Archive for July, 2007

Promises

July 30, 2007

“Promise me you’ll
care for your father
when I’m gone.”
That’s what Sarah’s mother
said as she lay dying.
For ten years now
Sarah has faithfully watched over her father
as he has grown older and more feeble.
A year ago, unable to live alone any longer,
he moved in with Sarah and her husband.
All three get along well, mostly.
But Sarah’s days are now taken up
with the increasing demands of her father’s care.
She can seldom leave her home anymore.
She and her husband have lost their privacy,
much of their social life,
their freedom to travel.
She said to me recently,
“I want to be a good daughter.
I want to be true to my word.
But this responsibility is becoming more
than I can bear.”

It is one thing to be asked,
“Will you care for your father after I am gone?”
It is another to be asked,
“Will you care for your father in your own home,
around the clock, without assistance,
no matter how physically challenging it becomes,
no matter how emotionally draining?”
It is still another thing
to be asked the first question and,
out of our love or concern or desire to please,
we read into it the second question.
When we’re conscientious caregivers,
we take our commitments seriously.
We want always to act in loving ways.
We make sure to follow through.
But sometimes it happens that
the safest, surest, healthiest care
comes best from people who are specially trained,
specially equipped, and physically stronger.
There are times and situations when it may become
not just unwise, but potentially dangerous,
for us to remain the main day-to-day caregiver.
Potentially dangerous for the one in our care,
for the others around us,
for us as a dedicated caregiver.
Such decisions are not at all easy,
but they can be quite sound
and, ultimately, quite loving.

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Not Natural

July 27, 2007

I had lunch yesterday
with my friend Katherine.
She has a degree in nursing.
She cared for her father
after he developed Alzheimers.
When her 92-year-old mother broke her hip,
Katherine rented an apartment for both of them
and cared for her mama full time for two years.
Katherine is one of the more caring people I know.
So I was taken aback when she confessed to me,
“I am not a natural caregiver.
This doesn’t come easy for me.”
My surprise must have registered on my face
because after lunch she wrote me this:
“My first inclination at most things is not noble.
I am an honest person
because I consciously choose not to lie.
I am generous
because I consciously choose not to be grasping.
Similarly, when called upon to be a caregiver,
I consciously choose to set myself aside
and see to another’s needs.
It is an intention I make.”

Not all of us are natural-born caregivers.
Some of us are inherently strong in other ways.
So what are we to do
when we’re called upon to be a caregiver,
yet we’re not instinctively made that way?
I believe, first, we can ask.
“What can I do that will help?”
we may ask the one in our care.
“What can I refrain from doing?”
“What do you need, and when, and how?”
Second, we can copy others.
What is it that natural caregivers naturally do?
What can we imitate caregiving-wise
in what we read,
what we see,
what we hear about?
Third, we can, like Katherine, clearly intend.
Aware that caregiving may not be second nature to us,
we can consciously choose to concentrate
on what this other person needs,
placing our own needs on hold temporarily.
We can intentionally decide to be a caring presence
because it is the right thing to do,
and the loving thing to do,
even if it is not the most natural thing for us to do.

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Getaway

July 25, 2007

A woman named Deary
is slowly dying
in Annie Dillard’s newest book.
Deary’s husband and two friends
care for her at home
around the clock.
All three take turns going out, at least once a day.
In Annie Dillard’s words,
“Dumping garbage was an outing;
they breathed the wind.”

Staying nearby is integral to most caregiving.
Usually closeness is required—
for the serving of meals,
for the handling of all things medical,
for conversing, for holding, for physically soothing.
Yet important as it is to stay in proximity,
it is equally important to get away.
We human beings are hardwired to crave a certain variety.
Life without any change becomes life without much vitality.
Work without any letup or relief becomes grueling.
We cannot wait around for others to step in
and make sure we receive exactly the relief we require.
Often these other people don’t understand how much we need
to refresh our eyes, refill our lungs, replenish our spirits.
They don’t always know what will enable us
to regain and renew,
to rejuvenate and reinvigorate.
We must take responsibility for finding and making ways
to step back and step away,
to take a break and escape awhile.
We must assume responsibility ourselves
to find again, to catch again,
what we’ve had before,
what the pressures of caregiving have taken from us.
We need to get away, however best we individually do that,
whether it’s for minutes, hours, days, maybe even weeks.
It’s not wrong or selfish to seek such recuperative diversion.
It’s the natural way we restore ourselves,
the way we regain the energy to keep going,
the way we make sure we keep offering
the very best care we can.

