paradox along the road

It has been about three seasons since I’ve come here to write on the topic of caregiving and “the road home.” A recent and mercifully short trip to the hospital with my mother has me once again pondering the paradox of her fragility and tenacity. Her spirit clings like the last colorful leaf on her autumnal body.

The heavy, panicky weight on her chest she felt was diagnosed as angina, a general term for heart pain. She has had congestive heart failure for many years, a slowly progressive weakening of the heart. Her new treatment is more frequent use of a wheelchair, and a nitroglycerin patch worn at night to prevent discomfort. Oddly, nitroglycerin was first discovered in the mid-nineteenth century and used as a powerful, and often catastrophic, explosive. Alfred Nobel, of Nobel Prize fame, in an attempt to make this highly volatile compound safer and more practical to use, developed and patented what we know as dynamite. It was decades later that nitro’s medical uses as a vasodilator were discovered. In an interesting twist of fate not lost on him, Nobel himself was treated with ingested nitroglycerin towards the end of his life. I ponder how nitroglycerin seems suited to my fiery mother. Of course it is well diluted in medical use, but its explosive history feels philosophically apt in her case—treating fire with fire! It is her most abundant element.

Every time I walk through the doors at her assisted living home, I am struck by the myriad paths the road home takes. Sudden loss is common—the lady down the hall with whom I just had a lively chat the other day has passed away quietly in her sleep. My mother’s dear friend across the hall now sits dozing in her chair, no longer very conversant, and my mom cuts up her meat for her at mealtime. More commonly, you witness the jagged ups and downs that eventually give way to release. And then there is my mom, along with many others, who putter along into their nineties, with occasional dips below the health horizon and ever-reducing function, but resilience triumphing repeatedly until the beginning of the inevitable end.

Resilience is a quality required of caregivers as well; at least those who will maintain their own health and well-being. Each little crisis summons adrenalin in preparation for any and all outcomes. Will it be a lengthy hospital stay? Will the nurses/doctors on duty be kind and inspire confidence? What kinds of tests will they order? What questions do I need to ask? Will she rebound? Or will she persevere but in a further declined state? Or—will she die soon? If she is approaching her death, will I be able to be present, with presence? Will she be conscious? Afraid? Or as ready and peaceful as she often claims to be? Will my family be okay while I devote my time to her in her hours, days, of critical need? What decisions will I need to make this time?

When I am at my most whole, and rested, none of these questions is unmanageable. Especially since I have a supportive husband and a long-distance but close sister who is always available by phone if not immediately in person—as well as access to healthcare for my mother. I am always aware that I have much more support than so many people in a caregiving role. Even so, the questions above draw on one’s deepest resources repeatedly along the road. One thing I know for sure, for all of us, is that filling our own cup regularly is essential to being able to juggle the needs of aging parents as they arise. As a massage therapist, I am always beating the drum of self-care with my clients—and friends—most of whom are caregivers of one kind or another. It reminds me to walk my talk, and I am grateful for both giving and receiving in this way.

Returning to the idea of paradox that began this reflection…. There are endless contrasts that intermingle on this journey of caregiving, for everyone. Love and fear, wholeness and brokenness, healing and pain, strength and weakness, joy and despair, vitality and exhaustion, duty and service—and an occasional desire to utterly flee responsibility. These may appear to be simple opposites at the ends of a spectrum, but it seems they can be experienced in such close proximity that the relationship feels more paradoxical… I believe how each person manages these complex dualities is in parts a result of what is written in their soul’s purpose, the circumstances and influences we have met along the way, and how we have used our gift of free will to learn and grow into what life asks of us. We will all fall short, in one way or another, but that is not the point. For that we are forgiven, if only we will forgive ourselves. Again and again, I come back to the power of presence. There will inevitably be times of distraction, and times when the ego and its wounds are in the driver’s seat, but it is when we are in mindful awareness of the whole of our messy human experience that we experience moments of grace, and that is what makes the suffering bearable and the joy so heart-opening.

