Dr. M was a brilliant, award-winning scientist suffering from metastatic prostate cancer and Parkinson’s Disease. It was difficult for Dr. M. to accept the limitations caused by his illness, and he demanded to be taken to his company office in full suit and tie every workday until his last week of life. Despite feeling weak and confused, he found peace and strength in his familiar business environment.
True to his nature, Dr. M approached his illness from a scientific mindset and valued frank discussions about what to expect as the disease progressed. Meanwhile, his three adult children struggled to provide adequate care without taking away their father’s independence and autonomy. Frustrated and scared, his family asked me for guidance and support in developing a care plan. As primary caregiver, his daughter Judith coordinated the various health professionals who routinely visited, and she stood by him whenever he was lonely, needed medication or felt too weak to even sit up on his own.
Understandably, Judith had many questions about her father’s health and needed her own support system throughout this trying time. She frequently reached out through emails, phone calls and texts, and I was happy to respond to every one at any time of day. I was with Dr. M hours before he died and communicated with Judith throughout his final moments, knowing that I was able to offer peace of mind and release from fear by making myself available to her. Not only did Judith feel equipped to deal with her father’s passing, but she developed the strength and clarity to share this understanding with her family.
The mother of a 50-year-old woman asked for guidance on getting her daughter, Sarah, detoxed from sedative medication. Sarah had used these medications for over 10 years and was unsuccessful in her prior attempts to stop taking them. She was also reclusive and had a long history of depression, anxiety and PTSD. Due to a severe food intolerance, Sarah was extremely thin and only weighed about 80 pounds. She consulted with many doctors, naturopaths and integrative practitioners and completed extensive testing on her blood, stool, saliva and genotype. The tests identified a fungal overgrowth in her intestines, but were otherwise inconclusive.
When I met Sarah, she was guarded and distrustful of doctors. She was so frustrated and overwhelmed that she had no hope for the future and asked me to help her die. Sarah’s parents were fiercely supportive and tried to help any way they could, despite the difficulty of coordinating care while living in a different city. They were stressed and fearful of what Sarah might do if her health didn’t improve.
I assured Sarah that my goal was to help her find joy and meaning in life without judging her or forcing her out of her comfort zone. I made my team available to her family whenever they needed support, and I held joint conferences with her physician and psychiatrist. I also connected her with a compassionate social worker and a nutrition expert, and my team’s acupuncturist and massage therapist provided therapeutic treatments at Sarah’s home. During frequent home visits, I comforted Sarah in difficult moments and helped her work through developing symptoms.
Because Sarah was embarrassed to speak with her parents, I reported to them with her consent and surrounded her with a supportive network of attentive caregivers. Ultimately, Sarah’s condition declined, and she refused further medical treatment, entering hospice care. In her final days, she had a gentle passing that honored her wishes, and her parents were grateful that her suffering was over. Despite a painful loss, they found contentment in their ability to provide exceptional care up until the last moment of her life.
A hospital discharge planner contacted me on a Friday evening to immediately meet with a distraught family member and help her make an important decision about her father, Andrew. The hospital was discharging him to a nursing home because he was too ill to return to his assisted living community. In addition to having mild dementia, Andrew was weak and dehydrated, and his prostate cancer had spread to his bones and lymph nodes in his pelvis and abdomen.
The family desperately wanted to remove him from the nursing home and provide the best quality of life during his final days. I referred the patient’s daughter to an elder relocation specialist, and together we visited three six-bed residential care homes. We arranged for him to relocate to a beautiful home in Rancho Santa Fe, and in the intervening days, I coordinated IV fluid treatments, physical therapy and speech therapy to ensure that he didn’t decline further in the nursing home before he could be moved.
I’m certain Andrew would have died within a few days if he remained in a nursing home or entered hospice care. He wouldn’t have received essential IV fluids or a fast response to the early pneumonia and urinary tract infection he later developed. Instead, Andrew lived comfortably for four months, compassionately cared for by massage therapists and physical therapists who made sure he stayed active and kept his skin and health intact. During an unavoidably challenging experience, his family gained peace of mind that they were making the best choices and invaluable time to share their love and appreciation for him.