July 2, 2009

Ceramic Dishes for those with Limited Mobility

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We headed out for a ride in the lush green countryside, through bean fields, wheat stubble after harvest, freshly mown hay being rolled into large round bales, gently rolling hills as far as the eye could see.  The day was warm and sunny with comfortably low humidity.  We took our time as we traveled to Harveyville, Kansas, a thriving metropolis populated with 136 male and 114 female humans and at least a two cats.  One of the cats is huge, by far the largest cat I have ever seen — friendly, but as usual, in charge of the Jepson Pottery Studio.

The studio is filled with hundreds of finished pieces as well as many that are in various stages on their way to completion.  Owner Barry was busy at the wheel turning some unusual looking vases (I think), interacting with two of his four young adult children while he worked.

We had taken to him a dinner plate we purchased at a Medical Supply store. The plate is made of some sort of very sturdy plastic, functional, but hardly pleasing to look at.  It is obviously a plate for use by those with dexterity problems.  The center of the plate is about a half inch deep providing a wall against which the food can be pushed to get it on the fork or spoon.  Without that deep lip, the food often just slides off the edge of the plate on to the table or Mary Ann’s lap or the floor.  The plastic plate is very light, demanding a piece of Dycem (www.dycem.com/), given us by our Occupational Therapist, to keep the plate from slipping.

He made one plate for us to try.  It worked.  Today we picked up five more plates so that we will always have a couple clean for both of us to use. They look great.  Mary Ann had picked the colors, a deep red with an uneven thin blue area around the rim. The plates are heavy, so no Dycem is needed.

We had already gotten four of the chili bowls with handles made with the same colors.  Those bowls have sides high enough so that, as with the plates, the spoon can be pushed against the side to get the cereal on the spoon without sliding over the edge.  I had often needed to feed her the cereal especially when she got to the last one third of the contents of the bowl.  With the chili bowl, I seldom have to help. She can use the handle to tip the bowl, making it easier to get the last of the cereal on the spoon and into her mouth.

He also made us some deep salad bowls, that, along with the chili bowls, can be used for ice cream should that be necessary. By the way, after picking up the ceramics, we drove another half hour or so to stop at the Braum’s in Emporia for hot fudge Sundaes with pecans.

I recognize that it would have been cheaper to use the functional plastic plates.  It is also true that just because Mary Ann has Parkinson’s Disease does not mean the aesthetics of our environment are no longer relevant.  If anything, they are more relevant.  We have less opportunity to get out and see beauty since we are at home most of the time.  We choose to have a quality of life that is nurturing and stimulating.  Objects of beauty are not just unnecessary extravagances but are visual cues that our life together is not just a matter of getting by until we die.

For some reason, Mary Ann did not at all warm up to the idea of using one of the plates to hold birdseed and be placed on one of the flat rocks in the waterfall area in our back yard.  It would look so great!

Today I encouraged Barry Jepson to set up a small area in the shows he does all over the country, an area with items that are user friendly for those with physical limitations.  Since it is a very busy time for him, he is not yet ready to put these new plates on his web site, but hopefully it will happen soon.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 30, 2009

Wildlife Moves from Deck to Bedroom!

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Why did I talk so much about the mother raccoon and her two babies that visited our deck the other night???  I should have known better.  For the last hour Mary Ann has been seeing a baby raccoon or two under the bed, on the side of the bed, in the bed all around her.  It may be a very long night.

Last night was not a good one.  It was very late before she finally settled.  It pretty much never fails that the day after a difficult night, the hallucinations ramp up in activity.

I feel pretty helpless when this happens.  There is nothing I can say to convince her that they aren’t there.  I know the rule is not to tell the person seeing the hallucinations that they aren’t real.  I have searched for them in the covers and under the bed and around her back as she lay in bed, assuring her that they are not there.  If I agree that they are there, there is no hope of her getting any sleep.  I am watching her on the monitor and will head in to reassure her whenever she appears to be bothered by the….whoops, there she goes.

When I got to the bedroom, she asked if the people (there were no people) had left yet, used the commode, while she holding the corner of the sheet she said she hated the fabric hanging there, she got back into bed and told me she was going to send the raccoons over to my bed.  I encouraged her to do so…back to the bedroom again.  This time a Tums was needed.

I have read hundreds of posts from those in the Lewy Body Dementia Spouses group.  It is pretty unsettling to read how many who have LBD (Mary Ann’s Parkinson’s Disease Dementia is a dementia with Lewy Bodies) have a much worse problem with hallucinations.  I don’t relish the time when her hallucinations become worse and more constant, assuming that happens.  Given recent experience, it appears likely that it will happen.

If these hallucinations don’t subside in a couple of days, I will phone the Neurologist to see about increasing the Seroquel.  There are some scary risks that come with Seroquel, but so far she has not had problems with it.

For tonight’s challenge, I am heading off to bed early to see if my presence will help. She has been quiet for a while.  Hopefully she will get a good night’s sleep.  Tomorrow is another day.  Maybe the raccoons will have left the bedroom and returned to the deck.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 28, 2009

Deck Retreat: Wildlife Population Grows

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…and baby makes three!  Actually, it is Mom and two babies.  One raccoon is sort of a novelty.  Three raccoons is two over quota.  The young’uns are not all that well behaved either.  The banging at 3:30am turned out to be one of the babies knocking a ceramic pot holding an asparagus fern off the old wooden box it was sitting on.

