Saturday, February 20, 2010

My Mother

Yesterday, was my mother's funeral. She was not perfect although we've practically canonized her this week. She was a remarkable woman and survived unbelievable hardships especially in her childhood. She was an extremely hard worker and had trouble adjusting to not working. She was a VERY generous woman--selfless really--there was no part of her that would understand the "me " generation. She was sweet and funny. I miss her so much. I share her love of quilting and music and reading and poetry. As a child, I often saw the "drill sargeant" side of her. Now that I am a mother and grandmother, I understand that military mode especially when there are so many tasks to be accomplished. I am amazed at everything she did and how she loved especially when she lost her own mother at such a young age so how did she learn how to be this wonderful mother and grandmother? It's going to be hard to go back to work and back to reality when I would rather curl up in bed for another week or so. I am so proud of my daughter Stephanie (who was named after Grandma Stella). She gave a moving eulogy. Mom--there'll never be another you.

Monday, February 1, 2010

How to live to 100 and enjoy it

Over 40 years ago, I saw a poster of an old weather-worn cowboy with a caption that said “If I’d have known I was going to live this long, I would have taken better care of myself”!!! It is a reminder to think about what we can do now to prepare ourselves for old age. Proverbs 22:6 says “Train a child in the way he should go, and when he is old he will not turn from it.” I think that is telling us that we can learn good habits and learn to make good choices when we are young and they will help us as we grow older. That may be hard to do in this instant gratification world. Will my lab work that is not due for another 6 months influence whether I have a cheeseburger and fries today or is it too far in the future to worry about? Is anyone really responsible for their cholesterol or heart disease or their diabetes or can we just blame it all on genetics and not take any personal responsibility for our health?

In my 30+ years of experience in long term care, genetics does play a large part in people’s health AND taking care of yourself also plays a large part. If the genetics in your family is already not good, it is even MORE important to take care of yourself.

