Wednesday, December 28, 2011

ALWAYS BEGINNING 5

I don’t even know how to say it. Must I be technical before the computer case is even removed? Can diagnosis be accomplished from the lack of activity on my monitor? If the heart stops beating must I give the cardiac description?

Or may I simplistically wail in anguish, “It’s dead!”

This December I have mourned dear friends who died this year. I grieve with friends who have lost family members too early.

To write of the death of my computer is hardly of the same seriousness. But the last week has been traumatic and continues to be frantically upsetting as I search for saved files and documents, research noted from many thick books I don’t want to re-read.

The memorial service for a dear friend was held in November. Memories of his emails and humor cause me to smile. His dog was an effervescent, shaggy sheep dog and they were not dissimilar. (It must be said that our friend's mind was sharper.)

Another friend is also gone but his life and relationship pokes hard edged into our memories. He was self-serving and often abusive. Enough said.

I remember the year my Uncle’s 5 & 10 store burned to the ground. The pain in my abdomen was similar to losing a beloved family member.

December is a month of remembering people and what we have lost. Our task is to sort through the memories, our shared experiences, conversations as well as words we never said.

As we remember clear eyed, we see what we wish to emulate and the characteristics we resented and need to leave behind. 

Part of the burden of loss is that we must deliberately build a new normal. A friend bemoaned her teenage son's behavior. The important question was, “is he dead?” If he isn’t she can seek guidance being the unconditional loving mother he wished he had. When we change, others change in order to regain their balance. As long as we are in the land of the living, we consider circumstances and choose a new beginning each day. 

And what person shall I become in the new year?

 

Saturday, December 24, 2011

ALWAYS BEGINNING 4

I have finally discovered the secret to giving the perfect gift. At the same time I found the solution to less-than-perfectly-wrapped presents.

Mostly my immediate family doesn’t exchange presents.

For the extended bunch I craft a plethora of similar products, wrap each in tissue and ship the whole thing across country in a $10 box to my mother. She spreads them out on the sofa and everyone chooses what they like. If they don’t like, they don’t choose. The expectations and hurt feelings that have accompanied giving and receiving in the past don’t appear. Furthermore, I’m not there.

Seeking perfection is like living a delusion. Significant people materialize only in our minds and their past criticisms sound deep into our subconscious. The noises drown out reason. I have it in my power to cut the tow lines and think gracious, self-enriching thoughts. I can choose to watch HGTV artists produce seemingly perfect beauty, and smile contentedly at the simple plastic, red apples I got free years ago.

If I choose the delusion I need to ask myself what I am getting out of it. And what I am missing.

There is a result of continually expecting perfection: Guilt. A recovering alcoholic friend was fond of saying Guilt is the gift that keeps on giving.

Forgiveness, first of myself and then of others, teases out of my experience anger, impatience, and lies that were never true. Once in the light of day they can be replaced and dumped. The best gifts to give are Forgiveness and Grace, beautiful kindnesses that accept reality but are never defeated by it.

Forgiveness is always a challenge, but especially at Christmas (or Hannukah). If I don’t find forgiveness in my stash of gifts, I will pack a load of guilt onto my sleigh. The sleigh will pick up speed and run me over. ("Grandma got run over by a reindeer....")

May you be blessed in your beginnings. 




Wednesday, December 14, 2011

ALWAYS BEGINNING 3

Television networks are airing Christmas musical specials, both new and repeats from previous years. How many ways can one sing “White Christmas?” Church children perform various sketches for adoring grandparents and friends. (Perhaps this year a five-year-old will raise her skirt or shout the lyrics at the top of his lungs.) Crèche scenes are displayed on folks’ front lawns along with Santa, Walt Disney characters and miles of colorful lights.

The message is that this is the "most wonderful time of the year." In some homes this may be unequivocally true. For others the gatherings of family have proven disastrous in previous years.

The Christmas card I received yesterday proclaimed Peace on Earth and Good Will to All Men.

Through past experience I admit that I am only moderately capable of producing either. I accept the reality and relax. I forgive myself and my family for our individual oddities and annoyances. I become more skillful each year at picking the hype of Merry, Merry, Merry, Merry Christmas like lint off my shoulder.

Time to turn on the colored lights, turn off all others and rock slowly in the near dark. Breathe in Grace. Breathe out Peace.


Perhaps this year I can simply hope there is something here that doesn’t depend on me.

Wednesday, December 7, 2011

ALWAYS BEGINNING 2

How can a beginning be numbered? By definition a beginning is always first.

But beginnings do not spring from nothing. Diets are easily begun on Monday morning after a weekend of caloric infusion.

Even mold needs a wet dishrag neglected beneath the sink, or a remnant of cottage cheese forgotten in the back of the refrigerator.

Beginning may happen when we turn from a previous purpose or direction and step away, reaching for new support as we go. We carry wisps of the past clinging to our coat tails and deep in our heart. Inaugurating a new profession, we view each new experience in contrast to the last work, office, or management.

As we step up to take on caregiving for a parent or spouse, we wear our previous relationship even as we reach for the new cloak of responsibility. Unless the parent or spouse is comatose, they also remember their role in caring for us and how we disappointed or made them proud. We should not be surprised when regrets and conflict materialize like steam issues as cold and warm collide.

