Archive for the tag “lifestyle”

Judy Zehr Shares Her Journey With Her Mom

Blissful + Kind-Hearted, October 2013
(full version found at http://eepurl.com/GQ8Az)

Hello dear ones,

Autumn is change; dying back, cooling down, tuning within. Autumn is sky. Autumn is clouds.

My Mom passed away this Autumn. Her ashes were spread under the yellowing Maple leaves behind the church we attended as children, where my Mother and Father were married, where we kids were baptized, where I sang in the choir until I became too cool for church and family and singing hundred year old hymns.

My Mom had become ill with c.diff., a superbug created from our over-use of antibiotics. C. diff isn’t so bad for healthy folks, but it can kill infants and the elderly or people with compromised immune systems. Within 6 weeks my Mom went from walking, going out to lunch, shopping and laughing to wheelchair bound, mumbling, unable to lift her head or complete sentences. She could no longer feed herself, or use the restroom. 

I learned so much trying to help my Mom through this, and I don’t want to assume this will be interesting for all, so if you click on any of the linked blue words throughout this text, you will be able to read one of my lessons. That way, you can skip them or pick and choose what has interest for you. The whole list of lessons is at the bottom of this newsletter.

Of course it is the natural course of life to say goodbye to our parents. My Mother had Alzheimer’s, and she hadn’t really known my husband or children for over ten years. The last couple of years she only had a vague recollection of me. But none of that mattered at the end. Love and forgiveness. That’s one of my lessons, when it boils down to this transition, all you can feel is love and forgiveness. As blessed a transition as birth.

ButterfliesFamilyNature. Death is a great companion, a beautiful mediator, a most powerful guardian, a kiss-blowing spiritual sender- off.

When we experience death and loss we are facing, what we call in Emotional Brain Training (EBT),  an “essential pain” of life. When we face these essential pains, heart open, awake, feeling our real feelings and staying in our body (without numbing, avoiding, hiding, distracting, diverting, etc.) we begin to open up to the earned rewards, or silver linings of life. This is at the heart of spiritual and emotional growth, of our own development, of our personal journey.

I continue to be amazed at how helpful the EBT skills are in traveling through life’s challenges staying in relative balance, connection, and awareness. I found these skills  lifesavers in helping my Mom, family and self through this transition.

This season, I am offering an EBT and Beyondtele-group for advanced participants, and a beginning EBT tele-group for anyone new to the work. I am also offering an EBT providers-only tele-group too. If you are interested in more information or signing up, please email me

This too was one of my lessons, stay true to what you love, be real which means flawed, imperfect, broken. Cherish the falling apart, the aging, the dying. Feel, breathe, sing.

May your Autumn be filled with love, song and what’s real,

Judy

P.S. I found some very nurturing and supportive tools during this time that I’d like to share with you. Click here and you can see some of the books, meditations and practices that seemed to hold me through this transition.

My Lessons:

Clouds

My Mom was born and raised in the Midwest, as was I, right near Lake Michigan. There was something so compelling about the big sky, the big lake, and the glorious clouds that showed up season after season and seemed to prompt us to play, explore, believe. Here in Portland, the sky seems small as we have so many hills and huge trees.

If you are a cloud lover like me, and you haven’t seen this TED talk on clouds, please do so ASAP! What an amazing speaker and group dedicated to clouds. It’s title? Cloudy, with a chance of joy.

 Ashes

Both my parents were cremated and had purchased small “plots” under a “Remembrance Wall” behind the church they attended. One of the most difficult moments was seeing my brother put the ashes down into the ground. I’ve heard the same from friends who witnessed a body’s burial … the sinking of the casket into the ground, the first shovels of dirt dropped upon the casket ….the most devastating, breathless moments.

I realized that for me, there’s secret joy in death – the freedom from the body’s pain, the rising of the spirit, beyond the limits of our senses and perceptions. It seems that death is a great uplifting, and for me, spreading my ashes to the wind and sky feels more nurturing and joyful. Have you thought of your last moments, how you want to celebrate and let go?

C. Diff.

http://www.mayoclinic.com/health/c-difficile/DS00736

“Illness from C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications. However, studies show increasing rates of C. difficile infection among people traditionally not considered high risk, such as younger and healthy individuals without a history of antibiotic use or exposure to health care facilities. Each year, more than a half million people get sick from C. difficile, and in recent years, C. difficile infections have become more frequent, severe and difficult to treat”.

What to do about superbugs? My Mom went into the hospital with a simple UTI, and came out with this virulent bacteria. She never licked it, even after rounds of antibiotics.

One thing we learned, she was not given the strongest antibiotics at first. She was treated with several rounds of ineffective antibiotics, antibiotics that physicians said work in 75% of cases, and are cheaper, so are first defense. If my Mom had received the stronger antibiotic, the one that costs more money and is not the first line of treatment, would she have been able to survive this superbug? Who knows, but what we did learn, for certain, our elders need advocates. My Mom needed the stronger antibiotic. She was in the 25%. She didn’t get it for months, and by the time she got it, she was beyond repair.

Information and advocacy. We all need it, and need it even more as we age.

Help my Mom

Honestly, it’s my Mom that is and was helping me. At her service my brother, sister and I shared some of the stories, values and “Mother wisdom” passed down from my Mom. Here’s what I shared:

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How lucky we are to have grown up with a Mom with such a big heart and strong character.

One thing Mom and I shared was a love for Winnie the Pooh. In fact, she taught me to read with Pooh books. So when Mom was ill I pulled out my old books and started to read. It had been almost 50 years. You can imagine my surprise as I realized Mom and Pooh Bear had amazing similarities – their philosophy of life, their wit and their big heart.