I have been visiting more frequently with my mother since this last hospital stay, a renewed tenderness welling up in me. As her sharply hewn edges are worn softer by the transformative waves of aging, it becomes easier to exhale in her presence, leaving room to experience moments borne of genuine feeling, not just duty. I speak to our particular relationship—each parent and child have their own emotional kaleidoscope through which to view the end of this part of your journey together. For caregiver and parent, whatever palette your experience is painted from, the truth in the brushstrokes is what gives your picture enduring meaning, and a beauty all its own.

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healing body and spirit

My mother is now 94, and is as bemused as ever by the fact that she is still alive. She was blessed with a remarkably hardy mind, body, and spirit, it seems. Some say that we die when our soul is ready, or in some traditions when we are “called,” but it is also true that in these times of modern medicine, the body may be kept alive far longer than in the past, allowing the soul the potential for a wider arc of embodied learning. The medicines my mother takes have allowed her more years than she might have otherwise had, more years to experience the world, to be in relationship with her family, to reflect on the many years that have come before.

But the body ultimately longs to return to its Source, and the most familiar path to that return is the gradual breakdown of its systems. We have made at least a half a dozen trips in the past month or so to the Wound Healing Institute, which is just as it sounds—a specialty medical practice for supportive treatment and healing of wounds of all kinds. They assess, measure, clean, debride, and dress wounds, which is often a long-term process. I am in awe of the nurses and doctors who choose this specialty. Most of us probably feel a bit of recoil at the idea of looking at, touching, and caring for wounds every day. When the flesh breaks down, it reminds us of our physical mortality, and what naturally will happen when we die. My mother has cardiovascular failure as well as diabetes, so gradually increased swelling in her legs resulted in skin lesions. An adjustment to her medication and the excellent care at the WHI, along with her innate impulse to return to balance, have her almost completely healed. As I have accompanied her on these visits, I’ve pondered again the concept of wound healing, and how the body and spirit seem to follow a similar path…

The treatment rooms (we’ve seen all of them!) each have an enormous padded chair with a leg lift. When my average-sized mother sits in it, she looks like a little child in a too-big chair. I sit in the extra seat at the window and offer information as needed as I watch and chat along with my mom and the staff. The nurses and doctor are unfailingly kind and respectful, and delightfully warm and upbeat. I notice they treat each other this way, as well, and I am grateful for the healthy work environment they have created, which of course makes their healing practice that much more effective…

The process week to week is similar—examine, debride, redress, go home and rest. When we have an emotional or spiritual wound we are working to heal, we often return to our inner child for information and guidance (my little mother in the big chair). We look at it. Revisit the place of origin. The body is the family. Then consider the underlying systems that must be brought into balance in order for healing to begin—is circulation or another dis-ease state creating the wound? And for spiritual wounds: Did you learn to mistrust and withdraw? To feed your emotions? To seek unhealthy attention? Debriding the physical wound is akin to clearing the wounding emotion by allowing the feelings to be fully experienced and acknowledged in the present. It hurts, but it is cleansing and necessary work. After cleaning and clearing, the balm and dressing is the new, corrected information you feed your spirit—I am worthy, I am loved and loving, I am whole as I am. I forgive myself. I forgive others. Then, rest. And repeat. Until the wound gets smaller, and the new skin grows, closing the gap in the body, mending the broken place in the spirit. All done much more easily with help from those who are skilled facilitators of healing—medical, psychological, or spiritual. We are here for each other.

A thought about scars: They need not be the memory of the wound; they are a reminder that you can heal.

I asked my mother recently if there was anything in her life she felt unresolved about. Her answer after thinking only for a moment, was No. She feels she has done all she could do in her family relationships, imperfect as their current state may be, and while she’d still like to have been to a few more places in the world, she has seen more than many and has an abundance of memories to entertain her, and she has made a difference in the lives of many students and friends. The mystery of why she is still here is one for her soul to answer. I have suggested to her in the past that perhaps she is no longer here for herself, but for what caring for her teaches all of us.

