Archive for March, 2008

Away

March 31, 2008

I’ve known Shelley
for twenty-five years.
She is very sweet,
very caring.
She has always been so.
So she surprised me
with her response when I asked her,
“Did you spend time with your father
this past week?”
Her father has emphysema.
He had an especially debilitating ten days—
he was on oxygen constantly, and mostly bedfast.
“No,” Shelley said, “I didn’t.”
I didn’t expect that response from her.
I knew that distance wasn’t an issue—
her parents live quite nearby.
I knew that she has always been good
about making time for them.
My face must have registered my surprise.
“He didn’t want me to see him that way,” she said.
“You know, lying around all day,
hooked up to an oxygen tank,
looking and sounding very weakened.
So I honored his wishes.”

Shelley’s father serves as a reminder
that not everyone who deserves care
wishes to be shown care.
In his case, he didn’t want his daughter
to witness firsthand the sight of him
as a man who was less than robust,
less than able to walk out the door
and play 36 holes of golf.
Some people are embarrassed
about the way they look or sound or act
when they’re ill or incapacitated.
Some don’t want to worry
their family members or friends,
or see the worry of those faces.
Some don’t want “to put other people out”—
they feel they don’t deserve the attention.
Some simply value their privacy
and want to protect their sense of independence,
even if it more or less isolates them.
Whatever the reasons given or not given,
we caregivers are called upon to remember
that our presence is not always wanted,
even if that is what we want.
And then we can show our care
by not showing our care,
at least in person.
That need not stop us from using the telephone,
or sending a note or gift,
or holding them in our thoughts,
or offering the most loving of prayers,
not just once but regularly.
If it is their wish,
we can be at our most caring
by not being there in body.
Mentally, emotionally, spiritually—
that’s a whole other matter, of course.

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Complex

March 27, 2008

Marty is a family friend.
She’s been a caregiver
for her husband Lou
since he had a stroke.
That was 20 years ago.
We spoke this week
about what those years have been like.
The heart bypass surgery.
The progressive waning of his energy.
The diminished family income.
The decreasing social contacts.
Now the awareness he could die anytime.
In the act of hearing her story,
one detail building upon another,
I came to realize how all-encompassing
her caregiving journey has been.
I felt admiration for her strength and stamina,
for how she has carried on so long
without drawing attention to all she does,
all the changes she’s had to make.
Marty paused in the telling of her story,
looked away, and then looked back.
“Right now I worry more about Amy
than I do Lou.”
Amy?
Amy is her daughter, age 39 and single;
the two are best friends.
Amy has not been feeling well.
“It appears she may have lupus.”
Lupus: a disease both progressive and irreversible.
Marty shook her head,
wiping the tears from her eyes.
Feeling the weight of her fears,
and the complexity of all her caregiving,
I shook my head too.

Marty’s quiet voice forcefully reminded me
of an important truth:
Family caregiving is seldom a simple, single story.
Wives give care to husbands,
and husbands to wives,
while simultaneously having to care for
one or more children with needs no less great.
Adult children care for aging parents,
as many as three or four,
sometimes in different, even distant, settings,
each parent requiring unique, changing support.
Grandparents care for a loved one their own age,
while bearing responsibility for family members
one or two generations below them.
These multiple, intergenerational relationships
often go unnoticed by those
on the outside, by the world at large.
But make no doubt:
simple caregiving can be quite complex.

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Watching Over II

March 24, 2008

I spent Saturday
with Dad.
He had forgotten
I was coming,
tho I had reminded him
ninety minutes before.
He was already in the dining room,
eating with his friend Virgil,
so I joined them.
The talk was of being a foot soldier
in France and Belgium in World War II.
Later Dad and I hung out in his apartment,
doing some random chores.
Mostly we chatted.
I organized the currency in his wallet,
since he now has a difficult time of it
when it comes to counting money.
Late in the afternoon the sun came out,
so we decided to take a short walk
in the 30-degree springtime air.
We Millers call this “getting out a bit
to blow the stink off.”
I zipped up Dad’s winter coat
and helped him with his gloves,
before I donned my insulated jacket.
Then we ambled outside.
Less than a minute into our walk,
he turned to me and asked,
“Are you warm enough in that coat?”
“Yes, Dad, quite warm.”
He nodded.
We took a few more steps
before he stopped again.
“Now, you’re wearing gloves, aren’t you?”
“Yes, Dad, I am. Leather ones, like yours.”
He nodded again.
A few more steps.
“You’re okay without a hat?”
“I’m fine, Dad—I seldom wear one.”
He studied my balding head.
“I just don’t want you to be cold.”