I have four quotes, straight from Winnie the Pooh’s mouth, to show you what I mean:

1. Yesterday is history, tomorrow is a mystery, but today is a gift. That’s why we call it the present.

Mom lived in, and had a deep appreciation for, the present moment. In my generation, where I live, out west, people pay big bucks for fancy retreats to try to learn the Betty Zehr style of living – Be Here Now. Even as she aged and lost her memory, caregivers would tell us how much they loved our Mom, how she taught them to notice and appreciate the little things – the cherry tree blooming outside the window, or the pretty cloud in the sky, as if seeing these things for the first time. 

2. It’s more fun to talk with someone who doesn’t use long, difficult words but rather short, easy words like “what about lunch?”

Mom had a simplicity about her. She didn’t like to analyze things, she didn’t like to get all bothered by ideas, politics, deep discussions. I remember Alison and Dad getting into arguments over politics, economics, society, almost everything, but Mom would always just shrug. She had a “que sera, sera – whatever will be, will be”, approach to life, asking everyone to please calm down, let’s look on the bright side, let’s not worry about that now.

… and what’s for lunch?

3. Love is taking a few steps backward, (maybe even more) … to give way to the happiness of the people you love.

Maybe this describes all Moms, all Dads, all Families. Mom was big on selflessness for the greater good, for family, for community, for nature and life. She put up with cigar smoke, non-stop football, four loud and busy kids, a smorgasbord of pets, I can’t tell you how many wild and other animals I brought home to try to rescue and she’d always help me find a box, or heating pad, or a little eyedropper to try to feed the baby bunny or bird or frog. She rarely raised her voice. She rarely became ruffled. She almost always took a few steps backward to give way to what we loved.

4. I have one more quote, and this final pooh quote really reflects everything I think we are all saying here, with so much love and gratitude for our Mom, and also for our Dad.

How lucky we are to have someone that makes saying goodbye so hard.

Say Goodbye

“Every life comes with a death sentence.”   – Walter White, Breaking Bad.

“I don’t know how you say good-bye to whom and what you love. I don’t know a painless way to do it, don’t know the words to capture a heart so full and a longing so intense.”  – Laura Weiss, The Way It Ends
 
Sigh, my simple lesson here is that there is no good goodbye. Perhaps you’ve experienced a perfect good bye where all words were said, all feelings felt and shared, all peaceful and whole. For me, I learned that expecting this is unreasonable. My goodbyes always feel inadequate, half baked, tongue tied, marginal.
 
The heart so full, the longing so intense. Breathe. Maybe breathe together. Maybe curl up one last moment in a shared breath, a syncopated heartbeat. Touch warm skin. Breathe.

Alzheimer’s 

When my Mom began to lose her memory, first not remembering my husband, then her grandkids, and finally my brother, sister and me, I made the big mistake of following her lead and I began to lose my memory of her too. I know it is cliché, but I tended to become impatient, hurried when around her, focused on the “to do” list and slightly annoyed.
 
I didn’t pull out pictures and reminisce until she was very ill with the c.diff. Pulling out the pictures, making a slide show, sharing photos with my family, all brought my Mom back to life and began the extraordinary wave of love and forgiveness.
 
And that was my lesson. Pull out the photos of your elders and hold the memory, as they lose theirs. Just because they forget, doesn’t mean you have to. Remember the good, the moment of joy, and rejoice in the remembering. Relive it, and it will be a balm for an impatient and annoyed mind.

Love and Forgiveness 

I know we all have constraints on what we can give to and do for each other. But what I learned is that when I nudge myself to give more, to take a more selfless path if possible, the returns are immense. OK, yes, deep fatigue maybe. Maybe it will take a while to get back on my own track, but the love and forgiveness that comes from a bit more selfless path is so worth it.
 
It sounds so cliché, but “what can I give?” is a much more satisfying question than “what can I get?” And it’s that deep, rolling satisfaction that feels like swinging in the sun, laughing alongside a river, walking barefoot on soft grass.

Butterflies

What do you know to be true? What are you not certain about, but have a hunch? I was pondering this one morning as I walked to the hospital to visit my Mother. I realized that I’m not an atheist, but I’m also not a believer in a theistic universe as depicted in any religions I’ve studied. I’m not an agnostic, although I can empathize with that point of view. It’s studying science that fills me with so much wonder and mystery, so much longing and possibility, that I feel certain that there is something greater happening than the simple structures of our every day lives.  In other words, I was thinking about God.
 
Here is what happened. I was pondering all this, at 6 am on a beautiful summer morning, walking to the hospital. Suddenly, a very large black and blue butterfly flew out of a bush right toward me. I grew up in the Midwest, and I have never seen a butterfly like this before. It looked like it belonged in the Amazon. It flew right up to me, and then circled around me. I spun around watching its flight. Time seemed to stand still and it’s large glistening wings flapped in slow motion. I stood breathlessly still as it flew away, in a leisurely, curious way, as if to say ….what was it saying?
 
A butterfly, a symbol of transformation, of the struggle in change and loss and letting go and the stunning beauty, the lightheartedness, the joy of becoming.
 
So maybe it’s simple. May we move through this life becoming. May we welcome death as another transformation into more profound beauty and mystery.

And every common bush afire with God; 
But only he who sees takes off his shoes,
The rest sit around and pluck blackberries

Family

A deeper love and devotion, a wider, more inclusive net. That’s all I can say.

Nature
 
Earth’s crammed with heaven
And every common bush afire with God;
But only he who sees takes off his shoes,
The rest sit around and pluck blackberries.

                                    – Elizabeth Barrett Browning

I know this sounds redundant and simplistic, but almost everyone I work with mentions the joy and comfort found in nature. Some people love walks in the forest. Others love the tides and drama of the ocean. Some love their pets, their backyard birds and gardens. When we ask, what brings you joy, almost everyone mentions some part of nature that they truly love.
 
