Book Review: 30 Days of Hope When Caring for Aging Parents

Hope in caregiving30 Days of Hope When Caring for Aging Parents  by Kathy Howard caught my eye both because of our own caregiving journey and because Kathy used to write for Do Not Depart, a group blog I follow.

Kathy opens with a brief introduction sharing caregiving experiences of her husband’s parents and her own. Then each of the 30 chapters begins with a Scripture passage, progresses through two pages of content relating the passage to caregiving, and ends with a short prayer.

Topics include how to still honor your parents when you’ve switched roles, “ugly emotions,” “losing them before they’re gone,” keeping peace with family members in the midst of differing opinions, forgiveness, perseverance, guilt, God’s grace in our weakness, and many others.

One point Kathy made that impacted me was that when we experience regret (over anger, impatience, or whatever), after we confess it to the Lord and receive forgiveness, we can release feelings of guilt and shame. God’s goal for those feeling is “repentance, restoration, and renewed usefulness (2 Corinthians 7:8-11). God never uses our past mistakes as a weapon against us. Instead, He desires to use them as a catalyst for our personal growth and change” (p. 65).

Another point I wish I had thought of was helping our parents deal with what they’re going through: loss of independence, failing bodies, upheaval in their living situation, death of plans and dreams, inability to participate in activities that have always brought them pleasure before, adjustments to new situations. By sharing God’s Word and truth with them, in a sympathetic rather than a preachy way, we can encourage their faith and help them renew their hope. There are aspects of this I just didn’t consider, and Jim’s mom was not one to complain or even say, “You know, I am really struggling with such and such.”

The format of this book is not an exhaustive treatise, but rather a friend sharing help, support, and information.

When you’re in the midst of caregiving, there is nothing quite like talking to or hearing from another caregiver who understands by experience all that’s involved. Kathy’s book provides that fellowship and encouragement and always points to the God of grace.

(Sharing with Semicolon‘s Saturday Review of Books, Literary Musing Monday, Carole’s Books You Loved)

 

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Caregiver Resentment

Even though my mother-in-law is sweet and easy to get along with, I sometimes battle resentment over the circumstances of caregiving: feeling tied down, having strangers coming in my home at irregular times, etc. I’m guest posting today at The Perennial Gen about ways God is helping me deal with caregiver resentment.

(Sharing with Inspire Me Monday, Literary Musing Monday)

It’s not for nothing

Joni Eareckson Tada recently passed the 50 year mark in her wheelchair as a result of a diving accident in her teens. I so appreciate her sharing God’s grace in her life. I read a number of articles about this milestone, especially her testimony here, but this one had me thinking for a long while afterward, not just about Joni, but about her helpers.

The article mentions a wake-up crew who helps Joni get out of bed and ready for the day every morning. I can empathize with how hard that would be, even with joyful and willing helpers. We so easily take for granted the ability to use the bathroom on our own or brush our own teeth and hair.

But I thought of these helpers from this angle: many of us aren’t comfortable or don’t feel qualified to be the out-front people. We prefer to be behind the scenes, enabling someone else in their ministry. We can’t have the unique ministry Joni does, but we’d be overjoyed to have a minuscule part in helping her.

But what about those who need that kind of care and don’t have any kind of public ministry? Who don’t speak and seem less and less present every day? Like the thousands of contracted, shriveled, seemingly vacant forms in nursing homes. Like my own mother-in-law.

I’ve written before that I am not a “natural” caregiver like many people I know. I don’t think I could ever have been a nurse. But every angle we have looked at it over the years comes back to the conviction that this is the best place for her at this time. And, like Moses, Gideon, Jeremiah, and others who didn’t feel qualified to do what God was calling them to do, we trust Him for His grace to do it. And He provides, not in one fell swoop of “feeling” qualified, but in the day-by-day ministrations from Him through us.

Sometimes it seems like it’s all for nothing, this trying to encourage food into someone, cleaning up the results of eating, changing position, showering, keeping comfortable, watching out for skin breakage, etc., when there is less and less response or even recognition from the person who sleeps maybe 20-22 hours day for years now, only to do it all again the next day and the next. My aunt called it “the long good-bye.” My husband describes it as watching someone die one brain cell at a time. Sometimes we can’t help but wonder why God still has her here and when He’ll release her from this crumpled, silent body to her new glorious one in heaven.

I’ve shared before what one friend who cared for a mother-in-law with Alzheimer’s said, that sometimes God leaves them here not so much for what He is doing in their lives, but what He is doing through them in ours, showing us our innate selfishness, teaching us to love unconditionally. And I have found that to be true in my own life as well.

As I remind myself of the truths I know, I thought I’d share them with others who are caregivers now or will be someday, who labor behind the scenes, doing the same thing day after day during a long decline. The care you provide is not for nothing, because:

God has made everyone in His image and that imbues them with value.

Jesus said when we minister to others, we minister to Him.

We should treat others as we want to be treated.

God wants us to honor our parents and care for them. They cared for us and deserve our care in return.

“Pure religion and undefiled before God and the Father is this, To visit the fatherless and widows in their affliction, and to keep himself unspotted from the world.” James 1:27

“God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister. Hebrews 6:10

Godly love is about giving and isn’t dependent on what the other can do for us.

“To do good and to communicate forget not: for with such sacrifices God is well pleased.” Hebrews. 13:16

“With good will doing service, as to the Lord, and not to men.” Ephesians 6:7

When our children were little, my husband and I often lamented that they wouldn’t remember the youngest stage of their lives and the fun things we did with them, but those years were the foundation of and a major part of the overall relationship. A baby can’t articulate what he needs or thank you for responding to him (at least until he can smile). But how you care for him matters. He can tell a difference between loving touch and care or harsh treatment. I believe the same is true of the elderly. They may not be able to understand, acknowledge, or define it, but loving care contributes to their overall well-being.

There may be little to no response from the person in our care: some of my friends have even experienced a negative response. There may not be any obvious results from your ministry. But it’s not for nothing. Your loved one or patient would probably tell you how much he or she appreciates your care if they could think right about it and express it. And God knows right where He has you for now and sees your loving care.

