February 4, 2010

Too Good to be True

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Three nights are better than none.  Mary Ann was up once every two hours last night.  That is good measured by past standards, but disappointing in light of the hopes raised by three nights of sleep with only a couple of interruptions each night.  She was up and ready to go at 6:30am this morning.

There were a couple of Volunteers this morning.  Two of the three other members of the Wednesday morning group could not make it this morning, so Paul (the other of the three) and I met for coffee at PT’s (of course).  Then I spent some time sitting in the car listening to a remarkable vocal ensemble called Anuna (performed in Riverdance).  I checked out a particularly meaningful Bible Passage.  Then I walked a little over a mile at Cedarcrest.

When I returned, Mary Ann was napping.  After a while, she ate the leftover Seafood Tortellini from yesterday’s lunch.  While she was eating she said “where did you get that” while looking over my shoulder.  I asked her who she was talking with.  She said it was her Mother (who has been dead for many years) who was holding a doorknob in her hand.

There were some intestinal blowouts that suggested the onset of serious diarrhea, but they subsided after a while.  I will spare the details of those challenges.

As the day wore on, there were a two or three more quick comments that seemed to reflect the presence of a hallucinations.  She spent much of the afternoon with her head on the table.  I gave her the stuffed frog, on which she laid her head.

During that time a friend came over to talk with me about a project on helping people make meaningful plans for their own or a family member’s funeral.  Having done countless funerals over the years, I have seen what helps and what does not help when going through such a time.  It felt good to be able to talk about some of those experiences and discoveries that came from them.  It is a nice feeling still to have something to offer.

Mary Ann spent the rest of the afternoon with her head down in her lap, on the stuffed frog.  She manage to eat a little, very little for supper.  With the new Baskin and Robbins now open, I put the Lifeline button next to her head as she lay it on the table after supper, and headed off to get ice cream for her so that she would have enough in her stomach to last the night.  Yes, of course I wanted ice cream for myself — did you even need to ask?

I decided to write a request on Facebook that anyone who can do so, get ice cream at that B&R and tell them Pastor Pete sent them.  When I stop back in a few days, I will be curious to find out if anyone actually did so.  It can’t hurt to have the owners of the B&R as friends!

I have to say that it has been very disappointing to see an end come to the good days and nights so soon.  I was hoping we would get weeks or months rather than just days out of the new dosage of Seroquel.  I was not at the monitor for a bit a few moments ago and heard the telltale thump.  She was on the floor next to the bed but not hurt.  When I helped her to the commode, she suddenly got an alarmed look on her face and told me not to step on the baby.

Fifteen minutes later she was up again on the side of the bed.  I went in to see what she needed.  She said, “What are you doing here at school.”  When I asked what school we were at, she said it was Granddaughter Ashlyn’s school.  Then she suggested that she get dressed to help her get oriented.  I explained to her that it was 11:10pm, and everyone else is in bed, so it would not help her get oriented to get dressed.  She decided to use the commode, even though she used it fifteen minutes earlier.  She is lying down in bed again, but I don’t expect it to be for long.

She made it almost an hour.  This time she was on a ride in the car looking for a house, looking at a parsonage.  There were some banshee eyes (not scary to her) that seemed to be like the 3-D glasses from the yesterday’s viewing of Avatar.  Didn’t I have to pick up the kids.  The raccoon was there (first she called it a porcupine).  She said that this looked like her bedroom.  I showed her the quilt on the wall again to assure her that it actually was our bedroom.  At least so far tonight, she has not been as agitated as she was last week.  Unfortunately, it is likely that if she gets less sleep than she needs in the next few nights, that intensity will return.

More than one of us in the online group have compared the rapid twists and turns and reversals of fortune that come with this sort of dementia to torture.  Each of us has our sources of strength and wisdom.  In my world view, the Biblical literature is  the place to which I go to find the framework of reality as I understand it, to locate meaning in the middle of things beyond understanding.  This morning as I sat in the car at the lot at Cedarcrest, my mind went to a passage written by a fellow named Paul, who had by that time gone through some terrible struggles.  It reads this way:

“But we have this treasure in clay jars, so that it may be made clear that this extraordinary power belongs to God and does not come from us. 8We are afflicted in every way, but not crushed; perplexed, but not driven to despair; 9persecuted, but not forsaken; struck down, but not destroyed; 10always carrying in the body the death of Jesus, so that the life of Jesus may also be made visible in our bodies. 11For while we live, we are always being given up to death for Jesus’ sake, so that the life of Jesus may be made visible in our mortal flesh. 12So death is at work in us, but life in you.” [2 Corinthians 4:7-12 NRSV]

Quoting Scriptures is not intended to suggest that these posts are only for those who share my theology or any theology for that matter.  I am simply reflecting the sources to which I go for strength.  When hopes and expectations get crushed, it is easy to feel hopeless.  It helps to hear from others who have been there, like Paul, a way to perceive reality that allows survival. It is the reality to which Paul refers that provides the ground on which this roller coaster we are riding rests.

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.

 

February 1, 2010

I Will Not Surrender!