My Mom loved nature. She had a passion for her garden, birds, rocks, water, trees. Once again I realize am nothing without this stunning green planet to hold me and carry me through. (Have you seen the movie, Gravity, yet?) Time to get off my couch and do what my Mom did, volunteer to support the planet and the nature I love, contribute to organizations that are honoring, saving and respecting nature, wake up and speak up — be a voice that will help make a difference for generations to come.

Companion

“This is how it is not. It is not that we have a meeting with death somewhere out in the future. But rather we are on a pilgrimage here on this planet and death is our great companero, our great companion. It was She who cradled and protected us as were being born from our mother’s thighs. She steps every step we step, sings every song we sing and weeps when we weep and it is She, death, the best friend, who will midwife us again in the second birth at the end of this life, the birth into the next world.”  – Clarissa Pinkola Estes, The Radiant Coat

EBT and Beyond Groups

EBT, Emotional Brain Training, is a comprehensive program which teaches you the skills to retrain your own brain: the way you process stress and the way you cope with challenges, your mood, behavior and focus. EBT was life saving for me, and transformational for so many of my clients. Why? We learn to move away from numbing, negative emotions and moods, addictions and excesses, and move toward feeling, expressing and experiencing life with joy and balance. Participants find results with all sorts of challenges: weight, depression, mood, anxiety, spending, clutter, relationship problems and addiction.
 
I have beginning and advanced telegroups available. Call or email if you have questions.

Sing

One of the things we did at my Mom’s bedside was sing to her. She seemed to recognize many of the old songs we all loved. If nothing else, we got great joy from singing together and sharing those moments of love and loss. We have begun to “sing our grind ins” in EBT, which means sing to ourselves our new expectations, positive, powerful thoughts, affirmations, new beliefs. Sing to ourselves our hopes, dreams and possibilities. Research suggests that we are more likely to remember, and be moved by, a song than simple words.
 
We had a bagpiper at my Mother’s funeral (she was very Scottish) and we had a guitarist play the Beatles song “Blackbird”. Here’s an audio version of this haunting song with lyrics. (covered by Sarah McLachlan). Enjoy.

Books, Meditations and Practices:

The Radiant Coat: Myths and Stories about the Crossing Between Life and Death – Clarissa Pinkola Estes  (borrowed from the wonderful Jeanne Tyler)
 
Reiki Relaxation by BronwenSteine — for some reason this was the only meditation CD that helped me feel better.

The Way To Love by The Last Meditations of Anthony de Mello

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When I Grow Up I Want to Be Wise

owl

I asked my 8-year old granddaughter, Sofia, what she thought “wise” meant. Her response: An older person who is smart and makes good decisions. I guess I would say that at age 8 she is wiser than most of us.

I then began to wonder if we aren’t wise at a young age and for some, again in older years. In between, we are deeply focused on gaining experiences, power, possessions and love, creating a false sense of wisdom.

Why “false”? Because true wisdom as Sofia tells us is not only being smart (“experience” smart, not intellectually smart) but also “making good decisions.” Believing that life experiences and success alone leads to wisdom is not a good decision.

The wise elders I’ve known have had a broad range of life experiences—some held powerful positions and were wealthy but most were of lesser means. Some were religious and others more spiritual. What they have in common is a believe in another power because they know that we can’t get through this life alone and the ability to incorporate life experiences at a “soul” level—a place where we can listen, see and “be” without all the layers of judgment that we learn throughout our life.

hands

Why is wisdom easier in youngest and oldest years? In younger years we haven’t yet incorporated all the taught and lived family and social biases, prejudices and expectations of power and possessions that become the basis for how we view ourselves and others. In older years, as losses accumulate, we realize any success or power or position is fleeting. At that time, the wise elders focus on incorporating all that was good and “not so good” in their past, realizing that all that has happened has made them who they are today and that even in oldest old years we continue to learn, to change, to wake up to a new opportunity to improve and focus on what truly matters in life.

However, choosing a path towards wisdom doesn’t come to everyone. Many become bitter as they view the past as “the best time” or as a time when they made too many mistakes. Meanwhile they exist in a present filled with loneliness and losses—loss of independence, of friends and family, of power and possessions. They may see this as a loss of self and as a time when their God has forgotten them.

Living beyond such tremendous losses and into wisdom that frees us from the weight of a judgmental, power-seeking life is a spiritual journey requiring tremendous faith and forgiveness of self and of others regardless of the injustices we may have experienced. Until we see ourselves as one with all others—those we knew and those we didn’t and one with the universe and with God, wisdom will be elusive.

Finally, wisdom and peace is also about accepting that we aren’t traveling alone. God—whomever that is to each of us—is not only at the center of this journey but is next to us holding our hand, above us watching over each step and beneath us holding us up when we are certain we can’t endure another loss.

Susan

 

Lessons from cooking

bake

I love to cook and always have. I learned to cook by watching my mom and as a youngster, the hardest part was patience—putting ingredients together correctly and slowly and waiting through the baking and cooling time. Today as I made a cake from one of her favorite recipes, I reflected on her patience. The recipe required that I fold in beaten egg whites “until there are no white ribbons running through the batter.” When I was younger—perhaps 40 and below, I would rush the process and usually move on to the next step before the whites were fully integrated. Now I take my time. I enjoy the process of watching the small stripes of white become one with the batter.

At 64, I experience life as a time to move more carefully, slowly, living in the “now” and letting the fullness of each event, each word spoken, settle into and become a new bit of “me”. I fold in the whites of day-to-day experiences more completely.

Of course, I am not always able to live in the present—I still worry about the future—the health and happiness of our children and grandchildren, my husband’s and my health as we age, and affording retirement.  These thoughts lead me to the “what ifs”—what if I hadn’t moved or had stayed in that fulltime job rather than starting my own business, etc.