My mother had many wounds from her own early 20th-century childhood, but also many blessings, and a hard-won understanding of the human heart’s capacity to heal. Her gradual return to a more childlike dependence and my becoming her caregiver has often compelled me to look more deeply into the wounds and blessings of my own life, and continue the healing process. Each life has its own unique formula for lessons through struggle and pain, and the healing of wounds, combined with the grace of knowing we are One with All that is Love. Perhaps the latter is at times still locked in our DNA, not ready to be brought fully into consciousness, but I have faith it is there. Grace survives all wounds, and is what walks us across the final threshold.

in honor of dolphin day

This post is outside of my usual topics, but in honor of National Dolphin Day (who knew? not me, until a few minutes ago!), I am posting one of my children’s meditations–this one focusing on the energy and messages of Dolphin. If you know a child who is feeling lonely or sad, this visualization can help them to reconnect and to lighten the heaviness. Enjoy!

Dolphin: Playfulness, Friendship, Harmony

All animals have unique qualities and special messages for us if we look and listen closely. Dolphin carries many kinds of wisdom, including serving as a playful reminder to find joy in friendship, and to remember our sense of humor when we are feeling very heavy and serious. Dolphin will accompany you now on a journey that will help you to lighten your heart if you have been feeling heavy emotions.

Another special quality of Dolphin is their breath. Because they are mammals, they must come to the surface of the water to take in oxygen before diving below. They hold their breath for many minutes, swimming and playing with their friends before surfacing to release their held breath with a big exhale from their blowhole. The Dolphin’s breath is its way of teaching us about filling ourselves fully with life force energy, feeling all the emotions and aliveness inside of us, and then releasing each experience with our exhale, breath after breath. You can fill yourself with this life force energy anytime you are feeling heavy or down by thinking of Dolphin, and breathing in rhythm with your friend.

Take a few moments to quiet your body. Sit or lie down comfortably, with your hands at your sides or resting in your lap. Close your eyes, and listen to your breath going in and out. Feel it passing in through your nose, down into your lungs, and then reaching every part of your body down to each cell of your fingers and toes. Breathe out any tension, and allow your body to sink down and relax. Feel your heart soften and open, and ready yourself to listen and journey inward.

Imagine you are sitting at the edge of an ocean dock, dangling your feet in the water. The waves are gentle, and the water is so clear you can see the sun sparkling on the sand and shells a few feet below. In the distance, you notice the fins of several dolphins as they swim and play together. You watch for a while, wondering what it would be like to join them. You’d like to talk to them and see what they have to share. In your mind, you call to one special one, and she swims over to greet you. She lifts her head above the water, nodding hello. You can hear her thoughts, and she says you may give her a name, any name you wish, so that you may call to her whenever you’d like to see her. Think of the name you would like to give her, and keep it in your heart. You can feel the love and friendship she is offering. She has a special way of understanding humans, and she is happy to be here with you and to listen to anything you want to share.

If you have been feeling heavy, sad, or lonely, Dolphin energy can help you shift your perspective, and offer you a new way of looking at things. She shows you how connecting with others can transform your feelings into a more lighthearted point of view. The way dolphins play together and cooperate in their community groups shows us the importance of connecting with others, and building harmony in our relationships. Allow your friend Dolphin to take you along with her group, and play in the water for a while. Let your heaviness or loneliness pour out of you and dissipate in the water, and allow yourself to be in the moment with these friends who accept you just as you are. There is no one else you can be but yourself, and when you can see and accept all that you are, including all the imperfections of being human, the world responds with love and acceptance, too. It isn’t always easy to feel loving toward ourselves when we feel down, but as you swim and play with Dolphin, imagine allowing the heavy feelings to flow through you, like clouds across the sky. Your spirit is the sky, your pure, unchanging Self, and your feelings and thoughts come and go like the ever-changing clouds that pass by. Imagine each thought, each feeling flowing gently through you as each wave of the ocean rises and falls… Dolphin reminds us not to take ourselves too seriously, and to balance our lives with fun, but also to respect our feelings and be gentle with ourselves when we feel heavy or down.

Gently bring your attention back to your breath as you play in the water with your Dolphin friend. Ride on her back and breathe deeply as you glide effortlessly through the water. With each breath, you feel your life force growing stronger, and your heart growing lighter. Inhale deeply, and then release your breath and relax your body even further as you ride along. You have nowhere else you must be, and nothing else you must do….

(Reader: Allow a short amount of time to pass in silence or with quiet music. You may vary the amount of time from a minute to several minutes, depending on what feels appropriate.)