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This morning I thought the increased dosage of Seroquel had gone too far and put her into a sort of drug-induced stupor.  She was sleeping so deeply.  She would not arouse.  She had hardly moved a muscle all night other than two commode trips.  Yes, I wanted to get some sleep, but not at that cost.  I would rather endure the rampant hallucinations than lose her completely into some distant world out of touch with reality, with who she is.

At that point I decided that unless things changed dramatically, I would call the doctor and do everything in my power to find a way to reset her medication regimen completely — take it all away (medicine vacation) and re-introduce only what is absolutely necessary monitoring side effects with each addition.  Some of the meds can produce hallucinations.  I would do it at home or in the hospital or wherever necessary.  I refuse to concede anything to this disease other than what absolutely must be accepted.

As I did morning preparations for the time that Sunday morning Volunteer Edie would arrive, I tried to awaken her a couple of times so that she could be dressed and have eaten and taken her pills.  Her hair needed washing after the last few difficult days.  She was just sleeping too soundly to get up.

I headed up to the lake after Edie settled in with instructions for giving meds.  I assumed that when I returned, Mary Ann would most likely still be in that same deep sleep.

As I drove the half hour to my spot by the dam, I put on a CD done by Lisa Kelly from the Celtic Woman group.  Her voice has a very engaging timbre.  Most of the songs were ones that I had heard and enjoyed before.  When I settled in by the lake, no eagles in sight at that time, the music and my image of Mary Ann in that deep sleep, began to burrow in.  For some reason, even though well-rested from last night’s virtually uninterrupted sleep, it all began to well up.  It surprised me at that moment to hear a song I would not have expected on a commercial CD for the general public.  The title is “The Deer’s Cry” from a movie called The Pilgrim.

I arise today
Through the strength of heaven:
Light of sun,
Radiance of moon,
Splendour of fire,
Speed of lightning,
Swiftness of wind,
Depth of sea,
Stability of earth,
Firmness of rock.

I arise to-day
Through God’s strength to pilot me:
God’s eyes to look before me,
God’s wisdom to guide me,
God’s way to lie before me,
God’s shield to protect me,
From all who shall wish me ill,
Afar and anear,
Alone and in a multitude.

Against every cruel merciless power that may oppose my body and soul
Christ with me, Christ before me, Christ behind me,
Christ in me, Christ beneath me, Christ above me,
Christ on my right, Christ on my left,
Christ when I lie down,
Christ when I sit down,
Christ when I arise,
Christ to shield me,
Christ in the heart of every one who thinks of me,
Christ in the mouth of every one who speaks of me.

I arise to-day

I am not embarrassed by this, but it has happened only four or five times since I was a child.  I have teared up, I have gotten choked up, but this morning I cried out loud. I just couldn’t stop. I was sitting in the car in the parking lot hoping no one would drive in and stop, as people often do since it is such a beautiful spot.

I don’t want to analyze all the whats and wherefores of what happened.  It was a deeply personal moment.  Writing it here risks trivailizing it.  I hesitated talk about it here, but it was too important to me for me to write about today honestly and not reveal it.  It just happened. I was overwhelmed with the vision of Mary Ann being lost in her own body.  She deserves more!

I refuse to be complicit in any way in treatments that make it easier to care for her at the cost of her being fully present to whatever degree possilble.  If I need to have paid help her overnight to be able to endure challenging behavior, so be it.  I wlll not lose her until the disease process itself takes her from me.

Yes, I am angry at this damn disease!  I don’t blame God.  The words of St. Patrick’s Breastplate in that song are what broke open the tears.  I sometimes forget how much I need what I sought to tell others all those years.  I am angry at myself for beginning too soon to accept losing her .

The recent decline and move into dementia has happened too fast.  Yes, sometimes declines happen so slowly that they are not noticed until they cross a certain threshold.  That can create the illusion that the change has happened quickly.  I remember a Neurologist in a Webinar saying that Parkinson’s progresses slowly.  If a change happens fast, it is not the Parkinson’s.  Something else must be the cause.  Lewy Body Dementia can change back and forth between getting better and getting worse quickly,  This decline and the increase in hallucinations has moved at a pace that suggests the need to look carefully, especially at the medications to see what other explanations there might be for the rapidity of the change.

I will accept only what must be accepted and will concede nothing more!  I am tired of just taking what comes and accepting as inevitable every decline.  While we choose to live in a certain denial day by day, I have no illusions about the general course of this disease. If anything, I know too much about what lies ahead, having read emails from other Caregivers struggling with this same disease in their families.

When I returned from the lake, I walked in the door to see Mary Ann sitting in her chair with Edie sitting next to her.  They were talking.  Mary Ann had gotten up shortly after I left.  She had taken her pills and eaten a good breakfast. She had drunk lots of liquids.  I had noted the color of Mary Ann’s urine in the commode this morning suggesting she might be getting dehydrated.  She had had a good BM (a big deal).  She had asked Edie about her new Grandchild.  She wanted to hear more about the baby.  She tracked the conversation, smiled and laughed at appropriate times.

After Edie left, we ate lunch — a sauerkraut and meatball soup that both Mary Ann and I love.  After much prodding, Mary Ann allowed me to help her eat. As a result she ate a good quantity of the soup and bread.  She had a big piece of carrot cake.  Not too much later she asked for and ate a bowl of ice cream.

