The Silver Tsunami

Silver Tsunami is the term used to describe the massive wave of baby boomers who are now entering the geriatric population. This is a hot topic in medicine given the obvious strain it places on the medical system to take care of the ageing population. After spending a week on my geriatrics rotation, I have to admit that I am relieved to have picked the specialty of Pediatrics, which is on the completely opposite spectrum.

I am not an "ageist," as I completely appreciate and respect the elderly for their wisdom and perspectives on the past, but I find it extremely difficult to take care of them. The majority of the patients have a multitude of chronic medical problems for which they take countless medicines. This picture is further complicated by the fact that most elderly patients are unable to live independently due to some degree of debility. Dementia or simple frailty often necessitate daily care from nursing, physical therapy and occupational therapy just to help these patients complete their activities of daily living.

During our week long rotation we visited numerous centers where geriatric health is administered, including a nursing home, an elder abuse center, and an adult day care center. Coming from a culture where elders are revered, it was really quite shocking to see elderly grandmothers and grandfathers living out the last months to years of their lives in these facilities. I fully understand that the medical problems of the average geriatric patient can far exceed the capacity of the family to care for them, however the family should still be responsible to fulfill the emotional needs of their loved ones. I went to check on a patient who had been living in the nursing home for 2 years and opened with my customary greeting of "how are you feeling, ma'am?," to which she answered "just dump me off somewhere, I'm no good to anyone." I don't think I will ever be able to forget her face or the despair in her voice.

There is certainly a lot of value in being a doctor who helps his patients live the final chapter of their lives in peace, but I don't think I could deal with the fact that most of my patients would die while under my care. The experience put my own life in perspective, again reinforcing the fact that we have no control over our deaths, but we certainly have control over our lives. I hope to use the experience as a reminder to cherish my youth and my health and to encourage others to do the same.