For a friend in hospice care

Death has become a more common part of life since we moved into our retirement community. That makes sense as all our neighbors are older. But being “common” doesn’t lead us to make friends with death. Death still jolts and stabs. And even though we believe in heaven and have the hope of reunion, our grief is real. The passing leaves a hole.

A good friend died just a few days ago and I’m still trying to settle my heart around that reality. Her passing did not surprise us. Janice had been struggling with cancer for several years, and earlier this year she and her husband decided to stop the chemo and try to live as fully and freely as they could with the time she had left. It was a good decision. The courageous way Brian and Janice faced death while choosing life has been a tremendous example to all of us.

But when she went on hospice care, we all knew that the time was drawing close. So we, her friends, tried to spend all the quality time we could with her. So much so that Brian eventually had to make a schedule permitting visits by two friends a day. (Family, of course, was there at all times.) In the last weeks, I got two of those scheduled visits. The last was on the day before Janice died. She was by now unconscious, but I sat by her side, read her a poem, and prayed with her. Brian, her sister, and a son were there, too. It was holy ground.

Following is the prayer/poem I wrote and read to my friend. It flows from images in the 23^rd Psalm, a passage that reflects God’s compassion and care for his children. A passage that shines a light of hope into the darkness, a light that ultimately vanquishes death.

 

Prayers for a Friend in Hospice Care

-1-
I hold you in my heart
which is a good place, my friend,
because Christ is in me,
the hope of glory.
You and Jesus are at home
in my heart, surrounded by glory.
Brian is there, too, of course.
Jesus has his arms around
you both. My prayers
blow in on a Spirit wind,
ruffle your hair, carry
the fragrance of hope.

Breathe in that fragrance, my friend.

-2-
What started out as the valley
of the shadow of death turns
out to be a glen in a redwood forest.
Morning light streams through the trunks,
floods the small space where you stand,
listening. The tall trees around you
are all at prayer.

-3-
I see a table in the forest, set
with beautiful dishes, real silver, and crystal
goblets. You and the people you most love
are seated, expectant, and, yes,
hungry. Soon the food appears.
The united chefs of The Red Lobster,
The Olive Garden and Tenderloin
seem to have collaborated, as angelically
gorgeous waiters carry in all
your favorite food. After a brief thankful
prayer, you dig in, conversation
temporarily suspended, though the sense
of companionship remains.

Somehow you all manage to ignore
the others, those peeking at you from around
the trunks of the surrounding trees
--pain, fear, death, defiance, defeat.
As your satisfaction and gratitude grow,
those others turn to mist, fade into the ground,
vanish. Soon all is light, all is beauty,
all is joy.

-4-
I ask the Lord to fill your cup with

Faith

in who he is, who he has always been
for you, who he promises to be in your future,
forever and ever, life without end.
Let faith light your way forward.

Hope

that all the faithfulness of the past
and all the promises for the future
shine here in this present moment.
Let hope’s light flood your being today.

Love

clearly revealed in the people
who surround you, who have become
God’s hands, arms, feet, and face.
May your love be released to bless
them back. To bless your Lord.
Let love’s light shine into
and out from your heart.

May your cup overflow. Faith. Hope. Love.

-5-

I see your friends, Goodness and Mercy,
sticking with you through the thick
of plenty and the thin of want.
They’re always there,
sometimes giggling, sometimes weeping,
sometimes running ahead
to hack a new path
through the brush,
sometimes walking alongside
to talk and laugh and wonder with you.
Often they follow close behind,
not always perceptible, but there
nonetheless.
They’ll be with you,
they tell me,
for the rest of your life.

-6-

And you will dwell
in the house of the Lord
forever.

Old wisdom, young wisdom

 Our grandson is serving a two-year term in a North African country, learning how to set up small businesses. Through the wonders of modern technology, we get to be in regular communication.

On Saturday we had a long conversation via whatsapp. At what we thought was the end of our time together, he told us how much he appreciated our years of experience and wisdom. He then shared a concern and asked for our wise advice.

My brain immediately froze. Although he was not in any way demanding, I have problems with wisdom-on-demand. For one thing, I’m uncertain about the amount of wisdom I might have. It’s almost a stereotype—wise old people. We’re either serene and wise or grouchy and bitter. Both stereotypes. Take your pick. I know I’m somewhere in the middle, never reaching the total grouch stage, but also falling short of an endless reserve of heavenly wisdom.