She and I watched television for the rest of the afternoon.  She probably wondered what was going on since I did more hugging and telling her I love her than has happened in a while.  Neither of us is very demonstrative.  This morning messed up my controls for a while.

I got ready for the Evening Service, got things in the car, the garage door open.  I had been talking about going to church, as usual.  I put her shoes on.  She was tired and had been sitting there with her head hanging in her lap, napping.  When it was time to get in the car, she just was not willing to go out.

I gave her some supper.  Then she went right to bed.  She has now had her pills and is in bed, moving around a lot. I will be heading in soon.  Even though last night was a wonderfully sleep-filled night and today was a good day, tonight and tomorrow could be completely different.  We can take nothing for granted.  It will take some time to process all that happened today.  I am out of breath from the ride.

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.

 

December 31, 2009

Wednesday’s Open Door Policy

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Shortly before 7:30am, Duane dropped off Eva at the house so that she could spend a couple of hours with Mary Ann.  Then came Shari and Edie for the Spiritual Formation Group that meets on the deck or in the downstairs family room.  Since the deck is covered with snow, it was, of course, a downstairs morning.  All is well whichever place as long as the coffee is made. 

A little later, Zandra came to give Mary Ann her shower and wash and dry her hair.  About an hour after they all had left, Kristie came to do the once a month cleaning of the house. 

Actually, we have an open door policy most of the time.  We have been very private people, especially Mary Ann.  All that changed in the last decade.  Since getting to the door is not always an option when someone rings the bell,  those who have come regularly to spend time with Mary Ann know that they may just need to walk in, if no one answers the door.  They walk in and announce themselves so that we will know that they have arrived.  We have become quite accustomed to the open door policy. 

While we did not get out today, the many visitors provided an antidote to any sense of isolation in our little cabin.  No cabin fever today.

Mary Ann did nap for a couple of hours during the day.  That allowed me to get some things done at the computer.  I did not spend time on the online retreat until she went to bed tonight. 

These two days looking at mental snapshots of events during the Teen/Young Adult years has again been thought provoking.  The Spiritual Formation Group discussion blended with the matter of receiving gifts from experiences, good or bad. 

I thought about last night’s post and the role singing played in my life.  While the high school and college years provided much affirmation as I participated in leadership roles, sometimes doing solo work as well as singing in ensembles, it was different at the Seminary.  Music  was still a dominant feature.  There was a three week choir tour that took us (Mary Ann and me) to England, Holland, Germany, Austria, Switzerland and Belgium.  There were powerful, moving worship experiences singing in the chant choir and performing Bach’s St. John Passion. 

My ego was taken down a few notches in the Seminary Years.  Illusions about my ability were shattered as I stood next to a tenor who had a Master’s Degree in Vocal Music from Indiana University.  I realized that I had been measuring my ability against non-music majors.  Louie provided a needed perspective. 

My injured ego came with me as I continued to sing in the Chant Choir at the Seminary, and the Cantata Choir that included people from the city.    The gift that came from those years was a more realistic view of my abilities.  While the truth can be painful, it is better to make friends with the truth than spend much time with pretense.  Another gift was an appreciation of being a part of something greater than one person.  It became less about me and more about the music and its impact on those listening. 

That shift in focus seems to me to have helped in the transition from a high profile role as Senior Pastor of a large and vibrant congregation, to a lower profile role of being the full time Caregiver to someone who needs that care, someone to whom I am fully committed.  

Those years included the joy that December 18, 1965, when Mary Ann and I were married in our home congregation in Northern, Illinois.  We had both had finals at our respective schools in St. Louis the Friday before the Saturday we were married in Aurora, Illinois, outside of Chicago. 

Those years included the death of Mary Ann’s Dad, just two or three weeks after the wedding.  He had walked Mary Ann down the aisle. 

The Seminary years included a year at a church doing an Internship, called a Vicarage.  It was the 60’s, including the three assasinations.  I became disillusioned with the institutional church.  I refused to accept a Call to a parish on the day my classmates all received theirs a few weeks before graduation.  Those were dark days.  I didn’t know what to tell Mary Ann, since I didn’t know what to do.  Lisa was due to be born about a month after graduation. 

Lisa was born on the Fourth of July in 1969.  She brought light to those dark days.  I can remember holding her as we watched the moon landing, wondering what it would be in store for her as we moved into the space age.  I remember her Baptism in the Seminary Tower’s Baptismal font, with water from the Jordan that John Damm had added before doing the Baptism. 

Out of that time emerged an opportunity to teach at Concordia Lutheran High School in Ft. Wayne, Indiana (where I had spent two of my college years and my Internship).  It was a school of some 900 students.  There were some volatile times there, which will be for a future post. 

Those years were a roller coaster of experience in most every way.  They provided a lifetime worth of highs and lows.  And the ride was just beginning.   The gift from those years came in the form of the recognition that most anything could happen, and with the Lord’s help, we would survive.  Little did we know then, just how important that learning would be. 

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.

 

December 30, 2009

Second Day of Escape from Cabin

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We got out of the house again today!  It just feels good to be out in the van running errands after so long stuck inside.  There was no nap again today.  I certainly hope in spite of that, there is more sleeping tonight than there was last night.  It was snack time at 3:15am. 

