Barbara Sparacino, MD

We are exquisitely good at managing the aging emergency and strikingly bad at preventing it. That is a system design choice, not a clinical inevitability.

Every physician who cares for older adults knows the pattern. A patient we have seen for years, stable, independent, managing, arrives one day transformed by a single event: a fall, a hospitalization, a stroke, an acute delirium. And in the seventy-two hours that follow, a family …

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There’s a moment that happens in almost every family caring for an aging parent. It usually begins the same way. Someone leans in, frustrated, exhausted, sometimes whispering, sometimes shouting, and says, “My family is crazy.”

As a geriatric psychiatrist, I hear this often. What’s interesting is that everyone says it. Every sibling group thinks the others are unreasonable. Every adult child believes they’re the only one who sees things clearly. Every …

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She did not begin with the abuse; she began with sleep.

“I do not know why the news is bothering me so much,” she said. “I cannot turn it off. I feel on edge all the time.”

She was in her late 50s, successful, articulate, and with no prior trauma history documented in her chart. She insisted she was not “overreacting,” just “sensitive to injustice.” At the time, headlines were saturated with …

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Thanksgiving is my favorite holiday. I love the cooking, the noise, the parade, the extra side dishes no one really has room for. Every year I tell my parents I want to “go bigger”: more food, more people, more traditions. And every year, my mother looks at me with a mix of love and exasperation and says some version of, “Can we please do a little less this year? My …

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I can sit with patients and families and talk about hospice, dementia, or end-of-life care without hesitation. Years of training as a physician and geriatric psychiatrist have prepared me for those conversations. But when my own parent needed care, all that training suddenly felt useless.

Medical knowledge didn’t shield me from fear or guilt. It didn’t stop the second-guessing that came with every decision. It didn’t help me navigate the family …

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