Before I was ever a doctor, I was a paperboy. And, I still remember meeting all those lovely elderly “customers” who stood at their letterbox, waiting for me. Most of the time, I was on time, and the papers weren’t soaking wet, so all good. And, when Christmas came, I still remember the little note I’d put in their letterboxes
“Christmas comes but once a year, and when it comes it brings good cheer. And in midst of all your joy, please don’t forget your paperboy”
And you know what, many of them wouldn’t. When Christmas came, they would leave a little envelope taped to their letterboxes with a tip, and sometimes a card.
I really got to know my paper rounds. I should think I should have because I did a paper round from the age of 12 till 18. 6 days initially, then 7 days a week, on my bike with milk crate or two strapped to the front with octopus ropes.
I got to know a lot of elderly people, having a quick chat here and there as I went along.
For some elderly customers, we’d have special instructions to place the paper at the front door, or throw it onto the front porch… no broken windows from recollection. So from a very young age, I got a gist that being an elderly person living at home, was a special experience. This was bolstered one day when an elderly lady was standing outside of her house, waiting for me. Nothing unusual about that, I’d often hand people their papers. But when I got there, she asked me to come in and help pump her husband’s tyre on his wheelchair. He had polio and was a paraplegic. I stepped in, helped, and carried on my business. But I remember it so vividly. I got my first glimpse of how hard it could be to be elderly, living alone or with someone, in your own home. Yet, looking at many photos and books, and treasured belongings, just how much it meant, to be able to do so, nonetheless.
When I became a doctor, I didn’t gravitate to serving the elderly immediately. Instead, I had great ambitions of being a surgeon. However, after training in that area, I realised that the field was just not for me. Perhaps I liked too much, talking to people while they were awake!
But I did like helping the elderly. I liked going to nursing homes, I liked seeing them at the clinic, and I liked seeing them in their home. I really liked seeing them in their homes. I would find myself noticing all the intricacies of their furniture, photos, artwork and everything else that I never knew before. So every time I would leave their home, I felt like knew them that little bit more, I felt like I understood them, that little bit more.
I remember once being asked to visit an elderly lady by her daughter, who lived with her. I went. I got to the house and was ushered in by her daughter. We progressed to her bedroom. There I found the patient, a frail, elderly lady laying in a bed, with a bell carefully positioned over the bed, hooked into place with a coat hanger. In actual fact, her daughter really had tried her best to set up a version of “hospital in the home”.
I remember sitting down with another elderly patient on her couch, and whilst I was trying to listen to her chest and heart, she was only too eager to discuss the painting she had herself completed of her grand daughter. I looked at the painting. It was really good. Wow, I thought. I’ll never forget the smile of that patient. Rosy cheeks always. The face, in this case, of a contented artist. It was sad news when I came to hear that she had to go to a nursing home. I remember talking about how much she didn’t want that to happen.
Over the last 7 years, I have been on call basically all the time after hours, visiting patients. Mainly at nursing homes, but sometimes in their homes. And, from fulfilling that role, over the 7 years then, I have learnt a lot about caring for the elderly, more than any of my textbooks ever could have taught me.
I lament however, that despite my contributions as a general practitioner, that I never was able to really see enough patients at home, during the day. Not as a regular doctor. Some I do, but I could have seen more. My own story has led me down the path of setting up a company, Atticus Health. Through this, we have opened a chain of medical clinics, as well as leading an earnest group of doctors who attend nursing homes. We have quickly become one of the largest providers of medical services to nursing homes in my home state of Victoria.
Despite all of this, I return to the fact that, when it comes to visiting patients at home, I wish I could have done more. It’s very difficult to find a doctor who is willing to visit a patient regularly during the day. There are many reasons for this, but essentially it amounts to being much more work and less pay, making it as a job, in the current situation, not a favourable one, when compared to seeing patients at a clinic.
Yet I find myself in a position now to help with some things. So I figured, it’s time to put that into action! By writing this book, my express intention is empowerment. I hope that carers can become better informed as they go about their selfless work of helping and advocating for the elderly person/s they care for. Perhaps even other medical professionals would find reason and indeed something useful in reading this book. And last, but not least, I hope that if you are an elderly person, trying to live at home, that this book may help you achieve that. That this book, somehow, leads you to better health and peace.