Allow your attention to gradually come back to the room or space around you. With your eyes still closed, begin to notice your hands and fingers, your feet and toes. Wiggle them gently, and feel the sensations and aliveness there. Notice any sounds in the room, and bring your awareness back to the people and place around you with a lighter heart. Know that you can call to your Dolphin friend whenever you would like to lighten up and feel the joy and harmony of friendship and life force energy. When you are ready, open your eyes.

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mission of light

In the spirit of sharing Christmas stories long after the date on the calendar has passed, here is one about friendship, lights on a dark night, and ageless wonder.

The week before Christmas, we decided to take my mom out one evening to join us in a drive around town to see the lights on the houses. The weather had been strange—lots of rain, very warm, and not very festive-feeling. We waited a little too long, hoping for an improving forecast, and ultimately settled on the 23rd for our ride. My mother happened to mention our plan to her good friend Retha, who lives across the hall. Much to her surprise, Retha expressed an interest in coming along! I loved the idea, the nursing staff cleared it with Retha’s family, and we were all set—when previously unforecasted rain interrupted our plans. We checked the weather and saw that it was supposed to be just cloudy on Christmas Eve, so we postponed. However, Retha was to go to church with her family that evening and so would not be able to join us. I assured her the lights would be up past Christmas and that we could go again and would be happy to take her along.

My mom reported to me later on the evening of the 23rd that Retha was quite upset by not being able to go along, and didn’t want us to have to make a special trip the following week. I was disappointed that our festive plan wasn’t working as smoothly as I’d hoped, but I felt it would somehow sort itself out. And it did.

On Christmas Eve, the weather was still very warm—and not just overcast but seriously looking like rain and even thunderstorms, again. We were all feeling a little iffy about whether our plan was wise, especially my safety-conscious and slightly bah-humbug husband, and at first I was resigned to just making a trip to my mom’s for a short visit that evening. Then I got a call from her at around 4:00 p.m., and she excitedly told me that Retha had called her son (of her own initiative) and told him she wanted to go with us to see the lights instead of to church with them! Uh oh. I thought at first that this was not good—were we drawing her away from her family’s Christmas Eve tradition? Would they be upset with me? Would we even be able to pull off this seemingly simple outing? How could I cancel on them now?

The other part of me was intrigued and surprised—it was unexpected for Retha to show such chutzpah! A little primer on my mom (Peg) and Retha’s relationship: Retha is Peg’s complete alter ego—tentative where my mother is certain, soft where she is hard-edged, docile where Peg is dynamic. The two of them have formed a rather sisterly bond over the past couple of years living across the hall from one another. I believe they have come to fulfill an important role in each other’s lives—Retha, widowed after a lifetime of being taken care of, looks to Peg for guidance and a strong voice. Peg, a teacher, divorced for more than forty-five years and accustomed to offering her counsel on many fronts, found a gentle soul willing to be lead.

Retha is soft-spoken but not shy—she is very warm, and even initiated the friendship, I would say. For all her assertiveness, I think my mother has a tendency to hang back and observe before making any overtures. In the beginning, Peg (the hardy Yankee) was somewhat bemused by Retha’s southern gentility, and this sweet and proper lady became a kind of study for her. As they got to know each other, Peg would comment to me that Retha was one of the only residents who ventured into her sitting room to visit, as opposed to just chatting in the common areas. Peg’s cat, Silky, would immediately wind herself around Retha’s legs and jump up to be petted, much to their mutual delight. On Saturdays when Peg practices her ritual of keeping her door shut for a day of solitude, Retha becomes a little concerned and lost, and always tells her the next day, “I missed you!” When Peg opts to stay in her room to read instead of coming out to play Jeopardy in the afternoons, Retha is disappointed—but Peg stands firm, confident guardian of her desire for independence.

In spite of Peg’s need for a periodic retreat from contact, I think Retha’s willingness to come into her space was a show of intimacy that deeply touched my mom. She began to reciprocate, going across to Retha’s a little before lunchtime each day to visit. This was a sign of true friendship, as Retha always has “The Price Is Right” on the TV at that time, and Peg is a PBS watcher and has nothing but disdain for game show noise (although she has been known to indulge in the occasional “Wheel of Fortune” episode). Nonetheless, she sits with her, and then they walk out to the dining room together.