After watching them for a while, I decided it was time to get them off the deck before the kids did any more damage.  I turned the deck light on and off a few times to scare them off.  Not one of them even flinched.  Mom and one of the youngsters kept eating what the squirrels had left in the pan of oil type sunflower seeds I provide to keep the squirrels attention away from the bird feeders.  The other youngster, I suspect, is the problem child.  He/she messed around some more and then finally left a while after the other two had headed off and under the deck.

The lights in the waterfall are now in, and as a result nighttime deck therapy is an  option.  Each of the four levels has a light at its base. The light is invisible until the timer turns it on.  Neighbors Tom and Amy and I sat on the deck for a while and talked, just enjoying the sound and sight of it.

What makes sitting on the deck possible is that the little seven inch screen on the A-V monitor keeps Mary Ann in view.  I can see when she starts moving and needs my help.  Without the monitor, I would need to head into the house every few minutes to be sure she didn’t need something.  This way I only have go when she actually needs me.  I have now ordered a second camera so that both the bedroom and living room can be seen by just moving the channel switch from A to B.  Again, the screen and audio-visual monitor is a Summer 2500 available at Babies R Us.

Mary Ann and I headed into Kansas City to spend time this afternoon with friends we have known since the early 1970’s.  The time there is always refreshing.  One couple in our crew, like us, is a caregiver/receiver couple.  Marlene has ALS. Charlie has retired (mostly) and is now a full-time Caregiver.  He is the one who sent me a beautifully written email when I first revealed my decision to retire and spend full time helping Mary Ann with her needs. In the email Charlie told me what an honor it is to be able to have the role of Caregiver.

As always, we enjoyed the time together.  There is no self-consciousness to distract from the relaxed friendship.  Whatever special needs Mary Ann has are just taken for granted.  Charlie and Marlene often have helpful suggestions.  There are ramps into the house and on to their deck.  The arrangement of furniture allows space for wheel chair movement.  Marlene uses a motorized wheelchair.

We returned home, and I have managed a few minutes on the deck with Mary Ann securely in bed.  Having just fallen asleep for a moment at the keyboard, i think it is time to post this draft and get to bed.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 23, 2009

Pundit says Marriage is Obsolete. Caregiver Disagrees.

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Author Sandra Tsing Loh has now declared marriage to be obsolete.  She and her husband of twenty years both had affairs and are divorcing.  She has concluded that marriage is simply obsolete these days.  It was useful in the agrarian culture up until early in the 1900’s, since many hands were needed on the farm.  Marriage is no longer useful.  Studies of primitive humans reveal that the spark in a relationship is programmed to last about four years, long enough to have two babies up and out.

I am tempted to get on a soap box and with great self-righteousness rant against such silliness.  That would be far too easy.  I have counseled couples through some very tough times over the years.  Some worked through their problems and found a new relationship that had more resilience and strength an intimacy than before they struggled through whatever it was.  Some concluded that they needed to divorce and begin new lives.  There were money problems, affairs, trust issues, problems with alcohol misuse, abusive behavior.

I respect those who worked out their relationship, and I respect those who chose to divorce and begin new lives.  Does that sound unpastor-like?  Divorce is among the most painful experiences anyone can have judging from what people shared with me over the years.  It is frightening how many killings are done by estranged spouses.  When I moved to Oklahoma City five months ahead of Mary Ann and our children, who were finishing the school year, I was standing just inside the door of a Skaggs Drug Store returning a faulty alarm clock I had gotten the day before.   As I was standing at the counter, someone ran in and hid behind the counter where I was standing.  When the doors opened, I smelled the gun powder.  Fifty feet away from me, outside the door of the store, an estranged husband shot his ex-wife in the face.  After a time, I went out the door to leave and walked by the paramedics with her.  She died there in that spot.  The ex-husband was found at Lake Overholser about a mile and a half away.  He had taken his own life.

Having seen the level of pain that comes with it, I no longer judge those who have chosen the path of divorce.  Those who have experienced divorce are unlikely to recommend it as something to be sought after.

With that said, most of those who divorce do not then conclude that marriage is obsolete.  Apparently, almost 90% of those who divorce choose to remarry.  It appears that we are wired to marry.  I realize that sounds ridiculously obvious, but apparently it is not obvious to some.

Assuming that in our primitive brain the spark that brings a man and a woman together has a four year shelf life, the conclusion implicit in the author’s contention that marriage is obsolete is that there is no point it staying together once the spark has expired.  In fairness, I think she would say that it is no longer sensible to try to recreate the spark after many years of marriage.

I guess the author’s conclusion might be reasonable if the spark were all there is to marriage.  To use her metaphor, a spark is what gets the fire going.  It would be pretty hard to weather a cold winter if the heating system in the house never had more than a spark.

If we chose to live only by what lay in our primitive brain, the fight or flight impulse would preclude the possibility of living in peace with other human beings, at least other than those in our tribe.  What makes us human is the capacity to use our frontal lobes to reason out a better way to live.