Beginnings can take us by surprise when our plans become disrupted. Winter drops cold temperatures onto us as we sleep through what we didn’t know would be the last autumn night. A fall, stroke or medical prognosis declares life as we know it at an end. The financial picture of our employer shatters into unemployment. We are pushed into a new beginning.


When we review the beginnings we experienced in our past, we can take heart. We survived before and will flourish as we begin again.


Wednesday, November 30, 2011

ALWAYS BEGINNING

Another season is beginning.

Public Television has brought out their Christmas concerts and married them to fund raising pledge drives. PUD is busily hacking tree limbs away from power lines. Snow plows and sanding trucks are lined up at the mountain passes. Sensible drivers who must traverse those passes are buying new tires for their cars.

Every evening more of our neighbors drape lights around their roof lines. We bought new outside lights last year and stored them so cleverly that we needed to visit Ace Hardware and purchase new this year. The cardboard point-of-sales signs declared our lights were priced 50% below usual. $9.95! But since the cardboard wrapping the lights made the same claim, I am suspicious of a marketing conspiracy. Our lights are 50% smaller than the LED bulbs sold at $15.95.

Our new lights are mounted on the back of the house so they can be seen by the hundred some neighbors coming up Ocean on their way home. We also purchased pre-lighted swags to drape over the dining room doors. They can be seen from 51st Place cul de sac through our front kitchen windows. We only have five neighbors who might turn their heads as they anticipate the corner, so these are interior decorations.

The swags also serve as our tree. Heeding the admonition that what goes up must come down, we have conserved our energies and declared our decorations sufficient.

November 2010 the bulb in our front light post died and Harvey replaced it. He gave our residents the choice of red, green, or white. The discussion was hilarious and we ultimately voted for green. It has been green all year and is still shining appropriately for the 2011 Christmas season.

Maxine Kumin has written a book of “Essays on a life in Poetry.” Her title is Always Beginning.

In the midst of change and decline there is always a beginning of something new. We may not appreciate the resulting status, but homeostasis runs in our blood and we adjust. Each day brings a new beginning.  Four times a year, a new season.


Kumin, Maxine. Always Beginning. Essays on a life in Poetry.

Wednesday, November 23, 2011

THANKSGIVING

I give thanks today for elastic. The spongy strings avoid necessary strain to get a button through the hole.

I give thanks today for plastic. Lightweight and sturdy, it doesn’t shatter into thousands of glass shards. Colorful and whimsical, it gives joy to the user.

I give thanks today for fleece and flannel that softly wrap and warm us during our cold, winter rains.

I give thanks today for caregivers who take on the needs of our residents as though they were the risk takers, because they really do care.

I give thanks today for families who regularly demonstrate concern for their loved senior, but trust us to supply their daily needs of food and what comes after, comfort and joy.

I give thanks for each of you who read and respond to Adagio Lyrics. May you be blessed in your own thanksgivings.

Sunday, November 20, 2011

NOTHING STAYS THE SAME

Insanity is reaching 60 and expecting the body and mind to function like 40, or perhaps 40 as if 20.  No one ever wishes for younger than 20 because teenagers are insane. For that matter, I’m surprised anyone considered me of much value before 50. So much to learn and so hard to admit there was a world I didn’t know.

On her 70th birthday my mother exclaimed distress that she wasn’t perfect yet. I’ve never considered perfection a worthy goal. I prefer the connotations of flawless. The novelist’s lovely heroine was of flawless complexion with her every hair effortlessly in place. But how do you dig up gladiolas and replant garlic, chase children with no hope of catching them, hug a woman who has lost her baby, and retain the appearance of flawless. I guess that’s why our heroine exists in fiction.

We reach a point of decision: what is worth our time and energy? Why beat ourselves up when we need to set something aside for the time being?

We have all experienced being the caregiver whether with our children or parents, or a friend in need. In those times we can free ourselves from a lot of guilt if we relinquish the insanity of being perfect, flawless and especially the appearance of either.

In the Sept/Oct issue of Today’s Caregiver magazine, Dr. James Huysman writes on the Halloween theme of the mask of perfection. He identifies the danger of berating ourselves over our inability to do everything, and asks “who will care for you when you collapse from the effort?”




Saturday, November 12, 2011

NOTHING STAYS THE SAME 3

Last night’s frost coats the neighbor’s lawn and roof with white sparkles in the morning sun. I knew it was coming, but the first frost always catches me unprepared.

The bird population at our feeders has for some weeks been the standard winter-hardy crowd of red finch, chickadees and tiny sparrows puffed to cold weather size. The frost on the neighbor’s car reminds me to move the hummingbird feeder closer to the house. I will need to replace the fuchsia with some camouflage as the tiny birds continue to feed all winter.

Today’s work fits into the allotted time, or not. My attitude for some years now has been that I clean our apartment once a week whether it needs it or not. And if something doesn’t get done then it didn’t need it. That goes for dusting picture frames, sewing seasonal placemats, cutting down expired asters. My ability to sit and watch sailboats chase white caps on the bay has improved with regular practice.

I am also learning to avoid shopping excursions that no longer serve me. Ross and Marshall’s irritate me with their bargains I don’t need and have no place to store. A collection can suffice at two or three rather than needing to buy another cabinet for 12 or 20.

