My Mother's Hip

Book excerpt: Some 400,000 hip fractures occur every year, the vast majority among the elderly; all too often these fractures are associated with death or severe disability. After her mother's double hip fracture, Luisa Margolies immersed herself in identifying and coordinating the services and professionals needed to provide critical care for an elderly person. She soon realized that the American medical system is ill prepared to deal with the long-term care needs of our graying society. The heart of My Mother's Hip is taken up with the author's day-to-day observations as her mother's condition worsened, then improved only to worsen again, while her father became increasingly anxious and disoriented. As both a devoted daughter and a skilled anthropologist, Margolies vividly renders her interactions with physicians, nurses, hospital workers, nursing home administrators, the Medicare bureaucracy, home care providers, and her parents. In the Lessons chapter that follows each episode, she discusses in a broader context the weighty decisions that adult children must make on their parents' behalf and the emotional toll their responsibility takes. Here she addresses the complex practical issues that commonly arise in such situations: understanding the consequences of hip fracture and its treatment, preparing health care proxies and advanced directives, enabling elders to remain at home, and the heartbreaking dilemma of prolonging life. Like many adult children, Margolies learned her lessons about eldercare in the midst of crises. This book is intended to ease the information-gathering and decision-making processes for others involved in eldercare.