(Sharing with Inspire Me Monday, Literary Musing Monday, Glimpses, Mondays @ Soul Survival, Wise Woman, Tell His Story, Faith on Fire)

 

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12 Things You Should Know About Caring For the Elderly

Every now and then I come across articles like “Ten Things Your Plumber Won’t Tell You” or “12 Things Your Doctor Would Like You to Know.” Often they are pretty enlightening.

I’ve written extensively before about our experiences caring for my mother-in-law, almost four years in our home and five years before that in assisting living facilities and a nursing home, and shared some hopefully helpful tips for people in the same situation. But I got to thinking, if I ever had an opportunity to speak to a group or write one article on this topic, what are the top few truths or principles I would share? Probably among them would be these:

1. Preserve as much of their independence for as long as possible. It seems like often family members will see an elderly loved one’s need of assistance before that person does. Sometimes denial causes the elderly to think they can carry on as they always have: I think more often it’s fear of loss of independence. I’ve heard more than one person express dismay or impatience that their loved one won’t just go along with the program and make it easier on everybody and move into a facility already. But have you ever thought about what that involves? Depending on the facility and how much money is available, it means much smaller living space, selling the family home, departing with long-loved objects in order to downsize, communal meals, not being able to control your own medication or, to a certain degree, your schedule.  The first time we moved my mother-in-law into a facility, I thought it was something like a cross between a dorm room and a hospital. I liked the dorms in college: I wouldn’t want to go back to them in my later years. Think about having had your own personal space for 50-odd years and suddenly moving into one room that anyone in the facility can come into at any time. Granted, that accessibility, having the staff control medications, etc., is for one’s safety: but that doesn’t make it any easier or make one look forward to it.

2. If/when you do have to go against their wishes, be as gracious as possible about it. My mother-in-law is very much a “stay with the status quo” type of person, at least since she has been here. She has had hearing aids for as long as I remember, but when she first moved here, she couldn’t hear much at all even with the aids, even if we were sitting next to her and nearly shouting. She’d just smile and say, “You’ll just have to speak up!” Frustrating! My husband took her to an audiologist, and all along the way until she actually got the new hearing aids, she kept saying, “I’m doing all right with what I have: I don’t think we need to get new ones.” Jim just kept quietly insisting that we needed to explore the possibility, and once she got the new ones, she was pleased. She wanted to keep baking soda in her room because she used it as an antacid: Jim didn’t think the extra sodium would be good for her health. Once when I visited she just kept bringing it up and insisting it was fine. I had an “out” in saying Jim didn’t think she should have it, but we kept going over the same points of conversation. He finally compromised in letting her keep a pack of Rolaids in her drawer (which technically we weren’t supposed to do: all medication was supposed to be handed out by the nurse). I don’t think she ever used them, but it must have eased her mind just to have them. It’s hard to know sometimes when to insist and when to let something go. You have to choose your battles. But don’t make it a battle, if possible: don’t be confrontational or argumentative. Thankfully his mom was never combative, but I have friends whose parents are. It’s hard to bathe an 85-year-old adult who doesn’t want a bath and even resists it. You can let it go for a while, but eventually it has to happen. Distraction or diversion works for many things, so perhaps discussing something else while getting set up for the bath will get their minds on another track. (If any of you have tips along this line, feel free to share them!)

3. Convey to them that they are still important and useful. When we moved my mother-in-law into an assisted living facility, my husband told her she would never have to cook or clean again, and after having done those things for most of her life, she was glad to hear it! She loved having time to enjoy reading, her favorite activity. One day when she was visiting our home for a family gathering, and an old family story came up concerning something funny she had said years ago, we all laughed, including her. Then she said, “Well, at least I’m still good for something” (meaning, good for a laugh). I was stunned. I hadn’t realized that she hadn’t felt “good for something,” that she had kind of lost her purpose. One of my regrets is that I didn’t do more on visits with her, like ask her about her life and history and write the answers down to share with other loved ones, or go through a box of very old photos and arrange them in an album with her.

4. Treat them with dignity: don’t treat them like children. Very old age does have some things in common with childhood, but it is not the same. In I’m Still Here: A New Philosophy of Alzheimer’s Care, John Zeisel writes, “It’s not right to think of Alzheimer patients as entering their ‘second childhood.’ They have knowledge and life experience children don’t have.” That’s true of any elderly person. Once when my husband came to pick up his mom at her facility, the aide with her said, “It’s almost like you’ve switched places, isn’t it?” and then turned to his mom and said, “Your daddy is here, honey.” No, it is NOT like that. He had to ask her not to say things like that. Yes, the son or daughter will have to make major decisions and handle things the parent used to, and the parent may be incapable of doing many things any more, but that’s not the same thing as reverting to childhood. Especially fingernails-on-the-chalkboard grating is talking baby talk to them.

5. Do NOT put them in a facility without checking on the regularly and frequently. You would assume that everyone who works in assisted living or a nursing home is kind, professional, skilled, and will take the best possible care of each resident. We learned, sadly, that that’s not the case. I could tell you stories…my husband has said often that he’s going to write a book about this some day. Each place had some jewels in their workers, but each place also had some who were neglectful, who handled her roughly, who paid no attention to her posture, who talked over her to their coworkers and didn’t even look her in the eye while handling her in some way, who didn’t clean her face well after a meal so that she got red, rough irritated spots on her face, etc. Once I walked in to a facility, and they had her in her wheelchair in the common room with the other residents, she was bent over the side of her wheelchair at a 90 degree angle, even though there were several aides in the room, even though we bought some small pillows to help keep her upright in the chair. Plus the employees are overworked and underpaid and the facilities understaffed. On top of that, the residents might not be able to verbalize what’s wrong, either due to dementia or possibly even fear. My mother-in-law had a “don’t rock the boat” personality, and the more she declined, the more help she needed, the more her care declined. “The squeaky wheel gets the grease” is as true here as everywhere else. There were some residents who really needed a staff member with them almost 24/7 for various reasons, and that left the quiet ones like my mother-in-law unattended for too long too often.

