Another wise voice – Regina Brett

Someone sent me the column posted below.  I googled Regina Brett and found that she is a Pulitzer Prize winning columnist for the Cleveland Plain Dealer (http://www.cleveland.com/brett/blog/).  Something good happens to my soul when I read good stuff written by a wise person.  Here you go.   Enjoy. 

“To celebrate growing older, I once wrote the 45 lessons life taught me.
It is the most-requested column I’ve ever written.

1. Life isn’t fair, but it’s still good.
2. When in doubt, just take the next small step.
3. Life is too short to waste time hating anyone.
4. Don’t take yourself so seriously. No one else does.
5. Pay off your credit cards every month.
6. You don’t have to win every argument. Agree to disagree. Both of you could be right at the same time.
7. Cry with someone. It’s more healing than crying alone.
8. It’s OK to get angry with God. He can take it.
9. Save for retirement starting with your first paycheck.
10. Love your parents because they will be gone before you know it.
11. Make peace with your past so it won’t screw up the present.
12. It’s OK to let your children see you cry.
13. Don’t compare your life to others’ lives. You have no idea what their journey is all about.  ;
14. If a relationship has to be a secret, you shouldn’t be in it.
15. Everything can change in the blink of an eye. But don’t worry; God never blinks..
16. Take a deep breath. It calms the mind.
17. Get rid of anything that isn’t useful, beautiful, or joyful.
18. Whatever doesn’t kill you really does make you stronger.
19. It’s never too late to have a happy childhood. But the second one is up to you and no one else.
20. When it comes to going after what you love in life, don’t take no for an answer.
21. Burn the candles, use the nice sheets, wear the fancy lingerie. Don’t save it for a special occasion. Today is special.
22. Over prepare, then go with the flow.
23. Be eccentric now. Don’t wait for old age to wear purple.
24. The most important sex organ is the brain.
25. No one is in charge of your happiness but you.
26. Frame every so-called disaster with these words: ‘In five years, will this matter?’
27. Always choose to be happy, then you will.
28. Forgive everyone everything.
29. What other people think of you is none of your business.
30. Time heals almost everything.. Give time time.
31. However good or bad a situation is, it will change.
32. Your job won’t take care of you when you are sick. Your friends and parents will. Stay in touch.
33. Believe in miracles.  Then you see when they happen.
34. God loves you because of who God is, not because of anything you did or didn’t do.
35. Don’t audit life. Show up and make the most of it now..
36. Growing old beats the alternative — dying young.
37. Your children get only one childhood.
38. All that truly matters in the end is that you loved.
39. Get outside every day. Miracles are waiting everywhere. Besides, sunshine makes you feel happy.
40. If we all threw our problems in a pile and saw everyone else’s, we’d grab ours back.
41. Envy is a waste of time. You already have all you need.
42. The best is yet to come.
43. No matter how you feel, get up, dress up, and show up.
44. Yield.
45. Life isn’t tied with a bow, but it’s still a gift.  Open it and say ‘Thank you

Final gifts . . .

I was with a family over the weekend who lost the husband/father/grandpapa/patriarch suddenly.  Yes he had had heart symptoms for a few years, but the fatal attack caught them all by terrible surprise.  He was well loved;  it was clear that he had lived a well-lived, well-enjoyed life.

He loved his sons and their wives;  he fished and played cards and talked – really – talked and listened – with his grandkids;  he had many friends and the respect of his colleagues.

He had pulled his wife’s pony-tail in the sixth grade and neither ever looked away again.

The family and I talked about the pain of sudden, wrenching loss.  And we also talked about how clear he had been that he did not want to linger in weakness and pain for a long time, and so that in some ways the very shock of his death was a gift.   He did not dwindle away.  He lived at full tilt and then he exited the stage still galloping.

Longterm Caregivers know about a different way of saying goodbye.  We know more than we want to about long and sometimes leisurely and sometimes searing leave-taking.   We  have to learn to keep living even when the one we love is slowly dying,  sometimes  dying inch by inch.  What are the gifts of the long way home?

Three months after my mother’s death, I am realizing that as she weakened, she was able to receive care and love from others in ways that she never experienced in the fullness of her strength.  She always gave advice (often real good advice)  and help.  This time around, she received.

She was not an emotional person.  In her strength, she would laugh lightly at an outburst of enthusiasm and push it away gently or not so gently.   In her weakness, I believe she opened herself to sadness and joy on a deeper level.  She became More in spirit.

