Shifting attitude on gratitude

Dear Annie: I am noticing a trend of giving no thanks at all. When I get a gift or someone does a favor for me, I send thanks via email or text. That’s all I expect myself, but some of my peers don’t even text a thank-you when I give them something. I find that very annoying.

I used to chalk up this thankyou note issue to laziness, but I’m beginning to agree with your readers who say that gratitude is trending down. It’s disturbing. It takes next to no time to shoot off a quick “Thanks for that!” on your smartphone. Dear You’re Welcome: Laziness is the enemy of gratitude, and reading your letter I have to agree that it seems to have the upper hand in a big way. Thanks to technology, it’s easier than ever to be self-absorbed and unappreciative of others; to do whatever’s convenient. Dear Annie: Your advice to Granddad’s Girl about speaking to him about his driving abilities fell far short. This man very likely has early dementia. His continued driving is a huge risk to himself and others. His family needs to insist he see his doctor, accompanied by a family member, to discuss this. I am a retired internist, and I often had to deal with this difficult problem. This was often scheduled as a “check up” to avoid alarming the elderly patient.

Discussion of driving abilities and tests of memory, spatial orientation, reflexes and executive functioning can be done in the office. Almost all states have laws requiring or allowing physicians to report impaired or potentially impaired drivers.

Going beyond having the DMV test his driving abilities, I would encourage the family to disable or remove his car. Simply taking his keys away is not enough. One of my wily elderly patients simply had the car towed and the ignition system replaced.

This is a very contentious problem in my experience, because it means a loss of independence, and often, a move to an assisted living facility or the home of a family member. These were some of the most difficult discussions I had with patients and family, but they were necessary for the safety of the patient and the public because of the high risk of accidents. Dear Retired Oregon Internist: You’re right. In my response, I should have been more emphatic about the importance of getting her grandfather a medical evaluation. Thank you for sharing your expertise.