Elderhood

by Louise Aronson

  “I’ll jump out the window” Ernaux, A. (1996). A woman’s story. New York, NY: Seven Stories Press. (73).

  “no longer a place for her” Ernaux, A. (1996). A woman’s story. New York, NY: Seven Stories Press. (74).

  she kept trying to escape Ernaux, A. (1996). A woman’s story. New York, NY: Seven Stories Press. (78).

  “she lost her self-respect” Ernaux, A. (1996). A woman’s story. New York, NY: Seven Stories Press. (80–81).

  beginning in Constantinople Clarfield, A. M. (1990). Dr. Ignatz Nascher and the birth of geriatrics. Canadian Medical Association Journal. 143(9), 944.

  Not until the Poor Laws Kelly, M., & Ó Gráda, C. (2011). The poor law of Old England: institutional innovation and demographic regimes. Journal of Interdisciplinary History. 41(3), 339–366.

  unsafe living conditions San Francisco Ombudsman program, personal communication, 2018.

  “deprivatization of experience” Gubrium, J. F., & Holstein, J. A. (1999). The nursing home as a discursive anchor for the ageing body. Ageing & Society. 19(5), 519–538.

  “nothing to do but sit” Nevins, M. (2012). Chapter 9: More meanderings in medical history (119). Bloomington, IN: iUniverse.

  comfortable and meaningful lives Warren, M. W. (1946). Care of the chronic aged sick. Lancet. 1, 841–843.

  “old ‘master and inmate’ relationship” Gilleard, C., & Higgs, P. (2010). Aging without agency: theorizing the fourth age. Aging & Mental Health. 14(2), 121–128.

  aging homeless population Knight, H. (March 5, 2016). Fast-aging homeless population may lead to public health crisis. San Francisco Chronicle; Sabatini, J. (April 11, 2016). Report: SF needs to adapt services for an aging homeless population. San Francisco Examiner.

  “taking care of the failing” Here and Now. (September 14, 2017). Florida nursing home under investigation after at least eight die. NPR.

  Zealot

  “upsetting those responsible for their care” Mount, B. M. (1976). The problem of caring for the dying in a general hospital; the palliative care unit as a possible solution. Canadian Medical Association Journal. 115, 119–121.

  even when they are unlikely to benefit a patient Polite, B., Conti, R. M., & Ward, J. C. (June 2, 2015). Reform of the buy-and-bill system for outpatient chemotherapy care is inevitable: perspectives from an economist, a realpolitik, and an oncologist. 2015 ASCO Annual Meeting; Wynne, B. (2016). For Medicare’s new approach to physician payment, big questions remain. Health Affairs. 35(9).

  9. Middle-aged

  Stages

  three, four, six, or twelve Thane, P. (1993). Chapter 46: Geriatrics. In Companion encyclopedia of the history of medicine, volume 1. W. F. Bynum, & R. Porter (Eds.). (1093). New York, NY: Routledge.

  growth, stasis, and decline Higgs, P., & Gilleard, C. (2015). Rethinking old age: theorising the fourth age. London, UK: Palgrave Macmillan.

  seven age groups Thane, P. (1993). Chapter 46: Geriatrics. In Companion encyclopedia of the history of medicine, volume 1. W. F. Bynum, & R. Porter (Eds.). (1093). New York, NY: Routledge.

  “legislation is passed and agencies are created” Hareven, T. K. (1976). The last stage: historical adulthood and old age. American Civilization: New Perspectives. 105(4), 13–27.

  a late-life analogue of adolescence Hall, G. S. (1922). Senescence, the last half of life. New York, NY: D. Appleton and Co.

  “a real wisdom that only age can teach” Hall, G. S. (1922). Senescence, the last half of life. (366). New York, NY: D. Appleton and Co.

  Bernice Neugarten Neugarten, B. (1974). Age groups in American society and the rise of the young-old. Annals of the American Academy of Political and Social Science. 415, 187–198.

  increasing numbers of people over age eighty-five Suzman, R., & Riley, M. W. (1985). Introducing the “oldest old.” Milbank Memorial Fund Quarterly, Health and Society. 63(2), 175–186.

  go-go, go-slow, and no-go Palmore, E. (1999). Ageism: negative and positive (2nd edition). (55). New York, NY: Springer Publishing.

  healthy, chronically ill, frail, and dying Carey, E. C., Covinksy, K. E., Lui, L., Eng, C., Sands, L. P., & Walter, L. C. (2008). Prediction of mortality in community-living frail elderly people with long-term care needs. Journal of the American Geriatrics Society. 56, 68–75; Lunney, J. R., Lynn, J., & Hogan, C. (2002). Profiles of older Medicare decedents. Journal of the American Geriatrics Society. 50(6), 1108–1112.

