Living and Dying in a Long-Term Care Facility: Notes from a Nursing Home Doctor

As she makes her daily rounds to visit her nursing home patients, a geriatrician tells us what life and death are like in long-term care, given the insights of a decade of practice. Gilah Silber, M.D., offers up candid portraits of patients, the families who surround or neglect them, and the varied personalities of facilities themselves, where treatment and care are colored by the administrative outlook and the attitudes of staff. Alongside her stories, which are by turns fascinating, funny, exasperating, and moving, Dr. Silber points up the problems and predicaments of old age and chronic illness, some of which can be 'solved' and some of which cannot. She raises searching questions about long-term institutionalized care, and shows how much the standards of business, science, and law-as well as shifting ethics-influence how we care now. In what might be termed 'self-help for the astute,' Dr. Silber's book is a catalyst, provoking us to think creatively about aging and the end of life.