We ran errands and ended up at the grocery again today.   Mary Ann likes being at the store.  It seems to be one of the most engaging and entertaining activities for her.  It frustrates her that she is no longer the chief of food preparation and pantry stocking. 

Lunch was left over chinese from yesterday.   Supper was Chicken Tetrazini that was brought to us from church by the Parish Nurse for the freezer.  I cooked some fresh broccoli to add a veggie.  The Tetrazini tasted wonderful to both of us.  I am always fearful that anything from the freezer will not spark Mary Ann’s interest, but she loved this meal too. 

The Parish Nurse program at the church from which I retired has been one of the strongest ministries.  It is so strong because Margaret has made it so with God’s help.  She visits folks who are homebound regularly, taking vegetables from Glenn’s and her vegetable garden, flowers from their flower garden, leaves from their Maple tree in the fall, CD’s of the last Sunday’s church service, and from the church freezer she brings food that has been designated for use by the Parish Nurse.   The sense of community and support from church is vivid for those who receive her ministry and the ministry of those who assist her. 

Since there was no nap today, it helped that a Volunteer was scheduled for two and a half hours this evening.  I got out for a coffee refill.  I got to the liquor store to buy a half bottle of Asti Spumonti so that we can tie one on Thursday evening, New Year’s Eve.  That will happen when we eat cheese and crackers and toast the New Year at about 8:00pm.  It will be the New Year somewhere on the planet by then.  The worst part of it is that every year we do that, we have of the half bottle left to sit in the fridge for a while.   I guess we are not the rowdiest partiers around. 

The time the Volunteer was here gave me a chance to focus attention on the online Ignatian Retreat I have started.  This week’s activity is remembering the mental snapshots of those events from the past that impacted our formation.  This evening began the Teen and Young Adult reminiscences. 

Many of them related to the choirs I was in.  I perceived myself to be a non-entity in social terms at the large schools I attended.  I was utterly shocked when my name was suggested for President of the 104 member Sophomore Choir.  I got to serve as President and Student Conductor or four more choirs through high school and college before entering the Seminary.  Singing was at the very center of my life from Junior High through the end of the Seminary (8 years post high school).  Music has had a sustaining and nurturing presence in my life for all the years since.  It feeds my spirit in a way that allows me to continue doing what I am doing now. 

One of my most vivid memories is of the night when I was about fourteen years old that I decided to go in the ministry.  It was a very spiritual experience.   There was not magic nor were there voices from above, just some powerful mental conversation that seemed to reveal the Lord’s leading to the decision.  I am always suspect when someone says the Lord told them to do something.  It seems often to be an attempt to use the Lord to make people agree with something the person has decided is so.   The decision to go into the ministry was tested and reconsidered as other career options moved to center stage, one in Physics and the other in Choral Music. 

That memory confirms for me a decision-making process that, at least in terms of major decisions, has seemed to leave me completely secure in whatever I have chosen to do.  I have never regretted a major decision or second-guessed it.  Whether right or wrong I have given myself completely to whatever has followed each of those major choices.  I have not lost energy because I wondered if I was doing the right thing.  I may have lost energy for other reasons, but not because I doubted the choice I had made.  That has been the key to dealing with the challenges that come with full time Caregiving.  As those of you who read these posts know well, I have plenty of times of frustration with my role and my own limitations, but I do not question the decision to choose the role. 

The time in life that is the focus of today and tomorrow is the time during which Mary Ann and I met and, three and a half years later, married.  I had endured the typical rejection by the first couple of Junior High crushes.  I will say it certainly did not feel typical.  I met Mary Ann (having known her name since we grew up in the same church) the summer after my first year in college. 

Romantic love is, of course, very selfish.  I fell in love and found that a gaping hole in my insides was filled by that relationship.  I can only speak for my own feelings on the matter.  I do not actually know much about Mary Ann’s feelings at that time, or since then for that matter, since she holds her feelings close to the vest, as they say.   While we have had the usual ups and downs, the relationship has remained secure for these many years.  I feel no less in love with her than I did forty-four years ago.  Even the waste management duties have not changed that.  If anything, the feelings are deeper and more fully developed than when we began our life together.  The struggles of these last few years have drawn us closer.  All of that does not preclude our getting grumpy with each other, or our resenting each other when things are not going well for us.   It just puts the problem times into perspective as just a part of a strong and healthy relationship. 

The online retreat is providing lots of fodder for the task of finding meaning in the circumstances in which I am living as a Caregiver.  Finding  meaning in the Caregiving tranforms frustrating days into fulfilling days.

 

December 29, 2009

Escape Cabin! Plan Sunroom Addition.

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I asked Mary Ann if she wanted to go out to lunch.  A ridiculous question, since she always wants to go out.  The sun was bright.  The temperature headed for a balmy 33 degrees.  All but the major thoroughfares were still in pretty bad shape, but it was doable.

We ate at Perkins, then headed for some errands.  Excluding a pit stop at the house, we were out from 11:15am to about 4:30pm.  I guess we had a lot of pent up need for running errands.