6. Don’t forget them. Whereas #5 was more concerned about their safety and well-being, here I mean don’t forget them on a personal level. Continue to interact even if they don’t remember who you are. A lady in our church who writes notes once or twice a month to my mother-in-law checks in with me from time to time to see if she still enjoys them or gets anything out of them. I tell her, honestly, I don’t know if she remembers who the writer is, and I don’t know if she remembers anything the note said five minutes after it’s read to her, but for those few minutes, she knows someone thought about her and cared enough to jot a few lines to her. It’s incredibly sad to us when holidays or her birthday go by (and the days in-between as well) and she hears from almost no one.

7. The best thing you can give them is your time and attention. When my mother-in-law was in a facility, we tried to visit her every day. We usually sat and visited, but I’d run out of things to talk about after a while. I felt more “useful” when I could pick up or straighten her room or do something physical, but that tended to embarrass her. Likewise, gift bags, flowers, etc., are nice, but don’t feel you have to bring anything. What’s most valuable is for someone to face them, look them in the eye, talk directly to them and focus on them, or, if you live away from your loved one, a personal note, perhaps an new photo, or Face Time or Skype if possible.

8. All eating problems do not mean the end is in sight. Whenever I have mentioned eating problems with my mother-in-law to almost any health care professional, they’ll say, “Well, you know, when they get near the end, they’re just not as interested in food.” That may be true, but that doesn’t mean other factors might not be involved. When we moved my mother-in-law to our home from the nursing home, she was around 90 lbs., and we thought we were bringing her home to die. That was four years ago. I think a combination of food prepared and seasoned well, warm and not cold from sitting on a cart while food is distributed, and, most important, someone to feed her who takes time with her, all contributed to her eating well again and gaining weight. We learned that eating tires her out, so sometimes you have to give her a few bites, give her a drink, wait a bit, then try a few more bites. Even now she’ll have certain meals, or even certain days, where she’s just not interesting in eating. Since she doesn’t speak much any more, we don’t know if the food is too hot, too cold, doesn’t taste good, or if she’s just tired or doesn’t feel well. Sometimes I think she’s just not going to open her mouth because eating is the one thing she can control in her life. But that usually lasts just a day or so, sometimes a few days, and then she’s back to eating normally.

9. It is probably going to get worse. My mother-in-law has been on a something of a plateau for a couple of years now, but for a long while, if anyone asked us how she was doing, the response would be that she wasn’t doing very well. Sometimes people were taken aback that we didn’t have a positive cheery answer, like when people say, “How are you?” and expect no other answer except, “Fine, how are you?” in return, and they’re jarred a bit at any other answer, especially a negative one. Once we said, “Well, she’s declining,” and the person responded, “Well, we’re all declining.” (Sigh.) I’ve wondered what people expect when they ask that question in the waning years of a person’s life. The person may have many wonderful days, but in the long run, they are either losing abilities (in my mother-in-law’s case) or multiplying health issues, and things are steadily going downhill.

10. The caregiver needs care. Even if the loved one is in a facility rather than the home, often one of the adult children is primarily in charge of seeing to her care and needs. And of course, if she is being cared for at home, obviously that person or family is taking on the bulk of her care. The caregivers need to know they’re not alone, that everyone else cares. They may need advice, emotional support, financial support, respite. I’ve known some cases where one is the primary caregiver, but the other siblings take the parent home for a weekend or a few days. Distance or the parent’s condition may prevent that, but it’s nice if it can happen. Thankfully we’ve had friends both in church and online who have cared for parents in their home, and they’ve been highly valuable and helpful to confer with, even just to have that fellowship of someone understanding exactly what’s involved.

11. I’m not a saint, except in the Biblical concept that everyone who believes on the  Lord Jesus Christ as Savior is called a saint. Some people put caregivers on a pedestal or overly praise them, but we’re just ordinary people struggling through what we’re called to do. Appreciation or encouragement are more welcome than unvarnished praise, but it’s hard to know where the dividing lines are sometimes.

12. It’s hard. It’s hard to see one’s loved ones decline and to see their circumstances and quality of life reduced. It’s hard to feel the weight of their care. It’s hard to feel guilty about feeling that their care is weighty or about occasional resentment. My husband feels guilty that he doesn’t spend more time with his mom, but she sleeps about 20 hours a day, and it doesn’t do either of them any good for him to sit in her room while she’s sleeping. It’s hard to feel limited. It’s expensive to hire outside help – the agency we use charges $17 an hour, and we already have them here forty+ hours a week just so we’re free to run errands, make appointments, or just have a break. But we can’t just pick up and go out to eat, go on vacation, go to our son’s house, etc., without making arrangements and incurring more expenses. One friend who lived alone with her mom had people who could come over for a few hours or even a couple of days, but, still, that’s a lot to ask of someone, so the caregiver doesn’t feel the freedom to ask that often. In our case, my mother-in-law’s situation and the care needed is such that just having someone come and sit with her would not be sufficient. We’re limited even in ministry: we can’t go to everything that happens at church. My husband was a deacon when we first brought his mom home and submitted his resignation to the pastor because he just couldn’t be away for long meetings, etc., at that time. It’s hard to feel like even mentioning these things sounds like complaining.

I’ve written about this before, but what helps most is just accepting that this is our ministry for now, just like having a new baby in the house is a mother’s primary ministry. As Elisabeth Elliott has said, our limitations just define our ministry: “For it is with the equipment that I have been given that I am to glorify God. It is this job, not that one, that He gave me.” Each ministry carries its own responsibilities, weights, and cares, but “God is able to make all grace abound to you, so that having all sufficiency in all things at all times, you may abound in every good work” (2 Corinthians 9:8).

I’ve written from our experiences and that of friends, but, of course, every experience is different. People have widely varying capacities as they age: we know a 90-year-old who still lives at home, drives, is active at church and with her hobbies, an 80-year-old who still travels internationally and even recently remarried. I had one friend whose mother-in-law had Alzheimer’s but was physically fine, and she was able to take her mother-in-law with her wherever she went, at least in the earlier stages of the disease. And there is much, much more that could be said. But I hope you’ve been able to find some degree of common ground here and something helpful.

