Welcome Wisdom

Slow Medicine

by Felicia Juntunen, MA, CMC, Director of Care Management

Aging Life Care professionals are familiar with the struggle clients and their families encounter as they determine when and to what extent to pursue medical care. For those living with chronic illness, advancing dementia, or increased frailty, this can be a dilemma. Slow Medicine, a term coined by Dr. Dennis McCullough, is a paradigm that encourages a shift in thinking about medical care solely focused on cure and lengthening of life. Instead, Slow Medicine embraces a holistic view of the person, factoring in the many aspects of their life that support their well-being.

A core tenet of Slow Medicine is the avoidance of over and under-treatment, focusing care on quality of life as aging advances and/or frailty increases. The avoidance of over-treatment requires a slower pace of decision-making when it comes to treatment. Questions posed at this stage include: are the consequences of treatment (side effects, rehabilitation) something the individual can physically and mentally endure? What will be the impact on their baseline of health? What is the likelihood they will return to their previous level of health? What potential is there that the treatment will negatively impact their quality of life?

Strategies for implementing a Slow Medicine approach can include completing an Advance Health Care Directive, having a conversation with healthcare providers about values and preferences, learning about end-of-life care, and recognizing the signs of frailty. Care managers assist clients and their families by encouraging discussions about what their clients value regarding their quality of life. Care managers regularly advocate for the completion of advance care directives to support those values.

Conversations with healthcare providers also help ensure those directives are applied in healthcare treatment. Aging Life Care Managers provide heightened advocacy to support client preferences as the client’s age and frailty increase. Care managers can help guide discussions with physicians, asking questions to support clients and their families in decision-making about treatments and procedures. Aging Life Care professionals provide education about end-of-life care programs like palliative and hospice care and other supportive services. An advanced understanding of what these services offer, when one can receive those services, and how those services support the individual’s preferences for care can help alleviate distress and fear later.

Aging Life Care Professionals recognize that changes in medical technology require changes in decision-making about healthcare, especially for aging adults and their families. Slow Medicine, with its emphasis on critical evaluation and slower decision-making regarding treatment options, offers the opportunity for conversations about care that supports quality of life.