January 2005: I met a cool lady recently, one of those short little ladies in their 80s. I told Mary that I want to grow up to be like her.
Blind since young, she makes her way around with a white cane and since she is also so hard of hearing that it is hard for her to follow the verbal directions of others, she leads her exercise group and admonishes the others to make sure they take the time every day to walk. When I was in her room she told me that her back was the best it had been in a long time, since she exercised so much and used her treadmill. She told me she had moved here from the midwest a few years back to be near her daughter and when she did she had decided there were still a few things left that she wanted to do- she wanted to ride a horse again, ride a Harley and ride in a helicopter. She showed me beautiful pictures of herself in a bright red helicopter and told me about riding a Harley around town with a Santa driving and riding a horse for the first time since she was very young. With these things accomplished she has decided that there is still one more thing she wants to do- ride in a hot air balloon. Actually, I doubt if she will ever be done. She is active, fiesty and her mind is busy with life and doing. Yes, that is how I want to be.
The world is round and the place which may seem like the end may also be only the beginning.- Ivy Baker
So, I went to talk to some elderly women at a table and before I could say anything one looked up at me and said, "You've got curly hair! You have curly hair like me. It's pretty, do you get lots of compliments?"
I told her that I do and that sometimes people ask me where I get my perm because they like how the curl is done and that I tell them God does my curls. The ladies chuckled and one piped up, "Yes, but you are the one with the perm, ours certainly aren't permanent!" More chuckles, including my own...
Later the lady with the curls showed up at a group meeting and waited to talk to me- she wanted to know where I got my hair cut and what hair products I used. I wrote those things down for her on a piece of paper she brought with her just for that purpose.
At the end of the work day I once again ran into the lady with the gray curls sitting with another woman in the living area of the building. She flagged me down and once again told me how much she liked my hair. We chatted a bit and I told her I would see her again the next day. The other lady asked her if I was her daughter, but she hardly noticed the question, looking quite puzzled. "Do I have an appointment with you tomorrow?" I told her no, but that I would be back in the building tomorrow and since I saw her so much today I figured I would see her tomorrow too. She nodded and I said goodbye again. As I walked away I heard the lady next to her saying, "And she is so good to you..."
I was in the building for the next two days, but did not see the lady with the curls again.
The simplest questions are the most profound. Where were you born? Where is your home? Where are you going? What are you doing?- Richard Bach
In my current job I do not have as much contact with clients, and I miss that. I still interview people but the interview is rather brief, compared to the couple of hours I am used to ... I was lucky enough to meet a couple of interesting gals recently though. I was standing in a dining area and I could feel someone come up behind me and start patting my hair. I waited and let her come around to my face- yes, nice curly hair she told me, or something to that effect. She had lost control of the words that came out, but the bits and pieces of words seemed full of meaning. The next day she approached me from the front, reaching up to pat my hair gently and again say incomplete words that sounded for all the world like "gibberish". It's funny how crystal clear even gibberish can be- is it still, then, "gibberish"?
Yet another time and place, another lady with very advanced dementia was giving words of reassurance to a fellow traveler on the same path as herself, "These people sure know how to take us out of the doom don't they?" And her fellow traveler nodded in agreement. The next day I knocked on the door of her room and she opened it, noticed me and with surprise noted I was still in the building. She asked me if I had moved in there to live and I told her that I was just there for three days. She smiled and shook her head, "It's nice to get away on a vacation isn't it?" she said knowingly. Later that day I ran across her offering comfort again, "Life knows what is best for us so we just go along with it, don't we?" She was amazingly verbal and social, and clear, amidst her profound confusion.
I also recently met a lady riding an electric cart. She knew that I was a social worker and asked me about services for her mentally ill son. It was information I do not have in my current position but I did know how to get it and gave her a resource to contact. She told me that her son has lots of problems and two years ago she had to stop taking care of him and move to a place where she herself could get help. She said she didn't know how she had made it all of those years, that the strain had been great on her. I nodded in agreement and understanding, but stopped short when she mentioned that he had turned 70 the week before. In my usual therapeutic way I blurted out, "How old are you?" She said she is 86. I told her she looked good for her age, because she does. "I had him when I was 17. I don't know how I did it. It was hard." A mother's longing for her child's safety sometimes finds no place in this world to rest.
"At fifteen life had taught me undeniably that surrender, in its place, was as honorable as resistance, especially if one had no choice."- Maya Angelou
More March 2005:
Sigh... busy, tired... whatever the reason, few entries this week made it past the thinking stage. But I did remember that I intended to include one more small tidbit about my hair... will the hair thing ever end? Mmmm, not too soon I hope.