However, increasingly I realize the futility of worrying over the future, or judging past actions and words of myself and others. I find I am able to move out of distracting and often negative thoughts and back into the present. This new ability to live in the moment, to walk away from unimportant thoughts, to forgive myself and others quickly is a gift of aging. In younger years as we rush through daily life to constantly seeking power and success, living in the now is nearly impossible.

I’ve noticed that our older adult clients—many who are in their 80’s and beyond are considerably more expert at living in the now than I am. Like many life lessons that make us better, stronger, and more adaptable, the many losses of later years are balanced by the gift of forgiveness, tolerance and hope of what is yet to come. I am thankful for my clients and for myself that the gift of now is available as a buffer to loss.

Meanwhile, if you want to watch the ribbons of egg whites disappear as you reflect on integrating your life stories, here’s my mom’s recipe for German Chocolate cake that she probably wrote down in the 1940’s when she was a young housemaker and my Dad was in the war.

German Chocolate Cake

4 ounces German Chocolate if you have it otherwise semi-sweet baking chocolate is OK

½ cup of water (I changed this to ½ cup of coffee—coffee enhances the chocolate)

2 ½ cups cake flour (or 2 ¼ cups regular flour)

1 tsp baking soda

1 tsp salt (I use ½ tsp because I use unsalted butter)

2 cups sugar

1 cup margarine (I always use unsalted butter)

4 large eggs separated

1 tsp vanilla

1 cup buttermilk

Heat oven to 350. Grease and flour three 8 or 9-inch round cake pans. I put parchment paper in the bottom as well.

In small pan (I do this in microwave), heat water (coffee) and add broken up chocolate. After it’s melted, let it cool.

Sift flour, baking soda and salt into a bowl and set aside. Beat room temperature margarine (butter) and add sugar until fluffy. Add egg yolks one at a time incorporating before adding another. Beat in chocolate and vanilla.

Alternately add in flour and buttermilk beating until smooth after each addition.

In a small bowl, beat egg whites until soft peaks form. Fold 1/3 of eggs whites into the batter until you can’t see any ribbons of egg whites. Then folk in remaining egg whites completely and quickly. Divide the batter into the three pans and bake. If you can’t fit all three pans in the oven, put the third one in the fridge.

Bake about 20-30 minutes testing for doneness. The cake should spring back when you touch it gently or test with a toothpick.

Coconut-pecan frosting

1 can condensed (sweetened) milk

2 eggs

1 cube margarine (unsalted butter please!)

1/2 tsp salt

1 tsp vanilla

1 ½ cups of coconut (best if you lightly toast this in the oven or in a pan on the stove in advance)

1 cup pecans chopped (I also toast these lightly)

In a medium sized sauce pan over a low flame, slowly heat butter, condensed milk and eggs, continuously stirring. Let come to a slow boil for a couple of minutes (stir carefully so it doesn’t burn on the bottom). Remove from heat, add vanilla, coconut and pecans.

When the cake is completely cooked, assemble the cake, spreading frosting between the layers and on the top of the cake—no need to do the sides unless you want to. The frosting is very sweet so doing the side of the cake can be overwhelming.

~Susan

You found the right assisted care facility but can your parent stay there long-term?

elderman

Be very careful when you help your parents move to an assisted living facility because they may be kicked out just when they settled in and think of the place as “home.”

Why?  Assisted care is just that—“assisting” a person who isn’t doing well at home and needs help with what are referred to as “activities of daily living” or ADLs. These include bathing, toileting, dressing and transferring (from bed to walker or wheel chair, etc) and help taking medications. Think of ADLs as the “personal” chores of day-to-day life. The assisted care staff is more “custodial” versus the “skilled” care of a nursing home. However, an RN is often on staff of the assisted care facility and able to administer some procedures such as insulin injections multiple times each day if needed. The decision about what is offered can vary from facility to facility and the monthly fee usually increases with escalating care needs.

When searching for the right facility for clients, most have said they will even keep the elder if they should suffer Alzheimer’s or other types of dementia.  As long as the client isn’t on an IV or some type of advanced procedure, they would be able to live out their life within the assisted care facility. This is important to older adults and their adult children because transitions are extremely difficult for elders. I’ve known of cases where within a few days or weeks of such a move, the very healthy elder died. The move was simply too much to absorb in a life already filled with losses.

Since few older adults will require skilled care provided in a nursing home, the assisted care facility should ideally be their last move. If they suffer a fall or pneumonia or other disease or injury require skilled care, they may be required to move to a nursing home for a brief stay to recover but then they should be able to return to their assisted care facility.

However in a two situations we recently experienced with elders we knew, the elder was asked to leave the assisted care facility. In these cases, it was determined by the assisted care facility administrators that client’s level of care had escalated and now required skilled nursing care that could only be provided in a nursing home.

On the outset, while sad that the elder must move again, it seems reasonable if the care required had truly gone beyond what was normally provided in assisted care.

However, in each of these cases, the children of the elder and the elders themselves stated that while they needed more support dressing or transferring, etc, they weren’t on IVs, in a coma or requiring advanced medical procedures or experienced nursing beyond medication management.

What these cases had in common was that each of the elders had outlived their personal financial resources and had transitioned to Medicaid support which pays less than the rates typically charged by facilities. In both cases, these facilities said they would keep clients who began as private pay and moved to Medicaid so they couldn’t ask the clients to leave based on the change in finances. However, they could make them leave if they could prove the elder required skilled care. I found it interesting that in two cases mentioned, the assisted care facility had been taken over by a large chain. One can’t help but wonder if the new owners wanted only private pay clients in order to maximize their income potential.

In both circumstances, the elders and/or their adult children filed a grievance and both won their cases allowing the older adult to remain in the assisted care facility.

