Archive for September, 2007

Village

September 28, 2007

Elaine never married.
She has no close family.
Retired once, she now works
for a trucking company.
When she had a heart attack,
her neighbor was the one
who rushed her to the hospital.
Six months later Elaine had heart surgery.
Later still she fell and broke a kneecap.
Each time people came to the rescue:
four neighbors, a co-worker, and a good friend.
These people cared for Elaine’s pets
when she could not.
They prepared her meals,
cleaned her house,
set out her trash bins,
filled her prescriptions,
and tended her garden.
They brought in her mail,
brought over books for her to read,
and often brought her some cheer,
which otherwise would have been
in rather short supply.

The African proverb goes,
“It takes a village to raise a child.”
Something similar is true for us, here.
For essentially all cases of caregiving today,
it takes a village.
Elaine’s situation is a bit unusual,
with no family members to step in,
no ready-made support to quickly appear.
It was up to the village around her
to organize and deliver her care.
Yet even in situations where plenty of family
and friends automatically and regularly
provide loving care,
still it takes a village.
Physicians and nurses,
pharmacists and lab technicians,
home aides and therapists,
good neighbors and close friends.
Those people who want to do something
for the one who’s ill or incapacitated,
and those people who want to support
the ones who are so busy
with the essential day-to-day care.
People of all ages,
from all walks of life,
with divergent experiences to call upon.
As caregivers, we can be grateful
that we live in a village,
whether that village is a rural community,
a mid-sized town,
or a teeming metropolis.

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Blurred

September 26, 2007

My neighbor Kathy
cared for her parents
as they grew older.
They each died, she said,
quoting her father,
of “acute TMB”—
acute too many birthdays.
In their home, in her home,
and finally in the nursing home,
she did what she could to help.
Her caregiving had its real limits
because Kathy has degenerative joint disease.
She has had 30 surgeries through the years.
So as she cared for them as they aged,
they were caring for her,
their daughter who lived alone,
as she negotiated chronic illness.
When they couldn’t support her physically,
they were there psychologically and spiritually.
Kathy’s children grew up with her medical condition
and learned to provide care for her
in many everyday ways,
just as she cared for them
as only a mother knows how.
Today that continuum of family care
continues to unfold.
These weeks Kathy’s oldest child, Mary,
is doing heavy-duty caregiving
for her 3-year-old son, Ben,
who has undergone fairly radical surgery
for a birth defect.
He came home with five different tubes
protruding from his body.
It’s been quite a caregiver’s saga,
bordering some days on the traumatic.
So Kathy is now acting in the ways she can
as caregiver to Mary and Ben and their family,
knowing it will be a long haul.
At the same time she deals daily
with her own disabling condition,
which Mary does not forget either.

So often we make it sound
so simple, so clear-cut:
“He is the caregiver;
she is the care receiver.”
The reality is, however,
that we’re seldom just one or the other.
We move in and out of these roles,
almost in a fluid motion.
And we can be giver and receiver simultaneously,
caring for another as we’re able,
while they reach out to us
in the ways that they’re able.
This reality blurs the distinction
between who each of us is.
This blurred experience makes these relationships
all the more equal,
all the more human,
and, when we’re fortunate,
all the more lovely.
May we all know that fortune.

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Funny

September 24, 2007

In The Stuff of Life
Karen Karbo tells the story
of being the caregiver
for her dying father.
His home is in Nevada,
while she lives in Oregon
with her husband and children.
She must fly back and forth a lot,
and flying makes her anxious.
These trips also create a financial hardship.
As her father worsens and the anxiety builds,
another stress is added:
their beloved pet, a dog named Nubie,
becomes ill and must be euthenized.
To get their minds off all the sadness,
their family decides to go to a movie,
a comedy.
“We laugh so hard,” Karen writes,
“we can’t hear half of it.”
When the movie is over,
she asks the usher, an older man,
if they might watch it again.
“We’ve just put our family dog to sleep,”
she says in hopes of persuading him.
Kindly, he gives them permission.
Karen writes,
“He knew what I was just figuring out:
that you could have a dying father and a dead dog,
you could pretty much have misery all around you,
but it was still possible
to shriek with laughter.”