What abouat the rest of us?  Her PhD daughter, her MD son, her The Rev. other daughter?  In the long end-stage of her life, we children received the very hard gift of not being able to do enough.  We could not stop her disease or assuage her loneliness.  But we did the best we could and to know that hard truth, in the  wisdom of humility is a gift that will bind her children together for as long as we live.

So one way or another, there are gifts to be given and to receive as we love along toward the swift or slow end of days.  Pain either way, too.  But also the gifts. Peace, martha sterne

Pilot or Passenger?

I was struck by an interview with Captain Chesley Sullenberger,  pilot of the plane which landed safely in the Hudson River a few weeks ago..  The interviewer asked “Sully” if he thought about the lives of all the people on the plane.  And he quietly said no, he couldn’t do that and also fly the plane.  He just thought about flying the plane.

There are times when it is imperative to just think about flying the plane, whatever that may be.  There are times when you are in charge and there is a situation that must be addressed quickly and forcefully. God bless Sully for his skill and courage and leadership.

But there are other times in all of our lives when we are just living along, doing the best we can, and really someone else is in charge  or decisions need to be made cooperatively.   We are more passenger than captain in many situations.  And what I want to suggest is that as caregivers, we need to be able to move back and forth between captain and passenger.

Sometimes we need to lead.  Sometimes we are just along for the ride.  Can you tell the difference?

Recently the woman who was my mother’s primary caregiver accepted another case,  actually my aunt.  It didn’t work out which makes me very sad because the caregiver and my aunt know and love each other and were eager to be with each other.  The problem occurred when the caregiver, who was in the pilot’s seat for my mother’s daily  care as far as my brother and sister and I were concerned, was relegated to ‘stewardess” by my aunt’s well-meaning daughter in law.  It was easy for us to give over day to day control of Mother’s schedule and personal care.  We lived 400 -1500 miles away.    The daughter in law, however was in a different situation.  My aunt lives with her son and his wife.  Is it any wonder that the daughter-in-law questioned the caregiver’s decisions, micro-managed the daily schedule, and argued with the caregiver’s assessment of the hours she had worked.  It didn’t work out.

I am sure that these two strong women both have true sides of this sad  story. That’s not the point.   It was the failure to define roles and to achieve clarity of expectations which doomed this flight.

This could happen in lots of caregiving situations – between professionals and family, among family members, and perhaps most of all between caregiver and the person needing care.

Knowing when to be pilot and when to be passenger can make life easier and more pleasant all the way around.  It also can be from time to time a matter of life and death.  Peace, Martha Sterne

God Talk (or Not)

A priest who is a therapist offered these thoughts on Sacred Space, which is the website I use for morning devotional:

As a therapist, I have to be a methodological atheist. I do not take it for granted that anybody believes in God. God gave us our heart. If you can get back to the healthy centre of it, you can trust it. Religious friends sometimes protest if I write something which does not stress the God factor. I trust the God factor in an experience with people if I can help them to their inner health and freedom. Freud offered an elegant definition of mental health: the ability to love and to work. If I can help people to love again (and to work again if they are of such an age), if I can help the love to flow again in a family, the Lord is there. You do not need a label or picture of the Sacred Heart. God is there.
One scriptural phrase that stays with me is that the love of God is poured out in our hearts through the Holy Spirit who is given to us. I see that in a tangible way when confronted by people with serious problems, people often weeping on the phone, in enormous emotional tension, but under their distress, they are still driven by love.

It’s Martha again. I noticed among the circle of caregivers I know, there is a wide variety of emphasis on the “God factor.” And yet there is invariably a holy quality in people with the capacity of caring for another human being who is weak and failing and often demented. Perhaps the talk of God is there. Perhaps not. But the walk with God sure is.

Peace, Martha Sterne

Anna Ayres Packer Rest in Peace, Rise in Glory

My mother died January 13, in peace with people who loved her and prayed and sung her over to the other side. Here is an article I found from an internet devotional site, Sacred Space (http://sacredspace.ie/) that I pray with every morning.  I find it comforting. Grace and peace, Martha Sterne