We had an appointment this afternoon that related to obtaining the means to accomplish a project here at the house.  While we have limited resources, there is a need to do whatever we are able to do to make our environment as pleasant and stimulating and nurturing as possible.  Most of the days we have left together will be spent here at home.  It is reasonable to expect our freedom to get out to diminish as time goes by.

We have a wonderful, calming pondless waterfall that has been installed in our back yard.  There are probably thirty or more trees surrounding the area behind the house.  There is a secluded feel to the space.  The problem is that we can’t see any of it from inside the house.  We have to go out on to the back deck to enjoy it.

Town homes are close to one another and often have very limited window space.  One reason we chose this home was that it had more natural light coming in that most of them, but it still is very limited.

Before we added the deck, there was a small patio under a portion of the roof in the back corner of the house.  When we built the deck, it included that patio area and extended into the back yard.  We are going to enclose the area under the overhang so that it will become a sun room.  The interior walls will be removed other than a column to support headers that keep the roof properly supported.  There will be a six foot by nine foot area added to the interior space.  There will be sliding glass doors flanked by windows the same size as each panel in the sliding glass doors.  There will be light!! By the way, yes, there will be Vertical Blinds to provide privacy at night.

Through those glass doors and windows we will be able to see the waterfall and plantings.  I will be able to see the birds that come to the twelve to fifteen bird feeders clustered around the deck.  Mary Ann is just not comfortable spending time outdoors. This way she will be able to enjoy the waterfall and back yard from inside the house.

I won’t deny that this project, along with the waterfall, is an attempt to satisfy my need to enjoy the outdoors.  We are here inside this small living space all day long every day much of the time.  This project will bring the outside in so that our cabin fever might be diminished even when we are homebound.

This afternoon the commitments were made.  The project should begin some time early in February.  Who was it that said his goal in retirement was to spend his children’s inheritance?  Sorry, Kids!

Since we were out for most of the day, there were no nap times.  What is odd is that while Mary Ann has slept pretty well the last couple of nights, having had one or two long naps during the day, she seems unable to get to sleep tonight.  There has been almost constant motion in the bedroom.

Since there were no naps, I have not had any time to spend with the online Ignatian retreat today.  Mary Ann did get in bed early tonight, even though without sleeping.  When she first laid down, I read an email that included a link to a YouTube video of the Taizé community singing in worship.  That link took me to a treasure trove of Taizé music with video or slides.  I spent the next hour trying to listen and watch.  That music touches me deeply at a Spiritual level.

I used the word “trying” in describing that experience, since Mary Ann’s movements caused me to hop up every few minutes.  In between times helping her with the television remote or adjusting the covers or using the commode or having a drink of water, I watched the monitor wondering what was coming next.  I found the conflict between the deep feelings I was experiencing through the meditative music and the constant attending to Mary Ann to be almost unbearable.

It is just a part of the Caregiving task for anyone who is attending to another’s personal needs.  What is so difficult is that the person in need becomes the constant center of attention, with no opportunity to just relax and focus on something else.  Any other focus needs never to draw attention completely away from what she is thinking or feeling or needing or doing or considering doing.  The pieces of Taizé music are anywhere from two to five minutes long.  I was not able to listen to even one of them all the way through without at least one trip to help Mary Ann.  This time after she goes to bed is the time I count on to disengage a bit and focus on something to stimulate my mind.  I have been up and down more that a dozen times while trying to write this post.  It is at times like this that the task of full time caregiving feels the heaviest.

I will head back to the bedroom now in hopes that there will be some sleeping that will follow.  The odds are not good for that happening.

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.


 

December 26, 2009

Blue Christmas

Posted by PeterT under Daily Challenges, Family, Meaningful Caregiving, Practical Tools for Coping, Sources of Strength | Tags: , , , , , , , , , , , , , , |
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A church in our area had a Blue Christmas.service scheduled this season. The church I served as Senior Pastor until I retired has had a couple of Blue Christmas services the two years before this one.  The holiday season is tough on folks whose situation does not match the wonderful loving family scenes portrayed in movies, television programs and the feel good stories that come at this time of the year.

There is, of course, nothing wrong with all the happy endings and sentimental stories that fill the media at Christmas time.  What is wrong for some is that what they see is not what they experience, or have any realistic hope of experiencing.

This Christmas Day did not seem very celebrative.  Mary Ann admitted on the phone with our Daughter to being sad.  I guess in that sense, we had a taste of what it means to have a Blue Christmas.  Before anyone who reads this gets concerned, we had a great family Christmas celebration last Sunday.  Our visiting children had to return home a little sooner than planned to avoid being trapped by the weather.

We were alone today.  We were trapped in the house yesterday and today due to the blowing snow, providing large drifts and sometimes impassable streets.  We will probably be here tomorrow also.  I had a bowl of cereal and Mary Ann a left over half-sandwich from yesterday for lunch.  She had frozen pizza tonight and I had the last of some leftovers.  Not much of a Christmas Day celebration.  We do have lots of snacks and sweets to satisfy our need for munchies and our sweet tooth.

There was great music available on the radio, but Mary Ann’s electronic medium of choice is the television.  I listened to some meaningful (to me) worship music while she was napping.  Music does not seem to hold her interest at this point.  There was very little on television that both fit her taste and lifted our spirits.  It was mostly silliness or violence.