If we chose never to move from the spark to that which the spark ignites, of course marriage would become obsolete. What the spark ignites is relationship.  The spark ignites feelings that grow into actions that produce newly discovered feelings that spark levels of trust and intimacy that could never be experienced if the spark were to remain the only measure of the value of marriage.

The spark needs to be in contact with some sort of combustible material or it will produce absolutely nothing but a tiny burst of light and heat lasting only a fraction of a second.  The combustible material is made up of promises and commitments that are lived out day by day in big ways and little ways.  The combustible material is not romantic gestures (although there is a lot to be said for them).  The combustible material is made up of time spent listening to one another, arguing with one another, forgiving one another, standing up to one another and giving in to one another.

Long marriages provide the possibility of a kind of relationship with a beauty and depth, that is far beyond the spark that brings couples together in the first place.  People who have not chosen to marry or are divorced or widowed, can also find deep and lasting relationships that grow out of the combustible material in their relationships with those who are closest to them.  Marriage, however, is certainly not obsolete as a meaningful and fulfilling way to live for as many years as life allows.

For Mary Ann and me, marriage is hardly obsolete.  It is what allows us survive in difficult circumstances.  We get to experience relationship that is deep enough to weather irritations and frustrations and misunderstandings without any of it stealing the fire from us.

When in the Seminary training to be come a pastor, I was in a choir that sang Bach’s St. John Passion three times over four years.  The third time we sang it was one of the most powerful experiences I have ever had in my life.  I will never forget singing the chorale at the conclusion of the Passion.  The power of that chorale lay in what had gone before.  Each aria and recitative and chorus sung over almost an hour built one on the last until all that had gone before filled the last chorale with overwhelming joy, more deeply moving than there are words to describe.  Without what had gone before, the chorale would have been a beautiful hymn.  With what led up to it, the experience touches me to this day, forty years later.

No, Ms. Sandra Tsing Loh, marriage is not obsolete.  For me, our marriage, now, after forty-three years is the chorale at the end of the something that has been building in strength and power for all these years.  The spark has ignited something enduring and of great beauty.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 20, 2009

Caregivers Sometimes feel Trapped

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I have been writing these posts with a certain bravado about our meeting the challenges and choosing to live with meaning, refusing to let the Parkinson’s rule.  As is often the case, saying it is far easier than doing it.

Every two or three months, I take up the shower mesh from the bathroom floor to scrub it with Lysol Cleaner.  We put the interlocking mesh squares on the bathroom floor to protect Mary Ann from experiencing serious damage from the ceramic tile floor if she falls.  An earlier post includes the gory details of the time she fell on that unprotected floor and ended up in the Emergency Room.

The mesh lets the water through so that what doesn’t run down to the drain dries fairly quickly.  The mesh is made of a pliable plastic material that is impregnated with some sort of mold resistance material.  It remains clean other than in some places having a thin layer of residual soap from multiple showers.  The scrubbing I do just makes me feel better about the cleanliness of that floor.

I was outside for a few minutes checking on the tiles drying in the sun on the driveway, talking with a neighbor.  When I went inside, Mary Ann was on the floor in the dining room. She was not hurt at all.  She could have been hurt, but was not.  In the process she had knocked over some coffee demanding some spot cleaning on the carpet.

With the addition of the video monitor, we have reduced the number of falls dramatically.  This relatively minor matter, the fall, reinforced that being out of sight of Mary Ann either by not being in the room with her or not having the monitor in sight is risky.

I struggle to write about being trapped by the Parkinson’s as a Caregiver when Mary Ann is trapped in her own body.  I have no right to feel sorry for myself when she has fought with her own body for over twenty-two years.  A number of years ago, I remember her saying through tears (she seldom cries) that she wished she could get a new body.

She is trapped in a more comprehensive way than I am.  She cannot get a Volunteer to come and give her a break from her own body.  She is trapped, and to a lesser extent, so am I.  The Parkinson’s has come to live with both of us and has become a constant presence in the lives of our Children and Grandchildren as well.

Speaking only from the vantage point of the Caregiver, at times I find it very frustrating that I cannot simply immerse myself in something that takes me out of visual contact with Mary Ann.

A few days ago, I needed to have a Volunteer with Mary Ann so that I could go out and clean the gutters.  The Volunteer had to leave before I finished.  There was at least one fall while I tried to complete the task.

The solution of having Mary Ann outside with me for anything I need to do is not as workable as it may sound.  Due to the Parkinson’s and medications, she does not handle heat well.  She does not enjoy just sitting outside.

Going outside to feed the birds has to be planned for when she is either early in a nap, when it is less likely she will need to get up, or in the first hour or so when she goes to bed.  After an hour or so there is more vulnerability to her needing to use the commode.  Watering the flowers is equally challenging.

Sometimes I just head out the door and walk up to the corner three houses away and look at the sky for a moment, check for nighthawks if it is dusk, or just enjoy the sunset for a few minutes.  There is sometimes a feeling of being tethered to Mary Ann and her needs.  On occasion as a full time Caregiver to someone who needs help to do most of the things she does, my movements are governed by her needs, almost like a marionette’s movements are controlled by the puppeteer.  She doesn’t want it any more than I do, but nonetheless, that is how it sometimes feels.

Gratefully, there are also lots of times when I feel good about being with Mary Ann, able to be close to her so much of the time after years of being away at work sixty to seventy hours a week.  I hope that Mary Ann feels good about my being here some of the time also.  She is not able to express such feelings, but hopefully, they are there.