As Alzheimer’s took over my cousin Moira, she became quite unable to manage herself, and needed constant care and nursing. When you visited her, you might get a smile, a flicker of recognition. At no one stage could you say ‘Goodbye.’ It was a slow parting. When she died, she who loved people was quite out of touch with humankind. What was God up to? I wondered.
I used to imagine it was our job to make ourselves holy. Our models were men and women who seemed to have achieved extraordinary levels of asceticism, prayer and generosity towards others. We are often seeking ourselves, our own satisfactions and complacency, even in the most apparently unselfish efforts. God shapes us, not we ourselves. Through life, in ways we would never have planned, God strips us of our ego, prepares us for Godself. For an active person, the hardest penance is to be unable to act. For Jesus at the height of his powers and vigour, the Cross meant being passive, nailed down, speechless, helpless. We could not and would not plan these experiences for ourselves. Jesus begged for the chalice to pass from him.
Who would ask for Alzheimer’s as a way to go? But if we believe in God’s Providence – and that is not easy – that must be what he was doing to Moira, who had given him a loving and enthusiastic life. The real achievement of that life was not in her creative efforts or sleepless nights at the service of others, but in her recognition of God’s hand in the suffering which accompanied her to the grave.

An Epiphany

An extraordinary thing happened in our family last week.  My brother was fiddling around on the computer and googled our grandfather’s name – Dr. Joseph A. Packer. He had died when he was in his early fifties and our grandmother, who had health issues, died within a year of his passing.  We have never known much about them;  our father, who was in high school when he lost his parents, didn’t talk about them almost as if it hurt to open that door.

So, here 75 plus years later, my brother fiddled around on the computer.  And up came an article describing our grandfather and his work and life in Alexandria, Lousiana and even a little bit about our grandmother and where they were both from.

Nothing flashy or extraordinary, just a life lived with energy and enthusiasm for his hometown, his family, and his work.

We have been so thrilled by this.  It is as if a piece of a puzzle has been slipped into place in all our lives. I got in touch with one cousin, and our sister reached another one and so we have connected in this generation as well.

I bring this up because I think it really matters that we pass down the stories of our families.  A gift of caregiving could be the opportunity to ask for these stories and to write them down or record them.  I am sorry that I didn’t do more of this with my father before he died and with my mother before she slipped into Alzheimer’s..  But with this out of nowhere story about my grandfather, I am grateful for an amazing discovery coming out of the blue!

Peace, Martha Sterne

Merry Christmas to you

Caregivers come in all shapes and sizes.  Some are spouses – imagine Joseph steadying his wife as she crossed the weary miles on donkey-back.  Imagine Mary smiling at him and encouraging him for she knew he felt a heavy weight of responsiblity for his family.

Some caregivers are people who know where the resources are and point you in the right direction.  The innkeeper didn’t have a room, but he did have a resource – a barn that served the purpose needed.  Sometimes you just can’t figure out the next move, and a caring person points you to the unexpected resource.

Some caregivers are animals – pets, working dogs, livestock who provide us with milk and meat.  It always touches me to see how much love and life an animal can offer – to a chronically ill person and to caregivers.  I imagine the animals in the stable both warmed the air with their body heat and also filled the space with the ordinary and creaturely wonder of life.

Some caregivers are strangers who just by a word or a moment of attention let you know that you matter.  And that your life – be you weak and needing care at this time or giving care to another and kind of wearing out – sometimes the recognition of your worth and a simple word of thanksgiving and praise to God for making you can make all the difference.  Think of what Mary and Joseph must have felt when the shepherd strangers came to their makeshift birthing room and declared how holy and gracious was the night and the life of their child.

And finally, all caregivers are giftbearers.  The wise men came from afar bearing gifts,  but sometimes the gift is in the pocket of the person who is your neighbor, your pastor, your friend, the pharmacy tech, your child, your brother, your sister, your dog or cat, your uncle, your aunt, your colleague, your student, your least expected encounter.

Merry Christmas.  Remember God so loved the world that God came to us looking for all the world like a little baby needing total care.  You need care, too.  And you have lots of caring gifts to offer the world in Christ’s name.  Peace, Martha Sterne

When is it time for hospice?

The following is an email from Moira Keller of the Sixty Plus Program at Piedmont Hospital. I had written her to ask how to enable the most consistent, appropriate care from five different caregivers for my mother. As of two weeks ago the caregivers have needed to change gears and are now needing to do all personal care including feeding and toileting. I thought her answer might be helpful for those who are wondering about when to do hospice. Peace, Martha Sterne

Hi Martha,

My immediate thought is maybe now is the time to see if your mom is hospice appropriate. If she is, then the hospice nurse could suggest a care plan such as you describe. She could give you more specific guidance in this area.

Here are the basic hospice criteria for late stage dementia:
1. Inability to walk.