I used to think that I was gifting my children. I hear friends use the same rationalization. The truth is that our children married spouses with their own opinions about what was important to collect. Rarely do they agree with mine.

When age and dementia remove us from our stuff, our children are stuck cleaning out the unfinished quilting and wood working projects. They will not appreciate the inheritance.

Our abilities and interests change. The ponchos we knitted and wore in the ‘60s are never the styles brought out in 2011. Nothing stays the same forever. Take a deep breath and let go.


Monday, November 7, 2011

NOTHING STAYS THE SAME 2

Our current population at Adagio has shifted from Bingo to reading, and re-reading books we know we read before but can’t remember the plot or ending. Books of the past become a new present. Uno and Bingo are for sissies who can’t remember where they left their reading glasses.

In The Great Gatsby, Jay Gatsby says “Can’t repeat the past? Why of course you can!”  Of course he’s wrong, but remembering the past famous people of our culture hints that we were once vital, strong and needed. We can be again as long as our wheel chairs are in locked position. Myrna Loy, Clark Gable and William Powell. Hubba hubba hubba. Lyndon Baines Johnson, the dirty rat.

While we are ensconced comfortably at the dinner table with no one asking difficult questions, we can enjoy the illusion that anything can be done again.

Our kids would no longer be the keepers of the driver’s license. The walker parked by our resident valets would truly be the Chrysler or Chevy of the 50’s. The phone call interrupting our meal would again be someone from our past who needs us to fix a problem in the present. We can walk, bend, dress ourselves and pick up our shoes from the floor. We can get an aspirin from the medicine cabinet independently without written permission from a doctor.

We would reinstate the past in a heartbeat. But first we need a nap.

Our families are often less realistic and argue against change more than we do. During the 30 minutes that the family visits we can fake attention and independence. They aren’t around when we can’t remember if the day is beginning, ending or somewhere in between. They don’t hear us insist we took our pills until we are reminded that we took them yesterday, not yet today. Our family is sure we can follow the directions on the plastic box, day and time.


We are important to them and they can’t bear the thought of losing us. That’s nice. But I think a part of going back to the past is that if we are of diminished capacity, they are the next generation at risk.

There is a time to live on our own and a time to admit to needing assistance. There are assessments a professional can accomplish easily. Then comes the hard part. Getting everyone to admit that the past is not the present.




Tuesday, November 1, 2011

RAINEY DAY

Is Medicare Stuck in the 1960's?


When Medicare was enacted, it was intended to serve as the foundation of the health care system for seniors and people with disabilities. For years it was seen as a highly successful program that saved the elderly and disabled from financial disaster.


Many, if not most people continue to believe in the promise of Medicare. But this is a fallacy, writes Jane Gross, whose opinion piece, How Medicare Fails the Elderly appeared in the Oct 15, 2011, New York Times.


"Here is the dirty little secret of health care in America for the elderly, the one group we all assume has universal coverage thanks to the 1965 Medicare law: what Medicare paid for then is no longer what recipients need or want today,” Gross writes.


This change, suggests the author, is a result of advances in medicine that now keep people alive well beyond what was considered a normal life span in the 1960’s. Today, much of the care Medicare is mandated to provide does little if anything to cure illness and improve the quality of life of seniors in America.


Medicare will pay for “heroic” care for a senior dying from the natural process of aging. It will pay for diagnostic tests, surgery, and emergency room treatment. It will pay for Hospice.


But what it won’t pay for is what most seniors need: long-term care in a safe and well-run facility, and/or home aides and caregivers to help with the tasks of daily living.


Nationwide, the median annual cost of a nursing home in 2010 was $75,000; room and board in an assisted living facility, with no additional help, was $37,500; and the most basic category of home health aide, who can perform no medical tasks, like the dispensing of medication, was $19 an hour.


 “These expenses are left to the elderly (and their adult children) to pay for out of pocket until their pockets are all but empty,” says Ms. Gross.


Ms. Gross proposes that the “mismatch between what is covered and what is useful” is the “essential flaw” in the way Medicare operates today. Today there are 47 million Medicare recipients, a number expected to rise to 89 million by 2050.


Legislative action is needed now, says Jane Gross. Otherwise the health care future for our seniors is bleak. To read the full article by Jane Gross go to:  NYT Article

Tuesday, October 25, 2011

DEEP BREATHING

I recently heard a writer admonish us to put oxygen back into deep breathing.

One of our Adagio family recently underwent a medical procedure. Her therapists drilled her on the importance of deep breathing to prevent pneumonia. She came home determined that each of us needs to take deep breaths. Like a drill sergeant she orders, “Breathe. Breathe.”
 
Once the humor of the situation passed I agreed with the diagnosis. Of course we need to breathe but there are many times when we hold our breath.

We hold our breath as a vehicle rockets from two lanes over into the small space between our car and the SUV with Baby On Board in front of us. We hold our breath as we try to abort a sneeze after drinking three cups of coffee,

We hold our breath when our seniors determinedly talk over each other, neither willing to give up air space. We hold our breath when they lurch sideways while maneuvering their walkers. When they declare they didn’t sleep all night and no one came when they called and called. (Snoring was contrary evidence but perceptions count.) We held our breath before calling when a visiting pet ran out the front door and down into the street.

Yesterday between dinner and dessert we were abruptly commanded, “Breathe. Breathe.” I asked when they remembered holding their breath. Any time they were startled was one answer.

