A geriatrician struggles to help as his own father's health begins to fail

By Michael Gordon
Vice-President, Medical Services

I had been practising geriatric medicine for almost 25 years. I was in the first batch of Canadian physicians certified as specialists in geriatric medicine in 1981, and had been able to pursue my career to the fullest as head of geriatrics at Toronto's Baycrest Centre for Geriatric Care and as a professor of medicine at the University of Toronto.

I had worked with hundreds of families as they navigated the unique and heart-wrenching challenge of watching a close family member fail, and had extensively chronicled my observations and experiences in numerous articles and lectures. Now it was my turn to live the reality of my practice. The health and cognition of my 89-year-old father, living alone in Brooklyn, N.Y., was beginning to falter.

My mother, to whom my father had been married for 53 years, had died almost six years previously. . . . For the following few years, my father spent much of his time in his little bungalow in Brighton Beach, taking daily walks on the boardwalk or in the shop-lined neighbourhood. He read the New York Times, the Wall Street Journal and Barron's, to keep him abreast of the stock market, which he dabbled in. . . .

Visits to his house were always a shock, as the accumulation of papers was overwhelming. An inveterate pack rat, my father had of late become much worse. He gradually was less able to keep the house clean and categorically refused any outside help, irrespective of how the option was presented to him. My sister Diane, a psychiatric social worker in Chicago, and I tried to respect his wishes to remain alone in the Brooklyn bungalow, and on each visit tried to clean and organize the house a bit, but it was a losing battle. . . .

The visit to New York in June to celebrate my father's 89th birthday was a shocker. For the first time in my life, my father looked "old" to me, not just older. . . . He was stooped, his hair was long and everything about him was laboured. He engaged somewhat during dinner but later wondered how he got to the restaurant. That night, Diane and I told him that he had to move to Chicago, where my sister and her family lived. We were prepared for a fight, but instead, looking weary and beaten, he acquiesced. He even said he would consider a retirement home rather than an apartment. For the first time, the idea of help appealed to him.

Three weeks later, Diane and I were in Brighton Beach, cleaning up the house, throwing out bags and boxes of paper, being careful to look through every piece, not knowing what might be found amid the chaos. We found unsent cheques, incomplete letters appealing parking tickets and cancelling magazine subscriptions, as well as investment and income tax forms, including the previous year's that had not been completed.

With the small Sentra loaded with his few important belongings and documents, my sister was ready to drive to Chicago. First we had to convince my father he was not driving, despite the fact that he had previously driven this route dozens of times. He was asked to be the navigator, whereby he abandoned the driver's seat for that of the passenger, maps in hand. Diane described it as "the longest two days of my life -- like driving cross-country with a two-year-old."

Three days later he was in the retirement home that Diane had found. He liked his room and by the evening agreed to sign the five-month lease, saying this would be a "long vacation." He said the food, provided as part of a seniors' drop-in centre, was a "six out of 10" which we thought was a pretty sophisticated answer.

As time passes he seems to be acclimatizing to his new environment but vacillates between saying he has to return to Brooklyn to look after the house, to telling us to sell it. He has accepted his car being "parked" at Diane's house to avoid the parking fee, and so far has not requested to drive it.

Diane has become the care-giving daughter, just like the many daughters and daughters-in-law accompanying their parents or parents-in-law to my office. I have become the son, the doctor, in a faraway city, always helpful but not there for the day-to-day trials and tribulations. It could have been the reverse, but my father refused to immigrate to Canada, even when he was accepted three years ago. I will be at a distance during the years of my father's inevitable decline. I will be unable to use all my professional status, knowledge, experience and resources as a geriatrician to directly help him. I cannot give back to him, in a tangible manner, all that he gave to me growing up and during my education. The best I can do is visit, call and support my sister, hoping in some way I can contribute to her tender caregiving.

(The article by Dr. Gordon was first published in the Medical Post, October 3, 2000)