The Psychology of Eldercare, by Ira Rosofsky

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My book, Nasty, Brutish, and Long: Adventures in Old Age and the World of Eldercare is a meditation on the intersection of my professional life as a psychologist in nursing homes and my own caregiving to my frail, elderly parents. I work both sides of the street with the personal meeting the professional, the health-care provider as health-care consumer.

In my book, I also move from the anecdotal to the general, and consider these questions.

• - Do our elderly need to be insitutionalized in places that look and feel like junior hospitals-hospital-lite?
• - Why does the government spend $70,000 to keep a patient in a nursing home while declining to spend only $30,000 for an often more appropriate, more home-like assisted living center?
• - Why do we spend billions on demonstrably ineffective anti-dementia drugs when we could be spending it on basic research and higher levels of staffing?
• - Why do the most highly trained staff in nursing homes-as well as most other human-service institutions-spend the least amount of time with residents?
• - Why do the staff in a nursing home view the closed door in a resident's room with the same suspicious eye as a parent viewing the closed-door of a teenager's bedroom.
• - Why can't you use the word "sex" in a nursing home without "offense" as a modifier?
• - Why is it immeasurably harder to get a simple glass of wine than a powerful major tranquilizer or a lethal cigarette?

Nasty, Brutish, and Long is also my baby-boomer rumination-at 62, I'm old enough to cash in my 401K yet too young for Medicare-about intimations of mortality. In the eyes of the people I see is the not-too-distant future of us all, or at least all of us who would like to grow old.

I have arranged an extensive radio tour, which can be viewed here, and is linked to from my web page.

Sometime in the next week, I will be publishing an op-ed in the Los Angeles Times about the coming epidemic of dementia, and the ineffectiveness of the current medical treatments-comparing them to the useless measures of medieval physicians against the Black Plague.

Ira Rosofsky, Nasty, Brutish, and Long, Avery, Penguin Books