2. Unable to dress without assistance.

3. Unable to bathe independently.

4. Incontinence of bowel and bladder.

5. Unable to speak or communicate meaningfully.

6. Infection within the past 12 months, could be urinary tract infection, skin breakdown, pneumonia or other respiratory infections, etc.

7. Weight loss, even if the person is consistently eating.

8. Trouble swallowing food. Patient will often “pocket” food in their cheeks and resist swallowing.

If your mom is exhibiting most of these symptoms (she doesn’t have to be showing signs of all of them) then it would be a good idea to ask her doctor for a hospice referral. Medicare will pay for a hospice nurse to evaluate her. Even if the nurse does not find her hospice eligible at this point, the nurse may give you valuable information about her current functional status and what to expect; the nurse may also suggest that in another few months or so your mom may be ready for hospice. At the very least, I think the hospice nurse could suggest a schedule for changing, turning, etc., even if the decision is that your mom is not yet ready for hospice care.

One thing to keep in mind: often, when older adults are in a state of steady decline, they will qualify for hospice care under the “failure to thrive” category. So even if your mom doesn’t have all or even most of the late stage dementia symptoms, she may have most of the FTT symptoms, and thus qualify.

Medicare will pay for the hospice team to come for short, episodic visits. Mostly it would be the nurse coming, but the nurse can bring in the chaplain, social worker, physical therapist, etc., other team members who may be helpful, as needed. I’m sure you know all of this!

So I think this should be your next step, asking the doc for the hospice referral, and go from there. If for some reason there are good reasons not to pursue hospice, then I would ask the doc if he can order an evaluation from a home health nurse, for one visit, and then you could pick her brain about scheduling. If the doc cannot do this (he/she may say that there are no skilled nursing needs that your mom has, thus Medicare would not cover such a visit) then you may want to hire a nurse privately to come to the home for one visit to assess the situation and give you scheduling advice.

A thanksgiving prayer

A PRAYER FOR THANKSGIVING 2008

Dear God of Grace and Glory,

We have given you our anxiety in these last several months.

We are anxious in our financial lives, anxious in our political lives,

Anxious for our jobs, for our family, for our country, for our government.

We worry about what we have lost, or what we might lose in the future.

We worry about what we have, and what we might not have.

The world is now full of our anxiety; we have infected the world with worry.

So be with us today, and this week, as we take time to give something else.

We have a choice this week, and throughout our lives.

We can choose to give anxiety, or to give thanks.

We can choose to offer worry, or to offer thanks.

Be with us today, and this week, as we take time to give thanks.

When St. Paul told the Philippians not to worry about anything,

But in everything with thanksgiving to let your requests be made known to God,

He was saying that it is impossible

To give anxiety and to give thanks at the same time.

It is impossible to be anxious and to be thankful at the same time.

Help us choose this week to be thankful.

We offer thanks this day, thinking not about yesterday,

Nor about tomorrow, but about today.

We seek first the kingdom of God and God’s righteousness,

And so many things are given to us. Today.

Sufficient for the day is the grace thereof, and we are grateful for that grace.

We give thanks for grace, for your grace,

Resting over us like daily glory in the wilderness.

We give thanks this day, not anxiety, not worry.

We give thanks.

AMEN. ( from Sam Candler, Dean of the Cathedral of St. Philip)

Asking for what you need – from God

This is the day the Lord has made; Let us rejoice and be glad in it. Psalm 118.24

WHAT ABOUT BEGINNING THE DAY WITH A MORNING PRAYER?  HERE’S A GOOD ONE.

O God, for another day, for another morning, for another hour, for another minute, for another chance to live and serve Thee, I am truly grateful.

Do Thou, this day free me

From all fear of the future,

From all anxiety about tomorrow,

From all bitterness toward anyone,

From all cowardice in the face of danger,

From all laziness in the face of work,

From all failure before opportunity,

From all weakness when Thy power is at hand.

But fill me

With love that knows no barrier,

With sympathy that reaches to all,

With courage that cannot be shaken,

With faith strong enough for the darkness,

With strength sufficient for my tasks

With loyalty to Thy kingdom’s goal,

With wisdom to meet life’s complexities,

With power to lift me to Thee.

BE THOU WITH ME FOR ANOTHER DAY AND USE ME AS THOU WILT. amen

(This prayer comes from my sister-in-law, Helen. Her friend, Ruth Ann, prayed this prayer several times a day as she was moving through a terminal illness all the way to new life.)