I asked if they were sometimes afraid and held their breath. Some answers originated from situations 40 years ago. More currently they said they were afraid when they didn’t understand what was going on. When they thought they might fall. When their family “talked over them” but they knew they were the subject.

At this point our drill sergeant announced “Too much talking. Breathe. Breathe.” And we did.




Monday, October 17, 2011

Guest Blog: Your Aging Parent Refuses to Spend Money on Eldercare

A Guest Blog from Alice Kalso, A Boomer's Guide to Eldercare
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A penny saved is a penny earned. All her life your aging parent has lived by Ben Franklin's words. But now, she needs assisted living or in-home care. The cost scares her to death.

Eighty-three-year-old Lois felt that way. Over the years she'd collected diagnoses like barnacles: diabetes, congestive heart failure, and more. She needed medication management, plus help with showers, dressing and other daily activities. As we talked, she fixated on the expense.

"It's SO expensive. It's SO expensive," she repeated.

"You can afford it," her son said, citing numerous investments. Lois wasn't convinced. So what to do?

Perhaps your parent's story is similar. Before you point out the "facts," try drawing her out with an open ended question. Something like: "I know you're really concerned about spending so much money. What troubles you most about that?"


You might be surprised at what you hear. Having grown up in the Depression, she may feel a sense of failure at spending money on herself, even though needed, instead of providing a larger nest egg for the kids. I've heard other elders say, "I've always given a substantial amount of money to the church. If I go to assisted living, I won't have as much to give." Still others are paranoid they'll run out of money. They've never spent more than their monthly income.

Whatever they say, listen before speaking your peace. And try to affirm their concerns. Then you can calmly point out how what the monthly fees will cover and how life will be better should they get care. Another tactic: Let them know that you'd like to move to assisted living or hire home care so YOU don't worry. The idea of sacrificing for you and your family members may make sense.

I often use this phrase:

"Remember during your lifetime you always saved for a rainy day?" "Well, right now it's beginning to drizzle." Or "It's pouring!"

Have you used other words to help convince your parent to get care? Tell me about it.


Wednesday, October 12, 2011

THE FORGOTTEN MAN

My father was a business owner who took risks. He paced the floor at night when the money didn’t come in and his suppliers wanted their tenth-of-the-month payment. He understood the risks and the cold fact that there was no agency prepared to give him a pay check if he failed. He contributed to community causes and drove a flatbed truck in the Fourth of July parade loaded with Girl Scouts tossing candy he bought for them. He paid a fair wage and was a respected member of his community. He maintained an Open shop.

I am person C in Dr. Sumner’s tautology. I am a small business owner. I take risks with my retirement investments that could be wiped out in a moment of lax attention. We must reserve funds to replace the roof and appliances that will fail.


I understand that without profit there is no reason to take the risks. We walk a defined profit line and weep because we cannot afford to take “Margaret and Robert” and pay a good wage to our caregivers. We hire certified care givers who have received training and continue to earn education units. Without us they might be unemployed.


As I see literacy programs, millions of dollars for developmentally disabled and needy older seniors being cut, and government bureaucracies being built, I know Margaret and Robert and Mandy and Cindy are not being forgotten. They are being kept in their place.


If you live in the State of Washington, please educate yourself concerning Proposal 1163. It is a repeat of 1029 which passed two years ago because the verbiage was misleading. We and our caregivers renew our background checks every two years. We must have a list of training plus continued education every year to keep our license. Such has been the law for many years (WAC). We always need more education, but not at the prejudiced hand of the SEIU. We turn to the WSRCC which is working hand-in-hand with the DSHS.


Vote No on Initiative 1163. It has the wrong priorities, is misleading, has no funding source and will cost $80 million. Every major newspaper has come out against 1163. WA congressional leaders and our Governor have also rejected 1163.

Greed is universal. Jesus said, “The poor you will have with you always.” Reasons for the poor include financial loss, misguided or no mentorship, disabilities, self-inflicted feelings of entitlement, sloth, usury, among many others. And, the greed that grumbles in each of our hearts.

Monday, October 3, 2011

THE FORGOTTEN MAN


My book review post of September 27 presents a pivotal change in Federal government interference representative in persons A, B, C and X. FDR lifted the descriptive term, the Forgotten Man, from Dr. Sumner’s work and wielded it like a TVA shovel.

“Roosevelt offered rhetorical optimism, but pessimism underlay his policies. Though Americans associated Roosevelt with bounty, his insistent emphasis on sharing—rationing, almost—betrayed a conviction that the country had entered a permanent era of scarcity. Both Hoover and Roosevelt overestimated the value of government planning.”

FDR chose to focus on X as pathetic, needy and unable to supply his own needs. FDR saw segments of the business community surviving bad times and pronounced their Depression success as unfair.

Since FDR, X has become caught in an entitlement trap difficult to escape. X sadly accepts the harsh judgment of a Federal and State bureaucracy that  generously builds itself. It speaks a largess language but demands increasing tax payment from C to build more social agencies and lease multilevel office buildings. Meanwhile it denigrates X with its pity and barely subsistent handouts.

