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Geriatrician helps families do the right thing:
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MGordon_MD
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Sep 16, 2010, 11:40 AM
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A Special Message from Dr. Michael Gordon
It gives me great pleasure to share a review of my latest book, Moments that Matter: Cases in Ethical Eldercare, from the Canadian Jewish News.
The review is entitled, Geriatrician helps families do the right thing. Enjoy!
By CAROLYN BLACKMAN, Staff Reporter, CJN
September 2010
Dr. Michael Gordon, medical program director of palliative care at Baycrest and a CJN columnist, wants to help adult children do the right thing for their parents who are in the later stages of life.
In his new book, Moments that Matter: Cases in Ethical Eldercare, Gordon uses case histories to provide an ethical framework that family members can use when deciding what is best for their elderly parents.
 “A family has to arrive at a place where they can feel at peace with the decisions they’ve made, and know that those decisions reflect what the parent would have wanted or are in their best interests,” said Gordon, who is also a clinical ethicist and professor of medicine at the University of Toronto.
A geriatrician for 36 years, Gordon, whose own father is 98 years old, said he is often asked to get involved with issues that could cause conflict. “I’ve gotten a wide perspective on what kind of ethical challenges families have to face. It may be the children or spouse of a patient, but certain themes come up again and again.”
When families struggle with a decision, he said, “they tell me that they want to do the right thing. When it is all over, they want to be able to live [with their decision.]”
Driving is one of the issues he hears about often, he said. “Most people do not think about the ethics of driving, [but] potential harm to themselves and others overrides personal benefit and convenience.”
He has had to recommend that a patient’s license be taken away, he said, “and I’m often challenged about ‘why I’m doing this to them.’ Like in other public health issues such as the mandatory reporting of certain contagious diseases, society has established the priorities to the public rather than the individual. Safe driving is no different.”
It can be especially difficult for family members to report driving problems to the doctor, he said, “but a review of the financial benefits of giving up one’s driver’s license and car, and using taxis instead may have some effect on the person.”
The matter of driving, he said, is often a prologue to a sequence of challenging decisions.
An often difficult decision is about the best place for an elderly parent to live, Gordon said. “It is not uncommon for a parent to reject help that is suggested by even the closest, most loving children.”
He said that one case he dealt with involved a physician’s parents who were declining. “The father’s problems were primarily physical, for which a great deal of assistance was required for dressing and bathing.
“His wife was developing progressive dementia and refused all help in the home, and would not consider moving.”
It was only when the wife fell and required hospitalization, said Gordon, that the husband was admitted as an urgent respite case to a retirement home for a short term while the wife recovered.
He said that when it became clear that the wife needed permanent long-term care, the husband joined her at the same facility.
“Repeated offers of help sometimes change the person’s acceptance of what is required, [but] on occasion you can only wait for a crisis to occur, which forces a care situation that resolves the problem for the parent.”
Gordon said that one of the most “difficult conundrums you and members of your family might face is what might be perceived as life-maintaining treatment.
“One way around the terrible guilt [of making such a decision] is to decide before initiating such treatment, whenever possible, the framework by which the treatment will be discontinued.”
Gordon said he attributes much of his interest in geriatrics to growing up with his grandmother in Brooklyn, N.Y. “She had a profound influence on my life. My deep affection for seniors is due to her impact.
“I always want to hear their stories. I can make a connection with them within a few minutes. I believe in people’s stories. It makes them who they are.”
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Dr. Michael Gordon is Medical Program Director, Palliative Care Baycrest Geriatric Health Care System in Toronto, Canada and Professor of Medicine, at the University of Toronto.
Dr. Gordon is the author of the engaging memoir Brooklyn Beginnings: A Geriatrician's Odyssey, published by I-Universe.
Brooklyn Beginnings is available in bookstores and online at: Indigo-Chapters, Amazon.ca, Amazon.com, Barnes and Noble and I-Universe
Moments That Matter: Cases in Ethical Eldercare: A Guide for Family Members, is available online at Amazon.ca.
His latest release is Late-Stage Dementia: providing comfort, compassion and care. It is available at Amazon and Indigo.
Visit Dr. Michael Gordon's website.
(This post was edited by MGordon_MD on Sep 16, 2010, 12:41 PM)
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Post edited by MGordon_MD
(User) on Sep 16, 2010, 11:43 AM
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(User) on Sep 16, 2010, 11:43 AM
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Post edited by MGordon_MD
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