So I did what seemed natural. I said, “Hal, you go first.”

He gave me an unhappy look but proceeded to share some experiences with our grandson, to give him perspective, I guess. It sounded good.

That gave me time to think. When my turn came, I realized that the best approach was first to ask questions and listen. So I asked him what he was hoping for, positive points, fears, what he could bring to the to the situation, and more such questions. He responded, Hal joined in, and the resulting back-and-forth conversation between the three of us actually led to some helpful insight. Not only did we share wisdom (I hope), we encouraged his wisdom to kick in.

Maybe wisdom is communal, at least in some situations. I think of the Quaker committees-for-clearness where a selected group of people centers their thoughts and prayers on one person and that person’s concern or decision. This involves times of silent waiting, questions, listening to the person, more silence and prayer. And then people share their sense of what the Spirit is saying. When it functions well, the person leaves with some clearer perspectives and a path to making his/her own decision. It’s all about wisdom and discernment. Communal wisdom.

I’m realizing that God invites us to ask for wisdom: “If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given you.” There’s no age requirement. Any follower of Jesus can ask—old, middle aged, young. Even children. The Book of Proverbs time and again encourages young men (and women) to seek wisdom.

Still, it seems natural that some older people, through years of right living, should be known for their wisdom. As to whether or not I’m one of those people—well, it’s probably not for me to say. Or even to wonder about. But I can certainly ask for wisdom as a gift. As can my grandson. Wisdom that sometimes comes from consulting with other people. Even grandparents.

The next time I’m facing a conundrum, I may ask one of my grandchildren for insight.

Gratitude in the old growth forest

 I’m a list maker: to-do lists, wish-lists, prayer requests, priorities, and so on. I just made a (helpful, I hope) list of migraine triggers. And because this is Thanksgiving week, a gratitude list seems appropriate. (Hal helped me come up with this list.) I focus on the retirement community where we now live. This is a very particular old growth forest.

I’m thankful for….

--an environment that not only keeps me safe but encourages me to keep growing

--that my long-time husband is still my best friend and we get to share this apartment

--for the art studio in the basement that lets me (a non-artist) keep my own locker of art supplies, invites me to come down anytime to experiment with my own projects, encourages me to join classes and discover that maybe, just maybe, I am a sort of artist

--lots of new “best friends,” all of them in their 70s, 80s, and 90s. (I had thought “best friends” was a high school thing. Wrong.)

--the opportunity to listen, understand, and be present to my neighbors in good times and hard

--a library with a good selection and a flexible attitude toward late returns

--food that is almost always good and sometimes delicious

--a room with a view—trees, hills, a sky full of dancing clouds

--a cozy burgundy rocking chair that swivels to let me see the view (It’s my early morning prayer chair and my afternoon nap chair.)

--the path around the Hess Creek Canyon that feeds my need to be among trees on a regular basis and to hear water moving over the earth

--the critters that inhabit the secret spaces—deer, birds, squirrels, the occasional racoon

--the staff that works behind the scenes to make our lives comfortable: the women who clean our rooms, the man who replaced the handle on my refrigerator door when it broke off, the tech expert who solves my computer problems, the cooks and waiters/waitresses who prepare and serve our meals, the community life director who plans our outings, the gardeners who keep the place beautiful, and especially the nurses and aides who care for our most vulnerable residents.

--beautiful and sometimes intriguing works of art that decorate our lobby and all the residential halls. We live in an art gallery with free admission.

--our own lobby on the fifth floor where we congregate to have meetings, celebrate birthdays, pray together, and work (play) on puzzles

--free coffee down in the lobby

--our community garden where this year, for the first time, we had our own plot. Amazingly enough, things grew (roses, tomatoes, Inca lilies, green onions, wild flowers, and spaghetti squash, among other miracles).

--an exercise room with lots of machines and open space for courageous classes. My favorite machine (called the New Step) faces a window with a forest view. Forty-five minutes can pass without my realizing it.

--a woodshop where I (Hal) find a community of like interests and skills.

--an active residential association that lets us self-govern, plan our activities, and come up with creative ways to serve the community

--a resale shop and storage space that not only provide residents with a place to donate their furniture, clothes, and other items as they need to downsize, but offers bargain prices on really good stuff

--the security of knowing that as I continue to age and need different levels of care, this community will provide that. That’s the nature of a continuing-care retirement community. My kids and grandkids can come be with me, but they won’t have to take care of me. That gives me peace.