I know X and my heart breaks for her. She is Margaret, age 82, diabetic and in rehab recovering from a broken hip. She has been living with her daughter who is herself recovering from a work-related back injury. The Rehab social workers are attempting to find a Home for Margaret. But they are faced with Washington State paying between $50 to $100 per diem for Margaret’s room and board and nursing care.

I know X. Robert is developmentally disabled, age 32, and may well live into his sixties. His aging parents can no longer care for him. His care expenses have almost wiped out their retirement savings. The State will pay $62 per diem to the Home that will take Robert. This paltry sum doesn't pay his nursing care at $12 per hour for 24 hours seven days a week, to say nothing of room and board.

X is also Cindy and Mandy and Bobbie who became pregnant before they were 16. Their mothers have trudged the welfare wheel all their lives and as these women give birth to more children, the cycle seems destined to continue. 

X is Juan and his family trying to extend their visa to stay in Seattle. Their two sons are attending school where the State social workers catch up to them. Juan is told that he can apply for welfare and his wife will not need to look for work. Juan and Sylvia decide not to sign the paperwork and find minimum paying jobs at the same family restaurant. The restaurant owner acts as their benefactor with the bank, their landlord and Immigration. In six months he finds Sylvia a translating position and he promotes Juan at the restaurant.

X is not forgotten. X is celebrated by government that buys their votes and encourages them to continue their sad dependence.

Laudable intentions. Unintended consequences. Tragic results.

Tuesday, September 27, 2011

Book Review: The Forgotten Man

Shlaes, Amity. The Forgotten Man. A New History of the Great Depression. Harper Collins Publishers. 2009.


“These unhappy times call for the building of plans that rest upon the forgotten, the unorganized but the indispensible units of economic power, for plans like those of 1917 that build from the bottom up and not from the top down, that put their faith once more in the forgotten man at the bottom of the economic pyramid.”

--Gov. Franklin Roosevelt of New York, radio address in Albany, April 7, 1932



“As soon as A observes something which seems to him to be wrong, from which X is suffering, A talks it over with B, and A and B then propose to get a law passed to remedy the evil and help X. Their law always proposes to determine what C shall do for X, or in the better case, what A, B, and C shall do for X….

What I want to do is to look up C. I want to show you what manner of man he is. I call him the Forgotten Man. Perhaps the appellation is not strictly correct. He is the man who never is thought of….

He works, he votes, generally he prays—but he always pays….”

--William Graham Sumner, Yale University, 1883.



The Forgotten Man “is the story of A, the progressive of the 1920s and ‘30s whose good intentions inspired the country. But it is even more the story of C, the American who was not thought of. He was the man who paid for the big projects, who got make-work instead of real work. He was the man who waited for economic growth that did not come.”

Tuesday, September 20, 2011

TRANSITION: Nearing Death Awareness

Grief Work usually refers to the survivor’s efforts to rebuild, to create a new normal. At Adagio until Grace’s passing we also used the term Grief Work to refer to our participation in our resident’s passage from life to death.

Two Hospice nurses have coined the phrase “Nearing Death Awareness” to describe the stations a dying person travels through to achieve the end of the line. We adopted this change in verbiage as we become aware of Grace’s transition points, gestures, statements, visions. 

A friend gave me the book Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying by Maggie Callanan and Patricia Kelley. They write “As nurses who care for the dying, we see ourselves as the counterparts of birthing coaches or midwives, who assist in bringing life from the womb into the world. At the other end of life, we help to ease the transition from life through death to whatever exists beyond.”  Our goal is to help our dying residents achieve comfort, peace and perhaps even joy.

Callanan and Kelley affirmed us with case studies describing similar experiences to our own. Each of our residents have reported or reacted to seeing loved ones who had died before them, a brother, mother, friend. Some would call this vision a hallucination. I was uncertain, but now am open to the possibility that they were met by important, caring people. These visions brought them comfort that they would not make the crossing alone. I leave it at that.

With our first near death experience I thought our work was the respect we owed someone who had contributed much to family, church, country during his life. I have since learned that expressing appreciation for and confirmation of their life was probably heard since hearing is the last sense to go. Speaking his name, the names of family members, organizations, assuring him that he had done well, he had been a good and faithful servant. He could let go. Speaking his name and assuring him, a confessing believer, that God knew his name and loved him slowed his breathing and I could visibly see him relax. Singing his favorite song in the emergency room calmed him into acceptance of the nursing staff’s physical ministrations.

My husband and I had learned through the years that people may be hanging on until their family gave them permission to “go home.”  They were fearful that they were abandoning their obligations. They may be struggling against death until a family member reunited with them and spoke of their love and perhaps forgiveness. Final Gifts affirmed that experience.

Our dying residents are not our only concern. Their families come in all stages of preparation and acceptance.

 “Patient and family exist as a unit—interacting and struggling together in what can become a perplexing maze of distress and anxiety. The solution to this maze requires attentiveness and willingness to listen and understand.” (Page 28)

Thank you to the Hospice professionals who have attended us at Adagio. Nearing Death Awareness…work we all will come to do at the given time.

Friday, September 9, 2011

From the Land of the Living

Several of you emailed valued responses and questions to my comment on "Patience" in my tribute to Grace. But like anxiety, patience requires research and hard thinking. I need a break from grief work.

