. For example, the individual may manifest:
- hypersexuality, including promiscuous sexual encounters with strangers; or
- apathy or indifference to grooming and hygiene; or
- "hyperorality" with disinhibited consumption of large amounts of food; or
- poor judgment with a lack of sense of consequences, sometimes coupled with poor impulse control
One chapter is unique, emphasizing the potential importance, after death, of an autopsy of the brain, and thus providing families with a way to contribute to biomedical research and the hope for better answers in the future.
Sunday, April 20, 2014
Former Supreme Court John Paul Stevens celebrated his 94th birthday on Sunday, April 20, in a rather unique way, appearing on ABC's This Week with an interview by George Stephanopoulos. And it was not exactly a soft ball interview, inspired in part by the Justice's bold new book Six Amendments: How and Why We Should Change the Constitution. To whet your appetite, here is a bit from the prologue:
"In the following pages I propose six amendments to the Constitution; the first four would nullify judge-made rules, the fifth would expedite the demise of the death penalty, and the sixth would confine the coverage of the Second Amendment to the area intended by its authors. The importance of reexamining some of these rules is already the subject of widespread public debate, but others have not received either the attention or the criticism that is warranted."
The title of a piece in the April 2014 issue of AARP Bulletin, "Dispatches from the Battle of the Ages," suggests that we're already in a battle between older and younger people, with the article detailing media reports about battlelines on jobs, funding for federal benefit programs, health care costs, and caregiving obligations.
"Alarmists use ... statistics to paint a portrait of generational warfare. But are they mounting that picture in the wrong frame? To paraphrase a slogan from the 60's peace movement, 'Suppose they gave a generational war and nobody came?'"
The article suggests an interesting resource, Paul Taylor's book (released in March), The Next America.
"Taylor [executive vice president of special projects at the Pew Research Center in Washington D.C.] and his Pew Colleagues conducted opinion surveys and pored over decades of demographic data. Yes, there is a palpable anxiety about the lingering recession and long-term problems associated with entitlements, plus the runaway national debt. Yet Taylor notes this anger transcends age barriers."
At times I do hear a strong resentment among students, both at the college level and in law school, and yet at the same time, I am also impressed by how many students choose to take courses and look for jobs in fields that will serve older adults. Is there a "war" -- or is it more of a struggle to find firm footing on ground that is ever shifting?
Wednesday, March 19, 2014
I spent most of our recent spring break in Arizona with my parents and sister (and trying to thaw my frozen bones). I had time to visit friends, some I haven't seen in decades, and often I was tempted to give a rueful chuckle. We're all in the same age range -- and several of us are searching for ways to help aging parents. With friends who have a parent with dementia, as soon as they find out that much of my work now focuses on "elder law," I would get what I've come to think of as "the question."
What's the question? "Is it inevitable that I too will develop dementia?" Of course, I'm a law professor, not a doctor. My friends are asking the wrong person.
But, then I noticed that several of my friends were reading the same book. The book is "100 Simple Things You Can Do to Prevent Alzheimer's and Age-Related Memory Loss," by Jean Carper, a well-respected medical journalist. One friend loaned me a copy. It was first published in 2010. I asked friends what they liked about the book, and more than one mentioned the "single idea" format for chapters, short enough to keep the reader on task, while sufficiently detailed to convince the reader why that "tip" just might make sense.
Some of the 100 "things" are, I hope, mostly an affirmation of common sense, such as Chapter 17's "Count Calories" and Chapter 20's "Control Bad Cholesterol." Occasionally a chapter strikes me as a bit trendy, such as the admonition in Chapter 22 to "Go Crazy For Cinnamon." But quite a few topics and explanations were either surprising, intriguing, or both, including Chapter 3's recommendation to "Check Out Your Ankle." The author explains how low blood flow in your foot, measurable by an ankle-brachial index (ABI) test, can point to looming troubles for the brain.
Happy reading and good luck adapting the tips to your life. Remember, with 100 recommendations to read, evaluate, and, as appropriate, embrace, it doesn't hurt to start "young."
Wednesday, February 12, 2014
Peter Strauss, Co-Director of the Elder Law Clinic at New York Law School, leads off his school's recent Law Review symposium by reminding us of a powerful early piece published in 1983 by Marion Roach. She recounted the first moments when she realized her mother her mother "might be going mad." She went on to explore her mother's Alzheimer's and the family's struggle in her well-regarded memoir, Another Name for Madness.
Professor Strauss' Introduction opens the symposium issue on the theme of Freedom of Choice at the End of Life: Patients' Rights in a Shifting Legal and Political Landscape. Videos of the presentations are available here.
Tuesday, February 11, 2014
Southern California estate planning attorneys Bradley Erdosi and Laura Bromlow offer an interesting list of "Essential Things Everyone Should Know About Estate Planning, Probate and Elder Law," for the January 2014 issue of Orange County Lawyer. The full article is available to bar association members, and is also available on Westlaw.
