While I was reading Cruikshank’s discussion of the medicalization of aging people, I was both surprised and horrified to find out that older adults make up “over sixty-five make up 13 percent of the U.S. population but use 34 percent of the prescription drugs (some estimates say 45 percent)” (Cruikshank, p. 53, 2013). With the aging community making up that much of the market for drugs, no wonder doctors, nurses, and other people of influence push to keep medications in the hands of the aging. This really surprised me and clicked something into place for me because every two weeks, typically on a Sunday, my grandma goes to her bathroom and pulls out a huge black bag full of medicines. I asked her once why she needed all those medications, and she started to list what each one of them did for her and why her doctor prescribed it. Some of them she couldn’t remember why they had been prescribed, but she could remember exactly how much they cost her, or if her insurance covered them partially or not. So, reading this chapter made me connect this to what I see my grandma do every two weeks. As I read on, I felt more horrified than anything: “Unrecognized drug interactions can lead to a false diagnosis of Alzheimer’s disease. Although the extent of this problem is hard to determine, it is likely to increase as the aging population increases” (Cruikshank, p. 55, 2013). Imagine going to the doctor for feeling disoriented; instead of them looking at the cocktail of the drugs you’re taking, they blame it on “early-onset Alzheimer’s.” That’s pretty concerning to me.
Reading the conversation between Aronson and Svetlana, I see how far Geriatrics is willing to go to cultivate the care of their patients. Had Aronson stopped her questioning, Dimitri would have just continued to coast at the nursing home until he eventually succumbed to his disease. The daughter, though somewhat knowledgeable about her father’s care, missed the signs because she wasn’t taught to look for them. And it seemed like talking about end-of-life care was somewhat taboo to talk about hence the part where Svetlana is hesitant to answer a question about care once things progressed beyond Dimitri being able to care for himself.
If I could use one word to describe Aronson’s approach to dementia, I would pick refreshing. At first, I did not see where she was going with it, but as that piece of the chapter progressed, I realized that she was trying to get us to understand that continuing to write of this disease as “just an old person’s disease” is stunting us as a culture from challenging the thoughts around aging. “In many ways, dementia is the prototype of the American approach to old age, and also its metaphor. When and how we talk about it, what we do and don’t understand about its impact on lives, and how we have and haven’t dealt with it both societally and medically in recent decades perfectly exemplifies our attitudes and modus operandi to the larger topic of aging”(Aronson p.56, 2019). Looking at this quote, she says just that.
First, can I express my challenge in finding research that did not include dementia as the catalyst of the research? I was looking everywhere; I felt like I had used all the right keywords and exclusions, but found little. I did find an article that I found interesting, Overtreatment in Elderly care: Ethical Considerations. This article is very short and sweet; it talks about the growing aging community and the consequent need to keep older adults medicated for multiple illnesses. This article sounds a lot like what Aronson was talking about when it came to adverse side effects and continuing unnecessary medication.
References
Aronson, L. (2019). Elderhood: Redefining Medicine, life, and aging in America. Bloomsbury Publishing.
Cruikshank, M. (2013). Learning to be old: Gender, culture, and aging. Rowman & Littlefield, Publishers.
Santos Cruz, R., Brito-Costa, S., Santa Rosa, B., & Silvestre, M. (2022, May 11). Overtreatment in elderly care: Ethical considerations. Acta bio-medica : Atenei Parmensis. https://pmc.ncbi.nlm.nih.gov/articles/PMC9171878/
Hi Maylaya! Great post. I can relate to the feeling of seeing that giant bag of pills and not even being able to tell you what these medications do. It is a sad realization because we want our loved ones to receive great care. I do not think that the nurses and doctors are actively trying to push more drugs onto older people. However, I think that their training and culture in the medical field cause this overmedicalization. Especially in the elderly. It is interesting how, when someone is younger, we are more likely to look into their environment or other causes for medical issues. However, when someone reaches a certain age, doctors and nurses are more likely to overlook environmental factors or overmedicalize an older person. I agree with your thoughts on Aronson’s perspective of dementia. Our society puts such an emphasis on dementia in older adulthood that sometimes we over diagnose that in older people where in a younger person, doctors would have looked further for the cause of the dementia and not just assumed Alzheimer’s.
Maylaya,
Your story about your grandmother is an excellent way to describe what Cruikshank discusses. You were able to take the concept and relate to real life – unfortunately, right? It isn’t unusual for older adults to have multiple medications that they have to manage and often they won’t remember the details about when they were prescribed. That is why gerontologists are so crticially important.
You can see that point in Aronson’s work with Dimitri’s family. And you could see why she then could look at dementia in a totally different way. It’s about the person – and their environment. Sounds a lot like a social worker, right?
Your discussion about finding an article is interesting. I would be curious about where you searched and what tools you used. Many of us utilize AI for reference research, but in this instance, no one did it very well. Once I finish grading these posts, I will create a video about ways to find reeferences more effectively – AI or not AI.
Dr P