--the blessing of knowing that this community is Christ-centered and founded on values such as integrity, compassion, stewardship, community, excellence and service. I can live with that. I can grow old in this environment.

I hope this doesn’t sound like a publicity pamphlet. That’s not my intention, and that’s certainly not my favorite writing genre. And this community is far from heaven-on-earth. We have our fair share of problems, conflicts, and challenges. After all, we’re all people.

But my intention today is gratitude and the above list represents my true feelings. (Maybe I’ll write an angry list another day. Probably not.)

Thanks be to God for blessing us in this time of life. Life in this old growth forest is good.

Grace in an old photo

 I’m downsizing again. Although we took on this task before moving into the retirement center, we stored some boxes in our son’s garage, stuff I planned on going through later. Well, that’s what I’m attempting to do now. Last week we brought over to our apartment several boxes labeled “memory stuff.” That’s dangerous.

One box proved to be full of letters and old photos from my mother’s side of the family. It had been entrusted to me at some point in the past, and I had set it aside. Now was the time. I sat on the floor and began digging and sorting stuff into piles on the carpet.

Some of it was helpful information, some mildly interesting, and some destined for the recycling bin. I loved the photos of my grandparents, my mom, and all the aunts, uncles, and cousins when they were young.

Among all the musty black-and-white photos and crinkled letters, I discovered a few treasures.

I found a photo of a lovely young woman. When I turned it over and read the name on the back, I gasped. Nancy Jane Nichols. I had never seen a photo of my Aunt Nancy. I had never even met her. And I am her namesake.

My mom, Barbara Nichols, was raised with six siblings—four sisters and two brothers. Mom was the third-born, and Nancy followed her two years later. I understand that Barb and Nancy were especially close as kids and young women.

When Aunt Nancy was in her early 20s, she began behaving in ways that alarmed her family. She alternated between deep depression and erratic hyper-activity. She became delusional and had difficulty speaking. Happening to such a kind and friendly person, this terrified her loved ones.  As it went on for some time, her parents began taking her to different doctors. Finally, a psychiatrist diagnosed schizophrenia, a little understood condition at the time.

According to the American Psychiatric Association, “Schizophrenia is a chronic brain disorder that affects less than one percent of the US population. When schizophrenia is active, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking and lack of motivation.” Although there is still no known cure for schizophrenia, ongoing research has found humane ways to treat the symptoms and to care for the person.

But back when Aunt Nancy was diagnosed, institutionalization was standard practice. So, with broken hearts, my grandparents committed their daughter to a mental hospital. She lived there for the rest of her life. The family apparently stopped talking about her as they tried to deal with their loss and move forward. It became the Family Secret.

Schizophrenia is inherited, and a generation later two of my cousins developed it in their early 20s. My cousin Eileen was also institutionalized. My cousin John committed suicide.

My mom was devastated by what was happening to Nancy, and the grief followed her the rest of her life. As best I can calculate, Mom was a newly married woman at the time. Two years following her marriage, my parents welcomed their first born—me—and they named me Nancy Jane.

As I was growing up, my mom never talked about Aunt Nancy. And of course I never met her. When I got old enough to be curious about my name, I was told I was named after an aunt who was now “gone.” Even as a child I sensed Mom didn’t want to talk about it, so I left it alone. It’s only been since my mom’s death that I’ve been able to piece together a few details that saddened me. Sad for my aunt, but even sadder for my mother whose heart never healed.

And so my excitement at finding the photo of Nancy Jane Nichols, and discovering her to be such a beautiful young woman. I imagine I see her character in the photo—a kind, loving person I’d want to have as a friend, if that were possible. Maybe the photo shows who she really is, not the person the disease turned her into. I feel privileged to be named after her.

My parents apparently didn’t pay too much attention to the meaning of names. They were not Christians at the time and certain words might not have carried much significance. But both Nancy and Jane are derivatives of the work grace. I’ll accept that. A double portion of grace. God’s grace child. That’s something to hold onto, cherish, and live into with the Spirit’s help.

My mom died at the relatively young age of 57 after years of degenerative rheumatoid arthritis. Her limbs had become twisted and she could no longer walk. She kept her quiet and cheerful spirit to the end, but it hurt to see her suffering.