If you think it’s possible that your parent could outlive her resources when moving to assisted care, be sure you understand the facility’s policies about Medicaid. Additionally, if your parent is asked to move, you can and should appeal.  As part of this process, get an ombudsman involved. If you are in Oregon, go to: http://www.oregon.gov/LTCO/Pages/index.aspx. If you are in any other state, Google “long term care ombudsman in XXX [your state]” or call the local Area Agency on Aging (AAA).

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Finally, when considering the possibility of moving your parent to a facility, call a geriatric care manager (GCM). We are experienced in listening to yours and your parents concerns and needs and advising about programs and support available that may allow them to stay at home. When moving is necessary for safety, we will help select the right facility that will support safety while also encouraging maximum, capable independence.

~ Susan

 

 

At Disneyland with Tonsillitis

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Unable to sleep at night, anxious with anticipation, I was days away from my first trip to Disneyland at age 8. Then, a day prior, I woke up with tonsillitis. I didn’t tell my parents because I wasn’t about to miss out on the Magical Kingdom. Although my throat was on fire, the pain was more tolerable when I walked through the gates and into the make believe world full of characters I had only seen on TV on Saturday morning.

Pain—whether emotional or physical—is often with us throughout our lives and we often tolerate discomfort by focusing on something external similar to my childhood trip to Disneyland. As adults, this is often a materialistic reward—a new dress, piece of furniture, a vacation or a new car.

As we age into oldest years, both emotional and physical pain from illness, loss of independence and death of loved ones surrounds us each day. Tolerating these injustices by looking forward to diversions is more difficult as we are limited in what we can do or experience.  We can’t plan a day at the park or a visit to a friend if we don’t have transportation. We can’t “buy” our way out of pain if we are on a fixed income.

Yet, according to research, while most older adults will admit to multiple illnesses or physical limitations, they also claim to be happy and in good health. Why is that? Fortunately, for most, they have given up the false comforts of materialism and instead, they enjoy reflecting upon an inner strength that allows them to live in a state of hope and purpose that helps them tolerate pain. Many older adults and researchers refer to this inner strength as spirituality.

Spirituality for some is about a structured religious experience; others reflect on their inner strength that comes from a God that they have defined; others look to nature to provide meaning; and for others, their inner joy and healing may come from the experience of their creative selves.

In working with the oldest old and I am touched by the heroic efforts to mitigate the pain and loss that is present for most. Their simple, pure expression of spirituality gives joy, hope and purpose. We all have the opportunity to call upon this strength but it requires a conscious exploration of what spirituality means to each of us individually.

Often, we find the time to explore our inner strength only when the artificial diversions that come from a materialistic life are removed. No Disneyland, no trip to the mall, no trip to the Caribbean; just the quiet to explore the strength within.

~ Susan

TRIPS, POPCORN AND MOVIES FOR PARENTS!

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When I began looking at assisted living homes for my 92-year old dad, I found some amazing places offering game rooms, ice-cream parlors, all-day popcorn machines, opportunities for group trips to casinos and even cruises. Wow. I was ready to move in myself.

Most of the large and/or chain assisted living or continuing-care homes have well-paid marketing specialists who realize that their target audience is often the adult children of older adults. These adult children are often active Boomers who, themselves, would enjoy having a full schedule of activities available.

It’s hard, at any age, to think of those much younger or much older than we are so we think about what it’s like for us and apply those feelings and thoughts to our parents.

I try to remind myself that at 64, I don’t want, need or enjoy many of the accouterments of a 35-year old. I would hate for my 35-year-old son to define my lifestyle through his personal perspective of what brings him joy and purpose.

If it’s necessary for your parents to move into some type of assisted living, consider bringing in an objective third party such as a Geriatric Care Manager experienced in working with elders. Then, with this objective third party, you and your parent(s) can explore what environment truly supports an empowering and purposeful daily life. Many, particularly when over 85, prefer a smaller environment that is better supported in adult foster care or, if at all possible, additional help so that they can “age in place” in their home.

 

 

5 Ways to Shake Up a Caregiving Rut

ducky

Are you feeling exhausted, stressed out, guilty or plain fed-up about caring for an elder? Often when a caregiver is frustrated, so is the elder. Stop doing what you are doing that isn’t working and consider SHAKING IT UP!

Time Together

Elder: As we age in to the oldest old years it becomes a time of loss. Elders lose friends, physical abilities, independence, dignity and seemingly anything resembling control. Everyone else thinks they know what’s best for them and often do not bother to ask for the elder’s opinion. Decisions from the unimportant issues like when they may want a bath or what they want to eat to the big life changes like taking away a driver’s license or deciding where they want to live. These choices become dependent on other’s availability or needs rather than the desires of the elder.  Often days are filled with an abundance of time to focus on not feeling well, medication concerns or side effects, next doctor’s appointments, boredom, and how to get some more attention from whom ever can fit you in to their busy schedules. It’s no wonder elders have a reputation for being cranky. Depression and suicide rates are high in the elderly. White males over 80 have the highest suicide rates in the elder population. National Institute Mental Health reports, “Depressive disorder is not a normal part of aging. Emotional experiences of sadness, grief, response to loss, and temporary “blue” moods are normal. Persistent depression that interferes significantly with ability to function is not.” The problem with negative feelings in the brain is when we dwell in negative thoughts we have more negative thoughts, so disruption in the situational sadness may help those with normal mood changes become more engaged.