Among the items, is the caution that "An Intended Beneficiary May Never See a Dime," a warning that special efforts -- and certification by an "independent attorney" -- may be needed to protect a bequest or other covered donative transfer to a caregiver from disqualification arising from a statutory presumption. Complying with California's rules will also help to protect the drafting attorney against an allegation of malpractice. They explain:
"California Probate Code section 21380 (Lexis 2011) outlines the presumption of fraud and undue influence regarding donative transfers to certain people, including a “care custodian” of a dependent adult. Therefore, the gift to your dear friend will be presumed to be the result of fraud or undue influence. However, the drafting attorney can overturn this presumption by following certain steps outlined in California Probate Code section 21384 (Lexis 2011). In completing a Certificate of Independent Review, the certifying attorney must be an “independent attorney” (as defined by the statute) and: (1) counsel the client-transferor, including the nature and consequence of a transfer to the potentially disqualified person, and (2) determine that the intended transfer is not the result of fraud or undue influence. If the above requirements are satisfied, the attorney then signs and delivers to the client a 'Certificate of Independent Review,' the language of which is set forth in section 21384."
Thursday, January 9, 2014
I suspect that Professor Nina Kohn (Syracuse, and a recent visitor at Maine) is having one of those "phone book" moments this week (as when Steve Martin's movie character jumps in excitement to receive the new phone book, because he's now "in print"). Her new casebook, Elder Law: Practice, Policy and Problems, published by Aspen, is now "in print" and a copy arrived on my desk this week.
I have to admit, a bit ruefully, especially to my co-writers on this blog (who each have great classroom texts), that I'm not always faithful in my affections for casebooks. I probably change texts more often than the average professor when teaching Elder Law courses, in part because I find new editions invigorating to read and use in teaching classes in this rapidly changing field.
Thus, I've already done a scan of Nina's new book, and it is fun to see her choice of cases, policy materials and (best of all), her incorporation of problems and exercises in each chapter. The book also appears to be "efficient" as it frequently incorporates rules and statutes into the text in "original" form, thus reducing the cost to students for statutory supplements.
I particularly like her use of several sample documents, such as a health care proxy and an advance health care directive, to give opportunities for readers to compare and contrast language. The book also does not shy away from ethical and practical concerns connected to Medicaid planning. For example, I'm looking forward to a careful read of her section on spousal refusal. She includes materials on cutting edge topics, such as grandparent rights and obligations, and the potential distinction between palliative care and hospice.
Elder Law profs are an amazingly busy group of folks -- just read Kim Dayton's plans for UNretirement on this blog this week if you have any doubt -- and I'm in awe of the prolific efforts of colleagues in this field.
Monday, November 11, 2013
In my experience, the Elder Law Bar -- those lawyers who work hard to help older adults and family members through the maze of options in deciding how to handle long-term care needs and end-of-life planning -- are also a warm, generous group of professionals to hang out with. When you need an answer to a tough question on one of your cases, someone always takes that call. When you need a speaker for a meeting, conference, or classroom, someone always volunteers, and then goes above and beyond, to provide a little something extra in terms of value for the audience.
Another example of the generosity of the bar occurred this semester in my Elder Law class, when a graduate of our law school, Robert C. Gerhard, Esq. stepped forward to teach a class for me when I was called out of town. The topic was "setting up your own elder law practice," and Bob was full of practical advice, including both encouragement and appropriate warnings. Bob is one of many great practitioners who have shared experiences with our students.
But Bob went above and beyond, providing each of the students in the class with a copy of the latest edition (2013) of his treatise, Pennsylvania Medicaid: Long-Term Care (Bisel Co.)
I had a chance to review the book over the weekend. It is a practical "bonanza," in the sense that it offers both narrative explanations of Medicaid law as practiced in Pennsylvania, and all of the key forms and hard-to-find informal state guidelines about the process. It is the kind of book that is useful both to the public as a "first step" and fellow practitioners who need reminders about the many next steps. Chapters 4, 5 and 6 are golden, using clear language to explain "achieving resource eligibility," the application process, and the ever-more challenging "estate recovery" rules.
I hope all elder law and estate planning professors have alums and colleagues in practice who are both generous AND good writers. Thanks, Bob!
Tuesday, November 5, 2013
Alice Hoffman, author of more than a dozen great novels, plus books for younger readers, recently published her first nonfiction work, Survival Lessons, inspired by her own life and the lives of those around her. It was a perfect book for me to pick up recently, when I was a bit weary from travelling too much, and she has good words on several topics related to aging.
At the start of the book, she provides a lovely epigram. I don't think it is giving away too much to repeat it here:
There is always a before and an after.
My advice, travel light.
Choose only what you need most
to see you through.
Thursday, October 24, 2013
I was delighted when earlier this month Canadian short story writer Alice Munro was named the winner of the 2013 Nobel Prize in Literature. I'm a long time fan. To add to the good news, one of my favorite stories by Munro has been republished this week in The New Yorker.
In addition to providing a window into a good marriage in twilight, Munro's short story "The Bear Came Over the Mountain" offers a great opportunity to explore with students some of the older theories that affected care of individuals with dementia in nursing homes. It helps us see why practices have changed, and thus may even offer hope about how more changes could be made. I won't say more about the story, because Munroe says it all much better.