I sat on a kind of divan made for two people at the intersection of two hallways. An elderly woman stopped by to check out my smile and sat with me for awhile. I told her how pretty she looked in her outfit- how the color looked so nice on her. We sat for a bit, talking now and then and watching others go by. Then I think she wanted to join in with where I was, to pay back the compliment. She told me I had on a lovely top and when I glanced over at her I realized she was gazing up at my head. In this world of sucky people, there really are oh so many lovely ones.
The older you get the more you realize that kindness is synonymous with happiness.- Lionel Barrymore
More March 2005:
When I worked at Ypsilanti State Hospital in the 1970s, I worked for a while on a couple of medical units. The patients, by and large, could no longer walk, could no longer control the wastes their bodies released. It was there that I first learned how fragile the barrier between "me" and the rest of the world was as I saw the holes that develop in the skin as a result of inactivity or simply brushing up against a bedsheet... Working with mentally ill people both there and here, I encountered parental and family anguish from losing their loved one while the body continued to be, continued to demand care without the person they knew inside. One young man I worked with, in his early 20s, had his parent move while he was out of the house one day, because the pain was too much to bear. I met many people who had been in and out of mental hospitals who did not know any longer how to contact family... and no family contacted them. The family anguish I encountered when I began working with dementia patients was by then very familiar. I've seen families decide about feeding tubes, or not decide. I've seen life without life.
I'm sure that there are people, caregivers, who work keeping up the bodies of patients who don't seem to any longer be "here" who would choose to continue to be kept alive if it were themselves- but I have not met people exposed to such life who would choose it for themselves.
I do not know Terri Schiavo or her husband or parents. I do not know what is right for her, actually she is the only one who knows. That is why it is important for us to share our own wishes with those who may have to make these kinds of decisions for us- often it truly is the spouse who knows, and not the parents. Who is it that you have confided these things in?
Many of my professional friends, along with myself, do not want to have our bodies kept alive and do not want to go into the world of dementia ourselves. We do not want to have our loved ones exhausting themselves and their money taking care of us. "Just shoot me." How many times have I heard nurses say that? Many. Please, do not keep me alive if I am no longer here.
God is easy to scapegoat, making Him responsible for keeping a body alive, but it really is science that keeps the body alive today. Using technology to keep a body alive that would, if allowed to follow a natural course, be dead, is the work of man. Science and technology are at convenient times seen to be evil, and at others seen as the hand of God Himself. This particular case is complicated by the disagreement between spouse and parents- that is a hard one, there is no easy answer. I could sit alone with Terri for a half hour and form an opinion of how cognizant of herself she is, and maybe she is aware, maybe she could even tell me, in some way, her wishes. It is up to her and her family- not politicians and those who would judge others as if they themselves are God. Those who invoke the name of God need to make sure that they heed their own source- do unto others as you would have others do unto you. Have you truly explored what it would be like to be in a vegetative state and be cared for? Have you done that caregiving? Is it possible that God's kindness includes simply letting our loved ones go home to Him? It may be helpful to stop shouting and listen, find the stillpoint and let the answer come.
Be careful what you wish for. Yes, and I would add: understand what it is you are wishing for.
Self-righteousness is a loud din raised to drown the voice of guilt within us.- Eric Hoffer
A lovely woman in her 90s graciously shared with me her time. I asked her questions and she told me that she did not know the answers, did not know how long she had lived where she now lived, where her son lived, what she had for breakfast. "I have trouble with my memory", she told me in a perky sort of way, over and over as if she had not just said it moments before. She was bright, her apartment was neat and interesting, looking as if she had lots of interests. I asked about the puzzle spread out on the dining table- "yes I love puzzles!" The pieces were all there- not one had been connected to another. She was lovely, kind in her responses to me, and acted as if she wished she could come up with the answers to my questions, as if she knew they were not complicated questions, despite her inability to answer them. "I wish I could get back to where my memory worked!" She startled me with this exclamation.
I started working with geriatric clients in 1995 and began learning about dementias. I found that some people with mid-stage dementia had their families in a tizzy (is that a word? Yes, my dictionary says it is English slang for a sixpence...) because they were not happy where they were, wanted to move, wanted often to move back to somewhere- maybe the town they had grown up in, or the town they had raised their kids in, or the town they had lived in before coming to live near their adult children. These lovely, confused people could formulate no plans for how to accomplish this or even give a coherent explanation for their motivation, but nonetheless many families were trying so hard to figure out how to make them happy, how to get them somewhere they wanted to be. Over the years I have explained to more than one person that their family member did not really want to be where they said they wanted to be, they wanted to be in a place where their mind worked, they wanted to get back to themselves. At least this was what I understood, what I thought their loved one was talking about. Until I met the woman I mentioned above I had never heard anyone with dementia say that, explain where they really wanted to be. I found it all very interesting, again.
