Reading Cruikshank opened my eyes to how much older adults rely on medications and how normalized overmedication has become. Many of her statistics weren’t shocking individually: elders make up less than 15% of the population but take more than 30% of prescriptions, their bodies are more sensitive to drug interactions, clinical trials rarely include them, and society assumes they naturally need more medications as their bodies slow down. What was surprising, however, was seeing all these facts together, revealing a systemic problem far bigger than I realized. Cruikshank describes medications as a “passport to health” for older adults, showing how cultural expectations and medical practices have created a cycle of dependency (Cruikshank, 2013).
Her analysis of natural body changes with age made the risks of medications very clear. Slowed metabolism, altered organ function, and reduced resilience increase the likelihood of drug reactions, yet her proposed solutions, cautious prescribing, close monitoring, and more inclusion of elders in research, felt practical and necessary. This discussion made me reflect on my own fears of aging, not just physically but in potentially losing control over decisions if the system automatically equates more drugs with better care. It reminded me that aging well requires being informed, asking questions, and staying actively engaged in one’s own health choices (Cruikshank, 2013).
Aronson’s patient stories brought these issues to life. Initially, it was concerning that Irina, introduced as a translator, was actually a nurse, raising questions about neutrality and accurate communication. Conversations with Svetlana, Dimitri’s daughter, highlighted how families often know best about the real-life effects of medical decisions. Aronson’s later conversation with Irina suggested that Dimitri’s rapid decline might be drug-induced, and I appreciated her quick action to stop certain medications and closely monitor him. What was astonishing was that within a week, Dimitri was noticeably better, showing the power of careful medication management and attentive communication (Aronson, 2019).
Her discussion of dementia also deepened my understanding. Compared with the Memory Loss Tapes, which center the voices and daily realities of people with dementia, Aronson highlighted how professional conferences often focus narrowly on symptoms and decline. Her critique reminded me that medical spaces can unintentionally reinforce stereotypes and minimize personal stories, underscoring the need to integrate lived experiences with clinical knowledge for more humane and effective care (Aronson, 2019; Hott & Gordon, 2009).
Finally, Aronson’s example of Gabow’s mother perfectly illustrated what Cruikshank describes as alternative approaches to elder care. Rather than defaulting to more prescriptions, her care emphasized lifestyle adjustments, support, and autonomy. Seeing how these thoughtful changes improved her health while preserving dignity had the biggest impact on me. It reinforced that focusing on the whole person, not just the disease, can be more effective than piling on medications, and it highlighted the empowering potential of alternative, person-centered care (Aronson, 2019; Cruikshank, 2013).
References
Aronson, L. (2019). Elderhood: Redefining aging, transforming medicine, reimagining life. Bloomsbury Publishing.
Cruikshank, M. (2013). Learning to be old: Gender, culture, and aging (3rd ed.). Rowman & Littlefield.
Hott, S., & Gordon, M. (Producers). (2009). The Memory Loss Tapes [Documentary]. HBO Documentary Films.
Hi Kacey,
I really liked how you connected Cruikshank and Aronson to show the impact of overmedication on older adults. I was also surprised by how quickly careful monitoring and stopping certain medications can improve someone’s condition, like with Dimitri. Your point about dementia care overlooking personal stories really made me think about how medical spaces handle these issues. Do you think there are practical ways families can help ensure doctors focus on the whole person, not just the prescriptions?
I think that is where interdisciplinary teams really come into play, since they bring together doctors, who focus on diagnosing and treating illness, with other professionals who address quality of life and daily function. This kind of collaboration helps ensure that care is not just about prescriptions but about the whole person. Families and advocates are also essential members of the team, because they can share daily observations, ask questions, and push for alternatives that doctors may not always consider.
I really agreed with all that you are saying here. It’s amazing to me that there are not more geriatricians and how little doctors are aware of the changes in older adults’ bodies and metabolic functions, therefore putting them at risk in their medications and treatments. It’s horrifying, too, the propaganda of the drug companies and the sway they hold over the consciousness of America. I, too, am more committed to my own health autonomy and self-advocacy because of reading this chapter. His drastic reversal of symptoms was mind-bending! He went from being almost catatonic, unable to communicate or do anything from living in assisted living and holding leadership positions. It’s outrageous that if she had not been able to talk to his daughter and figure out the timeline of his decline, he would have probably died, as a “natural” consequence of his disease. It is criminal frankly. I really liked what you said here about medical spaces unintentionally reinforcing stereotypes of decline and uselessness instead of trying to optimize the quality of life for the unique individuals living with dementia. We have to slow down and look at the whole human being in their environment. I agree. I loved how her mother gave her the opportunity to see medical standards through a different lens. She was able to see how the traditional interventions would be harmful and lead to decline. Older people especially need to be treated with unique extra care and looked at in context of what would be helpful. Preserving dignity is the least people deserve at the end of a long life.
This account of Dimitri also has me wondering why how we can utilize interpreters better in situations where there is a language barrier to thorough care. It appears maybe there was a blind spot with the nursing home’s Advanced Alzheimer’s Unit that lack of speech and movement supported the dementia diagnosis. Cultural and language differences need to be a regular part of intake in many facilities. It was interesting that the managing nurse had the language skills to assess functioning, but she had not been more thoroughly utilized in the intake process.
Kacey,
Excellent job on this post. I agree with your fellow students. You were able to connect the readings in all the wayss that matter. And you are absolutely correct – it does take a team.
Dr P