There are other things we can do to enjoy good health as we age. The New Scientist magazine at http://www.newscientist.com/article/mg19025541.500-how-to-live-to-100-and-enjoy-it.html?full=true&print=true has some tips on “How to live to 100…and enjoy it.” Here’s a summary of the article.
Go for the burn: Many researchers believe that small doses of "stressors" such as poisons, radiation and heat can actually be good for you - so good that they can even reverse the ageing process. The big unanswered question is at what dose does an otherwise harmful agent become beneficial? Clearly, too much radiation or poison are bad for you. However, there may be a safe way to trick your body's repair mechanisms into overdrive. Smith-Sonneborn and others suspect that the life-extending effects of exercise are also down to hormesis. She proudly practices what she preaches with an exercise regime that she says stresses her body to just the right level to get the optimum response. "I'm 70 and I have the bone density of a 35-year-old," she says.
Don't be a loner: Being sociable looks like one of the best ways to add years to your life. Relationships with family, friends, neighbors, even pets, will all do the trick, but the biggest longevity boost seems to come from marriage or an equivalent significant-other relationship.
Consider relocation: A recent study of elderly residents from a poor area of St Louis, Missouri, found that factors such as low air quality and dirty streets tripled the likelihood of their suffering from disabilities in later life. Likewise, a survey by Scottish newspaper The Scotsman in January found that people living in the poorest suburbs of Glasgow had a life expectancy of just 54 - three decades shorter than people in wealthier areas. Tom Perls, who heads the New England Centenarian Study at Boston University, represents the other end of the spectrum. He believes that while longevity may seem to run in families, environment accounts for up to 70 per cent of this effect. "Just because it's familial doesn't mean it's all down to genes," he says, because family members often share many environmental factors. He points to a group of Seventh Day Adventists in California whose lifespan averages 88, a decade more than the US average. They are genetically quite diverse, but share a lifestyle that includes vegetarianism, no smoking, no drinking, and with strong emphasis on family and religion, all of which can contribute to longevity. There is general agreement, however, that your physical location is less important than the personal environment you create through your behavior. You could move to the Japanese island of Okinawa, the world's number one longevity hotspot, but a better bet might be to live life the Okinawa way. "We boil it all down to four factors: diet, exercise, psycho-spiritual and social," says Bradley Willcox, a researcher with the Okinawa Centenarian Study.
Make a virtue out of a vice: One of the most informative studies of healthy ageing to date has been conducted at the convent of the School Sisters of Notre Dame in Mankato, Minnesota. The nuns there, around 1 in 10 of whom have reached their hundredth birthday, teach us that a healthy old age is often a virtuous one - which means no drinking or smoking, eating healthily and in moderation, and living quietly, harmoniously and spiritually. But clean living is not to everyone's taste. Besides, what is the point of living to 100 if you can't enjoy a few wicked indulgences? Assuming you will have some vices, the trick is to choose them wisely. The idea that one glass of wine a day is actually good for you is now ingrained in the popular consciousness. Another vice that you probably shouldn't fight too hard is sleep. Unless you can reset your body clock with lots of bright light and good discipline, fighting your natural lark or owl tendencies can be bad for your health. Your best bet if you are a chocolate lover is dark chocolate. Whatever your pleasure, the great news is that pleasure itself is good for you. Really good. Not only does it counteract stress, it also causes our cells to release a natural antibiotic called enkelytin. Whether it's chocolate, coffee, having a tipple or a flutter, a spot of sunbathing (with suncream), a romantic (or more carnal) encounter, or another form of sinful pleasure, think of it as self-medication. Just make sure that if you have a vice, you enjoy it.
Exercise the little gray cells: Study after study has shown that intelligence, good education, literacy and high-status jobs all seem to protect people from the mental ravages of old age and provide some resistance to the symptoms, if not the brain shrinkage, of dementia. Brain researchers and doctors are starting to refer to it as brain or cognitive reserve. Mental gymnastics are definitely on the agenda - everything from reading to learning new things to interacting with people rather than being a couch potato. But don't stop with mental exercises. At least one study has shown that older mice produced new brain cells faster and learned quicker than sedentary creatures when they were put on an exercise program. All this helps explain the remarkable mental health of those centenarian nuns, who fill their advancing years with both physical and mental activity, from gardening and crosswords to reading, walking, conversation and knitting.
Smile!: Centenarians have surprisingly little in common, but one thing most do share is their love of a laugh. People born with a sunny disposition cope better with stress, which increases their chances of reaching a ripe old age. The study of nuns in Minnesota reveals that those who had the most positive outlook on life during adolescence and young adulthood are also the healthiest in old age. Some people are born laid-back, but even if you are a natural stress bunny, there are things you can do to reduce your cortisol levels. "These include t'ai chi, exercise, having faith, meditation and yoga," laughing and smiling also reduce cortisol levels. A happier life is likely to be a longer one - and that's surely something to smile about.
Nurture your inner hypochondriac: One obvious piece of advice for anyone wishing to become a healthy centenarian is this: if you're sick, go see a doctor.
Watch what you eat: Metabolilc stability is the key to ageing. Eat up to at least 5 portions of fruit and vegetables daily. Eat foods high in antioxidants. There is strong evidence supporting the assertion that fresh fruit and vegetables, especially greens, keeps the brain sharp. A healthy diet is extremely important factor in longevity and eating high calorie, fat-laden foods is on e of the surest ways to an early grave.
Get a life: What you need is a bit of excitement along the way. Take some risks. Not only will new experiences bring you pleasure, you may also find they have added benefits. There is also plenty of evidence to indicate that the kind of buzz you get from traveling, learning a new language, completing a sudoku puzzle or creating your own artistic masterpiece helps delay the onset of neurodegenerative diseases, including Alzheimer's. Admittedly, some of the most thrilling - think mountaineering, cave diving or base jumping - are not entirely compatible with longevity, but maybe you can justify the risk by making a trade-off. If you smoke, quit now. Or cut down on some other major life-shortening habit such as binge drinking, reckless driving or cheeseburgers. Alternatively, if you want a thrill but cannot justify the risk, go for safer kicks such as fairground rides, amateur dramatics, a new lover or bungee jumping.

