Archive for October 2015

A Blush of Sadness

http://www.flickr.com/photos/alicepopkorn/

Photo by Alice Popkorn via Flickr

It’s been a busy day, in a busy stretch. With two cancellations for this evening, I have a rare moment of solitude in the house.  I can hear cars passing on the rain-wet street, and a mounting wind is quickly taking down the colorful autumn leaves and revealing grey-black tree skeletons, their crooked hands reaching for a darkening sky and the mysteries of All Hallows’ Eve.

As I sit for a bit, I am aware of a blush of sadness that crosses my heart.

What is it?

I try to trace the whisper of feeling back to its origin, and finding no obvious clue, I slowly scan a mental checklist and wait for another twinge:

  • Mourning the end of an extraordinary summer?
  • A streak of sugar from the hard butterscotch candy I just crunched down?
  • Weary from too-long days?
  • Full moon?
  • Concern for a loved one who is struggling right now?
  • Embarrassment about a missed deadline or missing document?
  • Untended grief?

It could be any of those things, I suppose.

It didn’t last long, but I noticed. I understood it to feel like sadness.

Then, rather than bury it or let it grow in crazy directions, like a sidewalk charcoal snake burning to its full height some hot Fourth of July, I investigate:

  • Where do I feel it?
  • How strong is it?
  • Where’d it come from?

I’ve experienced depression before, so I make a mental note to pay attention.

If I get sad and stay that way for more than a few days (my default nature is outrageously optimistic and upbeat), I pay even more attention, in case I need to be assessed for depression.

Humans feel stuff, like sadness, anger, disgust, jealousy, happiness, satisfaction, hunger, desire, and you-name-it.

Noticing helps us cope, as long as we balance that noticing with the proper degree of curiosity and nonchalance. That is, I don’t get freaked out by my fleeting thoughts or emotions.

Sometimes it’s just the candy.

***

Lisa Kendall writes about well-being and self-care for all members of the care partner team, and pays attention to thoughts, emotions, and feelings as a psychotherapist and clinical gerontologist in Ithaca, NY. 

Follow Lisa on Twitter @LisaKCounseling

Elder Care: The Dignity of Choice

Welcome to the fourth installment in a series of blog posts on The Eden Alternative Domains of Well-Being(TM). Read more about these domains by clicking HERE!

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My first job working with Elders was as “social services designee” in a nursing home in 1983. I learned many lessons from the Elders there, and many from older, wiser, and more experienced colleagues.

One lesson in particular is really burned into my memory.

I must have been in an Elder’s room with one of the nurses, or maybe we were out in the hallway. She took me aside and told me that even if the only decision a person living with frailty or dementia could make was how they wanted their toast cut, it was important to always offer choice.

She said it was about ensuring that a person has “autonomy,” necessary to preserving human dignity.

Wow.

It might sound like a small thing, but that lesson really made an impact on me.

Autonomy is one of the domains of well-being, as described by The Eden Alternative.  We have a human need to have choice, to know that we have some control over our lives.

Autumn Tree SunsetThroughout my career I’ve tried to tune in to how physical or cognitive changes might narrow our choices.

If our ability to drive safely is compromised, “taking away the car keys” can be painful and humiliating for Elders and family alike.

It can be a challenge to find the choice in that situation, when something so essential to our independence feels threatened.

How we talk about these difficult decisions can make all the difference. We need to think about how we recognize the need for autonomy, and then work to fulfill it.

In the case of making a different decision about transportation, we must offer as many choices as possible under the circumstances. In our community, we have a bus service for Elders, and also a volunteer driver program. Offering the Elder their preference won’t completely “fix” the loss of one’s own car, but at least it preserves the opportunity to choose for oneself from the possible options.

Autonomy also means that Elders, or the people who receive services from an organization or live in a community, should have a say in how they experience services, or in how their home is operated.

Does your local home care agency have Elders on the team that interviews applicants for staff positions?  Why-ever not!?!

We can also preserve choice by thinking about health care decision-making and choosing someone to speak for you when you cannot speak for yourself.  This is a powerful way to ensure your preferences are honored, your voice is heard.