The story was also made into a lovely movie, "Away from Her," with the always elegant Julie Christie playing the key character of Fiona.
UPDATE: When I first wrote this post, there was an active link to the full story. But when I rechecked, it seems the story is now behind a pay wall. I've linked to an excerpt. The whole tale is worth pursuing!
And my thanks to Carlisle Attorney Frances Del Duca for pointing out the New Yorker republication, before we shared a bit of wine with a great group of friends.
Friday, September 27, 2013
For example, I just finished teaching a series of cases that ask students to evaluate the voidability of large end-of-life gifts made by older individuals, usually to persons who appear to be caregivers or recent "befrienders." Were the transactions voluntary even if unwise, or were they the product of an unstable mind or undue influence? Close calls on most of the cases.
The cases that interest me most were the ones where an attorney represented the older person during execution of the documents. In one case, the court commented that the attorney who completed the transaction met with the new client for an hour on a Sunday afternoon and performed a series of "tests" that satisfied the attorney about the client's capacity to complete transfers of the bulk of his real estate. However, a geriatric psychiatrist who later evaluated the same individual, found the individual to have advanced dementia of an Alzheimer's Disease type and concluded the individual would not be able to understand the significance of the deed transfers signed earlier, even though he appeared to be "oriented as to time, place, and person."
Which professional's testimony carried the day? The court credited the attorney's testimony that his client was "lucid" while completing the documents in question, and pointed to the fact the doctor "conceded" that the individual had "moments of lucidity."
Exactly what "tests" does a lawyer, any lawyer, use to evaluate cognitive function? Perhaps every seasoned lawyer has a series of tried and true questions or techniques. But I suspect that many lawyers rely more on instinct than tests, and certainly most transactions by older adults are not challenged.
Should lawyers go further to assess capacity? To help frame the discussion on whether and when to go more deeply into questions of capacity, guidelines are available. Members of the American Bar Association (ABA) and the American Psychological Association (APA) participated in an interdisciplinary task force, which led to three separate documents, including worksheets that may be useful in any assessment of capacity:
- Assessment of Older Adults with Diminished Capacity: A Handbook for Lawyers
- Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists
- Judicial Determination of Capacity of Older Adults in Guardianship Proceedings: A Handbook for Judges
The good news is that all three documents are available on the internet. The less good news is the documents are copyrighted and permission is needed to make additional copies for distribution to a group or audience. The handbooks have been available since 2006. Nonetheless, I suspect most attorneys, many psychologists, virtually all other medical professionals, and a heck of a lot of judges have never heard of the handbooks.
Any opinions about the usefulness of these handbooks to practitioners?
Thursday, September 19, 2013
Congratulations, Nina! I look forward to seeing this new resource.
UPDATE: I've corrected the new book's title based on information from Nina. Apparently the editors overlooked the author's preference for alliteration!
Thursday, September 12, 2013
In Pennsylvania, as I blogged last month, we're following the high-profile prosecution of a daughter for allegedly assisting in the suicide of her 93-year-old father, who was on hospice when he reportedly ingested a fatal dose of morphine.
For an alternative perspective on end-of-life decisions, Knocking on Heaven's Door: The Path to a Better Way of Death has just been released by publisher Scribner. Katy Butler, the author, expands on an earlier article she wrote for New York Times Magazine, recounting her education about medicine, death and her journey with her father following a major stroke, his heartbeat preserved by a relenteless pacemaker, even as his mind and will-to-live were devastated by dementia.
Her book is already receiving high profile accolades, including "Letting Go," Stanford Professor Abraham Verghesse's thoughtful essay in the New York Times.
Hat tip to Penn State Law Professor Laurel Terry for spotting the Verghesse book review.
We're confronting major social issues in the USA, including movement toward national recognition of same-sex marriages. Is it possible we are also ready to expand consideration of legal recognition of rights for very ill persons to choose their own death?
Thursday, September 5, 2013
Over the Labor Day weekend, I happened to catch a great public radio interview with author Will Schwable about the book inspired by his two-year conversation with his mother about books. The End of Your Life Book Club describes how their mutual love of reading provided opportunities for the two to discuss life and death, both directly and indirectly. Why was this important? The conversations took place while his mother was receiving chemotherapy for pancreatic cancer. He said they never had "the big talk" you might expect when confronted with mortality -- rather, they had dozens and dozens of small talks.
It made me think about conversations with my own family members. We live far apart and while I try to make it home frequently (at this point, I'm the only family member who flies), I know I don't make it home often enough. But we talk a lot on the phone and I think we have also developed ways of speaking directly and indirectly about the present and the future. Lately, with my parents that has often been through funny conversations about Dancing with the Stars. (Thank goodness for on-demand television access, since I rarely catch the show on first airing.) We talk about who is "doing well for their age" or who isn't. We suggest who we would like to see on the show (Julie Andrews?), and who makes us cringe (sorry, Cloris Leachman). It has become shorthand for talking about memory, mobility, capacity, and our own aches and pains.
What works for your family? Or are you part of a (rare?) family who talks about such topics directly? (Comments open below)