Homecare

Posted in Aging and Illness, Grieving and Recovery

When I attended a workshop on the Native American flute (NAF), I didn’t realize that the lesson I would receive was one not only applicable to music but also to aging. “Play the contour of mountains,” the instructor said.  “It will open up your music and let you hear the inherent melody of nature.” The technique involved playing notes as if they were following a mountain ridge: raise the notes as the ridge ascends, lower them as it descends, and adjust the duration of the notes by how long the elevation stays the same: short peak—short note, plateau—long note.

At sixty-seven, I would like to think I have the physical strength I had at forty-years-of-age. Unfortunately, I’m forced to confront my self-deception when I struggle to lift a single case of bottled water. Ten years ago I carried two at a time. Fifteen years ago I played four-wall-handball with guys in their thirties and was energized even after playing for two hours. Now, I look for men older than me, and I am thankful when I have the strength to play a second game.  As a university professor, multi-tasking was a way of life, and I usually could anticipate what a student was asking after the first few words of a question. Now, holding onto a single thought can at times be challenging, and anticipation usually leads to awkward misinterpretations. These changes and many others are like that annoying person who you have avoided inviting to your party, shows up anyway, and after alienating everyone, announces she is your best friend.

It’s easy to accept aging when we think of it as something that will eventually happen. It even can be as humorous as a joke on Saturday Night Live or a self-deprecating scene on a television Sit-Com. But the humor evaporates when it moves from something that happens to other people, to what is happening to you. It becomes most poignant when it results in changing your identity.

Identities are based on how we view ourselves—our abilities, roles, values, needs, and beliefs—whether that person is Pope Benedict or me. While the components of our respective identity stews differ, the Pope and I face the same dilemma: change one significant thing and the flavor changes. Change too many things and what was minestrone soup becomes vichyssoise. Who we are consists of a complex amalgam that is unique, and like a good Texas chili, has no specific recipe. If unimportant components of our identity are lost, few things may change. Losing the ability to add numbers in my head is not significant since I can rely on a calculator or the bank teller. But I become a different person if I view the loss as an indispensable part of who I am. Hats off to the Pope for realizing the same thing.

Some people maintain that everyone has a “core” that never changes despite what we believe in or do. The reasoning goes like this: All we need to do is strip the non-essentials away, and there it is; our unchanging, universal soul.  Ah, if life were only that simple. But we are what we do and believe. The person who was an acclaimed professional football player ten years ago is not the same person now as he experiences the cognitive problems associated with a brain injury. The husband who relied on his wife for being socially appropriate, is not the same person who now, without her, stubbles through cocktail parties always wondering if he’s being politically correct. And it’s a rare caregiver who views her chronically-ill husband in the same way she did when they were first married.

Probably, one of the most important ways of accepting aging, is to understand that changes in our identity will continue to occur, right up until we die. The Pope today is not who he was when elected by the College of Cardinals. And who we are today is not who we were five years ago, and not who we will become next year.

Identities are dynamic, ever-changing entities. As our minds and bodies wind down, death is no longer something on the distant horizon, but rather an approaching appointment. And that realization changes who we are. I applaud and marvel at the Pope’s decision. Here is a person who holds the most powerfully autocratic position in the world and could remain in it, without challenges until he dies. Yet he recognized that he can no longer function effectively because of aging. Maybe I can now graciously accept the 20-something’s offer to give me her seat on the bus.

Posted in Aging and Illness

(An Excerpt from Leaning Into Sharp Points). Change is analogous to a large boulder balanced on a precipice. It looks like it could tumble off the cliff if just a little pressure were applied. But despite your great effort, it won’t budge. The weight and inertia of the boulder prevent it from moving. And just as with the boulder, inertia prevents us and our loved ones from changing a behavior that’s been with us for a long time.

There is a story told of a dog lying on the front porch of a house and moaning loudly. Next to him sat an old man in a rocking chair, impassively whittling a piece of wood. A stranger came by and was amazed by the scene. He walked up to the porch to see what the problem was with the dog.

“Howdy,” he said to the old man.

“Howdy,” the old man responded, barely looking up from the piece of wood he was carving.

“I was wondering why your hound is yelping.”

“He’s lying on a nail,” the old man said, taking a puff on his corncob pipe.

“How long’s he been doing that?” the stranger asked.

“Oh, I reckon about eight hours.”

“Eight hours!” the shocked stranger said.

“Yup.”

“Well why doesn’t he get off of it?”

The old man stopped whittling, took another puff on his pipe, and stroked his beard as if in deep thought. Then after a moment he looked up at the stranger. “I guess he forgot what it feels like not lying on it.”

We are all resistant to change, even when we say we are not. And just like that old hound dog, we fear change’s double-edged sword: giving up the known while simultaneously accepting the unknown. As a caregiver, change may be difficult for you and the loved one you’re caring for.

Your loved one is moving from independence to dependence, from health to illness, and from being in control to having little of it. You are about to give up significant parts of your life and substitute activities you never would have chosen if your loved one were healthier.

Both of you are moving from A to B: from what you were to what you are becoming. It’s a rootless psychological state that inevitably causes anxiety. There is discomfort in most transitions, sometimes even fear. You and your loved one will be moving from something you both know to something unknown to either of you. The discomfort can be reduced by holding on a little less tightly to what is familiar. Assume that many things in your and your loved one’s “pre-illness” life will lose their permanence and letting go of them may be the best way to keep what is important to you.

You can read more about the problems of change in Leaning Into Sharp Points: Practical Guidance and Nurturing Support for Caregivers.

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