Apart from writing this book, I still haven’t given up on the idea of getting more doctors conducting home visits and indeed becoming their regular home visiting doctor. Because of the way the NHS operates, this is commonly the case in the United Kingdom. As from experience, I think the need for home visiting general practitioners is real, and therefore I still believe this is a neglected topic. So what can I do? Well, I know how to lead and manage doctors, to support them. So, I reckon I could help make the activity less “demanding” that way, by providing them with great support. And, the outstanding thing then is – pay. In the current system, you lose money from doing home visits. That’s the plain fact. So what I’m planning to do is support all of those doctors by essentially providing all our services, including access to required software, administration, compliance, reception, the whole thing – for free. This project is called – Mobile GP. You can look up details here – www.mobilegp.com.au
Between increasing empowerment and knowledge, and delivering more doctors to elderly patients’ homes, throughout the whole of Australia, I hope that things change. That the level of medical care for housebound elderly people takes important, meaningful steps forward.
Caring for the elderly is arranged by considering health from a holistic perspective, what is said to be a “bio-psycho-social” model. That’s a biological, psychological and social model. Forgive me here, because I am a product of a medical degree, and we ideally considered the approach to any patient in these terms. However, I’m sure that there would be other valid ways to do it. Indeed I myself break from this organisation somewhat in the book, with a specific section on falls. This is an important topic, I felt warranted a stand alone chapter. Within the biological section, I consider problems in terms of systems – the respiratory system, cardiovascular system etc. I hope this provides for a logical way to search between topics. Along the way, I offer many short stories, where I remember them, to aid to understanding and perhaps make any information and advice more practical. This book isn’t exhaustive, it’s not meant to be. Rather it covers really common problems, and hopefully gives you an approach to consider health from a pragmatic yet sufficiently professional standpoint still. I hope that it’s simple enough to be an important tool.
Whilst here, I’d like to thank my family. This is going to be a big section. I hope you can understand why. I truly am grateful in my life, and so to make this brief, would not be sufficiently representative of that. And to be sure, as a couple of kids of mine have said, I’m talking about my “two” families. I’m talking about my parents, and my own siblings. And I’m talking my wife and my five kids. Family life is never perfect, let’s be honest. But somewhere there, in my life, there has been real magic of being part of these two families.
Mark, my dad was and is the most hardworking person I have ever come across. And what’s more, he loved each of his jobs. At the age of 70, I think he had three jobs still, at least two. And, I know, he seemed to love each of them. He went to work with a smile, and absolutely loved serving the public. He has passed away now, but I’ll remember him always. I’ll remember that he never forgot to massage each of his four children’s backs before they went to sleep. Massages are addictive, and so were his renditions of Neil Diamond’s “Song Sung Blue”.
My mother, Sylvia, would be called “fiercely independent”. I think that’s the description of someone still capable of slapping someone in the face if they had to! No, in all seriousness, she’s the toughest, gutsiest person I’ve ever met. Back in the day, I think she had to be. But despite that, I think she was born tough. From dodging her boarding school from making her a nun, to working full time, yet still getting four kids off to school – on time, what a legend. But perhaps most, I’ll remember my mum for somehow finding the time to, despite all, make me feel like a winner. She’d be cooking, and I’d be sitting on the dining table, perhaps peel potatoes or garlic, or perhaps drawing a picture. Yet somehow, in her company, she would genuinely take an interest in me, sufficiently so, that I grew up, as an adult, feeling like “I could do it”. Believing that I had abilities. Believing in myself. As a busy dad now, I find it incredible that despite being so busy every day, she somehow took the time and effort to make me feel so special as a child still. Mum, thank you. But please… it must be time to stop getting on the ladder and painting the eaves!
That leads me to my siblings – Clare, Rolf and Bruce. I must also mention here, that I had another brother, Clive, who died before I was born. He was five at the time. Clive, I hope you are resting in peace. As a result of Clive’s passing, I grew up being the youngest of four children, and frankly, I think I was lucky. The support I have received from my sister and two brothers has been so important and helpful to my life.
