Doctors making a difference: Dr. Fatima Maryam Hussain

This story is part of William Osler Health System’s (Osler) Doctors Making a Difference campaign featuring Osler doctors who are going beyond to improve our community’s health.

According to Statistics Canada, more than 7.8 million Canadians identified themselves as family caregivers in 2018. Udaya Mayurunn and her husband Mayur were among them.

For 15 years, they helped support Udaya’s in-laws to remain living in their own home until her father-in-law was diagnosed with Alzheimer’s disease and her mother-in-law, Parasakthy, could no longer manage his care on her own. After the aging couple moved into the Mayarunn’s home in Brampton in 2017, Udaya’s father-in-law passed away a year later and, by 2019, she and her husband found themselves caring for her ailing mother-in-law.

“For years she had been so busy taking care of my father-in-law that, after he passed away, she began experiencing feelings of emptiness and depression and, after a while, slowly started showing signs of dementia,” said Udaya. Following a referral from a family doctor, the family’s journey with geriatrician Dr. Fatima Maryam Hussain and the multidisciplinary team in Osler’s geriatric clinic began.

“Dr. Hussain was so understanding,” said Udaya. “She would listen to Parasakthy and to me, focus on my mother-in-law’s needs in that moment, and then ask how she and the team could help my husband and I manage her care. It was a place I could go and share what we were experiencing – Dr. Hussain and the team were amazing.”

It was during Parasakthy’s initial assessment at the clinic that Dr. Hussain tentatively diagnosed her with Lewy body dementia (LBD), one of the most common types of dementia after Alzheimer’s disease, based on her clinical history and supporting evidence from diagnostic tests.

“Given her heart history, we worked together with her cardiologist to determine which medications we could start her on to help address hallucinations, trouble with sleep, restlessness and agitation – all symptoms which are hallmarks of LBD, but can also indicate delirium,” said Dr. Hussain.

As Parasakthy’s symptoms progressed, appointments with the geriatric clinic team became more frequent, and during the height of the COVID-19 pandemic, the team pivoted immediately to include virtual appointments to ensure patients and families continued to be supported.

“There are very few things in geriatrics that are curable, so the whole goal of geriatrics is to improve quality of life, improve function so that people can live their best life, and help ensure that not only patients are thriving, but their family caregivers are as well.”

As it is for many caregivers, the Mayurunn’s journey was not an easy one. Both Udaya and her husband worked full-time. With Parasakthy requiring 24/7 care, the couple had to also organize and rely on other family members, as well as community volunteers and home and community supports, to provide coverage.

Dr. Hussain is quick to acknowledge Udaya and her husband for their exemplary care of Paraskathy. “Older people who are frail and vulnerable can’t remain in the community without a lot of investment on the part of family, friends and community services. While our focus is ultimately on the patient, we also need to make sure caregivers are supported and don’t burn out.”

Osler’s geriatric clinic team includes geriatricians, triage nurses, clinic coordinators, nurse practitioners, occupational therapists, physiotherapists, speech language pathologists, a dietitian, clerical staff, and a pharmacist. An outreach team makes home visits, as required, with a social worker, occupational therapist and nurse.

“Osler’s is the first geriatric clinic in Canada to have an interdisciplinary approach to this depth,” said Dr. Hussain. “I’ve watched this clinic grow from one geriatrician and clerical associate to the 20+ team members we have today, and when you enter the clinic, you can just sense how much this team cares about one another and the patients and families we serve.”

As a fifth-generation physician in her family, Dr. Hussain knew from the time she was a child that this was the field she wanted to pursue.

“When I was growing up, we used to have conversations around the dinner table about my great grandfather. The stories suggested that he was able to cure 50 per cent of a patient’s illness just by talking to them. That really resonated with me, so I wanted to pursue a field of medicine that allowed me the time to develop a longer-term therapeutic relationship with patients and families, which is very rare in the fast-paced world of medicine we live in now.”

While Udaya’s mother-in-law passed away in January of this year, she did so peacefully at home surrounded by her children and grandchildren. Udaya is filled with gratitude that they were able to fulfill Parasakthy’s wish to be together as a family at the time of her passing.

“I am so grateful that we had such a strong support system while caring for my mother-in-law, that I make a point of telling other family caregivers about Dr. Hussain and the geriatric clinic team at Osler. I honestly don’t know how we would have managed without their support and guidance. They were always there for us when we needed them most.”

Read about more Osler doctors making a difference.