I’m Dad’s 62-year-old little boy.
He still wants to protect me,
tho he can barely protect himself anymore.
He wants to guide me
in that quiet, loving way that is his,
tho he requires guidance himself at every turn.
He’s still watching over me,
while I am learning to watch over him.
I assume it will be that way
for quite a long time.
As in, eternity.

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Watching Over

March 20, 2008

My daughter Christen
is a hospice chaplain.
Recently she told me
about a patient of hers.
(I’ve changed the name
to assure confidentiality.)
Though Amanda is in her twenties,
she has the mind of a six-year-old.
She is dying, and she knows it.
Christen paid her regular visit last week.
She looked slowly through the scrapbook
Amanda has been making about her life.
They talked of the many memories
all the photographs held.
Amanda was not feeling well that day,
so Christen drew the blinds,
pulled a quilt over Amanda’s feet,
and began to sing to her quietly.
“He’s Got the Whole World in His Hands.”
“Jesus Loves the Little Children.”
“This Little Light of Mine.”
After the last song, Amanda raised up,
grabbed a notebook and said with insistence,
“Chaplain, we need to make a list.”
Amanda cannot write,
so she dictated her list to Christen.
“Put at the top,
‘Things Amanda Wants When She’s Too Sick to Talk.'”
Christen wrote.
“Number one.
I want you to talk to my mom.
She’s going to be really sad.”
Christen took it down, word for word.
“Number two.
I want you to sing that light song.”
That was the end of Amanda’s list.
Amanda inspected Christen’s handwriting,
repeatedly folded the page until it was a tiny cube,
and gave it to Christen for safekeeping.
“Now you won’t forget, will you, chaplain?
Especially the part about my mom?”
“No,” Christen assured her, “I won’t forget.”

Amanda reminds all of us:
our care receivers are often
quite good at caregiving too.
Sometimes they’re watching over us
without our even knowing it,
just like Amanda is watching over her mom.

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Slow III

March 17, 2008

I’ve been advocating
Slow Caregiving.
I see this approach
as much an attitude
as it is a speed.
It’s a decision
to always keep the care receiver’s needs
in clear focus.
In an interview in The Washington Post yesterday,
travel expert Rick Steves described
the culture in Italian restaurants.
“Slow service,” he said, “is good service.”
How is that so?
It’s their way of showing
they respect you, they like you.
“Please feel free to stay all night”
is what they’re communicating.
Unlike most American restaurants,
where it’s frowned upon to linger too long,
the Italian attitude is,
“Take whatever time you wish.
It is, after all, your meal.”
Carl Honore makes this distinction
in his book In Praise of Slowness:
“Fast is busy, controlling, aggressive, hurried, analytical, stressed, superficial, impatient, active, quantity-over-quality. Slow is the opposite: calm, careful, receptive, still, intuitive, unhurried, patient, reflective, quality-over-quantity. It is about making real and meaningful connections—with people, culture, food, everything. The paradox is that Slow does not always mean slow.”

Slow Caregiving means bring receptive
to what’s ultimately right for the care receiver.
Maybe they’d like certain things
to happen more quickly.
Slow Caregiving says, “We’ll try that.”
Maybe they’d like time to interact,
to talk, to reminisce, to linger.
Slow Caregiving says, “Let’s tarry here.”
Maybe there’s an emergency.
Slow Caregiving says, “Let’s hustle now!
Time is of the essence!”
Then a Slow Caregiver rushes ahead
with, as much as possible,
a Slow frame of mind—
intuitively, assuredly, calmly,
and with great caring.