I imagine the sisters, Nancy Jane and Barbara Mae, together now, healed, whole, and flourishing. They have an eternity to make up for time they lost here on earth.

Grace.

 

Creativity has no age limit

 Creativity and beauty are alive and well in the retirement community! Retirement doesn’t keep artists from painting, writers from writing, musicians from blowing their horns, photographers from capturing beauty, and artisans of all sorts from growing craftier than ever.

Speaking of art, the lobby of the main community building is its own art gallery, under the management of a resident activity group called Art on the Wall. It always features the work of a local artist and changes every few months. Sometimes the local artist is a resident of our retirement community.

That’s the case with the latest collection that circles the walls of the lobby and extends down the hall to the dining room. The artist just happens to be a good friend. I’ve known Sharon Longstroth since college days over 50 years ago. We’ve kept up our friendship over the years and now find ourselves part of the same retirement community.

After college, Sharon taught in grade school, as well as being a wife, mother, and homemaker. All along art has played a central part in her life. It’s part of her identity as a person.

She is currently known as a “Watercolor/Mixed Media Artist.” Sharon writes, “In recent years I have spent considerable time painting the things that I love: old buildings, people I know, flowers, birds, and anything else that catches my interest. A few years ago, I took a mixed media class where I learned to make books and art pieces using my own painted collage papers. I loved the results and the freedom of creating in a new way.”

Sharon tells me that living in the retirement community has encouraged her as an artist. It’s not just a matter of having more free time (although that is a major factor). It’s being part of a community of other creative people who inspire her and motivate her to keep learning new ways of creative expression. She is part of the Studio Arts Committee and spends a lot of time in their large studio on the lower floor. She sometimes teaches art classes and also enjoys taking some of the other classes the committee offers.

I don’t consider myself an artist, but I’ve taken a few of the art classes, including one Sharon taught on mixed media. But aside from art, the creative energy this group puts out encourages creativity in other forms. I find myself writing more stuff in a more creative manner. It’s part of the atmosphere of this community. I’m grateful.

Here are some of Sharon’s pictures currently on display:

Ageism in the health care industry

 We live in a time of medical specialization. We learn about the family doctor by watching ancient “Little House on the Prairie” re-runs. Where once one doctor oversaw all medical care and actually knew their patients, now it seems there is a specialist for each body part. Add to that the reality that as we age our body parts start malfunctioning; thus we end up seeing a lot of doctors.

Right now I’m in touch with my primary care physician (PCP), an audiologist, a neurologist who specializes in migraines, and a dermatologist. I accompany Hal on his visits to his urologist, gastrologist, an orthopedic specialist in hands and another one who focuses on backs. I may have missed one. All of these doctors are young (from my mature perspective), in their 40s or early 50s. Curiously, my doctors are all female, which I have nothing against. But Hal’s specialists are all male. We have the same PCP, a young woman in her 40s.

Another fact: more often than not these days, when we go to see one of these doctors, we’re likely to instead get the physician’s assistant (PA), usually someone in their mid-30s.

But we need their help, so we humble ourselves before the wisdom and skill of youth. And hope for the best.

I’ve been reading a fascinating book by award-winning scholar and geriatrician Louise Aronson. The book is entitled Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life (2019). Aronson, herself a woman in the prime of life, traveled a twisting path before choosing geriatrics as her specialization. She tells this story in her book.

Among other topics, Aronson gives a penetrating view of ageism (age discrimination, especially against the elderly) in the medical system, beginning with the training of physicians. She writes that

Over their four years in medical school and three to ten years of residency and fellowship training, doctors in training are taught that human beings come in two age categories that matter: children and adults. After required classes and rotations elucidating differences in physiology, social behaviors, and health needs between those two age groups, they choose whether to work in children’s hospitals or adult hospitals, and as pediatric specialists or adult specialists. If they happen to notice that older adults make up to 16 percent of the population but over 40 percent of hospitalized adults, or that patients over sixty-five are the group most likely to be harmed by medical care, that knowledge will be tempered not only by medicine’s predilections for saves and cures but also by comments from their teachers and mentors such as “Unless you really like changing adult diapers, don’t waste your time” learning geriatrics.” (5-6)

Aronson goes on to show how this kind of discrimination in training carries over into medical practice, with many doctors treating and medicating older persons just as they would younger adults, without considering that the aging body has different needs and reactions. She claims that “The second-class citizenship of older patients is entrenched and systemic” in the health care industry.