 

Caregiver: Maybe you love the person you care for, maybe you don’t, but either way you are the one in the trenches doing the work. If you’re lucky you have support from other family and friends, but then again they may be causing a lot of the stress involved in caring for an elder. But still, each day you roll up your sleeves and do it all from errands and medical visits to cleaning backsides and dirty dishes, only to get up and do it all again tomorrow. If you are a long distance caregiver you spend twice as much money as a local caregiver trying to support your elder and panic every time the phone rings, not to mention the struggle with guilt that you want to be with your elder more; or guilt because you are happy to be with them less. You hear about self-care and how important it is, but you are baffled by who has time when your head is down and you are just trying to get through the day, week, and month! Possibly you are part of the sandwich group who have several generations you are caring for at home and another job outside the home.

Does any of this resemble what is unfolding for you in your caregiving journey? Well you are in a very large club. In 2012, 15.4 million family and friends provided 17.5 billion hours of unpaid care to those with Alzheimer’s and other dementias alone. Eighty percent of care provided in the community

is delivered by unpaid caregivers. and the majority of caregivers are women over 45. With numbers like these, being in a caregiver’s rut could be the next national health hazard!

 

So how do we shake it up, find the silver linings or just simply do it different? Let’s begin with deconstructing the pattern…

 

  1. Dialogue ~ look at the routine you have when talking with an elder. Is it utilitarian habit or are you engaged in meaningful conversations? Do you talk to them as a petulant child or cower every time they raise their opinion? Communication tools can go a long way here. If the elder you care for has cognitive disorders, watch some of Teepa Snow’s http://teepasnow.com/wp/ training videos on communication skills for elders with dementia and Alzheimer’s disease or catch one of her talks locally (see her website for details). Some very basic changes can make a world of difference. For mentally healthy elders, communication tools are still very useful. Lifelong patterns over the family life course can make it difficult to change patterns but there are tools to help. Activities that create new ways of talking can be around the elder’s need to share stories. Engage in storytelling tools and activities at a level the person can handle. From computers, journaling, genealogy research or simply inquisitively chatting over a bath or over the phone can make a mundane activity more of an adventure. Elders have a need to tell their stories over and over as a way of processing their lives as time here grows shorter. This is where the details of life live and this rich activity will yield pearls for you as well as the elder.
  2. Outings ~ A friend recently told me that upon visiting her parents a few months ago in another state she took them out for a drive. Her father barely ambulatory and her mother prone to falls were thrilled to be going out. On this journey she surprised them and took them to their favorite Jazz Club where they went when they were younger. She enlisted the help of a waiter and got them situated in the back of the room. As the music played on she said she could see the years melt away and their younger selves emerge. For 3 hours they enjoyed a part of life that had been lost to them. They have a code name now for when she comes to visit so that other family members do not know what they are up to on these outings. How empowering! This could not have been an easy outing for my friend, but it gave her immense pleasure and changed her parent’s outlook completely. If this is too adventurous for your elder perhaps just a drive around town; or closer to home set up a Skype session with an old friend, do some snail mail letter writing or perhaps engage in a beloved hobby like baking where they can sit close by and “teach” you a favorite recipe. If your elder has cognitive issues, setting the table, walking through the garden, folding laundry, or dancing all become enjoyable new adventures. Don’t give into the usual routine; Shake It Up so it is fun for you as well. Portland has a beautiful Alzheimer’s memory garden where you can take your elder (http://www.portlandmemorygarden.org/PMG/Welcome.html).
  3. Self Care ~ OK we are diving in the deep end now. Funds are low, time is scarce and what is self care anyway? Simply put it is a change of environment to recharge your batteries. Connect with the spiritual side by gardening, taking a labyrinth walk, attending church or joining a choir or painting class. Identify something that brings personal joy and fulfillment for a few minutes a day and a few hours a week and a few days a month. No one will give you permission to enjoy something without regard for others, so you must be strong enough to go for it without permission from anyone but yourself. Typically caregivers put themselves last, which makes you the worst advocate for your own selfcare. By putting yourself last, you will likely have less patience and unlikely to find joy in your caregiving role. Magical things happen when you practice self care. Perhaps your biggest challenge is getting a good night’s sleep. If you can afford it, hire a professional caregiver to come in 2 nights a week so you know you will get some relief. If you are long distance, hire a Geriatric Care Manager to pop in and check on your elder and/or his care givers every week or month. If funds are tight, barter with friends to come spend the night in exchange for a homemade pie or watching their elder or child during the day. Get creative and reach out to local support groups and social services that will allow you the time you need when you need it. If you schedule it on the calendar it will happen. There are some ways to combine self care with your care giving activities. Give your elder a sacred foot massage and make a ritual of lighting a candle and using lotion or oil with a scent like lavender or chamomile. Then if the elder is able have them do the same to you. If you can afford to have someone come in and give you both foot massages then make it a weekly or monthly routine. There are many massage therapists who will come to your home. My favorites are Sister Emma at the Franciscan Center in Milwaukie, Oregon (503-794-8542) or Sister Delores at St. Mary’s in Beaverton (503- 944-9641). The important thing is to schedule the time and make sure it happens. Have someone come in for one day a week and you decide what you feel like doing that day. The answer may be nothing or a nap. That is OK! Learning to ask for help is the biggest challenge for caregivers. Do it, you will be surprised where the help comes from. You will be surprised once a routine is in place how your relationship with your elder improves. They may protest at first or even always when you leave them, but the benefits will come.
  4. Empowerment ~ it can be exhausting making decisions for another human being. Too often feelings of guilt or inadequacy flood in even when you are doing just fine. Know that nothing in the world is perfect and you simply being there is an amazing gift. The rest is all gravy. To help cope with the times it can be emotionally overwhelming, try learning a few mindfulness techniques. Our local psycho-therapist Donald Altman (http://www.mindfulpractices.com/) has some great tools for breathing and meditation that can help when things get stressful for you or if your elder is in a funk. Space cannot always be achieved physically, so having techniques to navigate through these times is priceless. These tools can be used by your elder as well. One of the best methods to decreasing your decision fatigue is by giving back some of the responsibility to the elder. Depending on your situation, the answer may be a modified version, but honoring their level of ability to give an opinion can go along way for both of you. Give your elder decision making power whenever possible. You are there to keep them safe. There are also local classes available designed by Legacy Health for Caregiver Help. This course is offered in many places from senior centers, hospitals, and even at the Franciscan Spiritual Center. The course is designed to teach you about community resources, care strategies, support group and self care. All great ideas to Shake Up your current routine.
  5. The Unexpected ~ If you haven’t already, begin building a support network: Online, in-person or host a weekly meeting in your home. Whatever you have to do to be with others going through the same important work you are doing. It is too common to become isolated with an elder. This is not good for you or them. Have some social activities in the home even if your elder does not engage. The presence of others can be soothing or annoying, so be aware of the best format for your situation. Online could be a great way to support long distance caregivers, start a facebook group and open it up for members. As life unfolds with your elder health challenges may increase, a need for hospice may arrive, or a medical need for a move into a nursing home or rehab center may happen. All of these situations can create crisis and stress for the caregiver and elder alike. Having medical, social, and caregiver support nets in-place can make the transitions easier. Our Geriatric Care Manager services can also be part of this safety net, there to pull the resources together to make sure the decisions for your elder are coordinated and serve the elder’s best interest through advocacy and care planning. Our website also offers tools and resources to help with these transitions www.FiresideCMG.com