An important aspect of living is eating. Last week we feasted on nectarines and the leftovers with berries became a free form tart.
This week we have enjoyed fresh peaches, but a few were developing brown spots. Time to bring out the church cookbooks. Thanks to our friend, Leona Van Sant, we have a copy of the 100th Anniversary Cookbook, I Reformed Church, Sully IA.  I began with the Fruit Crisp contributed by Kelly Zegers. We then developed our own concoction based on the standard oatmeal and yellow cake mix.

We welcome any variations or contributions you care to make. Perhaps we should offer a contest: the winner does not receive a snail mail package of our yellow, week-old broccoli.

Fruit Crisp

5 Tablespoons butter, melted
1 Tablespoon flour
1 cup brown sugar
1½ cup oatmeal
1 can fruit pie filling: apple, cherry, or peach

Place pie filling in bottom of 8X8-inch pan. Mix first 5 ingredients together and crumble over pie filling. Bake at 350° for 30 minutes.

Adagio Resurrection Dessert

   We prefer to serve fresh fruit but resurrect this recipe when our fruit is on its last leg: peaches, nectarines, pineapple, bananas, apples, etc., hence our name for Resurrection Dessert.

Grease casserole or 8x8 glass pan.

Pour in 2 cups peeled and sliced peaches or any fruit combination.

Sprinkle with cinnamon sugar. (All proper Dutch households store a shaker container of sugar mixed with quality cinnamon.)

Mix:
2 cups *yellow cake mix 
¼ cup melted butter
½ cup brown sugar
½ cup oatmeal
1 beaten egg
Water, enough to make thick batter.

Pour over peaches.

Bake 350° for 30 minutes or the cake topping becomes firm and golden brown.


"Eet Smakelijk"

Adagio Adult Family Home
Kim Edsall-Badgett
Maxine Brink

*We buy commercial-sized yellow cake mix so here is where your originality can shine.





Monday, September 5, 2011

TRANSITION

Grace transitioned this morning at 9:25. Her struggle with dementia is finished.

She taught me much. I now know patience is a decision made when I would prefer to walk away. I learned to release my grip on my agenda and listen to her expressed needs, garbled and vehement, but as legitimate as my own.

The person who thrived before dementia’s inroads took away her conversation skills still existed. She taught me to see the dead leaves and clutter beneath flower pots as offensive. Yet the pictures in her scrapbook are of lush dahlias and geraniums. She was a precise accountant and that mind set was evident as she made her bed and folded her napkin.

Before Grace, I did not know that death’s timing is off the clock. That it can nibble at your mind until it finally eats down into the brain stem, incautiously digesting the cells that on their own supply life to kidneys and lungs. Even in her loss she was gracious and easily smooched, “I like you.”

I did not know the danger in a nurse’s watch as it recorded seconds during which neither I nor Grace would ever breathe again.

Grace’s transition is complete. Mine without her has just begun. I miss you, dear one.


Thursday, September 1, 2011

PEOPLE: TREENA

Treena reads a National Bestseller paper back under the hair dryer. Her small frame demonstrates her life-long disciplined eating habits and she wears tapered blue jeans with an ironed crease.  Her knit tee shirt bears no logo or witty saying, like "the trouble with reality is that there is no background music." She carries her wit in her head and speaks clearly with a wry sense of humor.

Her hair began thinning in her thirties, unlike her younger sister who inherited their mother’s thick hair. Three years ago her sister was diagnosed with Alzheimer's disease which she inherited from their grandmother. The inequities cause Treena to laugh and inform her expectations of beauty.

The People magazine cover next to her chair pictures only attractive people 50 years her junior and she mostly doesn’t care. Her life has been full and she now feasts on the overflow.

Treena gestures to her hair. “It stinks. But I have arthritis in my hands and arms and can’t comb the back. When my friends come to pick me up they comb the back.”

She volunteers the subject of wigs. “Last time I wore my wig to work, when I took it off I realized I’d worn it backwards all day.”


Thursday, August 25, 2011

Alzheimer’s Association NAPA

If you’ve watched women’s college basketball, you will be dismayed by the news that the University of Tennessee’s legendary coach, Pat Summitt, confirmed she has been diagnosed with early onset dementia, Alzheimer’s type. She later told news media that her grandmother had suffered the disease.

On January 4, 2011, President Obama signed into law the National Alzheimer’s Project Act (NAPA). This legislative action passed unanimously by both Houses of Congress. NAPA establishes an Advisory Council on Alzheimer’s research, care and services.

The new Advisory Council will develop a national strategic plan to respond to the Alzheimer’s crisis and coordinate Alzheimer’s disease efforts across the federal government. NAPA will ensure the coordination and evaluation of all national efforts in Alzheimer’s research, clinical care, institutional, and home and community-based programs.

One of the most important components of NAPA is that it allows participation in the evaluation and strategic planning process by specialists outside of the federal government including patient advocates, health care providers, state health departments, Alzheimer’s researchers and health associations.

Why NAPA and Why Now?

The Alzheimer’s Association was the leading voice in urging Congress and the White House to pass the National Alzheimer’s Project Act. With a disease that is already impacting so many Americans, the Association recognized the need for a national, coordinated effort that pools the skills of all those working on the problem. The Alzheimer’s Association states the need clearly in its literature:

For too many individuals with Alzheimer’s and their families, the system has failed them, and today we are unnecessarily losing the battle against this devastating disease.