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Benefit

July 23, 2007

On June 25th
I wrote about Paul Johnson
who cares for his wife, Barb.
Her physical condition
has improved with time,
but she still calls for
a great deal of attention.
He cannot leave her alone,
so he no longer has the personal freedom
he once took for granted.
Paul regrets this has happened,
yet he has a second response too.
“I used to be a procrastinator,” he told me.
“I could put off things with the best of them.
But nowadays I have to get more done in less time.
Anymore when I have the time or opportunity
to do a chore or run an errand,
I just do it.
I never know when I’ll next have that chance.
That I no longer procrastinate like I used to
gives me a sense of accomplishment.
I didn’t expect this benefit, but here it is.”

Caregiving changes our lives.
These responsibilities that become ours
may get in the way
of our normal patterns of living,
our traditional ways of working.
When that happens, what will we do?
In addition to any regret or frustration we may feel,
does anything else await us?
Might these changes that are required of us,
as unwanted and inconvenient as they may be,
help us in any way
forge something of benefit?
Like Paul, might we give up procrastinating?
Might we perhaps let go of needing to be perfect,
or needing to be always right,
or needing to be constantly in control?
Might we make use of this time
to become more patient,
or to grow more resilient,
or to develop greater empathy?
Is it not possible
that our caregiving may hold some benefit for us
even as it benefits the one in our care?

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Easy

July 20, 2007

My wife Bernie had
foot surgery last week.
She has been sporting
a huge wrapped bandage
and a stylish blue boot.
At first she was on a walker
and for a couple of days
she looked a little blue-green
around the gills.
This week she’s coming along nicely.
Yesterday a friend asked me,
“How’s the caregiving going?”
I replied, “It’s goin’ easy.”
And it is.
It’s felt like hardly an effort
to prepare whatever meals I’ve prepared,
to do whatever extra chores I’ve done,
to help her with the little things she needed help with.
In fact, I rather enjoyed our different routine,
this extra closeness we’ve shared.
It’s been easy.

Not all caregiving is like that,
as we’re all aware, sometimes painfully so.
Hard caregiving, demanding caregiving
is more the order of the day
for a very large number of us.
Still, for a moment here, I want to voice this truth:
some caregiving is a breeze.
Shorter-term caregiving, perhaps.
Caregiving that progresses toward a sure return to health.
Caregiving, as is our case this week,
that promises a relief from pain
that has plagued the other.
Caregiving that gives people who enjoy one another
the opportunity to enjoy one another some more.
There is also another reality.
In the midst of any trying and tiring caregiving,
sometimes there are easier days,
or more loving experiences,
or unusually fulfilling moments,
without any of that being programmed at all.
Whenever caregiving comes like this, naturally and lightly,
whatever the causes,
and however long the feeling lasts,
it’s worth our nodding and adding this quiet word:
“Yes.”

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Unanticipated

July 18, 2007

A poignant act of caregiving
occurred a few days ago.
Neil and Abby,
friends of our daughter Christen’s family,
took on monumental responsibilities
when their daughter Scout
developed a malignant tumor in her jaw.
Later the cancer spread to other parts of her body.
For many months one or both were by Scout’s side,
often far from home,
through all her sickness and all her treatments.
While the prognosis was originally guardedly hopeful,
the time came when it was clear
that additional medical intervention would not benefit her.
A week ago Saturday Scout died—she was 8.
When it was time, Neil and Abby dressed her body
in preparation for its being taken to the funeral home;
cremation had already been arranged.
The hearse arrived and Scout’s body was placed inside.
The two of them had agreed that Abby would remain
at the house with their younger daughter,
and Neil would accompany Scout’s body.
As the funeral director was about to help Neil into the front seat,
Neil said, “If it’s alright, I want to ride in the back
with my daughter.”
So he climbed in the back of the hearse,
and that’s where he lay, arm over her body,
as they made their way through town
toward their destination.
He needed to be her caregiver, to care for her body,
for as long as he could, as far as he could.
He needed to do this for himself,
for his caregiving wife,
for his caregiving younger daughter,
for his caregiving larger family.