(Sharing with Inspire me MondayLiterary Musing Monday, Testimony Tuesday, Wise Woman, and Woman to Woman Word-filled Wednesday)

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Book Review: I’m Still Here

still-hereI first came across I’m Still Here: A New Philosophy of Alzheimer’s Care by John Zeisel at Lisa’s review here. One of the main points she discusses there, of not “testing” the person with Alzheimer’s (Do you know who I am? Who this is? Do you remember…) but rather giving them the information they need first hand (Hi Mom, it’s your daughter, Barbara, and this is your grandson, Jesse. We’ve come to visit you today) was so simple and practical and yet so good and helpful, I wanted to read the rest of the book. My own mother-in-law in our home does not have Alzheimer’s, but she has had bouts of dementia, and I thought some of the general information about aging might be helpful as well as the specifics about dementia.

One of the overriding themes of the book is to concentrate not so much on what the person has lost, but to deal with what they have now. “Those living with Alzheimer’s who use parts of their brains that still function well, feel enabled and competent, and are less apathetic, agitated, anxious, and aggressive” (p. 9). Those last four “A’s,” he says, are not so much symptoms of the disease itself but rather reactions or results that can be minimized.

Another theme would be to “discard old expectations and role relationships that limit our ability to see the person and relate to him or her in a new way” (p. 11).

Another would be that Alzheimer’s is more complex than just short term memory loss. For instance, a patient “doesn’t ‘forget’ how to get dressed or brush his teeth; it is just more difficult to put all the steps in the right order for multistage activities” (p. 70). Likewise, socially, it’s not so much that they “forget” how to act, but rather “losing control over naturally occurring feelings” (p. 71).

The author discusses the medical aspects of Alzheimer’s, which parts of the brain are affected and which still work well but may need help to be accessed, and gives multitudes of ways to help access that part of the brain and reduce some of the negative reactions. So many of these are so helpful and practical, such as the supplying of information rather than asking questions I mentioned earlier, or the birthday party he described for a person who angered easily. He suggested having it in a dining room, so the setting helps the person know what is expected (rather than a living room or community room where they don’t know what to expect), seating them next to a grandchild, which “evokes hardwired caring instincts,” and having everyone wear name tags (pp. 71-73).

One chapter dealt with arranging living spaces to facilitate patients’ movement and avoid problems. One good idea was “landmarks located at points where a decision must be made, such as a corner or a doorway.” Another was “camouflaged exits.” This was a big problem at one facility my mother-in-law was in. The main doorway was set off by a hall, making it so the workers couldn’t see it unless they walked that way. A lot of the residents accumulated at the doorway, making it hard for visitor to get in and out (in fact, I got scolded once for letting a resident out, but I didn’t know she was a resident. Visitors shouldn’t be expected to police the doorways). Another tip here would have helped this facility: have walkways that are safe and go somewhere, so the patient walks instead of wanders (p. 145). This particular place had no place for patients to “go” – they just had hallways to rooms and a big sitting area, and the aides tried to herd everyone in the sitting area to sit brain dead and silent in front of a TV to keep them under control and out of trouble (as you can surmise, I do not have good feelings or memories of this place). By contrast, the first facility she was in had walking paths that made a circle through the building (she was still using a walker then, and when my husband visited, they would “take a walk” around the circle). They also had a nice screened-in porch (without a door to the outdoors) so residents could enjoy the weather and view and fresh air and still be safe. “The hormone oxytocin is released in the brain when people feel safe. This in turn contributes to lower stress and to greater trust and sociability” (p. 138), so setting up an atmosphere as safe and wired for success as possible helps.

The author asserts that one area of the brain that still works well is creativity, and he spends a good portion of the book discussing the use of the various arts. My first thought was that that would not have been helpful with my husband’s mother, as she was never one for museums or art galleries or plays and such. But as he presented it, I saw ways they might have been useful earlier in her life, though I can imagine she would not have been excited about a trip to the museum at first. But many might find these tips helpful. I did appreciate some of the helpful, thoughtful tips scattered throughout this section, like not asking “What does this painting represent,” but rather asking a specific question about something in it, explaining why they were in the museum or gallery without being asked, not asking them what they saw a half-hour ago, not pursuing a line of conversation if they get anxious, and others (pp. 96-97). Some of these would translate well to other excursions.

One of the most valuable sections is on communicating with a person with Alzheimer’s. The author puts forth these rules and elaborates on them:

  • Hear and respond to the other person’s “reality.” Don’t try to talk them out of it.
  • Be honest.
  • Always address the person directly.
  • Don’t test (as discussed in the first paragraph).
  • Don’t say “don’t”; divert and redirect instead.

A few other important points:

It’s not right to think of Alzheimer patients as entering their “second childhood.” They have knowledge and life experience children don’t have (p. 10).

“Be sure to ask the person with Alzheimer’s for expressions of emotions rather than cognitive data. Ask how they feel about a topic, not who was there a little while ago, or someone’s name” (p. 190).

When moving someone with Alzheimer’s into a new living situation, don’t buy all new things for them or their room (p. 185). Make sure they are surrounded by familiar items, clothes, wall decorations, etc.

I admit near the end I got a little frustrated, because it seemed as if the author were saying that if we just did all of these things, everything would work out fine and Alzheimer’s would be a beautiful and rewarding experience, and I know from many friends experiencing this with loved ones that it is not that way, no matter what you do. But he does advocate, in a section on caring for yourself as a caregiver, having someone you can safely “vent” to, to “pour out your heart with all its anguish and fear” and share “the ‘terrible’ feelings you have” (p. 213). It helped to see this admission that there will still be those times. These tips won’t eliminate every difficulty with Alzheimer’s, but they will help in many ways.

