An Introduction

The “Perspectives on Aging” website has been set up to communicate with the general public about controversial issues affecting older people through commentaries on topics of timely interest. I am a physician specializing in the care of the elderly, with particular interests in making decisions about medical treatment and in ethical issues that arise near the end of life. While I will address on this site that are of potential concern to all older individuals and their families, I am particularly interested in providing information and guidance to the sickest, frailest, and oldest of the old.

My background is in internal medicine, with specialty certification in both geriatrics (medical care of older patients) and palliative medicine (care of people facing life-threatening illness). I have practiced medicine in a neighborhood health center, a community hospital, in a number of nursing homes, and in several tertiary care teaching hospitals. Throughout my career, I have been affiliated with Harvard Medical School, where I am an Associate Professor. Stimulated by my clinical experiences, I have written extensively about issues in geriatric care. While much of my work has been published in medical journals including the New England Journal of Medicine, the Annals of Internal Medicine, and the Journal of the American Geriatric Society, I have also written for a general audience. In particular, I have published 3 books, one on dementia (Tangled Minds: Understanding Alzheimer’s Disease and Other Dementias), one on frailty (Lifelines: Living Longer, Getting Frail, Taking Heart), and one on medical decision-making in old age (Choosing Medical Care in Old Age: What Kind, How Much, When to Stop). My newest book will be published in March of 2006 and will be called The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies.

It takes years to write a book and have it published and much is happening all the time that affects older people: Medicare has just rolled out a new prescription drug benefit; the Centers for Medicare and Medicaid Services (which runs the Medicare program) has agreed to pay for eligible patients to receive sophisticated technological interventions such as an implantable defibrillator (like what Vice President Cheney has); new initiatives have been introduced that have the potential to radically transform nursing homes. I want to be able to talk to older patients and their children about these issues as they arise; to that end, this website has been created.