With all of that said, Mary Ann and I are living lives of value and meaning with joyful times as well as frustrating times.  We are free to do what we are able to do when we are able to do it..  We are experiencing life fully, taking each day as it comes with the bad and the good — pretty much the same way any of us lives, no matter what our circumstances.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 17, 2009

Caregivers: Choose Life

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I have come to think that for all of us, but especially those with chronic, degenerative, life-threatening diseases, very many of our choices, big ones and little ones, can be framed as choices either to live or just fill time until we die.

At the Parkinson’s Support Group meeting while back, there were a number of people present who have had Deep Brain Stimulation surgery (see the June 4th post on this blog for a description of the procedure) to lessen the symptoms of their Parkinson’s.  When I thought about it after the meeting I concluded that those who chose the surgery were choosing life.  They were choosing not to simply bide their time as the disease progressed.  While people don’t die of Parkinson’s, the Disease often in some way plays a significant part in their death.

Of course not every decision we make is on the scale of whether or not to have DBS surgery.  With that said, I have begun to think that we can ask of very many of the decisions we make, are we choosing life, or simply filling time until we die.

I have been wondering lately if in our care giving and receiving mode, we are settling into a routine that is more about waiting and filling empty spaces of time than it is about living meaningfully. Every time we set foot out of the house to eat or shop or go to a public place, a meeting, worship service, to see our kids, to go for a ride, it is a major hassle.  We are always at risk for Mary Ann having some sort of problem that is much more difficult to handle away than at home.

When we eat out, it is often pretty hard to get food from the plate to its intended destination without some of the food taking a side trip to shirt or lap or chair or floor.  Just the logistics of getting to the table to eat in the first place is not always very easy.  When we attended that Parkinson’s meeting, there was unexpected intestinal activity that was pretty tough to deal with in a very inaccessible bathroom while a couple of folks we had enlisted to watch the door waited for what must have seemed like an eternity. Heading out for a drive of any distance can present the same sorts of problems.

It is so much easier to stay home and expand little tasks to fill more time than needed, to expand their importance and create the illusion that they are more satisfying and meaningful than they really are.

It is surprising how hard it can be when making a choice to determine which option is choosing life and which is just filling time.  For Mary Ann, watching television fills a void created by losing the ability to do most of the things she used to do for pleasure. However, watching television is also a very addictive life waster — something just to make the time go by more quickly.

There are times when watching a television program or DVD can be informative, mentally stimulating, very entertaining, refreshing and renewing.  There are also times when the television brings nothing to us, but rather consumes our lives, providing no real nourishment, just empty calories.

After procrastinating for a number of days, when finally we actually did do some flower planting outside, it seemed to be time we were living, not just waiting.  When we push ourselves to commit to something, a trip out, a visit, attending an activity, it is often life-affirming.  The temptation is to find some reason just to stay home, to do something familiar, something that in no way stretches us and stimulates us to live life to the fullest.

It is not as simple as concluding that staying busy is the way to fill our lives with meaning.  Busyness can be as life draining as watching reruns just to make the time go by.  For me, sitting alone, listening to a CD of an interesting piece of music, thinking and processing things mentally, calming my spirit, I find to be life-affirming.  Sitting on the deck, watching clouds and listening to birds is meaningful and productive time.  Quietly reading something that is engaging and mentally stimulating or spiritually nourishing is life-affirming for me.

Choosing to spend time with others is choosing life.  After a few days of talking about doing so, last week we called a couple of friends who, gratefully, were able and willing to say yes to a spontaneous invitation to go for a drive in the country.  The day was beautiful, the scenery was stunning.  We stopped at our favorite potter’s studio.  We stopped for ice cream in a picturesque small town in the area.  We tasted wine at a winery outlet, very tasty wine. (I know, ice cream and wine??)

Mary Ann chose to attend a salad luncheon with friends at church last Wednesday. While it was not expected of her, she insisted that we bring a salad – another foray into the kitchen.  Friends invited us to come down the block one evening for cookies and conversation.  The time together was not only entertaining but nourishing to some meaningful relationships.

It is very tempting to avoid the hassles and just stay home.  What was the catch phrase in those old Nike commercials: Just do it!  We have committed to a ten hour trip to Northern Illinois for a family celebration at the end of July.  From there we bring our oldest Granddaughter with us to Kentucky to spend time with our Daughter and her family.  We just received another wonderful thank you gift from the congregation I served. We provided a free place for the new Pastor to stay for a few months, waiting for his family to be able to move here.  The gift is a trip to our very favorite Bed and Breakfast in Arkansas — another long trip, but exceptionally life-affirming.

Choosing life is not always done in huge life-changing deciaions. Choosing life is often done one tiny decision at a time.  The cumulative effect of those little decisions determines whether we are living or just waiting until life is over.

Whether the choice is to undergo major surgery to provide hope of an improved quality of life, or to get out of the house and head down the block for cookies and conversation with friends, the choice is ours to make.  Either we choose life or just wait until it is over.

When given a choice, my hope is to have the courage to choose the option that is life-affirming rather than life-wasting, and, as the Serenity Prayer says, to have the wisdom to know the difference.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 15, 2009

Problems Sometimes Give Good Gifts!