Peg also finds areas where Retha is not speaking up clearly or assertively enough to suit her, and then gently butts in (although gently butting in could be considered an oxymoron). She has spoken with Retha’s children on a couple of occasions about encouraging her to speak up more with her doctors, and also had quite a few things to say on the topic of how to handle the sale and dispensation of the things in Retha’s former home. At first I felt uncomfortable with the degree of boundary-crossing going on, but when I saw that this seemed to provide reassuring support to Retha, and her children were not taking offense, I let go of my concerns. (Also, to be completely honest, it occurred to me at some point: “Better her than me,” as far as suggestions for how/what/when to do this or that…. Retha draws off some of my mom’s focus in a way that allows our relationship to breathe and maintain the boundaries that adult children caretakers need to keep their sanity.)

Back to Christmas Eve…. After I learned of Retha’s defection from the church service, I decided, darn it, we’re going to see lights and not let these two old ladies down! Thunderstorms be damned! So my loyal husband, who knew that to fight me on this would not have a beneficial outcome for anyone, dutifully climbed into the chauffeur’s seat, our daughter and I piled in, and off we drove to pick up our passengers. When we got there, the drizzle was turning into a full-on downpour. Peg and Retha were waiting for us just inside the door with bated breath—you’d have thought we were going to a secret rendezvous. There was a slow-motion scramble to get delicate bones loaded up and walkers stowed safely away till our return. I think we all felt a little like we were doing something scandalous—or even a little dangerous. I was balancing my thrill at defying common sense by taking not one but two rather fragile beings out in an approaching thunderstorm on Christmas Eve with no particular route planned, with an onerous sense of responsibility—mostly for Retha’s well-being (I knew Peg would be fine), but also for my poor husband, who’s mood was not the most light-hearted starting out. Thank goodness daughter Chloe was pretty much following my lead by getting into the spirit of the thing—she had little choice with me repeatedly saying things like, “It’ll be FINE. Come on, it’s an ADVENTURE!”

Peg sat up front with Karl, and I sat in the back with Chloe and Retha. We pulled out into the rain and darkness, Christmas music playing. I had an idea where we should go and suggested a route to Karl, which he took as seriously as a no-nonsense taxi driver. It was a little lost on him that we could pause for lights we saw all along the way to this neighborhood—several times Chloe and I had to shout, SLOW DOWN! SLOW DOWN! LOOK OVER THERE! and I began to wonder if we were trying a little too hard….

Then, the heavens opened up full force, lightning lit up the sky, and thunder boomed around us. It was no passing shower. We drove through deep puddles, and I prayed that we would make it back before we got stuck, hydroplaned off the road, or caused Retha to have an anxiety attack. But I should not have underestimated the power of a small band of souls joined together on a mission of light on a holy night. We pulled into the targeted neighborhood, and aha! Pay dirt. These people loved their outdoor holiday décor, and listening to Peg and Retha ooh and aah at every turn was almost as delightful as the first time your child’s face lights up at the wonders of the season. At 87 and 93, they don’t go out much after dark anymore, and having each other in the car doubled the joy for both of them, I think. Even with the rain on the car windows somewhat obscuring our view and the occasional ground-shuddering thunder, the lights in the dark night buoyed our hearts (even Karl’s). We arrived back at their doorstep just as the rain subsided, of course.

As we escorted the ladies safely to their rooms, their eyes were bright. My mother took me aside and told me how much she thought Retha enjoyed it. I think the gift for my mom was being able to share this simple experience with her friend at a time of life when even small adventures are rare.

In the days and weeks since Christmas, my thoughts keep returning to the sacredness of that evening. The temporal often meets the eternal in the simplest ways. It was a glimpse of kairos—where the magic of the moment suspends chronological time. Retha’s face and small utterances spoke volumes—as did her brave assertion that she was choosing to come with Peg’s family that night. I am so grateful for her presence in my mom’s life, and for the chance to witness the beauty of this friendship, which lies in the soul-to-soul connection they share. They have virtually nothing in common other than current geography—Retha doesn’t read books, can no longer remember any of her travels with her military husband, did not have a career or job of her own outside the home—but her spirit is gentle, her ability to connect full of grace, and her precious vulnerability an honor to behold. Peg may be worldly, but Retha’s friendship hones what it means to be human as they walk each other home.