There were a few places I disagreed with him. In one place discussing different types of health care and aid available, he mentions nursing homes as an option as if one can just choose and make arrangements to go there. I don’t know how it works in other states, but here, it’s pretty much impossible to get into one unless you’re coming from a hospitalization. One social worker said she could put us on a waiting list, but they almost never admit someone from a waiting list because they have so many admitted from the hospital (much of this due to Medicare regulations). A few pages later he mentions staff members in both assisted living facilities and nursing homes “who want to work there because they have a natural empathy with elders living with Alzheimer’s” (p. 206). As much as we would hope so and like to think so, that is just not the case (I could tell you stories….). Maybe they started out that way but got burned out, I don’t know. Finally, there is a New Age-y/Zen/Buddhist feel to parts of the book, culminating in a chapter on mindfulness meditation that I would personally be uncomfortable with and even find harmful.

But the strength of the book, and what I appreciated most about it, is the gracious and thoughtful approach to communicating with and dealing with those with Alzheimer’s that permeates every facet of the book.

Genre: Non-fiction
Potenti
al objectionable elements: Buddhist-type philosophies
My rating: For what I mentioned in the last paragraph, I’d give it a 10 out of 10, but due to some of the philosophical differences, overall I think I’d give it a 7 out of 10.

(Sharing with Semicolon‘s Saturday Review of Books and Carol‘s Books You Loved )

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The Introvert in Assisted Living

img_1894One of the things that stood out to me in Quiet: The Power of Introverts in a World That Can’t Stop Talking by Susan Cain was just how much society is set up for the extrovert, from schools to businesses. I don’t know if she mentioned assisted living facilities or nursing homes, but I found that they, too, were developed primarily with extroverts in mind.

Most activities at the facilities my mother-in-law has been in involved  trying to get everyone together in the common room for some event or performer. We’d get a calendar of events every month, filled with exercise classes, bingo, craft times, magicians, movie nights, and various groups coming to sing. I’m sure many of the residents loved a lot of those opportunities.

My mother-in-law was always content with a small circle of friends. She never drove. Her husband got groceries and ran most errands. She enjoyed going to church and helping with Awanas there until she couldn’t hear well enough to continue. A big portion of her dislike of getting together in large groups had to do with her hearing. She has worn hearing aids in all the nearly 40 years I have known her, and she told me once that in crowds, the aids magnified everything, so it was not only hard to pick out the voice of the person you were talking to, but it was unnerving that everything was so loud (they may have improved on that aspect now – I’m not sure). But even besides the hearing issues, she preferred home to just about anywhere else. They loved to go visit family or a handful of close friends, or go and get wood in the hills for their wood stove. She didn’t have many hobbies besides reading, her favorite activity when her work was done. She and her husband loved to watch the Atlanta Braves baseball games together and tinker in their garden or around the house.

One of our reasons (not the main one) for having her in assisted living rather than in our home was so that her world wouldn’t be reduced to just us. But when any of the aides asked if she’d like to come for whatever was going on down in the common room, she’d politely say no, she’d like to just stay in her room and read her book. Occasionally they could get her to if they didn’t ask, “Would you like to…” but rather just said, “It’s time for…” If they started helping her out the door for something that she seemed to be expected to do, she wouldn’t protest, though she didn’t like it (you do have to be careful of that kind of thing, though, so that you’re not running roughshod over their wishes). But once when I walked in and she was out with the others listening to a church group, she couldn’t understand what they said when they were talking, but she could get enough of the melody of old familiar hymns that she could sing along.

Once when I was trying to encourage her to participate more and telling her it would be good to get out of her room sometimes, she said, ” I DO get out of my room three times a day for meals!” Residents had to go to the common room for meals and sit at a table with two or three others (unless they were sick, and then a tray was taken to their room). And I thought, that’s true, and that’s quite a lot of social interaction compared to her life before assisted living. So I didn’t urge her that way any more.

She enjoyed coming with us to my son’s basketball games and to our home and church. We would take her out to eat with us sometimes, and I could tell she was tense and not entirely comfortable, but as long as we ordered for her (so she wouldn’t have to) and stayed close, she was fine.

Now, of course, with her decline over the years, her lack of mobility and speaking, about the only place she goes is outside occasionally in her wheelchair.

I know it was more cost effective and needed fewer workers to do things as a group rather than have one-on-one activities. There were just a few individual activities they did that worked well. A couple of the places would bring in therapy dogs and take them to individual rooms for residents to pet and interact with for a short time. She always had pets until assisted living, so I think she enjoyed that. One activity director would come to her room and paint her fingernails. I don’t think she ever painted her fingernails in her life before that, so I never knew quite what she thought about that one. But at least it was one-on-one.

My husband and I often thought that someone could make a business out of being a personal trainer in those kinds of facilities. My mother-in-law was under a physical therapist’s care at different times, but eventually their time with a patient comes to an end, and they leave them with a list of exercises. My mother-in-law never did the exercises on her own and didn’t want to go down to the group exercise classes, but she would work with the physical therapist (as she declined, she needed my husband to be there for the first few sessions so they could learn to communicate with each other. He was from Croatia, and she couldn’t understand him, so he thought she was just being uncooperative, and she didn’t really care if he came back or not. :-/ But after just a few visits with my husband there to interpret for her and urge her on, and showing the therapist how to communicate with her, they got along quite well.) We didn’t want our own visits with her to be all about exercising, so it would have been nice if there was someone on staff, or even someone who worked with different facilities, to come in and help people with their exercises.

One lady who used to visit my mother-in-law used to read and discuss with her parts of the Reader’s Digest, her favorite magazine. Nowadays, visitors often read a part of the Bible to her, valuable since she can’t read for herself any more (it’s important to remember if you are reading to someone with hearing problems that you stand or sit where they can see you clearly and speak loudly). Other one-on-one activities that we’ve done and others could do are taking her outside (one facility had a lovely screened in porch) for a change of venue, looking through pictures or photo albums with her (people love to talk about their families), or show her things on the computer. Sometimes when we had her over for a meal, my husband would show her some of the family members’ Facebook pages, or use Google Earth to see some of the places where they used to live. We talked some about her life before I knew her (I discovered she had been the editor of her high school newspaper!), but I wish I had done that more and then written it down. I also wish I had come up with some bit of interesting news or information to share with her. Often our conversations would start out with, “Well, what’s new?” And I’d reply, “Well, not much.” When you visit someone almost every day there is really not much new every visit. I did share family and church news and sometimes current events, but I wish on those days when I didn’t have anything new to share that I had taken the time to look up or come up with something she’d find interesting. I also wish I had put some of her old photos in a scrapbook with her, not just for the activity, but to hear more about the people in them.

