Slow Medicine

A nurse practitioner weighed in on the concept of "slow medicine" in a New York Times article published May 5.

Joanne Sandberg-Cook, an NP who works at the Kendal at Hanover retirement home in New Hampshire, says that each geriatric patient's circumstances"demand the time to think about all the what-ifs."

The what-ifs include whether, for example, it is practical for a patient to have surgery to remove a tumor if he also has early-stage Alzheimer's, because the anesthesia may accelerate his dementia.

Sandberg-Cook is an advocate of slow medicine for the elderly, because, as the article points out, many older patients are harmed more by addressing all health concerns immediately. Some call this "death by intensive care." Physicians, however, are paid per procedure, not to discuss whether a patient wants the procedure.

Residents of the Kendal facility have a great deal of choice regarding whether to receive health care. Nurse practitioners are an obvious choice as caregivers in this setting, because they are able to counsel each patient on what procedures may or may not improve their quality of life.