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learning from trees

Parker J. Palmer has become in recent years one of my favorite writer-philosophers. He often shares a poem along with his thoughtful reflections, and today’s topic on his facebook page was related to the ponderings in my last entry, and the wise practices of the Bhutanese. For those who may not know him, a quick Google search will reveal the breadth and depth of his writing and activism. I respectfully quote here a little of his introduction to the beautiful poem by Grace Butcher, which I will also share below:

“Every wisdom tradition counsels us to ‘practice dying,’ to embrace the ‘little deaths’ of everyday life—our losses, failures, disappointments—as a way of preparing for the death that ultimately comes to all living things.

Here’s a superb poem on this often-avoided topic. It’s about what we can learn from trees as they ‘practice dying’ each autumn, entering into ‘the fine dark emptiness’—and the mystery within and beyond it—as their leaves fall away.”

Learning from Trees

If we could,
like the trees,
practice dying,
do it every year
just as something we do—
like going on vacation
or celebrating birthdays,
it would become
as easy a part of us
as our hair or clothing.

Someone would show us how
to lie down and fade away
as if in deepest meditation,
and we would learn
about the fine dark emptiness,
both knowing it and not knowing it,
and coming back would be irrelevant.

Whatever it is the trees know
when they stand undone,
surprisingly intricate,
we need to know also
so we can allow
that last thing
to happen to us
as if it were only
any ordinary thing,

leaves and lives
falling away,
the spirit, complex,
waiting in the fine darkness
to learn which way
it will go.

-Grace Butcher

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mortality meets happiness

The people of Bhutan have been declared the happiest on Earth. They also set aside time each day to think about death—five times a day, to be exact. My sister Anne and I were talking about the connection between fears and disease recently, and she shared this article on the Bhutanese with me by travel writer Eric Weiner: http://www.bbc.com/travel/story/20150408-bhutans-dark-secret-to-happiness. A mind-body medicine practitioner (and MD) my sister had just visited sent her the article after their discussion of how our fears are often what prevent us from fully healing our physical and emotional selves. While there are many we grapple with, the fear that is by far the most common is that of our own death. Her practitioner is on a mission to get people to be more like the Bhutanese—I’ll come back to them a little later.

Death is not a popular topic. It makes us feel vulnerable. If you persevere in reading this essay, consider yourself brave. Even though there are many caring, skilled professionals who handle each aspect of the realities of death and dying with grace, it is still taboo for most of us in the Western world to talk about, and we keep it at a respectful distance—until we cannot. I can’t explain exactly why I am drawn to sitting with hospice patients, or talking with grieving family members—I struggle with this topic myself (maybe that’s why?). Even though I have a strong belief in the eternal nature of our soul’s energy, and a fascination with all that we will discover on the other side, I still have my own fear of the physical end of this body, my own “personhood.” It is hard-wired into most of us (except the most evolved of souls) to resist the end. My hospice friend Miss Jeannie was very afraid, and her daughter told me recently that even though she knew her mother was afraid, she didn’t talk with her about the fact that she was dying. She went about her usual care of her, right up until her last breath. She was now feeling horrible about this, wishing she had had the courage to speak about it with her mother, to help her face her fear while holding her hand. Their family is devoutly Christian, but fear of death knows no religious boundaries. My response was to let her know that her presence and care was the most important comfort to her mother. Words do not necessarily need to be spoken to understand what is happening, and her mother knew she was deeply loved.

Still, our avoidance of death ultimately does inform how we live our lives, or miss opportunities to fully live them. I recently read the book Being Mortal, by Atul Gawande, MD. It is written from the point of view of the surgeon author, whose own surgeon father faces a serious diagnosis late in his career, and shares the decisions they make as a family about his treatment and care, and the ramifications for his father’s remaining experience of life. Gawande begins the book by looking closely at how we as a culture, and in our healthcare system, avoid the topic of death, even when the facts show it to be imminent, and in fact sometimes increase suffering unnecessarily. The hospice philosophy is one gentle and important voice that has developed more broadly in recent decades to address the question of how to best live while we are dying. Gawande discusses the relationship between doctors and patients, medical decision-making, the history and development of nursing home care, hospice, our attitudes towards aging, and shares personal stories of many people facing the end of this life. It is a book about his own awakening to the importance of living fully until we die, which necessitates facing, and embracing, our mortality.