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Slow II

March 13, 2008

It all started
with a hamburger.
In 1986 McDonald’s
opened a franchise
in Rome, Italy,
near the Spanish Steps.
The Italians were not happy.
They had always cooked slowly and eaten leisurely,
allowing plenty of time to savor
the food and drink and company.
They had no desire for fast food,
which included fast ordering,
fast cooking, and fast eating.
So they organized an angry protest,
brandishing bowls of penne pasta.
Thus the Slow Food movement began.
The idea soon spread:
Slow Cities,
Slow Travel,
Slow Living,
always spelled with a capital “S.”
Now Dennis McCullough, M.D. has written
a book entitled My Mother, Your Mother
in which he advocates Slow Medicine
for caring for our aging loved ones.
He writes about those over eighty,
“…[T]his particular group of elders has the highest likelihood of benefiting from care that is more measured and reflective, and that actually stands back from the rushed, in-hospital interventions and slows down to balance thoughtfully the separate, multiple, and complex issues of late life.”
I agree with Dr. McCullough’s assessment.
I would go so far as to argue
that all people, whatever their age,
can benefit from measured and reflective care,
beyond emergency situations, of course.
That includes the kinds of situations
in which most of us are involved
as we care for our loved ones,
in our homes, in their homes,
and in healthcare facilities of many sorts.
Following Dr. McCullough’s lead,
I suggest that we practice Slow Caregiving.
I advocate that we go slow enough
so we can have time enough.
Time enough to really look at the other person,
to really see them.
Time enough to really hear
what they have to say,
to really listen to their hearts,
to really connect with their souls.
Time enough to come to understand
how and when our caregiving succeeds,
as well as how and when and where
our caregiving could be more useful,
more appropriate, more caring.
Time enough to savor any joy,
to linger over any closeness,
to fully appreciate every single appearance
of authenticity.
Time enough, in short,
to really care.

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Slow I

March 10, 2008

I can hurry with
the best of them.
I’m easily impatient
waiting in lines
when I’m shopping.
I’m on the lookout
for ways to speed my trip when I drive.
I’ve never been nominated for any award
that is based on leisureliness,
on choosing to go slowly.
These days, however, I’m learning the value
of another way of proceeding.
When I walk with Dad,
he takes short, deliberate steps.
It’s all he can do.
When we eat together,
his arm moves in slow motion,
and so does his mouth.
So I’m learning to adjust my pace
so it’s suited to his.
When I shaved him the other day,
kneeling on the floor
while he sat in his comfortable chair,
we spent a third of an hour
close together, side by side.
The lather, the razor, the towels
all figured into our ritual.
So did our quiet conversing,
and my re-doing that cleft in his chin
four times in a row,
and my running my fingers across his cheek,
searching for any errant stragglers.
It felt peaceful to take our time.
It felt gratifying to rub his skin,
dry his neck, clean his glasses.
It felt like a grace to joke with him
while simultaneously admiring him.
And when we were all done
and he said his gentle “thank you,”
I was as glad as he was
that we had lingered through those moments.
Had I moved quickly and mechanically,
we would not have felt as connected.
Had he not allowed this unhurried intimacy,
we would have missed this opportunity
to be father and son
in yet another way.
I’m learning,
appreciatively and now even willingly,
that slowness carries its own blessing.

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Respite IV

March 3, 2008

Apart and together.
That’s what helps.
All caregivers need,
and certainly deserve,
a break from duties.
Time apart.
The chance to rest, refresh, refill.
If we number more than one,
then our caregiving team will benefit
from having time apart together.
Then we can relate as unique individuals,
not just as fellow caregivers.
We can do things with each other
unrelated to our caregiving duties.
If we talk about our caring responsibilities,
we can do so privately, leisurely,
perhaps more candidly.
We can become more united
in what we’re doing,
more clear, more sure,
maybe more dedicated.
These are not empty words.
My siblings and I just spent fours days
at our brother Tony’s wonderful place
by the ocean in Florida.
Dad wasn’t with us,
and yet he somehow was.
We missed him,
and it was also important
to have some time without him.
Today we return to our homes
rested,
refreshed,
refilled.

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