 

As we advance in life it becomes more and more difficult, but in fighting the

difficulties the inmost strength of the heart is developed.

                                                                           – Vincent van Gogh

 

Ten Minutes

Tired from a turn-around trip that began with a 6:15 am flight out of Portland, I waited at San Jose Terminal B, gate 23 for my return flight on Southwest. I had spend much of the past week preparing for the new business meeting that took me to San Jose. As I sat in the terminal following the meeting, I contemplated business, the slow economic recovery, money and retirement. Looking up from deep thoughts, I noted an older man, somewhat disheveled walking unevenly and tentatively toward the gate counter. With shaky hands he withdrew his ticket from his shirt pocket handing it to the gate agent, “Am I in the right place?” She responded automatically, “Yes” and offered nothing else. He looked around and walked towards the empty chair next to me. Knowing he was uncomfortable, I wanted to make up for the insensitivity of the gate agent.

I began, “Hi, are you flying home to Portland or visiting someone?”

“I’m going to visit my son. I haven’t flown in a very long time and I feel so unsure of myself.”

“It’s fine. Together we can listen for the boarding call and then I can show you where to line up. Has it been a long time since you’ve seen your son?”

Tears filled his eyes as he replied, “No, he and his brothers and sisters have visited me often recently. Their mom died three months ago after being on life support for too long.  It’s an awfully hard decision to know when to say “it’s time’ after more than 60 years of a life together. I just couldn’t let go and I think I made her suffer too long.”

 

Filled with his pain, I offered what seemed like empty platitudes, “There’s no way to know when the time is right and no one can guide that decision. It’s something you worked though, and when you were ready and you felt she was ready, you let her go.  There’s no timeline for letting go of the person you’ve loved so dearly.”

His smile of appreciation felt undeserved.

“I’m John.”

“Hi John. I’m Susan. It’s so nice to meet such a brave man.”

With a weak chuckle he said, “I’m not brave. In fact, I know this will sound bad but I’m not sure I will choose to stay around much longer. That must sound awful to you, but each day when I begin to wake and reach over to the empty place on the bed, I can barely breathe. I lay in bed sometimes till afternoon. Just waiting for the pain to leave, for her to talk to me, for something…I don’t even know what. I’m so empty inside.”

Frozen in grief I couldn’t find words, and I knew that nothing I said could answer his need.  Still the energy connection gripped me. His heaviness was now mine as well.

Slowly and painfully I offered, “I don’t judge you. I have told my children that I when I’m done, I’m done. My father died recently—he was 95 and he very much wanted to die for the last two years of his life. It hurt me terribly to watch him. He even asked me to help him die and I could do nothing.  He thought he wanted to die when he was about 85 and my mother died. The first year was the worst.  After that he began going back to church, getting out a little more, and he found he had more life to live. Meaning and purpose may shift for you too.”

“I don’t know. I can’t see beyond today. I don’t really want to visit my son although I love him. It takes so much energy and I’m exhausted. I’m hoping that if I force myself, I might find some relief.  Traveling is hard on me. I’m uncomfortable asking for help or directions. I feel like people look at me like I’m just a helpless old man. I’m getting forgetful—happens when you are old.”

“John, I’m forgetful and I’m 63. I don’t know when this “forgetfulness” started for you but it started for me in my 20’s when I had four children!  It’s not exclusive to being older. It comes about because we accumulate years and years of to do lists, of birthdays, of 85 years worth of schedules and memories we want to hold onto.  People think so many things are old age related when in fact aging begins the day we’re born.”

He laughed and his hand grabbed my hand and he simply said “Thank you.”

The gate agent called for A boarding—my group. I asked John to move closer to the lines and told him that when they called for B boarding he would line up in the first column pointing to where he should stand. Noticing a seat near the line I suggested he sit until it was time to line up. As we walked together, I noticed a young woman making her way toward the seat. Touching her arm I asked if she’d mind if John sat. She nodded to him and said, “Of course not.”

John looked at her slyly and said, “Or I could sit and you could sit on my lap.”  Pleased with himself he lit up and we all laughed.

I was hopeful as I boarded the plane that his momentary joy might be a brief peek into a life of renewed purpose. He is such a beautiful soul and to have him leave this world early would be a loss for all those whose life he touched, including me. Ten minutes with John and my life is forever changed.