  “progressive, not retrogressive” Nascher, I. L. (1916). Geriatrics; the diseases of old age and their treatment: including physiological old age, home and institutional care, and medicolegal relations. (1). Philadelphia, PA: P. Blakiston’s Son & Co.

  “take a similar view of senility” Nascher, I. L. (1916). Geriatrics; the diseases of old age and their treatment: including physiological old age, home and institutional care, and medicolegal relations. (11). Philadelphia, PA: P. Blakiston’s Son & Co.

  “a period of life rather than as a bodily condition” Martin, L. J. (1930). Salvaging old age. London, UK: Macmillan Co.

  Help

  worse than death Rubin, E. B., Buehler, A. E., & Halpern S. D. (2016). States worse than death among hospitalized patients with serious illness. JAMA Internal Medicine. 176(10), 1557–1559.

  correct doses Fiatarone, M. A., Marks, E. C., Ryan, N. D., Meredith, C. N., Lipsitz, L. A., & Evans, W. J. (1990). High-intensity strength training in nonagenarians: effects on skeletal muscle. JAMA. 263(22), 3029–34; Reid, D. F., Callahan, D. M., Carabello, R. J., Philips, E. M., Frontera, W. R., & Fielding, R. A. (2008). Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial. Aging Clinical and Experimental Research. 20(4), 337–343.

  purpose, meaning, and relevant options McKnight, P. E., & Kashdan, T. B. (2009). Purpose in life as a system that creates and sustains health and well-being: an integrative, testable theory. Review of General Psychology. 13(3), 242–251; Stoyles, G., Chadwick, A., & Caputi, P. (2015). Purpose in life and well-being: the relationship between purpose in life, hope, coping, and inward sensitivity among first-year university students. Journal of Spirituality in Mental Health. 17(2), 119–134; Reker, G. T., Peacock, E. J., & Wong, P. T. P. (1987). Meaning and purpose in life and well-being: a life-span perspective. Journal of Gerontology. 42(1), 44–49.

  “the Fourth Age” Gilleard, C., & Higgs, P. (2010). Aging without agency: theorizing the fourth age. Aging & Mental Health. 14(2), 121–128.

  Prestige

  physicians’ annual income by specialty Kane, L. (April 11, 2018). Medscape physician compensation report 2018. Medscape.

  ranked thirty-seventh among nations Schneider, E. C., Sarnak, D. O., Squires, D., Shah, A., & Doty, M. M. (2017). Mirror, mirror, 2017: international comparison reflects flaws and opportunities for better U.S. health care. Commonwealth Fund.

  procedural and majority male Vassar, L. (February 18, 2015). How medical specialties vary by gender. AMA Wire.

  women … are going into surgery Farber, O. N. (August 6, 2018). Women survive a heart attack more often when their doctor is female, study finds. STAT.

  half with a man’s name, half with a woman’s Moss-Racusin, C. A., Dovidio, J. F., Brescoll, V. L., Graham, M. J., & Handelsman, J. (2012). Science faculty’s subtle gender biases favor male students. Proceedings of the National Academy of Sciences of the United States of America.

  Complexity

  people don’t designate a proxy Span, P. (January 19, 2018). One day your mind may fade: at least you’ll have a plan. New York Times; Givens, J. L., Sudore, R. L., Marshall, G. A., Dufour, A. B., Kopits, I., & Mitchell, S. L. (2018). Advance care planning in community-dwelling patients with dementia. Journal of Pain and Symptom Management. 55(4), 1105–1112.

  does not actually include “everything” Committee on Approaching Death: addressing key end of life issues; Institute of Medicine. (2015). Dying in America: improving quality and honoring individual preference near the end of life. Washington, DC: National Academies Press;
Huffman, J. C., & Stern, T. A. (2003). Compassionate care of the terminally ill. The Primary Care Companion to the Journal of Clinical Psychiatry. 5(3), 131–136.

  Sexy

  link sexuality with youth Freeman, J. T. (1979) Aging, its history and literature. New York, NY: Human Sciences Press.

  buff, and beautiful version of sexual attractiveness G. Herdt & B. deVries. (Eds.) (2004). Gay and lesbian aging: Research and future directions. New York: Springer. Fredriksen-Goldsen K. I., Cook-Daniels L., Kim H.-J., Erosheva E. A., Emlet C. A., Hoy-Ellis, C. P, et al. (2014). Physical and mental health of transgender older adults: An at-risk and underserved population. Gerontologist, 54, 488–500; Choi, S., & Meyer, I. H. (2016). LGBT Aging: A Review of Research Findings, Needs, and Policy Implications. Los Angeles: Williams Institute.

  in his nineties, put it this way Angell, R. (February 17 and 24, 2014). This old man. The New Yorker.