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Her name is Kim.  Everyone should have the chance to know someone like Kim some time in their lives.  Kim is a vivacious mother of two school-aged boys.  The boys are both gifted, caring, thoughtful beyond their years, the sort any parents would be proud to call their own.  She is wife to a good man who cares deeply for her.  I suppose that description suggests that Kim has a picture perfect life.  Oddly, she would probably tell you that is precisely the life she has, picture perfect. 

Kim’s life took a dramatic turn only months ago.  An unexplained pain that turned out to be unrelated to the Cancer led to tests which led ultimately to a diagnosis of Breast Cancer.   As you might guess, that summary hardly contains all the dynamics of the journey from pain to diagnosis. 

Because of family history, Cancer in the lives of Kim’s Mother and Grandmother, Kim realized that she needed an aggressive treatment response to her diagnosis.  She has had the double Mastectomy and will have a hysterectomy.   The good news is that the surgery has gone well, and chemotherapy is not necessary since it would have minimal effect on the statistical risk of recurrence. 

The word Cancer has the power to bring the strongest to their knees.  At first mention of the word, thoughts move immediately to the worst possible outcome.  From the very first word of the diagnosis, Kim has not broken stride as she moved through each step into her and her family’s new perspective on life. 

In almost forty years of ministry, I have watched people travel the path of dealing with a life threatening diagnosis.  No matter how bravely the people receiving the diagnosis respond, those who love them are shaken to the core.  It is cliche to say it, but it is true.  It is often harder for those who love someone going through a devastating illness and the resulting pain, than it is for the person with the pain. 

There is a sense of helplessness for those who watch and care deeply for someone with a life threatening disease.  Those with the disease sometimes come to acceptance before those who love them.  It happened that way so often for those to whom I ministered over the years, that one of the first conversations we had when I visited was the one about just how much they would be called on to help others come to terms with what was happening to them 

Back to Kim.  Kim has a deep faith that provides her with a sense of security and the freedom to face what is happening each step along the way.  As a result, she can talk and reason and process each option without panic or pretense.  She has talked openly with the boys who share her faith.  Nothing is off the table in terms of talking about the facts of her situation and what each in the family is going through.  Kim, her husband and the boys have all through these past few months expanded their capacity to understand life in all its depth and breadth. 

While Kim appreciates fully what has happened in their lives, she is profoundly grateful for the good gifts this problem has given her and her family.  Of all things she feels privileged.  If I remember our conversation correctly, that is precisely the word she used — privileged.   

I can testify, that not all those who have gone through what Kim is going through (or some other problem like it) have felt privileged.  I have watched some become bitter, fall into despair, lash out at God and anyone else within reach, feel so sorry for themselves that the world shrinks to become solely about them and their struggles. 

Kim is not one of them.  In what could have destroyed her and her family she has found gifts of deep and lasting value.   Faith has revealed itself more powerfully, the quality of relationships grown.  She has become for others a bright beacon of reflected light — reflected because the brightness comes from the unconditional love of a God whom she knows well, revealed in the person of Jesus Christ.  While those who read this blog need not share the faith that is the source of strength for Kim and for me, it is nonetheless our understanding of truth.  We cannot describe our experience without  reference to that faith.  If Kim were to agree that her life is picture perfect, it would not be because there is no pain, no fear, no struggling, but because there is a beauty that has become more visible than ever, the beauty of life with meaning, life well-lived, relationships that are real and deep, and hope that cannot be snuffed out. 

Almost five years ago, I did the funeral for a man named Tom.  Tom had a pain in his leg.  Two years later he died of the Cancer that had spread beyond the reach of the treatments available.  While it was hard for his wife to hear him say it, not long before he died he said that the last two years had been the most meaningful time in his life.  He found gifts that opened him to life more fully than ever, life with his wife and children.  Tom touched hundreds of lives as he traveled those last two years.  Tom drew strength from the same faith.

I have written before in the post on this blog some of the gifts that have been given to us in these twenty-two years with Parkinson’s traveling with us.  I would not presume to speak for Mary Ann on this matter.  I have seen pe0ple cluster around and come to know her and respect her and love her as friend — people who came at first to help her, and were ultimately helped by being with her.  She has revealed to all who know her and know of her, great courage and strength and endurance as she has taken so many hits and gotten up again after each.

I have learned more about what it means to love than I suspect I ever would have without the struggles we have encountered.  I cannot know what life would have been without the struggles, but I am grateful for what I have been taught by them.  Our Children and their spouses have revealed to us great strength of character, wisdom, love drawn out by the struggles they have helped us through.  Mary Ann and I have the joy of seeing three Granddaughters reveal a deep love and concern and caring that has been given the chance to be expressed in age appropriate ways. 

Kim would not have chosen the Cancer.   Tom would not have chosen to leave so soon.  Neither Mary Ann nor I would have chosen the Parkinson’s, but all of us have been given gifts of a value too great to be measured.  We have been privileged to find a quality, a meaning in life that cannot be learned from a book or a lecture or a DVD or a blog. 