I wrote about this a few years ago; you can check out my blog on planning for future health care by clicking HERE.

Person-directed care doesn’t mean that we can offer any and all choices, regardless of the consequences. It does mean we look at realistic parameters, confer with the person who is most affected by changes, and find ways to offer the dignity of choice.

***

Do you have stories about how you’ve been able to preserve choice, even when options have become limited? This can be a tricky area, so sharing what’s worked in your circumstance can be extremely helpful to others!

Perhaps you’re struggling with this now. Please let us know what issues are challenging you, and we’ll invite the  community to share stories that may help!

Please share your thoughts in the comment section below.

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Lisa Kendall supports well-being in her work with Elders and their family members, as well as with professional care partners.  She is an Educator and Mentor for The Eden Alternative, and has a private counseling and consulting practice in Ithaca, NY.

You can reach Lisa at (607) 351-1313, or via email at crossroadscounseling@hotmail.com

Well-Being in Old Age: How Elders Grow

Welcome to the third installment in a series of blog posts on The Eden Alternative Domains of Well-Being(TM). You can read more about these domains by clicking HERE!

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In the Eden Alternative philosophy, we define care as “that which helps another to grow.”

It’s a powerful way to shift our understanding of relationships, and to broaden our traditional view of care, which tends to focus on problems, and on treatment of the body alone.

When I was asking someone recently about their “support system,” they named a few people they felt close to. Then I shared this definition of care and asked “who or what helps you grow,” and the person poured out a list of resources they hadn’t thought of before.

These are the people (or animal companions) on our care team, and it all sounds like a good and positive thing. Still, I sometimes strike a nerve when I talk with people about “growth.”

“What is growth? What does that word mean?”

Dr. Bill Thomas writes about the stage of life known as “Elderhood” in his book. “What are old people for? How Elders will save the world,” and posits that growth is a part of Elderhood, as it is part of all of life’s developmental stages.

We are so used to thinking about Elderhood as a stage of decline that we overlook the many ways we continue to grow.

OMA Art by L KendallSome of us struggle with the very idea of growth in the midst of decline, or see growth through the eyes of Adulthood, where we strive to improve our job skills, increase income, or strengthen and build muscle.

These kinds of growth may or may not happen in one’s Elderhood. And we’re so use to looking at the world through the eyes of adulthood, that we may need to broaden our ideas about what growth can mean.

I started thinking about growth in the last phase of life when I had the chance to work with several people who were dying, or who were family care partners with loved ones who were dying. It’s easy to be overwhelmed by sadness and be focused on loss in this instance, but I have seen amazing healing and growth occur, even at the death bed.

This kind of healing and growth is almost always about intangible qualities, such as increasing forgiveness, wisdom, peace, acceptance, love, relationships, or one’s relationship to the Divine.

Growth is possible for people who are living with cognitive challenges, such as dementia. As care partners, we can learn patience, kindness, and forgiveness, to name but a few.  Elders may learn to accept support, let go of painful memories, and learn to express themselves with more freedom and joy.

The art that accompanies this post was done by me during a workshop by the good people at Scripps Gerontological Institute.  Their program, “Opening Minds Through Art,” (or OMA), shows us how people living with dementia can create fabulous art when we shift how we think about art itself.  Coloring between the lines may be difficult when you live with dementia, but watch the amazing transformation when Elders are given the tools and encouragement to create abstract art!  Check out this program at: www.scrippsoma.org

Have you seen someone grow in spiritual strength as their body is dying? Can you imagine growing in one’s ability to adapt to the changes brought about by aging or illness? Is there room for relationships to heal in our last stage of life?

What does growth mean to you? Who or what helps you grow?

Leave a comment about growth; you’ll be helping all of us grow in understanding!

***

Lisa Kendall supports well-being in her work with Elders and their family care partners, as well as with professional care partners.  She is an Educator and Mentor for The Eden Alternative, and has a private counseling and consulting practice in Ithaca, NY.

