Lifelines: Living Longer, Growing Frail, Taking Heart

The author (Tangled Minds: Understanding Alzheimer's Disease and Other Dementias, etc.), a medical specialist in elderly medicine, has written an accessible and instructive study of a subject that both individuals and society as a whole need to heed, particularly with the rising number of frail elderly (those who suffer from ""impairment in multiple domains leading to a profound difficulty functioning in daily life"") as life expectancy increases. According to Gillick, nearly two-thirds of women and almost half of men over the age of 85 are heavily dependent physically and emotionally on family members, who are frequently at a loss as to how to best help them. Through the stories of four patients drawn from her practice, Gillick combines professional experience, empathy and common sense to show possible ways that the elderly and their families can deal more effectively with the years of decline before death. Catherine Endicott and her daughters, for instance, struggled to face Catherine's escalating problems of breathlessness and pain caused by heart trouble. Although she rejected open-heart surgery as too risky, she finally compromised on a less intrusive procedure that allowed her to remain in an assisted living facility, where she found friends and a measure of security. Jack Simon, an energetic 84-year-old stroke victim, was expertly cared for by his wife; after her death, he had to adjust to life in a nursing home. The author deals forthrightly with the issue of sexual contact among the elderly through the unfolding of Jack's relationship with a female resident. Although Gillick cannot provide altogether happy endings to the lives of her elderly patients, she does illuminate their humanity as they and their families try to make the final years less frightening and more comfortable. (Nov.)