Although my mother-in-law would not have had the dexterity or interest in these, some might enjoy games or puzzles (although she did enjoy Scrabble sometimes at our home. We had to take it very slowly and she’d argue with us about words like “qi” and “xi.” 🙂 ). Some might even enjoy some of the group activities if they have a companion they know to go with them, at least the first few times.

The biggest help, though, both in any facility or in our home now, is just visiting with her personally. At different times over the years different individuals from our church would take it upon themselves to just go see her. Sometimes different groups within the church or community would make something for residents and bring it to their rooms, and that was nice, but really, the main help was just a short time of personal conversation and interaction.

When I was in college, one of the ministry groups I participated in for a couple of years was a “foster grandparent” program. There were other groups from college who would do Sunday morning and week night services at a nursing home, but our group would ask for names of residents who didn’t get as many visitors, and we would each choose two and then spend Friday nights visiting those two, just to talk and get to know them. I still have fond memories of “my ladies.”

Of course, staff members do not have time to do all of these things, and some are best done by family. But for those like the activities director who only painted fingernails, ministry groups, and individual visitors, these are a few ideas of things to do with one older person rather than a group activity.

Social interaction is important to every person, but introverts prize it on a smaller and more infrequent scale, with one or two people and quieter activities. That may be a little more time- and labor-intensive than group activities, but it can be highly valuable for both sides.

For more in the Adventure in Eldercare series, click the graphic below.

Eldercare

(Sharing with Inspire Me Mondays)

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But That’s Not My Spiritual Gift!

IMG_1761Some years ago it was all the rage to do spiritual gift tests. Spiritual gifts are those particular abilities that the Holy Spirit gives people when they are saved by which He wants to work through them to edify the body of Christ. You can find lists of them in Romans 12:6-8; 1 Corinthians 12:8-10, 28-30; Ephesians 4:11; 1 Peter 4:9-11. They have been taught about in almost every church we have been a part of, and in two churches we actually did the test during a church service, with one of them having a subsequent series about them.

The idea was to help people identify their spiritual gifts so they’d know how they best fit into the ministry of the church and not waste their time frustrated and ineffective in an area where they’re not gifted. And that can be helpful. When I first started going to church regularly as a teenager and then was recruited for various ministries, it seemed like a young woman was just naturally gifted for working with children, right? I was usually asked to assist and then later to teach in the nursery, Sunday School, children’s church, Awanas, etc. I could do it, I learned from it, I hope God used me in it, but it wasn’t until I was asked to take on a more administrative role that I felt I had found my niche and just sank into it with a delight and joy I hadn’t previously found in ministry. As other opportunities have opened up over the years I’ve had a similar response in a few different areas.

I think that might actually be the better way to discern one’s spiritual giftings: trying different ministries to see which one “fits.” The tests can help to a degree, but sometimes they’re more like personality tests; sometimes their definitions can differ from one another and/or from my understanding of what a particular gift entails. Sometimes the particular ministry I am in hasn’t really fit in any category I’ve seen on a test.

Another fault with the tests and perhaps too much of a focus on what *my* gifts are is the “That’s not my job” syndrome. I don’t have the gift of evangelism, so I don’t have to do that, right? No, we’re all supposed to be a witness for Christ in some way within our sphere of influence, though there are some who are especially gifted in that way. It’s the same with giving, showing mercy, extending hospitality, helping others, and many of the other spiritual gifts.

And then sometimes God drops us into a situation that we don’t feel gifted for at all: in fact, we feel totally inadequate. Moses, Gideon, Jeremiah, Jonah, and others didn’t greet God’s call on their lives the the attitude, “Sounds great! That’s just the kind of opportunity I was looking for!”

That’s where I am with caregiving. Someone I knew said of their daughter, who was training to be a nurse, that she was a “natural caregiver.” Another friend who is a nurse spoke of loving to use the talents God had given her to minister to people in that way – another natural caregiver. That’s not me. I want people to be cared for, particularly my mother-in-law. But I have never been good with or felt inclined to the hands-on type of caregiving she is in need of now, except with my own children.

Yet here we are. Do I tell God, “There must be some mistake here. Not only am I not gifted for this, but it’s keeping me from what I feel I am gifted for.” Probably not a good idea.

I was convicted by this sentence as well as other truths in the True Woman blog post “Serving in Church: When Your Spiritual Gift Isn’t Changing Diapers“: “This doesn’t mean my gifts aren’t important. What it means is that “sometimes the need for a servant is greater than my need to use a specific gift.” And from another article on the same web site, What About Your Desire to Do Something Great For God?: “When the desire to do for God supersedes the desire to obey God, it reveals that God is no longer the source of joy. A heart delighted in God desires to obey Him. A heart delighted in self desires to see what self can accomplish. A person delighted in God doesn’t care so much how God uses her, but rather that she is useful to God, the object of her delight. A person delighted in self cares deeply about how God uses her, because seeing the self she loves underused causes grief.”

Though we need to rely on God’s help, grace, and strength even for those areas where we feel He has gifted us, there’s nothing like being totally out of our element to make us lean on Him and plea for His enabling like never before. And though the main point of caregiving isn’t about me, but rather about showing love and ministering to my mother-in-law, perhaps one reason He has allowed this opportunity is to teach me lessons about my own selfishness as well as serving and loving others in the way they most need it, not in the way I am “comfortable” showing it.

Even as the Son of man came not to be ministered unto, but to minister, and to give his life a ransom for many. Matthew 20:28

(Sharing with Inspire me Monday, Testimony Tuesday, Woman to Woman Word Filled Wednesday, Thought-provoking Thursday)

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Bible Verses for Caregivers

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One of the first things I learned about caring for my mother-in-law was that I could not do it in my own strength. There are some Bible verses that I go to again and again. I thought I’d jot them down here both for my own remembrance and also for other caregivers. Of course, none of the lists is exhaustive, and I will probably add to them as I discover more.