Problems sometimes give good gifts!  For those of you who are midstream in the struggles, look for the gifts, open them, play with them.  They are more valuable than can be measured.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 14, 2009

Creating a Nurturing Environment

Posted by PeterT under Daily Challenges, Meaningful Caregiving, Practical Tools for Coping, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , , |
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I tried again tonight.  I am resorting to chemical warfare, natural, organic, but nonetheless chemical warfare.  The weapons: blood meal and Cayenne pepper.  I am determined to have sweet potato vines growing in the large pot on the deck, and the squirrels are determined that it will not be so. 

When we first moved in there were no squirrels.  I longed for them.  When the first one came, I fed it.  Now there are a cluster of them.  I still feed them.  That makes it even more annoying.  The ungrateful buggers.  I have taken care of them day in and day out and this is my thanks — eating my sweet potato vines?

That is not all.  I planted some Salvia in the barrel — four plants.  I caught one eating a salad of Salvia leaves.  More than that, chewing off the stems at the surface of the dirt.  If that is not enough, later I caught the squrrel as he was chewing off the Salvia plants that were still in the flats, awaiting transplantation to small circle of plants in front of the house.  I managed to salvage four plants for the front.  They are still growing a week later.  The squirrels seem not to venture into the front yard. 

I have a theory about the squirrels specifically choosing to eat the Salvia.  I mentioned my plight in the Wednesday morning group that meets on the deck.  One member remembered her daughter mentioning that kids sometimes smoke Salvia to get high.  Apparently a strain of Salvia is a hallucinogen.  I decided that the squirrels are partying on my Salvia!  I haven’t noticed any unusual behavior, but then who knows what  behavior is normal for a squirrel.  Actually, the strain of Salvia kids have smoked has been illegal in Kansas for the last few years. 

I have now been assured by two people that blood meal will repel squirrels  and by another person that the vines will absorb the Cayenne pepper — one bite sending the squirrel screaming in agony.  For some reason the movie Caddyshack, Bill Murray and Gophers just popped into my mind. 

With Mary Ann supervising, in the last week or so, I have planted three large pots on the deck, an area behind the house, a barrel near the front door, a small area in front of the house and will soon plant a vining Petunia on a berm next to the house.  There is very little rhyme or reason to the plants and flowers picked and only limited aesthetic value, but at least they are planted. 

Since our circumstances tie us to the house much of the time, it seems worth the effort to work at creating a nurturing environment.  Flowers and plants are a part of  creating that environment. 

One of the activities that creates interest at home for me is creating a friendly presence for the birds.  There are eleven feeders of one sort or another attached in some way to our little deck.  In addition there are a couple of ground feeding areas in the back yard near a tree behind the deck.  There is a heated bird bath attached to the rail.  I have just hung a new little meal worm feeder outside my office window at the front of the house.  I am still in the process of waiting in hopes that a neighborhood wren will discover it.  We have a speaker in the dining room that picks up bird sounds from the deck area through a microphone just outside the window. 

We have planted trees in the back to provide shade and cover for the birds and squirrels and aesthetic variety.  The wildlife that has wandered through includes a couple of Mallard Ducks who regularly come by to eat, a possum seen once foraging in the feeding areas under the tree, last night a brazen Raccoon stopped by to climb on the deck and munch seed from one of the bird feeders.  I have seen his paw prints more than once in the bottom of the birdbath.  Rabbits hang out under the deck and often join the others at the feeding areas. 

We live in a maintenance free cluster of townhomes with multiple subdivisions in all directions.  We have created such a welcoming space for wildlife because I find their presence to be nurturing to my mental health.  Mary Ann enjoys it some, but mostly just tolerates my penchant for feeding the fauna.   

Next week ABC Ponds will begin work on the pondless waterfall that will be constructed behind the deck.  What precipitated the idea was the need to deal with a problem with standing water behind the houses in our area.  Sump pumps cycle constantly emptying into the area.  The clay will not absorb rain water when comes.  What will be created is essentially a manmade wetland with a deep reservoire filled with natural filtering material, covered with perennial native marginal plants.  The water will be pumped from the base of the well to the waterfall.  Kansas State University has been using this process in recent years to deal with run off. 

The environment I have sought to create is not just a novelty.  It is an essential element in my survival here.  The television provides entertainment for Mary Ann.  I watch my share of it but find it to frustrate my sense of well-being rather than nurture it. 

Many a day we are not able to set foot off the property due to the complexities of Mary Ann’s physical needs.  There need to be nurturing elements in our environment. 

Inside the house are paintings, a metal wall sculpture, antiques, crystal and china and ceramics to add quality and variety to the interior of our home.  A few  years ago I commissioned two members of the congregation, a cabinet maker and an artist to create a small worship center that sits in my office, providing a focal point for meditation.  We have a sound system in the living room that provides a good quality of sound for the occasional time after Mary Ann is in bed for just listening to music that feeds my spirit. 

If I will be a healthy and able Caregiver for Mary Ann, there needs to be regular access to that which nourishes my well-being.  I am then better able to provide for her as nurturing and safe and healthy an environment as possible.  Rather than allowing the four walls of our little living space to be confining and boring, empty of the richness we both need to maintain our emotional health, we have committed our time and resources to creating a nurturing space in which we can live meaningfully. 

