Ann Cason Geriatric Consultant
Finding the Path to Family Care
Welcome to Ann's Blog
Life Is Just a Bowl of Cherries
As a caregiver, I look at the old person and wonder how to get what is stagnant moving again.
When I was growing up in Oklahoma, a bowl of cherries meant summer. Cherry pies came by the Fourth of July, the seasons marched on and life was closely connected to summer, autumn, winter and spring. But the older I got, with central heating and air, the less the seasons mattered. We moved to bigger cities where we could always have cherry pie and it was easy to forget the trees, like drinking milk and forgetting the cow. Easy to forget that the sounds of tires rolling on wet pavement are the sounds of men fighting for petroleum and rubber and other resources.
By the time we are old and unwell, what might have been the flowing connection to the seasons and senses has become the serious march of life moving on without much connection to being human, a human being with a warm heart circulating the blood thru the veins and arteries and channels of life.
So how do we who are aging or charged with caring for elderly people at the end of life get it going? What kind of care do caregivers need so they don’t feel stuck? How can we not sink under the weight of the suffering of old age?
Try a bowl of cherries. Cherries are expensive, but get enough to fill your favorite bowl. Set the freshly washed berries on the table, or the window ledge. Then feel what you feel: the beauty of red, the little stems pointing gracefully, the sun bouncing off berry and bowl. Then extend your mind to the cherry pickers. Feel your appreciation for the hardship of the farmer who grew the cherries and the pickers who picked them and the truckers who brought them to the store. Just let yourself go. Appreciate not only the fruit but also the potter who made the bowl and the trees who gave the wood to make the window sill. All that life and all that death, all for a bowl of cherries. And ain’t it the truth? You can expand your mind until your mental image of appreciation is vast and your worry is a small dot in the midst of so much treasure. Or it could be the other way around.
Then look in the daily paper in the Life and Living section and find all that is offered. I remember once when I was sinking under the weight of caring for an elder who was in the stage of repeating over and over, “I want to go home.” Finally I started driving around looking for something to do. Spotting a little neighborhood fair, I parked the car and took the old woman by the arm as we made our way through a crowd. There was cotton candy and the aroma of hot dogs and the sound of a rock band with a singer screaming. Finally my companion looked at me and said, “I want to go home.” She wasn’t crazy at all. We drove home and had an enjoyable supper, and as we ate, I heard the words of “Life is Just a Bowl of Cherries”:
“It’s time we found out,
We’re not here to stay,
We’re on a short holiday.”
Many Strokes for Different Folks
A few years ago I consulted with a family in California. The son’s 90 year old mother was at the end of her life with heart failure, but she didn’t want to go to assisted living. His wife was willing to help care for her husband’s mother within their home, but the unemotional accountant son wondered if he could do such a thing. The relationship between mother and son had been challenging.
The son drove to his office, listening to music and thinking about it, when Schubert’s “Death and the Maiden” came onto the radio. For a moment, his heart stopped. It was the same music played when his grandmother lay dying. At a family meeting he told us, “I believe in auspicious coincidence. I want to bring my mother here to live.” To him, it felt as if he had received a message from the cosmos.
So the family got some caregiving support from an agency along with a walker, wheelchair and hospital bed.The old woman came to live with her son and his wife. As her care progressed, the doctor suggested that the mother should have a catheter. She was so weak. It was hard to get her out of bed at night for frequent urination. A nurse came to put in the catheter. She was a little frazzled. Perhaps she misspoke, but she told me that her office had told her, “Don’t put in the catheter if it is to help the family. We only practice person centered care.” Perhaps the office was being overly zealous in their understanding of person centered care. Is the person some skin encapsulated ego separate from her family and helpers and home? When the phrase, person centered care was first used, it was an attempt to stay with a person’s goals and sense of living within the institution. It was meant to counter the over efficiency and materialism of the dark age.
Nowadays, we realize that a person is part of a whole stream of being. If we don’t care for the caregivers, we end up not with just one person dying, but a whole society acting like the walking dead. What support does the family need to bring comfort to a loved one without damaging the whole family’s state of mind and pocket book? We need more articles like the one in the AARP Bulletin in April, 2013, by Sally Abrahms called “Saving Money by Living Together: Three Generations Are Making it Work.” She dwells on the practical aspects of the arrangement which creates a situation that is more than saving money, but also the basic goodness of healing lives.
Many strokes for different folks. Each person is unique. Once you look at the whole person in the whole setting, you start to see what could make life easier for older people, for the family caregivers, for the professional helpers and neighborhoods and cities and a whole wide world.
The day before I left this consultation, I remember a goodbye party. Sitting at the table, with the sun shining in were the older woman with a wheelchair and a caregiver, and a grandson who was going to coordinate his grandmother’s care. They were laughing and eating chicken sandwiches. A coconut layer cake was waiting to be served. Later when I went into her room to say good-bye, the older woman thanked me and said, “Don’t worry about me, this is what happens, it can’t be helped.”
Beyond the Names of Things
I was a long distance caregiver to my father. I lived in Vermont where my son was in high school. My father lived in California with my step mother who gave him great care. But as he began suffering from multiple physical as well as mental health problems, he needed more than any one person could give. Over many years of his frailty, I visited him at home, I visited when he lived with my sister and her family, and I visited him at his nursing home where he lived for the last year of his life. My father died the day after his 80th birthday, very old considering that his father and brother all died in their 60’s.
Dad’s aging accelerated when he had open heart surgery at the age of 70. When I arrived at the hospital after the surgery, he was sitting in a chair by the side of his bed chewing on chipped ice. A nurse came into his room and told him, “Fresh open hearts shouldn’t eat ice”.
Startled that she referred to him as a “fresh open heart” instead of calling him by name, I paced out to the nurse’s station and up and down the hall. Is he labeled so that they don’t have to relate to him as a whole human being, who is born, ages, and dies? As we age, do we become what we are named? Or does the name land on who we are? But then I felt, for me, the real challenge is not the name, but how to open my heart to be with my dear father: warm, aware, and spacious beyond the name of things.
So I walked back into the room, sat with him, and sneaked him an occasional piece of ice. “Don’t chew it,” I told him. “Just let it melt and slide down your throat.”
A Caregiving Memory: One Thing My Father Showed Me
Ann Cason with her Father
Even though I had worked with frail old people for many years, before I became a long distance caregiver to my father, he was the one who taught me the most about caregiving. Our relationship carried a lot of baggage and so much love. But I was tested. I had to let my ego agenda fade and my love brighten. For me as well as for most caregivers, that meant slowing down, giving up self-importance, calming the anxiety that I can’t do it; or the arrogance that I am heroic for doing it at all.
Here is a story of mine published on caring.com which describes an incident where my father created the spark that gave my family a vision of a magical world.
“My family is together in Morro Bay, California, driving down the highway on our way to lunch. My father, who is an invalid, is in the back seat, chanting. “The rock, the rock. I want to see the rock.”
“Oh no,” I’m thinking to myself. “He wants to see Morro Rock, which is the opposite direction from the way we’re headed.” I can feel my irritation bubbling. He never could follow the status quo. The traffic on the freeway is speeding up and cars are rushing by. I look into the rearview mirror. My cheeks are flushed; smoke is coming out of my ears.
My father’s voice is steady. “The rock. I want to see the rock.” …
go to caring.com for conclusion.
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