Susan Cain, Sometimes weary but recently enlightened life course traveler

Enjoying the Gifts of Aging

 

In our last blog, we wrote about the challenges of aging that can include significant loss but also comes with important gifts. In this blog, we explore how to find those gifts through reflection.

Reflection in older years, for most, is more than reviewing an event or a lifetime of events—it is an integration of all that one has experienced, of moving beyond the labels of “good” or “bad” and into a sense of comfort that, overall, we are complete.  In Aged by Culture, Margaret Morganroth Guelette’s beautifully speaks to the process of integration and the gift that comes:

If, in telling our state-of-being, we find some co-identities disliked but admitted; some discarded or defunct;    some unchanged; some improving; some in flux of new importance; some about loss and some about gain—all in all, the storied identities feel like possessions. Mine. Achievements of my telling and of my aging. Such achievements deeply and rightly matter to people.

English: Portrait of old woman sitting by a wi...

So if this “gift” is so available to all, why might older adults miss this opportunity? It’s not an issue of training or education—researchers have found that the desire to spend solitary time in reflection happens naturally for most. Yet, the compression of losses that often accompany oldest-old years can create a barrier to thoughts of anything beyond the very present pain and sadness that can accompany physical, emotional and cognitive decline.

As a loved one, friend or care provider, you can’t force anyone into seeking or walking the path toward integration. However, you can help create opportunities to connect with the deeper more soulful self that can lead to renewed spirituality and purpose.

It’s important that quiet time older adults spend reading, reflecting, and praying is respected as growth and not disparaged or seen and referenced as “living in the past” or labeling the older adult as depressed and withdrawn. Allow as much time as desired for the older adult to review, reflect, and rest in the quiet of contemplative thought.  If the older adult is open to talking about their past, ask questions and listen, listen, listen. If you are close to this older adult, your memory of an event may be different—avoid telling your version or offering any contradiction or correction, and instead embrace the process and the potential.

Some older adults connect to their integrated self through a more active participation with friends, relatives or others exploring and recording their autobiography. This can be approached informally by taping or writing either by the older adult or the stories can be told to someone who can transcribe the interview. Additionally, there are experts who can help create this opportunity including personal historians: http://www.personalhistorians.org/tell/find.php and Guided Autobiography (http://www.guidedautobiography.com/ ), also known as GAB. Some senior centers offer “narrative aging” groups. The Q Center in Portland offers such meetings led by fellow gerontologist, Susan Kocen.

elder kondeli yogi

Whether quietly reflecting over ones life or writing or telling one’s life story, the end result is often the awareness of one’s wisdom that comes from an accepted, honored, and integrated life. Recognizing wisdom that comes from a long lived life is not only a healing process leading to renewed purpose, but sharing that wisdom creates good will and connects generations that are often separated.

~ Susan

Changing The Discussion From “Age As Loss” to “Aging With Gifts”

Aging into “older” years is often feared and imagined as a sad time primarily marked by losses. The losses begin slowly—for most in their late 40’s: The graying and loss of hair and development of hearing and vision issues; loss of our ideal body image as we lose muscle mass and gain unwanted fat; loss of roles in leadership and power positions within the community and workforce. These may seem significant yet they pale in comparison to the losses yet to come: Of loved ones who precede us in death; of independence as we give up our driver’s license; of dignity as we find ourselves relying on others to help us overcome limitations caused by physical and/or cognitive losses; of our image of “home” as people move into our home to care for us or we move to assisted living facilities. The Government and science dwell on these losses. The Government worries about how to address the wave of Boomers that will all too soon become “needy” for financial support. Science sees dollars and interesting challenges in improving and prolonging life.

Interestingly, at any age or developmental stage, we can measure life by losses rather than gains. Our 30’s—a time of infinite possibilities for many—often includes tremendous loss as we begin our families: Decreased expendable income resulting from the medical bills, day care and education; the concern of childhood illnesses; increased expenses, demanding careers can leave us worried and sleepless. In our late 40’s we are often “empty nested” and find ourselves financially struggling in order to pay for college; perhaps we must downsize our home. Nevertheless, most see this time not in loss but rather as new opportunities to travel, to re-engage with our spouse, to identify a new lifestyle, to get back to a healthy body.

Why is it we aren’t as willing to embrace the opportunities of late life as we are in our younger years? Perhaps because in our 30’s, 40’s and 50’s we have so much life ahead to change our direction, to make new decisions, to experience “more”. Life abounds with external opportunities to prove our limitless selves. In our 70’s and 80’s and beyond, the runway is getting shorter and we become a science and we re bombarded with messages of “age as loss”. Nevertheless research has shown that there are tremendous gifts available to us in our older years that are unavailable to younger adults.

These gifts include the beauty of solitude: of a time when we can spend long hours reflecting on the meaning and purpose of our lives, explore our creative selves, participate in the joy and promise of spirituality. Older adults tend not to dwell on “what if” or “if only”, nor do they become stuck on the “not so good decisions” they made in younger years. Instead life shows itself as a rich integration of each and every experience—the good and not so good decisions. They come together to make us who we have become. This quiet time of reflection, of letting go of the materialistic and even power over our own bodies is a gift that can bring comfort and peace to guide us through the challenging terrain of aging into our final years.

As with any developmental stage of life, this path to an enlightened older self isn’t a direct path and it isn’t automatic or even easy. There is no denying that those experiencing older years will suffer physically and emotionally. However, as we give up control and power, we attain the ultimate gift: the wise spiritual self who is now freed to imagine and embrace that which is yet to come.

The older adult may need support in finding this time as “gift” rather than loss. But that is another blog. If you want ideas about how to support the enjoyment of being an older adult or how to support your parents’ opportunity in older years, watch for my next blog: “Enjoying the Gifts of Aging”.

~ Susan

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