Marie Antoinette is famous for her line: Well, let them eat cake. When an elderly person is in the twilight of their life, I definitely believe we should let them eat cake and perhaps even allow them the occasional beer. 

Not only should we question the role of medicine as suggested in my colleague's interesting article about her recent and unfortunate injury, I think we should reconsider our responsibility to the elderly. Often we are so focused on the health of an elderly family member that we forget the little things (some of them not so healthy) that can affect the quality of their lives.

Judith Woodburn of the NYT wrote an article in which she laments the fact that she had given her dying father excessive amounts of wheat germ and not enough of what he really enjoyed: namely, beer and pie. Her father, however, made some of his own dietary choices; he enjoyed a daily cocktail and often left the wheatgerm-laced food where it belonged, in the left-overs in the refrigerator. Her story reminds me of my own grandfather, who at age 87, smokes 1 1/2 packs of cigarettes a day, treats himself to chicken-fried steaks for breakfast, and gets enjoyment from the simple things in life. As a granddaughter and a concerned family member, should I really be telling my 87-year old grandfather to cut down on his cigarettes and bacon intake? I don't think so.

Judith and I are not the only ones to think along these lines. In 2005, the ABC (the Australian Broadcasting Company as opposed to the American Broadcasting Company) ran a news segment about St Mary's Hospital in County Monaghan, Ireland, which is a nursing home with a bar, not only for visitors, but for patients as well. According to Rose Mooney, a nurse at the facility, "We do a lot of work in that area within the hospital. Instead of just, you know, catering for somebody's physical needs as they get older, we also try and cater for their social and recreational needs."

In response to a question about whether tea would perhaps be more beneficial to the patients than alcohol, Rose responded that, "It's about enjoying life and if enjoying life for older people means having a half and a whiskey or a small brandy, well that's what they should be entitled to." Rose's main point was that in Ireland, drinking and pubs are a way of life, and to take that away the pub experience from a patient on the last leg of their journey seems unfair.

I am not suggesting that bars in nursing homes and free shots of tequila for everyone over 80 is necessarily the way to go, but there are many things proven to enhance the quality of life of elderly patients that have nothing to do with prescription medication, health food, or abstaining from sweets. The music from a person's teenaged years, for example, has been shown to restore some memory function and enhance enjoyment of patients with Alzheimer's and dementia. According to a NYT blog devoted to the elderly, "Researchers and clinicians are finding that when all other means of communication have shut down, people remember and respond to music. Familiar songs can help people with dementia relate to others, move more easily and experience joy." Again, this is a simple thing that can enhance the quality of life for a patient more than a daily dose of wheat germ or flax seed oil ever could.