I can understand why the expectation of intense joy and warm feelings can make it a very tough time of the year when the reality is so far from the expectations.  Reality is not so simple.  It is far more complex than just all warmth and happiness or all struggle and pain. It is most often a measure each mixed together to produce life as it really is.  The challenge is to keep it all in perspective, enjoy the wonderful moments, deal with the not so wonderful moments, and accept the value of each in creating the history of our lives.  Our past has shaped us and our choices as they continue to come day by day form us into who we are becoming. This Blue Christmas is just one day in the journey.

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.

 

December 11, 2009

A Good Night Out

Posted by PeterT under Daily Challenges, Help from Others, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , , |
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If you have not heard “O Holy Night” sung by Kristen Watson, you have not heard “O Holy Night!”  Music has the power to break through defenses and touch us at the core of our being.  When trite or contrived or done badly, it has no power but to annoy.  When done well, with honesty and integrity, there is no defense that can repel its power to engage one’s spirit.

When Kristen sang “Gesu Bambino” there were no defenses left.  The last note with its quiet and gentle power, set the stage for “O Holy Night.”  Since retiring from the Pastoral Ministry, a combination of Caregiving demands and traveling to visit family have diminished dramatically the opportunities to attend the most powerful worship opportunities at Christmas.  Last night’s concert was an experience powerful enough to fill the spiritual longing that comes with each Christmas season.

What added to the deeply felt comfort was that I was able to sit with Mary Ann in the little raised area for those in wheelchairs.  My ticket was for a seat behind and a dozen feet away from Mary Ann. I couldn’t bring myself to sit down separated that far from Mary Ann.  It surprised me a little to feel so strongly the need to be next to her.  In the past, I have generally retreated into my own world at concerts, listening intently, immersed in the music.  Someone suggested the possibility, and I checked to be sure it was acceptable for me to sit in that area.  Companion Care Aide, Debbie, sat on the other side of Mary Ann.  As it turned out, there was no need for a trip to the bathroom during the concert.   All of us got to experience fully the entire program of music from silly to sacred.

There was a dimension to the evening that I did not fully anticipate.  Having retired from the role of Senior Pastor at the congregation I served for over a dozen years, I have not seen and talked with more than a handful of the members of that congregation since I retired a year and a half ago.  It was like a reunion.  It didn’t take long to realize how much I miss the people who had become a part of my life during those years.

There is an intimacy that develops between pastor and people that is hard to describe. The ministry is not as much a job as it is a relationship.  Certainly there are lots of other professions that include at least as strong a relational element.  I can only speak to the ministry, more specifically, my experience of it.  Last evening I redicovered how connected I came to feel to all those folks, and how much I have missed getting to interact, to talk and listen and kid around with people I care about.

The combination of celebrating a reunion of sorts as well as being lifted spiritually by the music made for a very good night out.  Mary Ann was greeted and engaged by many, and she too enjoyed the music.

After two days holed up in the warm house, protected against the elements (snow and bitter cold), we both needed the time out, distracted by something other than the television.

The change in the medicine mentioned in last night’s post seemed to have the hoped for consequences.  There was a return to a more normal level of intestinal activity almost immediately on discontinuing the generic Mestinon.  Today has been a fairly normal day.  Mary Ann got up early, then took a two and a half hour nap.  We got out to lunch at BoBo’s, headed to the Honda dealership for a quick minor repair of the CD player in the van, and visited the home of a friend, one of Mary Ann’s closest friends from almost the very first day we arrived here nearly fourteen years ago.

Tonight Mary Ann had some pain that needed a nitroglycerin pill.  Those are always scary moments, although not at all uncommon for folks with heart blockages such as Mary Ann’s.  The pain subsided after taking the pill.  She woke up a few moments ago and needed a trip to the commode.  The Thursday people are back.  She wanted to know what the next family was going to do.  She insisted on closing the bedroom door while she used the commode so that they could not see her.  I hope she is able to get back to sleep, and that she has a restful night.

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.

 

December 5, 2009

Outing Today and Caregiver’s Dilemma

Posted by PeterT under Daily Challenges, Help from Others, Meaningful Caregiving, Practical Tools for Coping, Relationship Issues, Sources of Strength, Therapeutic Activities | Tags: , , , , , , , , , , , , , , , , |
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I am sure there are a variety of media folks trying to get a clear handle on the reasons for the continued success of the movie “The Blind Side.”  We saw it today.  It is the true story of an essentially homeless teenager, accepted into a family, finding his way to success on the football field.  Thematically, it seems to me like the story of Susan Boyle who has become a metaphor for a nobody being discovered to be a somebody.  It touches the longings in most of us to find fulfillment, to come into our own in a way that is clearly visible to others and, more importantly, to ourselves. I suppose it is the same reason that “The Man from Snowy River” has always struck a chord in me every one of the fifteen or so times I watched it in former years.