The need to care for aging parents:

  • Honour thy father and thy mother: that thy days may be long upon the land which the LORD thy God giveth thee.  Exodus 20:12
  • And he said to them, “You have a fine way of rejecting the commandment of God in order to establish your tradition! For Moses said, ‘Honor your father and your mother’; and, ‘Whoever reviles father or mother must surely die.’ But you say, ‘If a man tells his father or his mother, “Whatever you would have gained from me is Corban”’ (that is, given to God)— then you no longer permit him to do anything for his father or mother, thus making void the word of God by your tradition that you have handed down. And many such things you do.” Mark 7:9-13, ESV
  • But if anyone does not provide for his relatives, and especially for members of his household, he has denied the faith and is worse than an unbeliever. 1 Timothy 5:8, ESV
  • If any man or woman that believeth have widows, let them relieve them, and let not the church be charged; that it may relieve them that are widows indeed. 1 Timothy 5:16
  • Therefore all things whatsoever ye would that men should do to you, do ye even so to them: for this is the law and the prophets. Matthew 7:12
  • As I have said before, this doesn’t mean that every Christian must care for elderly loved ones in their own homes, but they must see that they are well cared for.

The need to care for widows:

  • Pure religion and undefiled before God and the Father is this, To visit the fatherless and widows in their affliction, and to keep himself unspotted from the world. James 1:27

Serving:

  • Jesus knowing that the Father had given all things into his hands, and that he was come from God, and went to God; He riseth from supper, and laid aside his garments; and took a towel, and girded himself. After that he poureth water into a bason, and began to wash the disciples’ feet, and to wipe them with the towel wherewith he was girded…If I then, your Lord and Master, have washed your feet; ye also ought to wash one another’s feet. For I have given you an example, that ye should do as I have done to you. John 13:3-5, 14-15
  • Even as the Son of man came not to be ministered unto, but to minister, and to give his life a ransom for many.  Matthew 20:28
  • For I was an hungred, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in; naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me. Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me. Matthew 25:35-36, 40
  • Whosoever will be great among you, let him be your minister; And whosoever will be chief among you, let him be your servant: Even as the Son of man came not to be ministered unto, but to minister, and to give his life a ransom for many. Matthew 20:26b-28
  • Now we exhort you, brethren…comfort the feebleminded, support the weak, be patient toward all. I Thessalonians 5:14
  • Whosoever shall give to drink unto one of these little ones a cup of cold water only in the name of a disciple, verily I say unto you, he shall in no wise lose his reward. Matthew. 10:42
  • To do good and to communicate forget not: for with such sacrifices God is well pleased. Hebrews. 13:16
  • God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister. Hebrews. 6:10
  • With good will doing service, as to the Lord, and not to men. Ephesians 6:7
  • Well reported of for good works; if she have brought up children, if she have lodged strangers, if she have washed the saints’ feet, if she have relieved the afflicted, if she have diligently followed every good work. I Timothy 5:10
  • Bear ye one another’s burdens, and so fulfil the law of Christ. Galatians 6:2

Love:

  • A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another.  John 13:34
  • This is my commandment, That ye love one another, as I have loved you. Greater love hath no man than this, that a man lay down his life for his friends. John 15:12-13
  • And hope maketh not ashamed; because the love of God is shed abroad in our hearts by the Holy Ghost which is given unto us. Romans 5:5
  • For the love of Christ constraineth us; because we thus judge, that if one died for all, then were all dead: And that he died for all, that they which live should not henceforth live unto themselves, but unto him which died for them, and rose again. 2 Corinthians 5:14-15
  • And I will very gladly spend and be spent for you; though the more abundantly I love you, the less I be loved. 2 Corinthians 12:15
  • With all lowliness and meekness, with longsuffering, forbearing one another in love. Ephesians 4:2
  • In speech, conduct, love, faith and purity, show yourself an example of those who believe. 1 Timothy 4:12, NASB
  • And walk in love, as Christ also hath loved us, and hath given himself for us an offering and a sacrifice to God for a sweetsmelling savour. Ephesians 5:2
  • May the Lord direct your hearts to the love of God and to the steadfastness of Christ.
     2 Thessalonians 3:5, ESV
  • May the Lord make you increase and abound in love for one another and for all, as we do for you. 1 Thessalonians 3:12
  • Ye yourselves are taught of God to love one another.  1 Thessalonians 4:9
  • Seeing ye have purified your souls in obeying the truth through the Spirit unto unfeigned love of the brethren, see that ye love one another with a pure heart fervently. 1 Peter 1:22
  • Finally, be ye all of one mind, having compassion one of another, love as brethren, be pitiful, be courteous. 1 Peter 3:8
  • Above all, keep fervent in your love for one another, because love covers a multitude of sins.  1 Peter 4:8
  • If I speak in the tongues of men and of angels, but have not love, I am a noisy gong or a clanging cymbal. And if I have prophetic powers, and understand all mysteries and all knowledge, and if I have all faith, so as to remove mountains, but have not love, I am nothing. If I give away all I have, and if I deliver up my body to be burned, but have not love, I gain nothing.
    Love is patient and kind; love does not envy or boast; it is not arrogant or rude. It does not insist on its own way; it is not irritable or resentful; it does not rejoice at wrongdoing, but rejoices with the truth. Love bears all things, believes all things, hopes all things, endures all things. 1 Corinthians 13:1-7, ESV
  • Beloved, let us love one another: for love is of God; and every one that loveth is born of God, and knoweth God. He that loveth not knoweth not God; for God is love. In this was manifested the love of God toward us, because that God sent his only begotten Son into the world, that we might live through him. Herein is love, not that we loved God, but that he loved us, and sent his Son to be the propitiation for our sins. Beloved, if God so loved us, we ought also to love one another. No man hath seen God at any time. If we love one another, God dwelleth in us, and his love is perfected in us. 1 John 4:7-12
  • And we have known and believed the love that God hath to us. God is love; and he that dwelleth in love dwelleth in God, and God in him. 1 John 4:16

Encouragement:

