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Treatments can help maintain quality of life

Carol Bradley Bursack

Dear Carol: My dad is 86 and quite healthy other than his eyes. Recently, he developed the wet form of age-related macular degeneration (AMD) and needs to get regular injections in his eyes to slow the leaking of the blood vessels. Dad tolerates the treatment well, so I've been taking him to the clinic for this, but my sister is having a fit.

I know that she loves Dad, but she lives 1,000 miles away so rarely sees him. She says that most older people shouldn't go through a lot of treatment. I'd agree if we were talking about extensive surgery or chemotherapy but this seems different. Dad's mind is good enough that he can still enjoy reading and watching TV. He's perfectly willing to go through the treatments to keep his vision. My sister resents me because I'm Power of Attorney so she won't take my word for anything. What is your take on medical interventions for people Dad's age? — RU

Dear RU: The short answer? Your dad wants the treatments and they will help preserve his quality of life, so there's no question in my mind that he should have them.

I understand that your sister is referring to some older people having surgery or other miserable interventions that can cause more harm than good, but this is a completely different situation.

According to the American Macular Degeneration Foundation, macular degeneration is the leading cause of vision loss, affecting more than 10 million Americans, which is more than cataracts and glaucoma combined.

There are two types of AMD, dry and wet. The treatment for early dry AMD is generally nutritional therapy, with a healthy diet high in antioxidants to support the cells of the macula and added supplements for some patients.

People with wet AMD may be more fortunate since they can be treated with periodic injections of vascular endothelial growth factor (VEGF). The injection goes directly into the eye, which sounds horrible, but numbing agents can be used to make it tolerable. It's not a cure, but it helps people continue to see so, for most people, the treatments are worth some stress and discomfort.

I'm wondering if your sister is just using what she's read about treating older people with aggressive therapies as a way to circumvent your legal authority. It would be unconscionable if sibling issues between the two of you prevented your dad from getting the medical help that he needs.

Remind her again that this treatment is about improving your dad's quality of life, which is vastly different from having a treatment that does the opposite while still not curtailing the disease.

It sounds as if your dad is perfectly capable of telling your sister how he feels about this medical issue, so that's what he needs to do. If she still isn't convinced, ask her to contact your dad's doctor. What your dad is receiving is a gift that will help keep his quality of life the best that it can be.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of Minding Our Elders: Caregivers Share Their Personal Stories. Bradley Bursack hosts a website supporting caregivers and elders at She can be reached at