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    The Salami Salesman and His Daughter Falafel: What an Older Man’S Death Can Teach Us About How and How Not to Care for the Frail and Dying
    The Salami Salesman and His Daughter Falafel: What an Older Man’S Death Can Teach Us About How and How Not to Care for the Frail and Dying
    The Salami Salesman and His Daughter Falafel: What an Older Man’S Death Can Teach Us About How and How Not to Care for the Frail and Dying
    Ebook66 pages54 minutes

    The Salami Salesman and His Daughter Falafel: What an Older Man’S Death Can Teach Us About How and How Not to Care for the Frail and Dying

    By Laurie Mallery

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    About this ebook

    As a practicing physician of internal and geriatric medicine at a major urban teaching hospital, I take care of frail older patients and see a lot of dying. From my experience, health care providers, caregivers and families dont understand how to properly care for older adults with multiple medical problems. As a society, we need to fifi nd more value in care giving. Furthermore, much too often what we see is distressing, dehumanizing and lonely deaths that have become the norm for older people, who are routinely subjected to tremendous unnecessary suffering and forced into conditions that rob them of their last shred of dignity. Useless tests and surgical procedures become the main focus of dying. A meaningful death experience where people gather to comfort and support the dying personis replaced by ceremonies of blood draws and invasive procedures. My dads last year of life drove this point home in a way that I could not ignore. ThTh is book follows his health care experience as a means of illustrating the challenges families face today when they try to help their loved ones navigate the health care system and their fifi nal years of life with dignity and comfort.
    LanguageEnglish
    PublisherAuthorHouse
    Release dateFeb 18, 2011
    ISBN9781456716769
    The Salami Salesman and His Daughter Falafel: What an Older Man’S Death Can Teach Us About How and How Not to Care for the Frail and Dying
    Author

    Laurie Mallery

    Dr. Laurie Mallery completed Medical School at the University of Pennsylvania. She is a practicing Internist and Geriatrician and is head of the Division of Geriatric Medicine at Dalhousie University in Halifax, Nova Scotia. Dr. Mallery co-founded the PATH (Palliative and Therapeutic Harmonization) clinic, which provides care planning for frail older adults and has developed a program that trains health professionals about comprehensive geriatric assessment.

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      Book preview

      The Salami Salesman and His Daughter Falafel - Laurie Mallery

      The Salami Salesman

      and

      His Daughter Falafel:

      What an older man’s death can teach us about how and how not to care for the frail and dying

      Laurie Mallery, MD

      Care principles developed with Dr. Paige Moorhouse

      missing image file

      AuthorHouse™

      1663 Liberty Drive

      Bloomington, IN 47403

      www.authorhouse.com

      Phone: 1-800-839-8640

      © 2011 Laurie Mallery, MD. All rights reserved.

      No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

      First published by AuthorHouse 1/24/2011

      ISBN: 9-781-4567-1676-9 (e)

      ISBN: 9-781-4567-1898-5 (sc)

      Library of Congress Control Number: 2011901350

      Printed in the United States of America

      Any people depicted in stock imagery provided by Thinkstock are models,

      and such images are being used for illustrative purposes only.

      Certain stock imagery © Thinkstock.

      This book is printed on acid-free paper.

      Because of the dynamic nature of the Internet, any Web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

      Contents

      Introduction

      The Salami Salesman and his Daughter Falafel:

      The Beginning and the End

      Too Many Medications

      The Fall

      The Annoying Family

      The Salami Salesman

      Rehab, but not Really

      A New Meaning of Home

      The Final Phase

      What’s Wrong with this Picture

      Concluding Contemplation

      What to Do

      Acknowledgement

      About the Author

      Introduction

      AS A PRACTICING PHYSICIAN of internal and geriatric medicine at a major urban teaching hospital, I take care of frail older patients and see a lot of dying. In my work, I notice that health professionals, caregivers and families do not always understand how to properly care for older adults with multiple, serious medical problems. Much too often what we see is distressing, dehumanizing and lonely deaths that have become the norm for older people, who are routinely subjected to tremendous unnecessary suffering and forced into conditions that rob them of their last shred of dignity. Useless tests and surgical procedures become the main focus of dying. A meaningful death experience—where people gather to comfort and support the dying person—is replaced by ceremonies of blood draws and invasive procedures. My dad’s last year of life drove this point home in a way that I could not ignore, and empowered our family to find value in caregiving. This book follows his healthcare experiences as a means of illustrating the challenges families face today when they try to help their loved ones navigate healthcare systems with dignity and comfort during their final years of life.

      The Salami Salesman and his Daughter Falafel:

      What an older man’s death can teach us about how and how not to care for the frail and dying

      MY FATHER DIED ON September 11, 2008, and I miss him. Yet his death inspired me to consider how his life ended and how the medical system could have better served him at the end of his life. When my father began his slow decline towards frailty and eventual death, I was able, as an internist and geriatrician, to view these poignant life events from a unique perspective, and personally experience the many obstacles in the health care system that make it difficult for frail, older people to receive appropriate care.

      Astute practitioners of geriatric medicine try to understand common health conditions of the elderly, aiming to improve function and prevent disability. When that is not possible and death is inevitable, we support the dying process. The holistic approach used by geriatric medicine is different from a traditional approach that may make decisions using a single illness model. The single illness model sees only one thing wrong at once – the heart, the lung, the cancer – rather than considering the full picture that reflects the complex and interacting issues. Treatment guidelines developed for healthier individuals (those that typically have more life ahead of them) are inappropriately applied to older people with multiple medical problems who may be nearing the end of life.

      Within traditional medicine, there is still unwillingness to face the fact that many older adults with multiple medical illnesses will do poorly despite our best efforts. Conversations about illness severity, irreversible symptoms, and the dying process are rare. Families often have inadequate knowledge of the complications related to medical and surgical interventions and may have limited advanced warning about the chance of dying.

      Discussions of death and dying typically only take place in the last

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