I was going to write a thorough review of Being Mortal, but this book did not exist in a vacuum for me as I read it—I kept relating it back to my hospice work, my own mother’s aging and the decisions we have made for and with her, and my passion for living an examined life. Instead, I wanted to ponder the intersection of all these things, along with the captivating Bhutanese. For a beautifully done review of the book, here is a link to Sheri Fink’s article in The New York Times:

http://www.nytimes.com/2014/11/09/books/review/atul-gawande-being-mortal-review.html?_r=0

One point Gawande brings up that was painful but important for me to face was the reality that most of our decisions about our aging family members are made for our own desire to keep them safe, which does not necessarily align with what allows them to live most fully until the end, retaining as much autonomy, if not complete independence, as possible. When my mother lived with us for several months before moving into her assisted living home near us, I saw her frailties every single day. It is a reminder to us that the human body is made to eventually wear out, as all living things. When it is your parent, this realization is also complicated by your feelings for them. This is the one who birthed you, who held you and cared for you when you were helpless, no matter how flawed they may be. Now you are the custodian of their last act, and no matter how philosophical and seemingly unafraid that parent is, there is sadness for you both.

As the caregiver, you take your responsibility very seriously, and you see safety as a hallmark of that responsibility, as if safety can hold sadness and loss at bay…. Had she gone back to living alone in her home with occasional help and no family members nearby, we all agree she probably would be gone by now—fall risk that she is. But would it have been her deepest preference to live out her life in her own beloved home even if it shortened her life by a few years? If we are completely honest, yes, most likely. She is gracious and holds no grudges for our having persuaded her that moving here near us was the best decision. It has had great benefits—my daughter will have lasting memories of her grandmother and will have seen a model of caring for elders that not all kids get to see at her age. I have had time with my mother that I cherish. My husband gets to bask in her unconditional approval, admiration, and love. She enjoys community life in her retirement home and has made some fond new friends.

Moving her here has also had its hardships and drawbacks. I have taken on a role that has no predictable timeline, and it does take a significant amount of my time and energy. Managing her now-empty home from states away is difficult and has had a definite financial down-side, even though having long-term care insurance has made her care in assisted living possible. My mother misses her longtime friends and favorite places, and her more absolute autonomy—even if her family might disagree with how she was choosing to eat, live, care for her home, isn’t it her right to make those decisions, if she is of sound mind?

Geography plays a huge role in this. Had we still lived a few hours apart and not moved several states away, perhaps she would have stayed in her home long enough to make a more self-determined exit. It is a complex set of factors that goes into deciding the best path for all…. The point Guwande makes in his book is that when we talk about death, it can help us clarify our choices for the most satisfying life, and when we as a culture talk frankly about death, it allows us to create options that support one another in living the most satisfying interdependent life with one another.

So, back to the Bhutanese. I can’t improve upon the article, so here is the link again: http://www.bbc.com/travel/story/20150408-bhutans-dark-secret-to-happiness. I don’t suggest that we replicate the practice of thinking about death five times a day, but perhaps a few minutes here and there—when something in the media or your life raises the spectre of death, or as a part of meditation practice—don’t look away from its essential truth: we are finite physical beings; don’t flee from the scary, sad feelings this raises, but appreciate that we are here to live, love, and serve with the time we have, in whatever ways that move us and we are able. When we deeply inhabit our mortality in all its complexity, the Bhutanese seem to understand that it opens the portal to a freer flow of joy and gratitude from our deepest Source—hence, the happiest place on Earth.

Many thanks to my sister Anne for the article on Bhutan, and my brother Steve for recommending Being Mortal.

Bhutanese man

endings and beginnings

For those who have read a little of Miss Jeannie’s story here, I learned this morning on my way to see her that she passed in the night with her daughter by her side. May she find peace as her soul lifts into the Mystery, and may her daughter find rest and comfort.