The Journey Ahead
As we age, our life circumstances change. Unfamiliar issues arise. There are situations which we may have contemplated but never planned for. Deborah Kahn developed The Journey Ahead to provide a resource for older adults and their families to help them work through some of these challenges with an experienced professional. These challenges may include changes in health status, mobility limitations, or cognitive changes. It may also be important for an older person to address or readdress their healthcare goals and advanced care plans, and for their families to understand their goals.
Who is behind The Journey Ahead?
Deborah Kahn has over 20 years of experience practicing medicine as an internist and geriatrician. In that time she has become familiar with the consequences of aging for seniors and their families. Now, she works with older people to put their life changes into context, helping them take control of their future and shape their Journey Ahead.
Deborah's Story
Deborah had been a practicing physician, working in a teaching hospital, caring for seniors and educating medical trainees when her circumstances shifted. She, her husband, and their children moved from the Philadelphia suburbs to San Antonio, Texas. After settling her family into a new environment, Deborah found work with a team of doctors and allied health professionals, providing in-home medical care to people with complex health conditions and limited life expectancies.
The opportunity to visit with patients in their homes was instructive. Deborah was able to learn more about how her patients live, whom they relied upon and who relied upon them. She deepened her appreciation that a patient is more than a constellation of symptoms. Deborah saw how people's life circumstances, more than anything else, affect their wellbeing and also dictate their relationship with the medical community.
During this time, COVID-19 was affecting all of us. It was having a big impact on Deborah's father, Alvin, who was living in an assisted care facility in New York City. He was 96 years old and had mild dementia and other health problems. Because of the COVID lockdown he was unable to socialize and was suffering from the effects of the isolation required to prevent worsening spread of the virus among vulnerable people. His mood and mental abilities were taking a nose dive.
After complicated discussions with her siblings, Deborah, her husband, and their children decided that the most reasonable thing to do was to have her dad move into their home. Fortunately, Deborah was a geriatrician, had some extra room in her home, and had a swimming pool which Alvin would be able to use. She was connected with people who could provide her father medical care and who could give him social support.
Alvin moved in with her family. Deborah then had the opportunity to see aspects of care from the inside. She was also able to work through her own family dilemmas--all the things that come up when caring for a parent:
-Who should be his doctor?
-How aggressive should we be with treating his medical conditions?
-What does he enjoy doing?
-Can we help him have a really good quality of life?
-How do we determine who takes responsibility for what?
-How do we manage expenses?
-What are our goals?
-What are Alvin's goals?
-How do we discuss challenges and make decisions together?
Deborah's situation was made even more complex because she is the youngest of eight in a family with multiple physicians and health professionals. Each family member's opinion was equally valued. Each voice needed to be considered when making decisions which impacted Alvin's life. Some issues were very hard for us to agree upon. Zoom and FaceTime helped us overcome geographic obstacles and allowed us to work through difficulties and differing opinions with the help of technology.
After lots of conferring and contemplation Deborah's family was able to put together a strategy which allowed them to deliver a fitting end to their father's life.
The experience of caring for her father in his final year changed Deborah's perspective. She decided that she was ready to shift her role, from being a physician treating patients' ailments as they age, to consulting with families through one of life's most challenging Journeys. It is for this reason that she developed The Journey Ahead.