Alzheimer’s is the 6th leading cause of death in the United States and is the only cause of death among the top 10 in America without a way to prevent, cure or even slow its progression.

Making her announcement, Coach Summitt said she had the company of her son, Tyler, during her time at the Mayo Clinic. He explained his mother's feelings after being diagnosed.

"Nobody accepts this," Tyler said. "And there was anger. 'Why me?' was a question she asked more than once. But then, once she came to terms with it, she treated it like every other challenge she ever had, and is going to do everything she possibly can to keep her mind right and stay the coach."


To read more go to http://www.alz.org/index.asp

Thursday, August 18, 2011

ANXIETY 5

Ready or not, the political season is once again attacking us. Political candidates, pundits and pollsters attempt to define the anxiety of our country in economical and emotional terms. Anyone who does not agree with them in congress or the presidency is disparaged as partisan. This revelation should not knock your socks off.


Dissent and lack of control increase the level of anxiety and volume of proclaimed disbelief that anyone would hold to such an idiotic position. Comparisons to Hitler proliferate. I'm already weary of patriotism claims and accusations of terrorism.

The more anxious we become the more we slant the issue, stack the facts, and shade our witness in our attempt to show our position in the best light. The story can never reflect the whole truth because, with our hysteria controlling our reactive thought processes, we can’t see the whole truth. Our emotions warp our perceptions so our thinking spirals out of proportion. And as our thinking goes, so does our story. (More on this with future posts on Storytelling.)

We frantically defend our point of view as we vehemently dismiss our opponents. Anxiety blinds us to our part in the devilment, as it binds us in our need to convince others to protest with us.

In a troubled marriage there is no totally good spouse and totally bad spouse. In an angry family, there is no good parent and bad parent, as there is no single bad child and the rest escape as acceptable. In an organization a wide swath of grey wanders between the black and white. But we do so love to assign blame.

We are naturally wired to become anxious when threatened or we think we see threat. (“Anxieties of life” Luke 21:34) Loss of job, income, home, health, family. You can name your anxiety of the day.

As dementia diminishes the thought process, the sufferer thinks they can continue to take charge; sometimes they do, sometimes they don’t, and we never know what’s coming next.

A small coalition of members decide the leadership isn’t performing and they foment for change. The neighborhood around the church changes complexion as members move out and cash flow, with the membership, fails to meet agreed upon goals. Misbehavior alleged or real by a leader or member jump-starts the rumor mill.

Dr. Peter Steinke in How your Church Family Works, writes, “Crowd delirium is fed by both emotional extremes—ecstasy and anxiety. Both numb the thinking processes. As long as people function in reciprocally reactive ways, there is little emotional separation between them.”  Blobs wobble; differentiated individuals reason.

Like any challenge, anxiety's impact depends on how we handle it.

Sunday, August 14, 2011

Book Review

Caldwell, Bo. City of Tranquil Light. Henry Holt and Company. 2010.

In 1906 two Mennonites, Will and Katherine, separately join a missionary journey to the North China Plain. They are surprised by love for each other and the people of Kuang P’ing Ch’eng—City of Tranquil Light. Together Will, the preacher, and Katherine, the nurse, share hardships and personal loss as they survive the crumbling of a more than two-thousand-year-old dynasty. Through societal collapse and dangers from bandits, civil war, and the attacks by Southern armies of Chiang Kai-shek, Will and Katherine slowly earn the respect of the local people. These courageous nationals continue the work when the Communists threaten and missionaries are forced to leave China.

“City” is a beautifully written life story told from Will’s perspective with Katherine’s journal entries, growing tendrils of grace and faith from the earth of China to our hearts far across the sea.

“Chung-Kuo.  It means Middle Kingdom, because of the people’s ancient belief that their country was at the center of a vast square earth, surrounded by the Four Seas, beyond which lay islands inhabited by barbarians. That’s us.”


Thursday, August 11, 2011

ANXIETY 4

In earlier posts on Transitional Thinking (Wed., April 20), I described the differences between Problems and Polarities. When an organization’s operational system does not distinguish between the two, anxiety heats up. In the frantic search for solution, finding someone to blame becomes crucial.

To review, a Problem can be solved. People involved in a tiff can be brought together and held accountable. (Gossips must also be held accountable.*)

A Polarity, however, requires management because “there are two complimentary dimensions, which are always in tension and need to be appropriately balanced for the context.” Sometimes we want hot water, sometimes cold, both appropriate desires.

Members of a family age and leave for their own households. But they carry with them the learned pattern of knee jerk reaction/shouting, or calm/quiet waiting for explanation: two system extremes. To qualify for the middle you react to anxiety-producing stimuli by going on alert, but ask “why” or “what is the matter here” before you respond.

An organization like a congregation is composed of individuals who learned how to handle anxiety from their families. Every group we have encountered contained individuals demonstrating both extremes and the middle. We have experienced congregations whose corporate character tilted from productive Problem solving and Polarity management toward reactive chaos.

Organizations with ineffective systems neither resolve the Problem nor explore the contrasting dimensions of a Polarity. They hover anxiously. Anxiety becomes the modus operandi; the organization deteriorates as it must. (The word dysfunction has been misused as the blameworthy cause.)

An anxious group may find temporary relief when new leadership demonstrates and demands behavior change. But when the leader departs, if the group does not own its new insights, the system may return to former patterns like a hard ball on a rubber band. If you’re the next leader, watch out! You’ll get the “icks.”