Not all caregiving is a heavy experience, by any means.
But many of us are faced occasionally
with the miseries of caregiving,
and some of us face these regularly.
What Karen Karbo learned,
what any of us may be learning,
is that even in the midst of sadness,
laughter can still be possible.
Sometimes the gift of our humor comes
as a welcome diversion from all
that our caregiving is requiring of us.
Sometimes our laughter serves as emotional release—
deeply buried tears come pushing up
through howls of hilarity.
Sometimes we come upon something
so purely, radiantly funny,
that we laugh involuntarily,
whatever else is happening around us.
Life can be like that—
comedy and tragedy in close proximity.
When our laughter erupts in our caregiving,
that doesn’t mean we’re avoiding or denying
the seriousness of what is happening.
Healthy laughter is simply a grace
by which we open to the moment,
and to one another,
and to shared feelings,
and to that whole wide range
of incredible life experiences.

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Fired

September 21, 2007

“You’re fired!”
That’s what her mother,
age 94, said to Jean.
“What would you do
without my caregiving?”
Jean protested.
“I’m just firing you as my accountant,”
replied her mother.
“It’s true I cannot walk,
nor can I see the best,
but I can still add and subtract.
And better than you!”
At the suggestion of a well-meaning advisor,
several weeks prior Jean had taken over
her mother’s finances.
This was a mother who had a detailed system
for paying and recording her bills,
for regularly tracking her money.
A woman who still had all the records
for her 1932 Ford Model A coupe.
A feisty spirit who not only
demoted her daughter as her bookkeeper,
but took on her daughter’s checkbook and
made it balance for the first time in years.
Meanwhile, Jean went back to doing
only those things her mother could not do alone.
Each was the happier.

Sometimes as caregivers,
we may need to be fired from our jobs.
Not from our whole job of providing care,
of course.
Just from those parts of our work
that we really shouldn’t be doing.
And if someone doesn’t fire us,
we’ll keep on doing those things,
convinced we know what’s best.
The examples are many:
Do we speak for the one in our care,
not realizing we’re denying them their voice?
Do we do for them what they’re able
to do on their own,
not understanding how this delays their recovery
or diminishes their self-esteem?
Do we perform some role for them,
sure they would want us to,
when they don’t want us to at all?
The story of Jean’s mother is a reminder
for us to offer what is truly appropriate,
not what we think is appropriate.
How do we do this?
By listening well.
By watching carefully.
By clarifying our understandings often.
By respecting the other’s boundaries always.
In doing so, we’ll reduce the likelihood
of our receiving too many pink slips.

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Suitably

September 19, 2007

In later life French thinker
Michel de Montaigne
hid away in a room
and wrote all day long
for several years.
He penned wonderful essays
that remain rich with meaning
400 years after his death.
In one of his more personal pieces he wrote:
“He has spent his life in idleness,” we say;
“I have done nothing today.”
What, have you not lived?
That is not only the fundamental
but the most illustrious of your occupations.
“If I had been placed
in a position to manage great affairs,
I would have shown what I can do.”
Have you been able to think out
and manage your own life?
You have done the greatest task of all.
To compose our character is our duty,
not to compose books,
and to win, not battles and provinces,
but order and tranquility.
Our grand and glorious masterpiece
is to live suitably.

In one way or another
I’ve heard person after person say,
“On the grand scale of things,
I haven’t done that much.
Recently I’ve just been the caregiver
for someone who needed me.”
For those of us who make such self-evaluations,
and who use the word “just” so blithely,
I can imagine Montaigne lecturing us
across the centuries:
“What, have you not spent your days
adding to another’s life?
Have you not offered relief?
Have you not brought solace
where solace would help?
Have you not held hope
when hope was in short supply?”
I can imagine him putting his face
closer to ours and continuing,
“What, in the face of adversity,
have you not shown resilience?
In the midst of difficult times,
have you not demonstrated strength?
Have you not offered love
in one of its more unselfish forms?”
Were Montaigne alive today,
I believe he might offer his praises:
“Oh, you caregivers!
Yours is a grand and glorious masterpiece,
learning to live suitably
while caring lovingly.
I honor you.”

