Wednesday, July 31, 2013


“When we are no longer able to change a situation, we are challenged to change ourselves.”   Viktor E. Frankl, Man’s Search for Meaning

Guest Blogger: Alice Kalso

As life draws to a close for your aging parent--or for any of us, for that matter--the complex becomes simple.  Dr. Ira Byock, MD, physician and author of "The Four Things That Matter Most," boils down the essence of end of life into four sentences:

1.  Please forgive me.
2.  I forgive you.
3.  Thank you.
4.  I love you.

Notice the order of the sentences.  Forgiveness comes first. Not terribly surprising.

Dr. Byock's preface contains a meaningful quote by theologian Paul Tillich about forgiveness.

"Forgiving presupposes remembering.  And it creates a forgetting, not in the natural way we forget yesterday's weather; but in the way of the great 'inspite' that says I forget although I remember: Without this kind of forgetting no human relationship can endure healthily."

Our job is to listen, support and affirm.  And  forgive.  As we hear these four sentences--either audibly or nonverbally--we enfold our aging parent in love.


Saturday, July 27, 2013


Imbalance may be related to conflict. Families have had years to develop impediments in their interpersonal relationships and behavioral habits.

A mother can sit calmly as her sons walk in the front door, but become agitated and quarrelsome as the daughter visits. A father can lie unresponsive in his bed when one son visits and exhibit agitation and anxiety when a different child appears.

These are patterns that have developed through the years and will not disappear when dementia moves into the parent’s brain.

The time to resolve conflict is when we mentally can. An entire lifetime does not need to be brought out, he said she said teased apart and isolated for examination. But children were children when the relationship was built usually while the parent was anxiously building a career and discovering who they were themselves. Assumptions both child and parent made were partial truths. Identifying a particular memory and cleansing it in apology deactivates the deadly power the memory has to divide and continue to cause pain.

War is a deadly method of resolution. Balance can be restored by lifting one foot to see what impediment causes the hazard. Then holding on to the arm of the offender/offended, scrape it off and together throw it away.

Sunday, July 21, 2013


The tempo Adagio is sometimes prescriptive rather than descriptive, the required balance nowhere in evidence. Balance is an interesting concept originating from the Vulgar Latin balancia equivalent to the Late Latin, a pair of scales. When we lose our balance the sight can be truly (vulgar) outlandish.

Balance requires kinesthetic sense placing our foundation -- usually our feet although sometimes the weight distributed in the pelvic area – beneath our gravity centers as we stand or motate. Interestingly, walking requires balance to be shifted from foot to foot while in transition until a new foundation is established, suspending us imbalanced. We don’t think about it until someone pulls the chair out from under us, or our foot is placed wrongly and we stagger, out of balance.

Balance is so important that we carry the concept’s language into interpersonal relationships, mental conditions, family budgets, business relationships, etc. Where do we place our weight?

When dementia afflicts a brain the balance between reality and delusion becomes affected. To varying degrees we each maintain our own psychological balance between fear, need, and satisfaction. When balance remains precarious, we invent compensations that allow us to move forward in living either scherzo, adagio, grave, or some combination. Compensations like eye glasses, crutches, wheel chairs, or even war to remove the impediment.

Friday, July 12, 2013


Recently I conversed with an 86 year-old widow caring for her 62 year-old disabled son. Fortunately he is highly functional and a pleasant man. She told me of her plans for her son when she can no longer be the chauffeur and main functioning member of their family. We agreed that her plans were not for “if” but allowed for “when” the transition would take place. She is a wise woman.

A major transition in our country’s economics occurred on October 15, 2007.  It was the day the very first baby boomer filed for social security benefits.  For the next 20 years more than 10,000 baby boomers will hit retirement age every day and nearly 75% of them expect to live well into their 80s, even 90s.

Major companies for many years have recognized this shift in finances and wisely prepared for it. Fewer and fewer companies offer pensions. Most encourage and contribute to 401 plans. This means the employee must save and plan for herself.

It also means that contributors to social security will no longer be doing so but will become a draw. For millions of retirees their monthly checks are not enough to live on, an income which, of course, social security was never meant to provide. Somehow expectations have exceeded the possibility.

In practical terms the transition from “if” to “when” affects the money the baby boomers’ children thought they could spend on vacations that “they deserved”; it means they will not have their homes paid off by age 50. It means they will not have the savings necessary for assistance “when” they need it at age 62 or 72 or older, costs that—without medical bills and prescriptions—can deplete their funds by $3 to $9,000 per month.

Baby boomers themselves can be the worst culprits in the denial game. The statistics of people over 62 shows falls as a major debilitating experience. But we continue to load our golf clubs into the van with no plan about when the physical fails.

Today my right eye ball was measured for cataract replacement. My two technical nurses had both experienced life threatening car accidents but neither knew about the POLST form.

If we fail to plan realistically, we plan to fail at great cost.  (I do dislike this ditty but have none other that serves the purpose as well.) Transition is not about “if” but “when.”  

Tuesday, July 2, 2013


When we bought our adult family home we were edging side step toward retirement. Having never been retired before, we were uncertain how to define our life. Time was obviously an element of the definition as was activity. Remove meaningful activity and retirement becomes a slow death. We decided we preferred transition.

Our licensed home carried a name that began with an R and had little meaning for us. My husband suggested Adagio which would put us at the beginning of the alphabet (marketing tool). A musical term, Adagio indicates a slower tempo than Presto or Allegro, but faster than Grave.

We particularly liked the dance definition as “a section of the pas de deux in which the ballerina and her partner perform steps requiring lyricism and great skill in lifting, balancing, and turning.” Lifting and turning sounded a lot like transfers and physical therapy. Adagio is usually the second movement in a four-movement symphony. After almost five years of senior care, movement is written daily in our log but accompanied by important words like hard, formed, loose.

Adagio is a deliberate tempo giving time for reflection and deep breathing, rich harmonies and counterpoint. We move with ease from running arpeggios into soft, exploratory chords.

Adagio is a good change of pace regardless of your age or situation, a balanced stance during transition.