  “a new sort of freedom” Athill, D. (2008). Somewhere towards the end. New York, NY: W. W. Norton & Co.

  “Talk to me, not my daughter!” Hawthorne, F. (May 9, 2012). Talk to me, not my daughter. New York Times.

  Thirteen million Americans are incontinent Gorina, Y., Schappert, S., Bercovitz, A., Elgaddal, N., & Kramarow, E. (2014). Prevalence of incontinence among older Americans. Vital and Health Statistics: Series 3. 36, 1–33.

  haven’t asked about incontinence Cochran, A. (2000). Don’t ask, don’t tell: the incontinence conspiracy. Managed Care Quarterly. 8(1), 44–52; Hahn, S. R., Bradt, P., Hewett, K. A., & Ng, D. B. (2017). Physician-patient communication about overactive bladder: results of an observational sociolinguistic study. Public Library of Science One. 12(11).

  our present notions of male and female speech and power Beard, M. (2017). Women and power: a manifesto. New York, NY: Liveright Publishing.

  “difficult and unappealingly limited” Gawande, A. (2014). Being mortal: medicine and what matters in the end. New York, NY: Metropolitan Books.

  Disillusionment

  too anxious to leave his office Shaw, B. (2015). Last night in the OR: a transplant surgeon’s odyssey. New York, NY: Plume.

  because of the constant tension Rush, T., & Shannon, D. (2018). Why I left medicine: a young doctor’s views on burnout and non-clinical transitions. ReachMD.

  “it meant I fell behind” Shannon, D. (December 2, 2015). Physician burnout: it’s bad and getting worse, survey finds. WBUR.

  “There is no escape and no relief” Personal e-mail communication, 2015.

  experiencing burnout Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings. 90(12), 1600–1613.

  similar education and work hours Huynh, C., Bowles, D., Yen, M.S., Phillips, A., Waller, R., Hall, L., & Tu, S. P. (2018). Change implementation: the association of adaptive reserve and burnout among inpatient medicine physicians and nurses. Journal of Interprofessional Care.

  “quality of the health care delivery system” Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings. 90(12), 1600–1613.

  a shortage of forty-five thousand to ninety thousand physicians Association of American Medical Colleges. (2015). The complexities of physician supply and demand: projections from 2013 to 2025. Washington, DC: Association of American Medical Colleges.

  poignant essays about burnout Hill, A. B. (March 23, 2017). Breaking the stigma—a physician’s perspective on self-care and recovery. New England Journal of Medicine. 376, 1103–1105; Humikowski, C. A. (July 2018). Beyond burnout. JAMA. 320(4), 343–344; Métraux, E. (March 20, 2108). I experienced trauma working in Iraq: I see it now among America’s doctors. STAT; Talbot, S. G., & Dean, W. (July 26, 2018). Physicians aren’t “burning out.” They’re suffering from moral injury. STAT; Xu, R. (May 11, 2018). The burnout crisis in American medicine. The Atlantic.

  Priorities

  her eyes strayed from me to her screen Alkureishi, M. A., Lee, W. W., Lyons, M., Press, V. G., Imam, S., Nkansah-Amankra, A., et al. (2016). Impact of electronic medical record use on the patient-doctor relationship and communication: a systematic review. Journal of General Internal Medicine. 31(5), 548–560.

  not sequenced in the way our conversation was proceeding Friedberg, M. W., Chen, P. G., Van Busum, K. R., Aunon, F. M., Pham, C. Caloyeras, J. P., et al. (2013). Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. Santa Monica, CA: RAND Corporation.

  an ever-growing list of tasks Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., et al. (2016). Allocation of physician time in ambulatory practice: a time and motion study in four specialties. Annals of Internal Medicine. 165(11), 753–760; McDonald, C. J., Callaghan, F. M., Weissman, A., Goodwin, R. M., Mundkur, M., & Kuhn, T. (2014). Use of internist’s free time by ambulatory care Electronic Medical Record systems. JAMA Internal Medicine. 174(11), 1860–1863.

  midlevel providers Brown, D. F., Sullivan, A. F., Espinola, J. A., & Camargo, C. A. (2012). Continued rise in the use of mid-level providers in the US emergency departments, 1993–2009. Internal Journal of Emergency Medicine. 5(21); Liu, H., Robbins, M., Mehrota, A., Auerbach, D., Robinson, B. E., Cromwell, L. F., & Roblin, D. W. (2017). Medical Care. 55(1), 12–18.