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 12, 2009

Caregivers: Be Safe or Sorry

Posted by PeterT under Daily Challenges, Meaningful Caregiving, Relationship Issues | Tags: , , , , , , , , , , , , , , , , , |
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The extension ladder is old and not very stable.  The years of very little exercise have stiffened this sixty-six year old body so that moving up and down a ladder is not such an easy task any more. Lifting the ladder off the hooks in the garage tested my wheelchair lifting muscles.  Then there was the matter of moving the ladder every few minutes along the gutter so that I could climb up with my bucket, hook it on a rung and grab handfuls of smelly rotted little seeds from the neighbor’s trees.

I am not much of a ladder person.  Heights are just not my thing.  I suppose I am sort of acrophobic.  I don’t mind riding in an airplane, although recent news events may change my opinion on that.  On Youth trips to a beautiful camp fifty miles northwest of Colorado Springs called Lutheran Valley Retreat, I joined in the climb up Cedar Mountain.  I still remember my first time.  I was terrified.  As a pastor and counsellor on the trip, more than ten years older than the oldest of the Youth, I was too embarrassed to admit it.  The way I got through the climb that first year was to convince myself that if thirteen year old people could climb it, at thirty, I ought to be able to climb it.  I decided that in spite of my insides being less sure of it, I was safe.

Other than the year the lightning almost got us, I felt safe from then on.  After the first year I was a seasoned pro, climbing with bravado.  Still, if I am not completely confident that I am secure, heights are very unsettling to my insides.  I will not walk to the edge of a very tall building to look out windows if they are floor to ceiling.  Vertigo sets in.

As I was climbing up the ladder to clean out the gutters yesterday afternoon, the issue of my safety came to mind.  The ladder sometimes slipped at the top toward one side or the other as I climbed up.  I started thinking about what I would do if it fell, where I would land, what way to jump if it started going.  It was not a particularly scary thought to me, just a matter of fact analysis of the situation.

As I was analyzing the dynamics of falling, it popped into my mind that hurting myself would not just be a matter of getting fixed whatever broke, arm, shoulder, knee, or something worse.   What about Mary Ann.  She needs me to do the most basic daily tasks with her or for her. Hurting myself would hurt her.  She counts on me. If I were to do something stupid, our ability to maintain our little world would be gone, at least for a time.  She would certainly be mightily irritated with me.

The way I responded to that realization was to become very methodical about setting the feet of the ladder, making sure it was flat against the gutters.  I stepped up the ladder more slowly.  I caefully hung the bucket for the sludge.  Thinking about my responsibilty to Mary Ann as Caregiver translated to more care of myself.  

What happens to me is not just about me.  Those of you who have children are likely to have come to the realization that the choices you make do not just affect you.  Riding a bike without a helmet, ignoring the seat belt, driving twenty miles over the speed limit (under ten is okay, right?), smoking like a chimney, whatever puts you at a significant health risk is more than an issue of your freedom to do as you please.  It is no longer just about you. 

There is also a frustrating flip side to the matter of keeping safe for the sake of our care receiver.  What would be fair, if fairness were an option, is for the one for whom we are caring to have the same concern for keeping safe.  It would seem fair for the Care Receiver to avoid taking risks so that their Caregiver would not have an even tougher time trying to deal with the consequences of their risk-taking gone bad. 

I hesitate to bring this one up again, but it is one of the most difficult areas in our relationship as Care partners.  It seems that one of us in this partnership is intent on taking risks no matter how likely the risk is to produce more work for the Caregiver.   The truth is, there is no thoughtful intent to make work for the Caregiver by taking unnecessary risks.  The kind of thinking that would be needed for that intent is no longer available.  The risky actions are just the reflex actions of a mind and body with the simple need for the freedom to move at will and do the same things that have always been done.  There is no fully conscious awareness that the disease process has taken away some freedoms. 

Nonetheless, it is very difficult to watch a Loved One assert that independance without regard for the consequences to herself or her Caregiver.  It is just part of the reality within which we live now that Parkinson’s and Parkinson’s Disease Dementia have joined us in our journey.  Fairness is irrelevant to matter of safety. I need to keep myself safe so that I can continue to care for her.  She is free to do whatever she can no matter the risk. 

Nobody said life is fair.  If it was fair, she wouldn’t have to deal with the ravages of the Parkinson’s in the first place.  It is not fair, it just is.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

 

June 10, 2009

Who Makes Daily Decisions and How?

Posted by PeterT under Daily Challenges, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Uncategorized | Tags: , , , , , , , , , , , , , , , , , , , , , |
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Should we go to the Neighborhood Brunch or shouldn’t we?  It took at least three days to get the decision made.  The way I finally figured out whether Mary Ann wanted to go or at least was willing to go, was by jumping up to help her when she got up from her chair and headed out to the kitchen.  She was looking for the recipe for the Blueberry French Toast that has always been a hit at the Brunch and wherever else we have taken it.  She finally signaled her wishes by her actions.  it was 5pm in the afternoon of the day before the Brunch.  We had only a few of the necessary ingredients in the house.

Getting decisions made is an unbelievably difficult challenge in our household.  We have regularly played the “What do you want to do?” game.  We almost always played that game when it was time to go out to eat. It is a miracle that we ever actually got to a restaurant and ate.  The process of deciding where to eat always went the same way unless some external circumstances led both of us to the same idea immediately.  If it was time to eat and we happened to be near Bobo’s Diner, the decision was easy – still is.  The vast majority of times it went this way, I began listing every restaurant that I could think of until I named one that brought to Mary Ann’s mind a particular menu item for which she was in the mood. Sometimes that went on so long I started heading home out of frustration.