At this point I need to stop and say that all of my doctors have treated me with kindness and respect. (I can’t say the same for some of the PAs). I’ve detected no obvious ageism.

Yet there is something subtle going on, an uncomfortable itch that only gets worse as I scratch it.

About eight years ago, just as I was entering retirement age, I began experiencing symptoms of head-pressure and dizziness. (I’ve told this story in other blogposts.) I began reporting it to my doctor. Aronson notes that “When a patient uses the word ‘dizzy’ most clinicians will tell you that something inside them clutches, if only for a second.” Even more so if the patient is older. After several years of my mentioning this (probably not forcefully enough), my doctor began ordering tests and referring me to specialists. Lots of them. After two years of exploring the options, every doctor involved told me they found nothing wrong. One even said, “Don’t worry. Most old people have some degree of dizziness. It’s aging.” My PCP said, “I’m sorry. I can’t do anything for you.” And smiled sympathetically.

It felt like no one believed me. So I changed insurance plans and found a neurologist at a research hospital who finally gave me a diagnosis. Like I said, I’ve already told this story.

I really don’t know how many of the obstacles in my journey were due to my age. Probably not all of them. Even so, having read Aronson and made my own observations, I recognize that age discrimination is widespread.

Here are some preliminary conclusions I’ve reached:

1.     I am thankful for people like Louise Aronson on the forefront of a change of attitude in the health care industry, a positive change I believe is coming.

2.     I will prepare myself better for each medical visit, reminding myself that I am a person of value, that my health matters as much as anyone’s. I will gently insist on being heard.

3.     I will prepare to treat my doctors with respect, no matter how young they are, a respect I trust will be returned, no matter how old I am.

The quote at the beginning of Aronson’s book is by Cicero. Apparently ageism has been around for a long time. He said that “Old age will only be respected if it fights for itself, maintains its rights … and asserts control over its own to its last breath.”

Windows, waterfalls, and a beautiful view

 My first thought was an unannounced partial eclipse of the sun, so quickly had the shadow entered the room. I turned to find it wasn’t an eclipse but a man outside my window, pressing up against it.

   I would have screamed had I not then remembered that it was window-cleaning day at the retirement community. It surprises me twice a year, even when it’s announced a week ahead of time. This is partly because we live on the fifth floor, with no balcony. The sudden appearance of the cleaner always catches me unaware.

Actually, I’m grateful that this establishment provides bi-annual window cleaning. One of the reasons we moved into this apartment was the north-facing wall of windows in both rooms. It makes the small area feel spacious and open. We never tire of the view. After the cleaning, the far hills seem especially clear and lovely.

A clear view is so important to personal well-being. When choosing and moving into a new place, my first questions were always, “What will we see looking out the windows? How much light gets in?”

Another type of window cleaning common to people of retirement age is cataract removal/lens replacement surgery. I’m still amazed at the thought of an operation on the eye and that it’s become so quick and routine. “Don’t worry,” my doctor told me. “I do dozens of these each day.”

“Dozens a day” makes it seem like minor surgery, and so it is. But for the person undergoing the procedure, me for example, it’s huge and life-changing. Hal and I had the surgery several years ago. I was thrilled with how sharp and clear my vision was afterward, much better than a window cleaning. I could actually read road signs. The greens were greener, the reds redder.

The name cataract interests me. It has two meanings in English: 1) a clouding of the lens of the eye and 2) a waterfall. The latter is an older usage. But in Spanish the word catarata is the common word for waterfall.

Just before my surgery I wrote the following poem:

I’m having my waterfalls
removed. It will be good
when all the mist
that floats between me
and the sun is gone.
Even so, I’m going to miss
the rush and swirl of moving
water, the mad leap over the edge,
the plunge and crash and all
the lovely daily drama that goes
with having my very own
waterfalls somewhere
inside my head.

Clarity of vision is indeed important to human flourishing. I find my soul frequently needs a window cleaning. Cataracts of fear and discouragement need the surgery of the Spirit so that I can again see the beautiful reality of life in God’s kingdom. The Apostle Paul prayed for the new believers in Ephesus that the “eyes of their hearts” would be opened so that they would clearly see all that God had provided for them.

Clear vision.

Eyes that see truth and beauty—in myself, in other people, in God’s world.

A requirement at any age.