Here's a sample of Gillick's insights and blunt style:
Our government insurance systems and the training of medical professionals conspire to rob elders of agency when we become frail (and most of us will.) Medicare doesn't pay for what many old people need to stay in their homes: occasional household help, perhaps to clean, do laundry or cook. Unless relatives step in, elders don't get help from the system until/unless they are sick or injured enough to require hospitalization. And Medicare doesn't cover long term nursing home care; for that, elders must become poor enough to qualify for Medicaid, the state program for the indigent. All of this means systemic preference for the most expensive ways of caring for old people -- and persistent calls to cut the burden to the taxpayer.
Doctors are ill-prepared to help old people hang on to what independence our bodies allow and to make choices that are in accord with our individual values and preferences. Everything about their training makes them aim to defeat disease and decay -- that's medicine's "dangerous fantasy" to which old people are too often sacrificed. Gillick believes it is the doctors job to help patients decide when enough is enough.
This book with the wonderful cover was published in 2007. These issues seem to be getting more widespread discussion these days, post-Obamacare, in such works as Dr. Atul Gawande's Being Mortal and Dr. Angelo Volandes' The Conversation. Dr. Gillick continues her reflections at the blog Life in the End Zone.
I should add, if looking for conversation about and among elders, you might like Time Goes By.