Tuesday, January 26, 2010

Compassion Fatigue

I am tired. I think I am suffering from compassion fatigue. I became a parent in 1972 and through 1998 continued to have children or foster children at home. 1989-90 was the height of parenting when we had 5 teenagers plus a 12 year old in our home. 3 of the teen-agers were developmentally disabled. 2 of them were bedwetters so there was all of their bedding to be washed each night. Grocery shopping was a nightmare as I filled 2 grocery carts each week to say nothing of the dentist/doctor visits, IEP and other school meetings, parent-teacher conferences and meetings with social workers and working with the mother of the foster children!! Although, I was and am married, Arden did little or none of the caregiving. He didn’t wash clothes, or shop for groceries, or take children to appointments or go to school appointments or write reports or prepare meals. It wasn't his fault, I didn't ask him to help me as I thought it was my duty to do it all. He was a good financial provider and was inciteful in providing council to the kids.

In addition to all of the kids and those responsibilities, I held a very demanding job that required compassion, decision making, conflict resolution and problem solving. WHEW!! No wonder after nearly 40 years, I am tired. Added to all of that is this difficult placement in an extremely rural area of high poverty with many, many struggles. The area is not going to change, but I think that I must make a change, sooner rather than later to save my sanity. I am showing many of the signs of compassion fatigue.

I came across some notes from a workshop on "Surviving Compassion Fatigue". In the people business there are certain givens:1. You're going to feel overworked2. You're going to feel under-appreciated3. There are going to be communication glitches4. Burn out is a daily event so daily we must do something (selfish) daily to fill our tanks5. Don't let circumstances steal your joy--do not take offense

What is compassion? Dacher Keltner, a psychologist who leads the Greater Good Science Center, defines compassion as “concern to enhance the welfare of another who suffers or is in need.” This is different from empathy, which is the “mirroring or understanding of another’s emotion.” So empathy is feeling; compassion is action.
Why is compassion so universal, not just in individuals but through social networks and institutions? It was thought for a long time that compassion was the exception, selfishness the rule. After Charles Darwin made his case for evolution, many Europeans interpreted the survival of the fittest to mean that only the fittest should survive. Europeans even invented an ideology called Social Darwinism, the belief that alleged intellectual and behavioral differences between people with different skin pigmentations were rooted in biology, making some races fit to rule and some fit to serve.
But that was all wrong right from the start, because Darwin’s theory of evolution suggested that the good in human beings was just as adaptive as the bad. In other words, we have compassion because compassion helps our species to survive. Compassionate acts, Darwin wrote in Descent of Man, “appear to be the simple result of the greater strength of the social and maternal instincts than that of any other instinct or motive; for they are performed too instantaneously for reflection, or for pleasure or pain to be felt at the time; though, if prevented by any cause, distress or even misery might be felt.”
In other words, our evolved instinct to help other people is a reflex, like smiling back at someone who smiles at us or flinching at the sound of a gunshot. When we are prevented from acting on the compassionate instinct, it hurts; we feel miserable. The effect can be deadening.
So we are literally wired for compassion; we experience compassion in both our minds and our bodies, and the experience makes minds and bodies healthier. This explains why the absence of compassion is so painful.