  scribes Soudi, A., & McCague, A. B. (2015). Medical scribes and electronic health records. JAMA. 314(5), 518–519; Yan, C., Rose, S., Rothberg, M. B., Mercer, M. B., Goodman, K., & Misra-Hebert, A. D. (2016). Physician, scribe, and patient perspectives on clinical scribes in primary care. Journal of General Internal Medicine. 31(9), 990–995.

  belies my internist’s greater experience Darves, B. (October 3, 2014). Compensation in the physician specialties: Mostly stable. New England Journal of Medicine CareerCenter.

  always expensive, and sometimes nonsensical care Brownlee, S., Saini, V., & Cassel, C. (April 25, 2014). When less is more: issues of overuse in health care. Health Affairs Blog; Fuchs, V. R. (July 2104). Why do other rich nations spend so much less on healthcare? The Atlantic.

  “differences in access” U.S. National Library of Medicine. (2016). Health Disparities. Bethesda, MD: National Institutes of Health.

  shown to prevent illness Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of primary care to health systems and health. Milbank Quarterly. 83(3), 457–302.

  high rates of overuse and waste Smith, M., Saunders, R., Stuckhardt, L., & McGinnis, J. M. (Eds.). (2012). Best care at lower cost: the path to continuously learning health care in America. Washington, DC: National Academies Press.

  “embedded in the political and economic organization” Farmer, P. E., Nizeye, B., Stulac, S., & Keshavjee, S. (2006). Structural violence and clinical medicine. PLOS Medicine. 3(10), e449.

  American health care Stone, T. (December 6, 2016). Incremental fixes won’t save the U.S. health care system. Harvard Business Review.

  far exceeded those of the other countries Papanicolas, I., Woskie, L. R., & Jha, A. K. (March 13, 2018). Health care spending in the United States and other high-income countries. JAMA. 319(10), 1024–1039.

  a system-less system Parente, S. T. (2018). Factors contributing to the higher health care spending in the United States compared with other high-income countries. JAMA. 319(10), 988–990.

  we fail to prioritize care that most helps patients Yao, N., Ritchie, C., Camacho, F., & Leff, B. (2016). Geographic concentration of home-based medical care providers. Health Affairs. 35(8), 1404–1409; Lown, B. A., Rosen, J., & Marttila, J. (2011). An agenda for improving compassionate care: a survey shows about half of patients say such care is missing. Health Affairs. 30(9), 1772–1778.

  harder for clinicians Bodenheimer, T. (2006). Prima
ry care—will it survive? New England Journal of Medicine. 355, 861–864; Beckman, H. (2015). The role of medical culture in the journey to resilience. Academic Medicine. 90(6), 710–712.

  Sympathy

  found him wholly unreceptive Weinstein, M. S. (2018). Out of the straitjacket. New England Journal of Medicine. 378, 793–795.

  10. Senior

  Ages

  “the idea of childhood did not exist” Aries, P. (1965). Centuries of childhood: a social history of family life. (R. Baldick, Trans.). (125). New York, NY: Vintage Books. (Original work published 1960).

  sentiment … idea Ulanowicz, A. (2005). Philippe Ariès. Representing Childhood project, University of Pittsburgh.

  he did not approve of this change Acocella, J. (August 18, 2003). Little people. New Yorker.

  The human brain naturally makes categories Thomas, B. (December 26, 2012). Meaning on the brain: how your mind organizes reality. Scientific American.

  “a term not already tarnished” Laslett, P. (1991). A fresh map of life: the emergence of the third age. (3). Cambridge, MA: Harvard University Press.

  could not overlap with the Fourth Laslett, P. (1991). A fresh map of life: the emergence of the third age. (4). Cambridge, MA: Harvard University Press.

  “crown of life” Laslett, P. (1991). A fresh map of life: the emergence of the third age. (vii). Cambridge, MA: Harvard University Press.

  more attention Gilleard, C., & Higgs, P. (2010). Aging without agency: theorizing the fourth age. Aging & Mental Health. 14(2), 121–128.

  more a set of behaviors and attitudes Gilleard, C., & Higgs, P. (2005). Contexts of ageing: Class, cohort, and community. Cambridge, UK: Polity Press.

  inevitable decline and “ignominy” Laslett, P. (1991). A fresh map of life: the emergence of the third age. (3–5). Cambridge, MA: Harvard University Press.

  “failure by institutional forms of care” Gilleard, C., & Higgs, P. (2010). Aging without agency: theorizing the fourth age. Aging & Mental Health. 14(2), 122.