* Romans 1:28-32 “Since they didn’t bother to acknowledge God, God quit bothering them and let them run loose. And then all hell broke loose: rampant evil, grabbing and grasping, vicious backstabbing. They made life hell on earth with their envy, wanton killing, bickering, and cheating. Look at them: mean-spirited, venomous, fork-tongued God-bashers. Bullies, swaggerers, insufferable windbags! They keep inventing new ways of wrecking lives.”

The Message


Sunday, August 7, 2011

ANXIETY

Proverb


Fools have short fuses and explode all too quickly;

   the prudent quietly shrug off insults.



Truthful witness by a good person clears the air,

   but liars lay down a smoke screen of deceit.


Thursday, August 4, 2011

ANXIETY 3

One of the houses in which we sojourned offered hot water in the downstairs bathroom that could redden skin in the split second it took to reach from the loose hot to the stuck cold handle. Contrarily, the hot water in the upstairs bathroom where we showered took longer to get warm than a dead mule to move. Such was the water system in that house.

Organizations, be it a family, a senior care facility or a congregation, have developed a system for dealing with anxiety, pain with an uncertain cause. These systems range in effectiveness.

We all agree that anxiety is a miserable experience. One of my favorite people used to describe her anxious spells as the “icks.” A professional person, she sat in the back row in church.

I quickly learned to turn the cold water on before the hot. In every congregation we have served there was one person who had learned to start yelling as soon as he felt anxious. Dementia does the same because controls have been lost. A previous resident liked to “poke” her family and then refused to respond when they jabbed in return, claiming to dislike conflict.

When we become so obsessed with the temperature in the room, the minister’s leadership, or our spouses’ driving that it interferes with our ability to live, worship God, enjoy the car ride with our mouth shut, that’s a concern.

If we are expending so much energy on the worry that we can’t function effectively, we have a problem that needs to be addressed. Our coping system is not working effectively.

Tuesday, August 2, 2011

CHANGE

Hope moved into our home bringing her bedroom dresser. Her children removed the drawers at her house, transported them, and without sorting through any of them, slid them into place at our home.

One afternoon about 3:00 PM she needed redirection. I brought her into her room. She picked the drawer and I placed it on her lap. We rolled the drawer to the kitchen table. We slowly removed the contents piece by piece, talking about their use and where they came from.

One of the contents was a yellowed paper lined with mimeograph ink smudges. If you don’t know what a mimeograph is, Bing it. The language is from the days when bread was $.05 a loaf and a house kit from Sears and Roebuck cost less than $2,000.

The treasured article is as follows:

OLD FOLKS

Remember we old folks are worth a fortune. We have silver in our hair, gold in our teeth, stones in our kidneys, lead in our feet and gas in our stomachs.

I have become a little older since I saw you last and a few changes have come into my life since then. Frankly, I have become quite a frivolous old gal. I am seeing five gentlemen every day. As soon as I wake up, Will Power helps me get out of bed. Then I go see John. Charlie Horse comes along and when he is here he takes a lot of my attention. When he leaves Arthur Ritis shows up and stays the rest of the day. He doesn’t like to stay in one place very long, so he takes me from joint to joint. After such a busy day I am really tired and glad to go to bed with Ben Gay.  Wow, what a life!

The preacher came to call the other day. He said at my age I should be thinking of the hereafter. I told him, “Oh I do all of the time. No matter where I am, in the parlor, kitchen, etc., I ask myself, What am I here after?”


Wednesday, July 20, 2011

ANXIETY 2

From previous post Anxiety

“Because anxiety affects our thinking capacities, it diminishes clarity and objectivity. It interferes with our capacity to think creatively. We cannot stand outside of the vague dread and observe it."  Dr. Peter Steinke.

Suspense generates excitement in an Alfred Hitchcock movie. He is quoted as saying, “If you touch off a bomb, your audience gets a ten-second shock. But if the audience knows that the bomb has been planted, then you can build up the suspense and keep them in a state of expectation for five minutes.”

That’s great cinematography but in an organization, uncertainty and tension of opposites creates anxiety. Anxiety in an organization that is uncertain of its direction explodes into discord and disunity. Its free-floating-fear fastens onto an issue or person blowing rumors and opinions out of proportion.


Another Hitchcock technique hid aspects of reality from the viewer. The scene would begin looking normal and safe, but behind the ordinary lurked extraordinary evil. As the camera would lead the viewer through the home or the office or the church—although I don’t know of a Hitchcock movie revealing the evil possible in a congregation—a nervous unsettling would stir in the viewer. He played with our natural anxiety.


Congregations mired in anxiety are only fooling themselves. A visitor may not know what specifically is wrong, but they are uncomfortable and exit never to return. And the reputation is made. Unlike "The Birds" or "Psycho", organizations disintegrating in conflict are not recommended for second viewing.


Dementia is more honest about anxiety. Loud noises, raised voices whether laughing or angry, door bells, unexpected changes cause emotional pain and the reaction is immediate.


Our seniors have taught us to listen before speaking, nod sagely, breathe deeply and deliberately before responding to their upset. Their anxiety can never be ignored and passed on for another day. (I apologize to my children that I lacked this skill when they lived in my home.)