Sometimes caregiving extends even beyond physical death.
Caregiving may include souls as well as bodies,
the spirit as well as the flesh.
I imagine thoughtful caregiving can extend to
the memories of loved ones,
the legacies of loved ones,
the dreams of loved ones.
I believe caregiving may take on forms we cannot predict,
or would not anticipate,
and yet when the moment arrives,
we will know what is ours to do.

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Going Solo

July 16, 2007

Mark’s mother suffered
both kidney and liver failure.
She spent ten weeks
in four different hospitals.
Three times she almost died.
She’s on dialysis now.
Unable to live alone,
she has moved into Mark’s small home
with his wife and two teenage daughters.
The younger daughter gave up her bedroom
and moved to the basement
so her grandmother could have her own room.
As he and I sat at lunch last week,
I asked him what it’s like to be a caregiver.
His first words were, “It’s been hard.”
Later he said, “Originally I was frazzled but I’m less so now.”
Later still he shook his head, saying,
“There is absolutely no way I could do this alone.
No way.”

What Mark cannot do alone is similar
to what so many other family caregivers cannot do alone:
all the medical appointments,
all the special meals and preparations,
all the constant oversight and care,
all the changes in schedules and routines,
all the daily and nightly accommodations.
When the caregiving is long-term and heavy-duty,
it’s too much for one alone to handle.
It may even be too much for three or four.
When we realize it’s too much for just us,
we need to let others help us:
spouses and partners,
children and grandchildren,
parents and grandparents,
friends and co-workers.
And if they don’t show up on their own,
our task is to ask them to, in all earnestness.
And if that doesn’t work, or isn’t possible,
then we need to enlarge our scope to
social workers and chaplains and healthcare professionals,
congregations and community organizations,
perhaps government agencies and advocacy groups.
Going it entirely alone is not a valid option.
Too much is at stake—
for whoever it is we care for
as well as for we who give the care.

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.

Good-byes

July 13, 2007

Annie Dillard’s latest book
is a novel, The Maytrees.
One of the characters is Lou,
a woman who lives alone
in a seaside cabin on Cape Cod.
At one point in the story
she prepares to take in a married couple
she has not spoken to in twenty years.
The woman is dying of heart disease
and the man has been so badly injured in a fall
that he can no longer provide care for his wife
and now needs to be cared for himself.
Annie Dillard writes what Lou, the willing caregiver, did:
“She bade her solitude good-bye.
Good-bye no schedule but whim;
good-bye her life among no things but her own
and each always in place;
good-bye no real meals,…
The whole fat flock of them flapped away.”

In the absence of clear directions
about how to prepare for caregiving,
we may not realize all the goodbyes we must say
as we undertake this role.
Like Lou, we may be called upon to bid adieu to our solitude,
to the way we’re used to spending our days on our own.
Some of our farewells may seem quite minor,
making them easy to say.
But some may feel wrenching to us—
the freedom to keep our own schedule, for instance,
or to continue the career we so enjoy,
or to maintain the financial independence we’re used to.
We may need to say so long to beloved pastimes,
long-held dreams,
certain established friendships.
These good-byes need not be final.
Also, they need not impact us in only negative ways.
In Lou’s case, for example, she came to feel she was needed
in ways she had not felt in many years,
and her days took on fresh and unexpected meaning.
Still, endings are endings,
and they’re not to be ignored.

Click on this image to enlarge it. Then right click to print it, send it to another, or use as your desktop wallpaper.

Please select this LINK for a printable version of this image.