An Aging Society – What’s the Ideal Situation?

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Ms. Smith: Welcome to an MUSC Health Podcast. Welcome to Age to Age. I'm Sally Smith. Let's talk. Today, we're fortunate to have with us Dr. Layton McCurdy, who's Dean Emeritus of the Medical University of South Carolina. We've been talking about the crisis in the world, really, and in America of aging and care giving as people live much, much longer and involve more care, more dollars, all sorts of resources that go toward keeping people safe and alive longer when they can no longer live alone. And there are many problems that we've talked about, there's solutions we've talked about. What I'd like to talk about right now is what do we see as the ideal? If we could be magical and have all the resources we wanted, how would we see the best case scenario of this big crisis resolving itself?

Dr. McCurdy: Well, at the risk of sounding facetious, ideally we would all live and die healthy, at an advanced age, having been independent, and healthy. Now, having said that, we're obviously not there yet. Our science is not there, our medicine's not there. There are a whole variety of things, and you and I have had this conversation before about what we would want for ourselves, what I would want for myself. And I have thought about this, of the various things that could befall me. For my part, what I would like, the thing that worries me most, and I think a lot of people, is being incapacitated with my brain, and not knowing anything, and not being able to take care of myself, or to deal with that problem if I had it. You know the Eskimos, I think it's accurate, I don't know if it still goes on, had a wonderful custom, when a person reached a certain age, and the elder, they put him on an ice floe and pushed him off into the ocean.

Ms. Smith: I heard that story, but I always heard they gave him a bottle of vodka for the journey.

Dr. McCurdy: It's not a bad strategy to do that. But you know, I've wondered in other cultures, and I know less about this, but in other cultures, how do they manage this, how do they manage this in cultures that are less sophisticated than ours? Not necessarily in Europe, but even in Africa and Asian cultures that are less sophisticated. Do we all face the same issue? I think so.

Ms. Smith: I think so, and one discussion I heard recently actually is in Europe, it's either French or British, or both, in their systems which are much more socialized of course, you don't get the same treatment for a forty year old, healthy bread winner that you get for an eighty year old frail person. You know, they just aren't available. And of course in America, we're so used to taking it to the max, you know, give everybody the ultimate opportunity for the highest level of being well. But what that does is it takes unbelievable resources. And I remember someone saying not long ago when all the parts of the body began to be able to be replaced, joints and things, plastic parts, and some doctor said you know it's going to be so hard to tell when somebody dies. You know, you've gotta be able to die of something eventually. And you know, they're creating wonderful possibilities on one hand, but you know we haven't gotten to the point where we can, as you said, keep someone healthy, just let them die at an advanced age, but still healthy. So, how do we resolve that? It's going to be a big, moral, psychological switch to do the Eskimo ice flow for America.

Dr. McCurdy: It is. It will be very difficult. But you know, even in our country, we don't like to talk about it, but we ration organ transplants. There's some circumstances in which you would be in line before me, and I before the next person, and you ration by virtue of your place in line. The state of Oregon had an effort to do this somewhat a few years ago, I don't think it really came to be. I mean, they tried it

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