Where is the yesterday that worried us so?- Joan Walsh Anglund
More April 2005:
There has been a lot of controversy about the new movement to test students. Sometimes the advocates of such testing seem to think that students don't actually need an education, they just need to learn to pass tests. Washington has its own high school graduation test (WASL) that is heading into high gear. Some of the controversy centers on the simple question of what the questions should be...
My friends know that I have lots of thoughts and feelings about the public school system, and really none of them are complimentary for the schools or its teachers. As they know, I can go on and on with examples related to my experiences with my own children in school, but the reality is that the letters sent to my home from the schools were embarrassing to read- poorly written, poorly presented and obviously not prepared by anyone who had worked professionally outside of the school world. It is a sad state of affairs that really cannot benefit from me ranting on and on.
I have not been fond of the idea of teaching to a test, but recently it has become obvious that one side effect of this testing insanity is that the poor outcome that schools are producing is now being measured and publicized. I really don't care about parents not being involved enough, or students being bad, or not enough money, or large class size. What is the deal with kids in high school not knowing how to read, write and do arithmetic? Classes are no larger than mine were in grade school, as schools built like crazy to meet the demands of the baby boom. There were bad parents, bad kids and all of that before too. Blaming all of these things does not address how we are going to have educated people move into adulthood. Period. If a child is "bad", or has "uninvolved" parents, what then? What happens when this is identified? How is this addressed? How does the strategy change- what does the school system do to attempt to make this child successful? It is simply not acceptable that a child with a normal IQ does not learn basic skills in thirteen years of schooling. Other professions have to answer to what they produce... and change accordingly.
Anyhow, this is all prelude to comments I have made again and again about my observations regarding the literacy of our elders. I have met so very many elders who did not complete school, who have told me with embarrassment how they only made it through 8th grade, or 3rd grade, because they had to work to support the family during the Depression, or The War. Those and other elders are also embarrassed about their penmanship, as they sign documents with their arthritis-gnarled hands. But the reality is that I have marveled over and over at the actual beauty of their penmanship, the level of their word skills. If you do a therapy group with them, sooner or later they will correct your spelling or grammar. All this and they can balance a checkbook too. How is it that these elders with so little education are so skilled?
Where is it that we lost our way? Remember all the "new math"? The abandonment of phonics? Is there a baby out there that indeed did get thrown out with the bath water?
Perhaps in time the so-called Dark Ages will be thought of as including our own.- Georg C. Lichtenberg
From August 2005: Many years ago I worked with a client who was in her mid to late twenties and very paranoid. She had lost her husband and lost her legal rights to contact with her child because of insidious, troubling paranoid ideas that had made her a danger to herself and others at times. I worked with her for several months as she moved from one place to another, each home in succession deemed by her to be unsafe. She was once again at a new living place the last time I visited her; she had different things strewn about from the move and as I looked around my eyes fell upon a number of family photos. The photos filled me with a feeling of intense sadness that saturated me with almost visceral loss. The photos showed a younger woman, one full of life, full of promise, a woman with a future, a woman with a family. It's hard to explain the loss I felt gazing at those photos that were like all family photos- glimpses of the past- but these came with a stark acknowledgement, a realization that the future had arrived and the promise was gone.
I recently felt that familiar feeling again, looking at old photos with a fellow in a dementia facility. He showed me photos on his walls and photos in a box, as he wildly went on about unseen dangers and other reasons he needed to move back to the area where the pictures had been taken- faded pictures of a young woman ("that's the girl who wanted lots of babies"), a young man with the young woman, homes in black and white, homes with young children lined up to have a picture taken, children in clothing of another decade, another century. The wife had passed away, one son was dead. The days in the pictures had come, and had gone. The days that made up the man's life were now almost all gone; he could make sense of so very little of their remains. He was desperately intent on the idea that maybe if he moved back, back to the state the pictures were taken in, he could get back...
People who work in health care cannot escape the obvious- that we live and then we die. We are unlike "normal" people who go about life day after day as if there were no end- for us life's parameters are very real. Witnessing others' loss of function, loss of intellect, loss of life is part of our "normal" workday, but even we are brought up short at times- like when we are confronted with pictures of a past whose future is ending. We make amends as best we can with realities we cannot change: the inevitable loss of ones so dear, and of our self. We remind ourselves to cherish the time and function we have now, and hold onto a hope, faith, that life has meaning, that loved ones can be found again, found for forever, once we too go over that rainbow.
And when he found
That he was drowned,
It took him unawares.