I am not really sure how Mary Ann felt about it.  Her comment at the end was, “Did we end up in the wrong movie again?”  The last time we went to a movie, she had gotten in her mind that there was another one we were going to see.  When I asked her what movie she thought we were going to, she referred to an interview this morning on the television with Robert DeNiro about a movie he is in.  I did not see that interview.  In both cases, I had only talked about going to the movie we saw, and had not at any point mentioned the other.  At best, communication is a difficult thing.  Since Mary Ann is not verbal, it is hard to know what she is thinking.  I talk enough that she needs to tune it out.  As a result, I can say one thing, and she can have something completely different in her mind.  It is hard to know how many of the miscues are simple communication problems and how many are precipitated by the dementia that has begun to show its face on occasion.

On another note, there is a dilemma emerging that impacts my role as a Caregiver.  In a matter of about 48 hours, I received three overtures that would ultimately involve commitments of time.  Committing time to something other than caring for Mary Ann is no small matter.  I have seen just how stressful it is to have time pressure enter the picture when Mary Ann’s needs come without warning, often demanding immediate attention.  I can’t count the times I have had to get off the phone or at least excuse myself for a moment, when Mary Ann popped up and headed toward the bathroom.

It became clear very soon after I retired, that I could not count on being able to keep commitments if I made them.  Every commitment had to have an easy way out, in case Mary Ann’s situation demanded my attention.   Even tasks that don’t have appointments to keep pretty tough to accomplish, since the tasks that come with the caregiving role, make it tough to get a long enough block of time free to concentrate on anything else.  Those who volunteer to spend time with Mary Ann have busy lives of their own.  There are not a large number available to cover multiple times for meetings or whatever.  The cost of using paid Companion Care from the Agency we sometimes use prohibits making many commitments.

If I add commitments that use up all the time covered with Volunteers, I may as well go back to work.  One reason I retired was that it was too hard to move between working and caregiving wtihout time for rest and renewal.

With all that said, there must be something else going on in my thinking, something of which I am not fully aware that has caused me not to immediately decline the overtures.  I have accepted one.  It allows a great deal of flexibility and is likely to be very satisfying.  It is simply providing a sounding board for a friend from a former time.  While I may decline the other overtures, I am actually considering them.  I know too little about them yet to actually make a decision.

I suspect that part of the reason I have not dismissed the overtures out of hand, is my need to feel useful outside of my caregiving duties.  It is challenging to realign my thinking and feeling to be able to feel fulfilled and valuable without external validation.  At a spiritual and intellectual level, I can find fulfillment without affirmation.  My insides, however, are not so mature and selfless. At the very least, it is nice to have been asked.

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.

 

November 29, 2009

More from Cardiologist

Posted by PeterT under Daily Challenges, Information on Parkinson's, Meaningful Caregiving, Practical Tools for Coping | Tags: , , , , , , , , , , , , , , , , , |
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There are a couple more of observations on Mary Ann’s appointment with the Cardiologist, Dr. M, on Friday that have come to mind today.  They were comments that he made may be of interest to other Caregivers and Spouses.  I mentioned them in passing in last evening’s post, but they seem to me to warrant more reflection.

As I mentioned in last night’s post, I had brought some information from the Internet on a medication that seems to offer a an option for keeping Mary Ann’s blood pressure up when she is standing, to keep from fainting, without raising it when she is lying down, the time it is already too high.

I had brought the information to his office earlier in the week to allow time for him to look it over.  He didn’t see it until he studied the chart before coming into the Examination Room.  He did take time to read what I had brought.  When he came in he said that he thought the medicine sounded very appropriate.  In fact, he indicated that he appreciated the information and would consider using for others when the need arose.

He added that he was not at all uncomfortable with patients bringing in information.  He did not perceive it as a threat.  Not only was I grateful to hear that, but it impressed me as an attitude that any of us, Caregivers or patients, should look for in a doctor.  Dr. M is confident enough in his role, that he is not afraid to deal with any sort of question or suggestion.  He will answer the question if he can and tell us if he can’t.  He will take suggestions when they are good ones, and explain why if they are not good suggestions.

I have the advantage of being in an online group of folks who have all had years of experience dealing with Lewy Body Dementia and often Parkinsonism if not Parkinson’s Disease itself.  The thoughts and ideas and suggestions there are very helpful since they have been tested in real world situations.  One thing may work for one person and not work for another, so the suggestions can only be just that, suggestions, when taking the information to the doctor.  Bringing an arrogant attitude to a doctor’s appointment is sure to produce an unpleasant result.  I suspect that doctors feel the same way about arrogant Patients and Caregivers as Caregivers and Patients think about arrogant doctors.

Another conversation the Cardiologist had with us was triggered by my asking if the Congestive Heart Failure that took us to the hospital actually demanded a hospital stay.  I told him about the tough time we have had since the hospitalization.  He suggested that if we come again, we ask if it would be possible to monitor her situation for a few hours rather than admitting her right away and starting a regimen of medicine administered intravenously. Again, if we explain our reason for asking rather than simply being demanding, it might impact the doctor’s decision.

Dr. M made the observation that doctors factor in their assessment of the Caregiver or Patient’s wishes concerning whether or not they want to be admitted.  I inferred from what he said that there is a sensitivity about whether or not Caregivers and Patients feel able to handle the situation at home, when deciding whether or not to admit the Patient to the hospital.