Some things have changed as the disease process has taken its toll on Mary Ann.  The Parkinson’s has softened her voice and slowed the mental process, making it difficult to respond to questions.  The Parkinson’s Disease Dementia (a Dementia with Lewy Bodies) has stolen even more decision-making ability.  Sometimes it is almost impossible for Mary Ann to get hold of what she is thinking.

Imagine trying to play the “What do you want to do?” game when the person being asked that question has absolutely no answer, no idea how to answer.  Please understand, that does not mean there has been any change in the wanting of certain things.   It is just next to impossible for them to locate that want, name it, and get the words out of their mouth.

As with most of us who are doing full time caregiving, much of the time I can read Mary Ann like a book.  I may very well have enabled her lack of responsiveness by figuring out what she wants without her having to say anything out loud.  We have been at this relationship for well over four decades.  I can usually figure out what she wants by analyzing the circumstances at a given moment and remembering what she has wanted a thousand other times in those circumstances.

Making a decision on anything other than routine matters where circumstances can easily be read is often a protracted and painful process.  I asked about the Neighborhood Brunch occasionally for a couple of weeks.  There was no reply, nor were there any non-verbals that gave a clue as to her wishes.

I suppose the question could be asked of me, why bother to include Mary Ann in the choosing.  Why not just make the decision and go with it.  For one thing, that is not how I function. Ask those poor folks who worked with me in a Team Ministry.  Being inclusive of everyone in the process of making a decision at work often makes for a better decsion and more likelihood that all the participants will be on board when it comes time to act on the decision.  On the other side of it, I know there were times when we processed things too long and everyone wished as the Senior Pastor, I would just make the decision so that everyone could get on with doing what we were talking about.  As I often admitted, I just wanted to work it out so that I wouldn’t get the blame if the decision turned out to be flawed.

Why include Mary Ann in the decision-making?  She deserves to have something to say about her own life.  Because of the Parkinson’s and the cluster of additional health issues, she has had stolen from her any shred of control of her own life.  She has always been strong-willed, so running roughshod over her wishes would not work.  She would figure out a way to stand up for herself, even if she might take a passive-aggressive approach.

I work very hard at trying to give her the chance to decide what we will do.  I usually try to guess what she wants and then frame the question about what to do by saying “would you like to [insert what I have guessed she wants to do].”  I often have to follow it with “just say yes or no?”

As the Satuday of the Brunch got closer, I became more specific about the options.  If we went to the Brunch it would mean having the hassle of making the Blueberry French Toast, but then we would have the valuable social interaction.  I probably said it in a way that would have revealed to the attentive that I was not much interested in the task of making the BFT.  For the last two days before, I tried the “do you want to go, yes or no?” approach a number of times.  There was no response, nor where there any non-verbals I could read.

By Friday afternoon, I was specific that if we were going to go, we would need to go to the store soon.  The recipe demands that the BFT sit overnight before baking.  Still there was no response.  I don’t remember how long after that attempt at getting a response she got up with that restlessness that indicates there is something she intends to do other than the usual.  It only took me seconds to put two and two together.  She was looking for the recipe.  We were going.

I have to admit that there is a part of me that resents that she had not given any indication sooner and that her decision meant I would need to get us to the store, come home, make the Blueberry French Toast while trying to include Mary Ann in the process of making it (harder than doing it myself).  I dreaded the fact that I would need to get up at least two hours earlier than usual to get myself cleaned up, get the dish out of the fridge to stand for thirty minutes, cook it covered for thirty minutes, uncovered for another thirty minutes, make the blueberry sauce that needed to be cooked just the right length so that it could be poured over the casserole just before serving it.  During that same time Mary Ann needed to be aroused, dressed and fed so that we could make it to the Brunch on time.

When all was said and done, the Brunch went well, the Blueberry French Toast was a hit (the huge pan came home completely empty) and we enjoyed the morning.

Making decisions is terribly difficult to do, but Mary Ann deserves to be a part of them.  As frustrating as the process can be, it is important that Caregivers and Care-receivers make decisions together.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.

Added bonus:
BLUEBERRY FRENCH TOAST

12 slices white bread
2 8oz. cream cheese
l c blueberries / 12 eggs /2 c. milk
1/3 c. maple syrup

Sauce: l c. sugar l c. water
2 T cornstarch l c. blueberries
l T butter

Cut bread into l inch pieces. PLACE 1/2 in buttered 13 x 9 baking dish. Cut cream cheese into l inch cubes. Place over bread. Top with berries and rest of bread. Beat eggs. Add milk and syrup. Pour over bread mixture and chill overnight. Remove from fridge 30 minutes before baking. Cover and bake at 350 for 30 minutes.. UNCOVER and
bake for 30 minutes or until set.
SAUCE: in a saucepan combine sugar, butter, and cornstarch add water. BOIL for 3 minutes over med. heat stirring constantly. STIR IN BERRIES and reduce heat. Simmer for 8-10 minutes. Pour over French toast before serving

Mary Ann Tremain
Faith Lutheran Cookbook 6/25/02

 

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