  • Therefore, my beloved brethren, be ye stedfast, unmoveable, always abounding in the work of the Lord, forasmuch as ye know that your labour is not in vain in the Lord.  1 Corinthians 15:58
  • We glory in tribulations also: knowing that tribulation worketh patience; And patience, experience; and experience, hope: And hope maketh not ashamed; because the love of God is shed abroad in our hearts by the Holy Ghost which is given unto us. Romans 5:3b-5
  • And let us not be weary in well doing: for in due season we shall reap, if we faint not. Galatians 6:9
  • God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister. Hebrews. 6:10

Source of Strength:

  • He giveth power to the faint; and to them that have no might he increaseth strength.  Even the youths shall faint and be weary, and the young men shall utterly fall: But they that wait upon the Lord shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint. Isaiah 41:29-31
  • Fear thou not; for I am with thee: be not dismayed; for I am thy God: I will strengthen thee; yea, I will help thee; yea, I will uphold thee with the right hand of my righteousness. Isaiah 41:10
  • As thy days, so shall thy strength be. Deuteronomy 33:25
  • The joy of the LORD is your strength. Nehemiah 8:10b
  • But seek ye first the kingdom of God, and his righteousness; and all these things shall be added unto you. Matthew 6:33
  • The Lord is my strength and my shield; my heart trusted in him, and I am helped: therefore my heart greatly rejoiceth; and with my song will I praise him. Psalm 28:7
  • I can do all things through Christ which strengtheneth me. Philippians 4:13
  • Abide in me, and I in you. As the branch cannot bear fruit of itself, except it abide in the vine; no more can ye, except ye abide in me. I am the vine, ye are the branches: He that abideth in me, and I in him, the same bringeth forth much fruit: for without me ye can do nothing. John 15:4-5
  • He that spared not his own Son, but delivered him up for us all, how shall he not with him also freely give us all things? Romans 8:32
  • Therefore seeing we have this ministry, as we have received mercy, we faint not. 2 Corinthians 4:1
  • And God is able to make all grace abound toward you; that ye, always having all sufficiency in all things, may abound to every good work. 2 Corinthians 9:8
  • But the fruit of the Spirit is love, joy, peace, longsuffering, gentleness, goodness, faith, Meekness, temperance: against such there is no law. Galatians 5:22-23
  • But my God shall supply all your need according to his riches in glory by Christ Jesus.  Philippians 4:19
  • Strengthened with all might, according to his glorious power, unto all patience and longsuffering with joyfulness. Colossians 1:11
  • But we have this treasure in earthen vessels, that the excellency of the power may be of God, and not of us. 2 Corinthians 4:7
  • And he said unto me, My grace is sufficient for thee: for my strength is made perfect in weakness. Most gladly therefore will I rather glory in my infirmities, that the power of Christ may rest upon me. Therefore I take pleasure in infirmities, in reproaches, in necessities, in persecutions, in distresses for Christ’s sake: for when I am weak, then am I strong. 2 Corinthians 12:9-10

I probably should have a section about selfishness, because that is what I wrestle with the most. But a lot of verses under Service and Love deal with that.

Linda has a different list here. Our lists overlap a bit, but her situation is different in that her mother has Alzheimer’s and can be verbally abusive sometimes, and some of her verses deal with handling that.

I hope these are as helpful to you as they are to me. Do you have particular verses that help you in loving and ministering to others?

For more about caregiving, see:

Eldercare

(Sharing with Inspire Me Monday, Woman to Woman, Testimony Tuesdays, Tell His Story, Works For Me Wednesday, Thought-provoking Thursday)

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Book Review: Caregivers’ Devotions To Go

caregivers devotionsI got Caregiver Devotions To Go by Gigi Devine Murfitt from a Kindle sale a few years ago, and it has been sadly languishing on my Kindle app since then. I just recently rediscovered it and thought it was the perfect time to read it.

Gigi writes from the perspective of a daughter who helped her “widowed and disabled mother as she cared for her ten children” and then later cared for her mom when she was older, and then as a mother of a son with special needs. In some cases her definition of a caregiver broadens to include teachers, firefighters, etc. She shares here 30+ short (a little over 2 pages each on my device) devotional thoughts on various aspects of caregiving. Each one includes a Scripture verse, several paragraphs, a prayer, and activity ideas.

The devotionals cover a variety of topics, from acceptance to finding strength to showing love to our need and the provision for forgiveness when we fail. One of my favorites was when a friend wrote a letter to Gigi’s son after he was born with arms only 3 inches long, saying that he was as fearfully and wonderfully made as anyone else and that she was looking forward to see how God worked in and through him. Another was when her sister, after finding her mother in “a five pound, urine soaked diaper” at her nursing home more than once, even after speaking to the nurses about it, asked if she could visit with the staff. She thought she was just going to have a meeting with the nurses and aides who cared for her mom specifically, but she found when she arrived that she was the guest speaker for a staff meeting of about 60 people. She talked about what residents gave up to live in the nursing home – homes, pets, most possessions, autonomy, etc., and emphasized their need for compassion, pointing out that “for many of them, the caregivers were the only contact they had on a daily basis. A touch, a smile, a gentle response, an ‘I care about you’ attitude could make a bleak day brighter.” She asked them to treat the residents as they would want their own family members taken care of. When my mother-in-law was in various facilities, I often wished I could address her caregivers, but I never thought to ask. My husband did speak to the person in charge more than once, but I would have loved to gently urge everyone to remember that these are people they are dealing with, not just tasks, and to treat them as they themselves would want to be treated in the same situation. Now I find myself needing to be reminded of the same truths.

Though not every entry applied to my situation, and though I would differ with the author on a couple of issues, overall I benefited much from this book, and I think any caregiver would as well.

(This review will also be linked to Semicolon‘s Saturday Review of Books.)

National Family Caregivers Month

Anita at Blessed But Stressed is celebrating National Family Caregivers Month by inviting blog friends to guest post on the subject throughout November.  I am honored to be a guest there today on the subject of Battling Resentment in Caregiving. I hope you will check out the series: I have found a lot of encouragement in the other posts so far.