living your best to the end
My big brother, John, had the best possible end

My big brother, John, had the best possible end

My bro died at home, on Palliative/Hospice Care Although we did not know it at the time, my brother’s ‘end’ started November 2018, with a brain tumour diagnosis. Surgery before Christmas that year was deemed ‘successful’ and John was in such good physical shape that he was released early. He sailed through weeks of radiation and chemotherapy with few of the expected side effects. His only physical change was that he started wearing hats. Humour was his go-to modus to get through, the sillier the better. We cheered every picture he sent us, mugging for the camera: electrodes on his head or ridiculous hospital gowns, a ‘brain fart’ toy. the tumour came back with a vengeance In August, results of an MRI were devastating. From then until he died –almost a year to the date of diagnosis – the speed of his physical decline was shocking.   It was his confused speech that led to the initial consult that led to the diagnosis, but – until August of 2019 – he was able to have a conversation, with words ‘filled in’ for him. When he lost that ability, he still hammed for visitors.  His right side was the first to ‘go’, but he still made funny hand gestures with his left hand and jiggled in his seat when bouncy music played. His wife, Susan Teskey (herself a formidable producer/director) proved an amazing caregiver who also did her best to inject humour wherever possible: each piece of home care equipment was named and formally introduced. The commode, for example, was Clarence. The high top toilet seat, Harold. She made sure his...
Men writing about The End of Life

Men writing about The End of Life

Men writing from the inside out about life’s end. In the picture in The New Yorker, sitting with his dog, on a bench by a park, Roger Agnell, looks none of his 93 years. Famous for his sports writing, ‘This Old Man’ is Agnell’s reflection on life, starting ith what is and isn’t working- kind of a Medical History but with the life that was going on around the health issues. The lower-middle sector of my spine twists and jogs like a Connecticut county road, thanks to a herniated disk seven or eight years ago. This has cost me two or three inches of height, transforming me from Gary Cooper to Geppetto. My left knee is thicker but shakier than my right. I messed it up playing football, eons ago, but can’t remember what went wrong there more recently. I had a date to have the joint replaced by a famous knee man (he’s listed in the Metropolitan Opera program as a major supporter) but changed course at the last moment, opting elsewhere for injections of synthetic frog hair or rooster combs or something, which magically took away the pain. I walk around with a cane now when outdoors—“Stop brandishing!” I hear my wife, Carol, admonishing—which gives me a nice little edge when hailing cabs. In the New York Times, James Collins (author of Beginner’s Greek – a novel) title had me gearing up for a grim diagnosis: My office supplies are going to outlive me But, no! No health issue prompts Collins. Instead, it’s when he takes stock of the sheer number of staples in his office he...
Palliative Care: Doing ‘nothing’ is not an option

Palliative Care: Doing ‘nothing’ is not an option

 Dr Daphna Grossman wants to set the record straight “In healthcare it seems we talk about ‘doing everything’ or ‘doing nothing’. With Palliative care ‘nothing’ is not an option. Certainly there are standards and recommendations and then there’s the Art of Treatment: our goal is to treat the whole person – physical, psychological spiritual and social. We look at a person’s goal of care. Can this goal be achieved? Not all illnesses can be cured however, symptoms can be alleviated.” Dr. Grossman is a Palliative Care Doctor at North York General Hospital, co-lead for the supportive care program, and involved in research and teaching. She paints this picture: deputy head of the palliative care unit, and site resident coordinator for palliative care. – See more at: http://www.baycrest.org/educate/insights-into-aging-101/presenters-bios/#sthash.yuLPPMKA.dpuf deputy head of the palliative care unit, and site resident coordinator for palliative care. – See more at: http://www.baycrest.org/educate/insights-into-aging-101/presenters-bios/#sthash.yuLPPMKA.dpuf deputy head of the palliative care unit, and site resident coordinator for palliative care. – See more at: http://www.baycrest.org/educate/insights-into-aging-101/presenters-bios/#sthash.yuLPPMKA.dpuf deputy head of the palliative care unit, and site resident coordinator for palliative care. – See more at: http://www.baycrest.org/educate/insights-into-aging-101/presenters-bios/#sthash.yuLPPMKA.dpufHer passion for palliative care radiates off her, paints this picture: “If we only treat patients in terms of their physical issues such as addressing their test results it’s like looking at a picture in black and white. We need to also address the context, the person, who they are, and what is important to them to paint a picture that is in colour.” The thing is, people,often perceive Palliative Care as a euphemism for on the doorstep of death, where nothing more will be done....
Infections in the elderly how to best treat: Are antibiotics always the answer

Infections in the elderly how to best treat: Are antibiotics always the answer

‘If you don’t give her antibiotics, she’ll go toxic and die.” Although my 96 year old aunt (pictured at left, between me and my cousin – her daughter) had no symptoms of a bladder infection, a urine test resulting from cloudy pee revealed she indeed had a Urinary Tract Infection (UTI. My aunt hadn’t complained about pain or discomfort, my cousin – her ‘power of attorney’ – authorized treatment with antibiotics. Many would agree. However, when I shared this with Dr. Jocelyn Charles, Chief of the Department of Family & Community. Medicine and Medical Director of the Veterans Centre at Sunnybrook Health Center, she shook her head. “Treating the test results and not the patient.” The (assuredly well-meaning) healthcare professional who made that pronouncement was talking about ‘sepsis’: when the bloodstream – and therefore the whole body – has become one big infection it becomes ‘toxic.’ In a younger person, antibiotics – standard protocol – would be a no-brainer. Rarely it seems, is taken into account the repercussions of ‘standard protocal’ in the elderly. Functionality and age should have an impact on treatment decisions From the blog, Geripal – devoted to optimal treatment of the elderly: Survival from severe sepsis: yes the infection is cured but not all is well – the point is made that, in the elderly – unlike those younger, whose bodies have more resources – treatment does not equal ‘back to how she was before’. Instead, treatment that sounds so necessary and logical can lead to increased confusion, worsening dementia, and a more vulnerable immune system. In my aunt’s case, several courses of antibiotics failed....
10 ways to think creatively

10 ways to think creatively

What if what you want until you die can’t be done exactly as you imagined? Consider it an opportunity for creative thinking.  No ocean in sight? Make an ocean sounds playlist Ocean pictures: on the wall or on a digital photo album Video the beach and ocean, make a loop Virtual reality Ocean simulator game Create a mini beach scene: sand, a cocktail umbrella Make a Japanese sand garden Books about the ocean Make the most of an opportunity: the ambulance driver made a pit stop at the beach, for a last visit Find a sympathetic accomplice: a nurse broke the rules: she wheeled her patient to a balcony where he could see the ocean, have a smoke and a glass of wine...