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Validation

September 17, 2007

Betty, who is 90,
lives with her daughter, Laura.
They’ve been very close
through the years,
and now they’re close
in another way:
as care receiver and caregiver.
Theirs has been a reversal of roles.
Once so competent and independent,
Betty wants to carry on in life
as she has up until now.
But physically she is no longer strong
and mentally she is no longer competent,
which means she can no longer be independent.
The mother must now endure having limits
being put in place by her daughter.
And the daughter, always so obedient,
must be something other than obedient
if she’s going to provide truly loving care.
Neither quite likes her evolving role.
Both are grieving.
Betty grieves the loss of her abilities
and the loss of her freedom.
Laura grieves the loss of her mother
as she once knew her.
Now daily they do their dance of life together,
one learning painfully to lead,
the other learning painfully to follow.
Sometimes they step on each other’s toes.

Without question, those who are forced
into needing another’s care—
in this case our care—
have their work cut out for them.
Often they must deal with some sort of pain.
Their condition may lead them toward all sorts
of strong feelings.
They may also be grieving—
grieving what they’ve lost,
what they must give up,
what will never come to be.
They need and deserve our validation
for all that they now face.
But that is not the entire story.
Our caregiving leads us toward our own pain,
our own strong feelings,
our own grieving.
While we may feel sad about their sadness,
we’ll likely have our own sadnesses too.
Our fears, anxieties, and griefs will be different,
and perhaps less obvious, than theirs,
but that doesn’t make them any less important.
So, yes, let us care deeply for all
that is happening to the one in our care.
And let us be equally aware
of that which is happening to us, in us.
We can always use some validation ourselves,
and if it comes from nowhere else,
may it come from within.
May we also find it in these very words.

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!#*&!

September 14, 2007

Commentator Morton Kondracke
is the primary caregiver
for his wife, Milly,
who has Parkinson’s.
In his book Saving Milly,
he writes that he has tried
to be loving, patient, and supportive
ever since her diagnosis in 1988.
Largely he has succeeded, but not always.
Especially frustrating were those times
she would try walking by herself
when she wasn’t supposed to,
wasn’t able to.
She would fall and hurt herself
and he had to come running.
“Even though she was in pain,” he writes,
“and deserved comfort,
I’d explode in fear and anger:
‘I told you not to do that!'”
It upset him greatly to find her sprawled
on the floor, bruised and bleeding,
which happened a number of times.
It angered him that she would endanger
her health in that way,
so frequently, so unnecessarily.

Not all caregivers are as honest
about their feelings of anger.
How do we reconcile
our wish to be loving toward someone
with our impulses to rant and rave at them?
Perhaps they’ve done something dangerous.
Maybe they’ve been demanding
or belligerent, unreasonably so.
Maybe they’ve acted rudely
or said especially hurtful things,
uncharacteristically so.
In such a situation a common response is
to be frustrated or annoyed or downright mad.
This happens more often than many realize
or want to admit.
A 2002 national study documented
that family caregivers tend to evidence
higher levels of hostility than noncaregivers.
So the word is out to those who give care:
anger happens.
It goes with the territory.
When two people are in such constant contact,
and when they have so much to deal with,
such feelings aren’t just to be expected—
they’re virtually unavoidable.
While these feelings may be directed
toward the one in our care,
they may also be directed
toward physicians and nurses,
toward anyone who is less than
helpful or understanding,
toward God.
In reality the true source of our anger
is more likely what’s causing the unwanted changes
in this person we love and care for,
not to mention the unwanted circumstances
in which we now find ourselves.
Consequently, anger is not bad
any more than we are bad
for feeling upset and frustrated at times.
Anger is a sign we’re involved.
It’s a sign we care deeply.
It’s an indication that we have feelings too.
And it’s proof we’re perfectly human,
perfectly normal.

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Effortless

September 12, 2007

I interview caregivers
regularly these days.
One question I ask is
“What types of caregiving
have you done
through the years?”
People tell me about all kinds of situations.
After they describe caring for loved ones
following accidents, through illnesses,
and as death approaches,
they’ll often say,
“Of course, I cared for my children (or grandchildren)
after they were born.”
These are, without question, caregiving experiences—
ones that require plenty of time and energy,
ones that can extend for many years.
Yet this normal child-rearing type of caregiving
is unique in an important way—
it is usually anticipated.
This is what we want to do.
Often it is what we have longed to do.
Our caring flows out of us, effortlessly.
In a sense it is unstoppable.
I am learning, and re-learning, that
these days as a grandfather.
Any of us can learn this, and re-learn it,
as parents and aunts and uncles,
as stepparents and godparents,
as people whose ties are of the heart,
whether or not our genes are linked.
The love streams out.
It resists being contained.
It’s rather wonderful, isn’t it?

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