But I believe that when we’re confronted with evil, we cannot respond in kind. I don’t believe in fighting fire with fire. Instead, I’d argue, we must aim to reestablish the connection between us as human beings; this is the definition of goodness. In the face of cruelty and stupidity, we have to respond with empathy and imagination. We have to leave the confines of our own minds, and travel that biological and social bridge of emotion, and try to help those who have hurt us, and try to imagine what drove them to hurt us. We must make their pains our own. Not for their benefit, but for the sake of our own potential.
But human beings are not, as we know, robots, and there is a great deal of research suggesting that somatic empathy — that is, the involuntary, unconscious empathy we feel in our guts—is a major factor driving compassion fatigue, a state of mind in which we become less and less able to help others, for fear of being hurt ourselves. We’re talking about natural processes—namely, compassion and empathy —being put to use over and over again in highly repetitive, artificial situations.
That kind of work will wear down even the strongest person, especially during times like these, when budgets are being cut and resources, including human resources, are being stretched to the limit, and distressed people are counting more than ever on infrastructures of care. It’s in historical moments like this one that compassion fatigue becomes a real threat, not just to professions like nursing but to our entire society.
Charles Garfield is an advisor to Greater Good magazine, clinical professor of psychology at the UC School of Medicine, founder of the Shanti Project, one of the first HIV/AIDS community organizations in the world, and an expert on compassion and compassion fatigue. In his book
Sometimes My Heart Goes Numb, Charlie describes the symptoms and consequences of compassion fatigue: depression, anxiety, hypochondria, combativeness, the sensation of being on fast-forward, an inability to concentrate.
Caregivers, he writes, “describe greater and greater difficulty in processing their emotions. They are anxiety-ridden or distressed. Fellini-esque images intrude on their days and nights, painful memories flood their world outside the caregiving arena.”
So what we can you do? First of all, take care of yourself. Use your weekends and your time off to do things you enjoy, eat healthy foods, read novels, go for long walks. If you’re struggling with darkness, look for light wherever you can find it. Show compassion for yourself—recognize suffering in yourself and act to alleviate the suffering. That’s different from self-pity, when we see suffering in ourselves and we don’t do anything about it. We just feel sorry for ourselves. With self-compassion, we don’t allow the suffering to define us. Instead, we are defined by our resistance to suffering.
What is in italics was taken from http://greatergood.berkeley.edu/greatergoodscience/?p=404

Monday, January 25, 2010

Always go to the funeral

As an administrator of a nursing home for nearly 30 years, I feel it is important to attend the funerals of the residents in my care. I am representing the facility and the rest of the staff when I do this. In addition, I conduct regular memorial services in the center for staff and residents to attend because they can't always get to the funeral. This is a neat way to sing and cry and laugh and remember the residents who have died. The Good Samaritan Society also has bedside memorial services at the bedside of the resident when they die. It is a meaningful thing to do at the time of death and helps us to provide comfort to each other. Tomorrow, I will attend another funeral of a resident who died last week.


I heard this piece on NPR radio and wanted to share it with you.


ALWAYS GO TO THE FUNERAL by Deidre Sullivan on NPR

Deirdre Sullivan grew up in Syracuse, N.Y., and traveled the world working odd jobs before attending law school at Northwestern University. She's now a freelance attorney living in Brooklyn. Sullivan says her father's greatest gift to her and her family was how he ushered them through the process of his death.

August 8, 2005

I believe in always going to the funeral. My father taught me that.
The first time he said it directly to me, I was 16 and trying to get out of going to calling hours for Miss Emerson, my old fifth grade math teacher. I did not want to go. My father was unequivocal. "Dee," he said, "you're going. Always go to the funeral. Do it for the family."
So my dad waited outside while I went in. It was worse than I thought it would be: I was the only kid there. When the condolence line deposited me in front of Miss Emerson's shell-shocked parents, I stammered out, "Sorry about all this," and stalked away. But, for that deeply weird expression of sympathy delivered 20 years ago, Miss Emerson's mother still remembers my name and always says hello with tearing eyes.
That was the first time I went un-chaperoned, but my parents had been taking us kids to funerals and calling hours as a matter of course for years. By the time I was 16, I had been to five or six funerals. I remember two things from the funeral circuit: bottomless dishes of free mints and my father saying on the ride home, "You can't come in without going out, kids. Always go to the funeral."
Sounds simple -- when someone dies, get in your car and go to calling hours or the funeral. That, I can do. But I think a personal philosophy of going to funerals means more than that.
"Always go to the funeral" means that I have to do the right thing when I really, really don't feel like it. I have to remind myself of it when I could make some small gesture, but I don't really have to and I definitely don't want to. I'm talking about those things that represent only inconvenience to me, but the world to the other guy. You know, the painfully under-attended birthday party. The hospital visit during happy hour. The Shiva call for one of my ex's uncles. In my humdrum life, the daily battle hasn't been good versus evil. It's hardly so epic. Most days, my real battle is doing good versus doing nothing.
In going to funerals, I've come to believe that while I wait to make a grand heroic gesture, I should just stick to the small inconveniences that let me share in life's inevitable, occasional calamity.
On a cold April night three years ago, my father died a quiet death from cancer. His funeral was on a Wednesday, middle of the workweek. I had been numb for days when, for some reason, during the funeral, I turned and looked back at the folks in the church. The memory of it still takes my breath away. The most human, powerful and humbling thing I've ever seen was a church at 3:00 on a Wednesday full of inconvenienced people who believe in going to the funeral.

