Dennis McCullough, MD, is a respected physician and author.A graduate of Harvard Medical School, he has been a family physician andgeriatrician for 30 years. Dr. McCullough serves as a faculty member in theDepartment of Community and Family Medicine at Dartmouth Medical School. In anexclusive interview with Health Monitor, he discusses his latest book.

Your Mother, My Mother

No one likes to think about the fact that our parents aregetting older and beginning to develop health problems, or that they eventuallywill need our help. DennisMcCullough, MD, suggests thinking about their needs sooner rather than laterand has outlined an approach in his new book, My Mother, Your Mother: Caringfor Elders in Late Life (HarperCollins, 2008). Here, Dr. McCullough answers HealthMonitor’s questions about how to prepare for the inevitable.

Health Monitor: You call your approach to dealing with agingelders “Slow Medicine.” What does that mean?

McCullough: Icompare it to the slow food movement that originated in Italy as a rejection offast food. Slow food emphasizes local ingredients prepared around the kitchentable. Slow Medicine is a return to care and decision-making by the family in ahome-centered setting. It encourages you to plan for the changing needs of youraging elders long before emergencies arise and away from all the pressure andconfusion of hospitals. Slow Medicine is also a commitment to caring for ourparents as we would want to be cared for ourselves.

Health Monitor: You suggest a 72-hour visit to parents toassess their health habits. What can this accomplish?

McCullough: You can learn a lot by watching and carefullistening. Watch how your mother spends her day, observe her exercise,nutrition, and hygiene habits, her social life. If she isn’t getting anyexercise, encourage her to get out and walk with friends. Help her improve herdiet by introducing her to good ready-made meals available in most groceryfreezers. Make sure she knows how to read labels in order to choose betterfoods. It’s never too late for a health and diet makeover. But most of all,listen…

Health Monitor: You mention advance directives. What arethey and why are they needed?

McCullough: Advance directives include a living will anddurable power of attorney for health-related matters. While they’re stillcapable, encourage your parents to think about how they would like to betreated if they can no longer make their own decisions. Write it down. You canget formal advance directive forms through state governments and agingorganizations. A good online source is www.caringinfo.org/index.cfm?page=256.Click [2] on Advance Directive.

Health Monitor: What is an advocacy team?

McCullough: These are the people who will be essential toyou as health crises arise: family members, your parents’ favorite doctor,their closest friends and neighbors. All of these are people who can help,advise, and advocate for your parents should they become ill or confused and nolonger able to advocate for themselves. An advocacy team can be invaluable forsupport when a health crisis occurs.

The high cost of caring

The estimated 34 million Americans who are caring for agingparents (or an aging spouse) spend an average of $5,500 a year to cover thecosts of groceries, household goods, drugs, medical co-payments, andtransportation. That figure comes from a telephone survey of 1,000 adults whocare for someone over the age of 50 conducted in November 2007 by the NationalAlliance for Caregiving and Evercare, a division of the United HealthGroup. Costs were highest forthose who provide long-distance care, almost $9,000 per year.