Identity and Age

https://www.flickr.com/photos/thomasrstegelmann/1811854387/in/photolist-3L7ebK-pkc6tN-5uiz6E-64zny-5JGsnE-5P2CM3-5sQTMb-boxwhh-4FjTxT-4wkCAt-9d69qF-64zoC-38oyd9-xUiw1-4MRxcX-rkvyv-4km959-K3Y2U-K3YcW-9w9dKW-q8bgQV-4vdwk-64vP9z-2w6KQ9-4M5JNi-ABJEr-ehiBXD-5HDdD9-qXwhx-5hQGof-dSp8Ka-pQxH1b-5ZtHAE-51sFsv-7zkdyx-8KGRCA-rA7Bae-5JGshy-5JCbpZ-5Pqed4-qHyG6-oMiQei-4sMAYF-sGXftu-5rNCji-ncyBXt-hLEdup-8SoHfT-4wjQEe-8YV1Ln

Thomas R Stegelmann, courtesy of Flickr

Welcome to the second in an 8-part series of blog posts on The Eden Alternative Domains of Well-Being(TM). You can read more about these domains by clicking HERE!

  • * * *

In 1984 I worked in an Adult Day Program that served people living with dementia, and also had a fair number of people attending who lived with Parkinson’s disease. One of the things that really jumped out at me at this time of my career was how differently our staff care partners thought about and interacted with the Elders, as opposed to how the family seemed to see them.

A woman I’ll call Helen had a beautiful smile and often struggled to get the right word out. I could usually get what she was trying to tell me by watching her gestures, and she sighed with relief when I offered the misplaced word.

Helen was always well-dressed, lipstick in place, and she carefully carried her purse on her arm. She had worked as an accountant in her career, and she enjoyed sitting behind the director’s desk. She looked completely at ease next to the large adding machine!

I loved Helen, appreciating her playful spirit, and the way she laughed when someone would dance with her. One day I had the ladies gather in a circle in the side yard and we tossed a Nerf football around. Helen placed her handbag carefully at her feet, and proceeded to have a great time with our silly game. No rules, just fun.

Helen’s family members were often tearful when they dropped Helen off at the program, and explained how hard it was for them to lose the “old Helen,” the mother and wife who had been so sharp in her work and careful in her dress. Now Helen couldn’t tell one end of a sweater from another, and needed help getting it turned right-way around.

Which identity was truly Helen?

Here is a place where we want to “embrace the power of ‘and,’” as Dr. Bill Thomas says in his book, “What are Old People for: How Elders will Save the World.”

A big part of Helen’s identity was about her past: her work, her relationships, her special skills and talents. Knowing her history helped us understand why she was so attracted to the big desk and its adding machine. AND a big part of Helen was the desire to connect she brought to the program every day: the painstaking conversation, the laughter, and the dancing.

I always honor the grieving process a family experiences when a loved one lives with dementia and the changes it brings, AND I am here to say that there is tremendous joy in seeing who the person is now, and getting to know them as they are, now.

Sometimes it felt like Helen and the other folks in the day program needed some time away from their dearest loved ones, where the sadness and frustration couldn’t help but reflect in their eyes. I believe they needed an environment where they could be accepted and loved for who they are now, and that can be easier for someone who is not a close relative or long-time friend.

We may be seen by the people around us in different ways, depending on the relationship and the context. It’s another way to understand how a care partner team can work together to both give and receive care from one another, and help us express the many facets of our identity!

How do you support identity for Elders who live with dementia? How about your own identity – are you able to do the things that connect with your innermost self, or have you pushed some part of yourself aside to cope with the challenges of caregiving? Please share your stories with our community in the comment spaces below.

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Lisa Kendall supports well-being in her work with Elders and their family care partners, as well as with professional care partners.  She is an Educator and Mentor for The Eden Alternative, and has a private counseling and consulting practice in Ithaca, NY.

How do you define “Well-Being” for Elders and Caregivers?

What does "well-being" mean to you? We often equate well-being with health, strength, and the vigor of youth. When these fade, whether through illness, injury, or advancing age, society sees us (and we may see ourselves) as unable to truly have well-being. Read the rest of this entry »
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