Saturday, January 23, 2010

My siblings and I moved our parents for the third time in ten years last weekend. In order for the process to be done in a weekend, we have to make pretty quick decisions about what to keep and what to throw or give away. When we moved them off the farm about ten years ago, we all took boxes home and our homes were filled. In addition, we have all of the stuff we've accumulate in our 50-60 years of life. In some cases we are also housing boxes of stuff from our kids who may not be settled yet!! UFFDA!!


I am determined to at least make some sense of all the stuff and to organize it or to scrapbook it. We hope that we are building a new house in this next year and it's not going to be huge so I really want to keep only the best and most important stuff.

I like the "minimalist" look because it is so clean. I love organization because it makes everything so efficient. But on the other hand, I love the memories created by seeing some of the stuff. I have an old chipped bowl that my mother always kept salt in. She would just reach in for a pinch and put it into whatever she was cooking or baking. How can I get rid of the patriotic beanie baby bear that was given to my father in law when he was battling cancer? How about the giant birthday card that Tyler made me from poster paper? So now you see the conflict. As in many things, the key is balance. I don't want to become a hoarder and not able to get rid of anything but I also do not want a sterile and impersonal environment. Kinda reminds me of the following song.



Who's Gonna Know?

Written by Jon Vesner and performed by Kathy Mattea on "Walking Away A Winner"



On the top of my desk mid the clutter and dustsits an old 5x8 black and white

It's one of my favorite pictures of us

I'll carry with me all my life

I must have been a-bout five or six

Mom's hair was still brown and Dad's was still thick

But to look at it now some-times I get scared

To think that some-day they might not be there

'Cause who's gonna know but me



Who'll help me recall those small mem-o-ries

I'm all that's left of this family of three

Who's gonna know but me?

Down in the cellar under the steps

Sits an old box of junk that I've saved

Newspaper clippings, letters and cards

Even some code-a-phone tapes

Slices of life I can hold in my hand

And show to my kids so they might under-stand

In those years to come when they ask me some night

What Grandma and Grandpa used to be like

'Cause who's gonna know but me



Who'll help me recall those small mem-o-ries

I'm all that's left of this family of three

Who's gonna know but me?

If life were a video I could rewind

I'd go back and slow down each moment in time

Then I'd disconnect the fast forward button

So I'd have for-ever to tell 'em I love 'em

The older I get, I can't get enough of 'em

'Cause who's gonna know but me



Who'll help me recall all those mem-o-ries

I'm all that's left of this family of three

Who's gonna know but me?

Who's gonna know but me?

Friday, January 22, 2010

What love is

When I was in college I read the sappy novel "Love Story" and cried over it. The infamous line in it that says "love means never having to say you're sorry" truly IS sappy. True love DOES indeed say that you are sorry for your wrongs and sometimes even when you are not wrong. If the other person loves you back, they will forgive you and forget the wrong that was done.

Other thoughts on love:

Love is:

  • being able to tell someone that their hair is sticking up, "just a little" in the back.
  • being able to tell someone that they need a breath mint or that their zipper is down
  • being able to discuss the hard things in a sane, quiet way without accusations and name calling
  • not belittling others but building them up
  • coming back to those hard conversations until they are resolved
  • learning to laugh when things get tense
  • believing the best, not the worst in others

Andrew Carnegie wrote these wise words:
"You develop people just like you mine gold,
When you mine gold, you don't go into the mountain looking for dirt.
You look for gold, no matter how small or how much dirt you have to push aside."

We can all learn better how to mine gold in those we love and even in those whom we don't know so well.

By the way, I told Arden some time ago that he could just get up every morning and say "I'm sorry". That should just about cover all of the mistakes he might make that day. LOL!!