- Father Goose
From September 2005: It is interesting how we come to take our own skills for granted, not realizing that things we do without thinking twice are things that simply do not occur to others to do, even others in closely-allied professional fields.
I was once asked to assess a man in a nursing home to see if he could be discharged, if there were any resources I could muster to help him return home safely. He was an elderly gentleman, in his late 80s or early 90s, who had been injured in an auto accident and was not bouncing back as well as expected; he wasn't getting up out of bed and this was concerning in terms of sending him home, even though his wife would be there. She was also a nursing home patient. The couple had apparently been getting some help at home but the discharge planner wasn't sure what all that entailed- MSW to the rescue. I decided I would do something daring, something I have learned through my extensive clinical experience to do- I would go ask the wife what kinds of things they were getting help with at home before the accident. In the man's room I met a lovely little older woman (I say "little" because so many older women are shorter than myself, my own not-so-tall stature; when elderly women are taller than I myself I invariably ask them about that experience...). She herself had received injuries in the accident but had recovered fairly well and could easily be discharged home, although her ability to provide care for another, care for her husband, was certainly in question.
I hacked my way through the forest of unknowns, seeking those elusive answers I had been asked to assist with, and chatted with the wonderful lady, finding out that she was a devoted life partner who wanted desperately to return home with her husband. Yes, they had assistance from programs I was familiar with, yes it sounded like they would be alright at home if he could get up, go to the bathroom and get about so that she did not have to physically assist him. She was not aware of concerns about her husband not getting up and out of bed but agreed he needed to do so. I told her I was going to talk with him about this issue and she quickly interjected that he was hard of hearing- yes, I knew this. And he could hardly see, "You need to get up real close to him so he can see your lips moving". Okay, yes, I was used to that, but as she was telling me this last bit I was drawing upon my acquired skills, attempting to mask the alarm that wanted to spread over my face... Excuse me, his eyesight is that bad? Wasn't he the one driving the car when the two of you were injured? The reply was perky and matter-of-fact, "Oh yes, but my eyes are good and I talk loud... I am his eyes for him as he drives." My brain was reeling while one thought kept repeating itself, one simple thought: Oh my.
I checked out with the lovely lady the couple's future driving plans and, indeed, this item had been discussed up front with them and they were considering other options, considering not driving when they got home. Sigh. Okay. I sidled up to the man's bed, got my face close and began my complicated inquiry: How are you doing? That was quite an accident. You're not going to drive anymore, right? They don't want you to go home until you can get up out of bed yourself- they are worried about your wife because she needs to be able to just take care of herself. Why aren't you getting up out of bed? I asked the complex questions I have learned to ask, and with this skill I was able to get to the bottom of things, to find out why he layed there, what he needed to get back to the point that he could go home... He was sweet, pleasant, yes, he wanted to go home. He indeed had been driving, his wife is his eyes, and maybe they would stop driving when they went home, maybe. Oh no, his wife shouldn't physically help him, he did not want her to injure herself. Yes, all the "kind of right" answers were coming from him and as it turned out he only needed a teeny bit of help before he would indeed be ready and safe to return home. He just needed to be told he could get up. "When I came here the nurses told me not to ever, ever, get up without help. I guess they were afraid I would hurt myself, fall or something. So I lie here- I wish they would just let me get up." Hmmm.
The nurse discharge planner thanked me profusely for my clinical assessment, for my clever detective work in figuring out this complex case. Yes, they would tell him he could get up, they would see how he did the rest of the day and overnight and, if he was steady, the couple would go home with some increased help. My master's degree in social work is in administration; sometimes in the past I have wondered about my clinical skills, mostly gained by the seat of my pants. It took me years to trust my own clinical judgements, after multitudes of times having my own second guessed, only later realizing I was right to begin with. Sometimes my inquiries are clever, I think. Most of the time I just ask people questions, and most of the time they just answer.
...perhaps there is a pattern set up in the heavens for one who desires to see it, and having seen it, to find one in himself.- Plato
From October 2005: I met an elderly man today, nothing unusual about that, but he was wearing an interesting t-shirt. It seems like I rarely run into elders wearing t-shirts with sayings or jokes on them. There were a number of words, no pictures, on this man's t-shirt. It read:
A Rind is a Terrible Thing to Waste.
Yet another person who enjoys words... The picture at right is of the corner of our compost bin.
"Words are, of course, the most powerful drug used by mankind."- Rudyard Kipling
Many pictures posted on my pages link to somewhere in the cyberworld... try clicking on each of them.
E-mail comments to: firstname.lastname@example.org or click MAIL TO
Click on our mailbox to view comments (after I've added them).
Music: Click on the Licking Lips
Page Created November 2005
Click for 2006 Stories >>