MGordon_MD
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Dec 13, 2010, 1:45 PM
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By Dr. Michael Gordon
I got a phone call from the day program that one of my long-standing patients was attending.
“We need your help,” the social worker said. “Mrs. P’s son just called and told us to cancel the occupational therapist’s home assessment, which we had just arranged, to ensure Mrs. P’s home environment is safe. She is showing some worrisome deficiencies.
“The son said he doesn’t want anyone going into his mother’s house without his meeting the staff and the therapist. But the son will be abroad for another month, and in the meantime, he does not want anything done. We are also concerned that she may not be taking her medications,” the social worker said.
“There is a nursing agency involved, but they are not sure what their role is because they keep getting conflicting instructions. The agency director is unsure of whether she is putting her employees at risk for not carrying out what they believe is their professional duty.”
Soon after the phone call, an e-mail from the son arrived, telling me he’s losing confidence in the staff at the program and the agency because they are not following his directions. He asked my advice, but indicated he would prefer that they back off and wait until he returns to the city, adding that he would be going away again for another few weeks.
I knew from past experience that this only son was a senior executive and needed to feel he is in control. I also suspected from my experience with him and his mother that he was somewhat ambivalent about his relationship with his mother. He had postponed career advancement because of her needs, but then decided to take a good offer although it meant he would travel a good deal and would be available only long distance, as if a BlackBerry and laptop could replace constant filial presence.
He arranged his mother’s financial affairs because he is a financial expert, but he did allow her access to some funds at her bank through an arrangement that limited the amount of money she could withdraw. At times, she forgot that she had been to the bank recently and tried to withdraw more money than her limit. Bills were paid automatically, and she could shop using a credit card, which the son was responsible for so he would know what she bought. She agreed to shop with someone hired to help her.
After hearing the input from those involved, I surmised that the son’s desire for control was impeding the care of his mother and potentially putting her at risk. I diplomatically suggested that he had to decide what he wanted – to be in control, which would likely require that he change his career path so he could be in the city most of the time, or to defer to health and social-service professionals who are devoted to his mother. He acknowledged that they had her best interests as well as her wishes at heart. I emphasized that they needed the leeway to carry out their roles without his constant micro-management and excessive scrutiny and tendency to criticism.
It took some negotiating, but finally he agreed that he had to collaborate with and have faith in those in whose care he had left his mother. Managing at a distance can be an enormous challenge, and getting help that one can trust is crucial to fulfilling that goal.
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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.
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