I work with my sister, she’s an executive in my company. We work well together, and have done so for many years. But her loyalty goes much further back. Clare is a nurse and I still remember coming back from school, sometimes with a headache, and she would voluntarily get a warm face towel to sponge my face, particularly my forehead. And she would enquire, “does that feel better”. When the towel got too cool, she would put it under hot water again and place it on my face once again. She’s a kind soul, and always been so, with me.
My brother Rolf is an inspiration. He’s an engineer and cardiologist. If you’ve heard about the “Heart of Australia”, that is, specialist medical care being delivered throughout rural and remote Queensland via specially designed massive trucks, then you would have heard about him. It’s with his daringness to “think big” that I too dare to let my audacious dreams spur me to action. Indeed, I took lead to study medicine, in the first instance, and never looked back since. Rolf, thank you for the inspiration you’ve provided me in my life.
My brother Bruce. If there was ever a person who truly loved spending time with people, Bruce is that guy. And, I have a problem. You see, he’s also a great cook. As a consequence of that, I usually end up in a ‘food coma’ at his house, fast asleep on his couch, hopefully not drooling. Although I do think there are a few unauthorised photographs that may have been taken along the way, showing me doing so. I’m not sure, I was asleep at the time! Thank you for forgiving me for being such a poor, and all at once, thank you yet for inviting me over so often. It’s such a pleasure having people, family in this case, to see over the weekend. I don’t know how isolated my life would be without the company of you and your family, but it would certainly be a less joyous one. Bruce, you really have taught me what it means to live simply and be generous. Thank you.
Now let’s get to my “actual” family (I think that’s what my daughter referred to it as). To my kids, Tobias, Jonah, Livian, Gideon and Angelique. For putting up with all my randomness including my willingness to drop you off at your schools in my pyjamas, thank you. And, might I say, that I think I’ve learnt more from you, than I’ve taught you. Most of all, thank you for being so understanding about me getting phone calls really any time of the day, any day. This included whilst we were reading bed time stories, while we were having dinner, while we were doing anything. I always had plans not to be on call, but that never quite worked out. And you guys could have gotten very upset at me many a time, but you never did. In fact, you usually run to bring me my phone. It’s because of you that I’ve been able to be able to help others over the years, especially after hours.
Oh yes, and my wife, Nathalie. We met in medical school (she’s an anaesthetist now) you see, so we should know each other pretty well by now. But in actual fact, she still never ceases to amaze me. And I have to reveal something perhaps that should be embarrassing, but nevertheless here goes. I have what’s commonly known as a turkey pile. That’s right, out the front of my cupboard, lays a pile of clothes. If you choose to not buy or read this book because of this. I understand and forgive you. But let me tell you something, after years of telling me off, one day, Nathalie stopped telling me off. I still don’t quite get it. She just seemed to accept it. And somehow, it reminded me of something I’d read in Charlie Brown comic “friends don’t try to change you”. Something like that. I want to change my turkey pile, for you Nat, not for me. Except, I’ve got no damn idea how to organise my clothes, that’s the truth! Nathalie, you really have stuck by me through thick and thin. And, as tough as it has made things many a time, you’ve let me loose to take risks and think big. Yet never critised me, when things didn’t pay off. That’s something special. You’re an amazing mamma, friend and wife, grow more beautiful every day, and I love you.
So that’s it, that’s my whole family. I have more people to thank also, my friends, my colleagues, my patients. I am grateful for getting to know all of you in this life.
So with all of that being said, I hope you enjoy this book and get much out of it. It’s my humble yet best attempt to record what I know about helping and caring for the elderly. I hope that by reading it, you may be more empowered, and confident in combating medical dilemmas. Most of all, I hope that this book, by improving medical care, helps more elderly people stay living for as long as possible in their homes. And not just so that they can tip the paperboy at Christmas, although, commit this to memory – “In the midst of all your joy, please don’t forget the paperboy”!
Happy reading ?
A note: since commencing writing this book, my mother has since sadly passed away. May she rest in peace.