We have a pretty good system here at home for dealing with Mary Ann’s problems.  If (when) we end up in the Emergency Room again, we will evaluate carefully the value of being treated at the hospital against the toll a hospital takes on her ability to function.

In Mary Ann’s case, that might have meant getting the shot of Lasix and checking the Cardiac Enzymes for a few hours to see if they stayed the same or declined.  While sometimes I feel pretty overwhelmed by what is already needed to give the care that is necessary, I think we would even be able to deal with IV meds at home, as long as a nurse put the IV in, and a nurse would be on call in case it got pulled out and needed to be inserted again.  It is too bad that our system of medical care does not make more allowances for care to be given at home.   It is easier on the patient (more rest) and it would seem to be less costly.

The day was quiet.  PBS had a number of specials today with Celtic music.  I told Mary Ann that I wanted to take charge of the television today and watch them.  As I have metioned before, in our division of duties, she is the boss of the TV remote control.  She stayed awake to listen to the music with me.  She ate pretty well.  She has been a little restless tonight.  I hope she settles in for the night 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.

 

November 16, 2009

Imagined Possibilities – A Moment of Sadness

Posted by PeterT under Daily Challenges, Meaningful Caregiving, Practical Tools for Coping, Therapeutic Activities, Uncategorized | Tags: , , , , , , , , , , , , , , , , , , , , , , |
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Today was a good day in most respects.  Mary Ann got up, ate, took pills and got dressed in anticipation of Volunteer Jan’s arrival.  Jan did her hair and nails, a real treat.  Mary Ann had eaten a good breakfast with some help.  Around noon she ate a half sandwich, chips, Pepsi, and large and tasty chocolate chip cookie that Jan had brought.

Mary Ann was up all day, watching football — her choice.  The Chief’s won!!! She was awake and mobile enough for us to go to the Evening Service at 6pm.  She ate a little supper before church and headed to bed shortly after church.

This was pretty much a normal day even by pre-hospital standards.  So far it appears that our new normal will include a little less mobility.  Eating by herself was a challenge before the hospital stay.  She now needs help much more often than before.  Walking unaided seems to be less of an option now.  It seems as if in most other areas, we are back to pre-hospital stay levels.  That is pretty encouraging.  I won’t deny that the last couple of weeks have been scary and stressful, with lots of fears about the possibility of not regaining any of what had been lost.

Maybe it was the barometer change today, but my time away this morning was not so refreshing as usual.  The rain did not allow the long walk that releases the mood-lifting endorphins.  I sat in the car enjoying the peacefulness of the rain at the lake, listening to a CD.  The Taizé Music seemed to open a certain vulnerability to thoughts and feelings that usually don’t have the time or space for attention with the moment by moment demands of the caregiving.

I am embarrassed at the self-centeredness of the thinking, but I have never pretended to be perfect — far from it.  I began thinking of who I am as an individual, separate from my role.  I thought of all sorts of things I have not yet experienced in life, things that most likely will never come to be.  I am not absolutely sure that I would really do some of them even if I had the chance.  That is why I titled this post “imagined Possibilities.”

Imagined Possibilities:

  • Singing with an Early Music vocal ensemble.
  • Spending a week of study and reflection at Holden Village.
  • Hiking a section of the Appalachian Trail.
  • Birding in New Zealand, hiking to see some of the waterfalls.
  • Seeing the Snowy Mountain region of Australia, visiting each part of that huge country.
  • Visiting Cornwall England and searching out my Father’s ancestral home there.
  • Visiting County Cork Ireland, from which my Paternal Grandmother came.
  • Heading off to Poland and Germany to see where my Mother was born (a German settlement in what is now Poland).
  • Spending time at the Taizé Community in France and singing the music, having a chance to serve as a Cantor.
  • Seeing some of the National Parks with my own eyes.
  • Going on Spiritual Formation retreats at various places in the US.
  • Probing with great minds the intersection of theology and Quantum Physics (at least listening and questioning).
  • Attending organ recitals and hearing great choirs and orchestras.

What is so selfish about all this, is that Mary Ann has lost the freedom to do so much more than have I.  This morning just opened a bit of sadness about what I might have imagined for myself.  I don’t know all the things that Mary Ann would like to have done.  Once I was asked where I would like to go if I could, and when I mentioned Australia, Mary Ann said she would like to do that too.  We have both talked about never having seen even the Grand Canyon.  We talked about going across Canada on a train, traveling to see the fall colors in New England.  We got to visit England and Northern Europe forty three years ago, and had talked about wanting to go back, especially to England.

I know intellectually, and most often viscerally, that life is lived wherever each of us is.  There is no need to be in some special, exotic place to live life to the full.  The grass certainly is not greener on the other side of the fence, as they say.  It was just a moment of imagined possibilities and some sadness at what will not be.  No matter what any of our circumstances are, all of us have things that are beyond our reach, things we cannot have or experience.  We can either face the loss of those imagined possibilities, grieve their loss and get on with life, or spend our precious moments stuck in self-pity.

I have the privilege of caring for someone I love.  There are so very many who would give anything to have that privilege.  I guess part of living this life to the full is allowing a moment of sadness into it.

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.

 

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