Ain't No Empty Chair

I spent some time with my extended family recently. They are full of life, tons of fun, and boiling over with jokes and one-liners. My favorite crack of the visit came about when one of the oldest members of the family was asked about her husband's health. He has had some small strokes and TIAs, and is left with physical impairments, but he really is in good shape given all he has been through, as evidenced by his skills at playing corn hole! At one point the question arose, "How is he doing these days" to which his wife responded "Ain't no empty chair". Translation for those of you who don't speak sarcasm or Appalachian... He is alive, he is here, and what more could we ask for.

My personal thought, and professional one as well is that we can ask for a lot more!! In fact when I see people who have dealt with illness, strokes, falls, health problems in general keep on moving through life, being active, staying social, it makes me so very happy. Quality of life means a lot, and throughout the long weekend with my family I heard them talk about bowling, traveling, parties and gatherings with their friends. I watched some bike, take walks or run. Some played games, cards, or shot pool. Some chased and wrestled with the little ones, there was singing and storytelling galore, and let's not forget the hysterical belly laughing that occurred on a frequent basis. In this microcosm of the Cooks I saw that QUALITY of life was in the forefront of every single moment, interaction, and decision made despite the fact that the words, if taken literally and out of context, pointed to a less fulfilled existence.

I have always been inspired by the way my family has lived, and their boisterous approach to the world and their lives. Each and every single family member is just a blast to be around. This visit I was in awe of the energy that continues throughout their aging. What I know from spending time with my fabulous people is that we have an advantage. We value the fun, the joy, the happiness created through experiences we choose. How lucky I am to have such wonderful role models for aging. So even if you ask how I'm doing and my response is "Ain't no empty chair" know that in actuality I am probably dancing on the chair and smiling because I know there is just more good to come!

Language: An Expanded View

Off the wall, not your typical awayfromthemind post, maybe so, but I had to share. Listening to Deepak Chopra sparked a thought, then a series of ideas, hence the blog. Hope you will find his words as thought provoking as I do.

“Language is the maker of reality…material reality”

When you think of language, do you immediately go to words, images, verbalizations, writing? I would imagine this is the first concept most people have, words comprise language, but that is really a very narrow view. Verbal language is only a piece of whole picture. Preverbal language exists, and more importantly, serves as the basis for the more common concept of language, words, ideas, insights communicated with one another. All living things have preverbal language abilities, which consist of information, sound, energy, and vibration. So, wouldn’t it be true that with sharper sensory perception skills, preverbals may be sufficient for some interaction and exchange? In my experience the answer is yes. More is often said in the absence of words, the look in a person’s eyes, the movement of their body, a small sound, a sigh or a moan can say it all.

Now what I am wondering is how this can impact the people in our world who have lost their verbal language. How can we as caregivers, therapists, and family members of those aging reframe our idea of language and communication? Would it be beneficial to more astutely observe a person, watching, listening, and feeling to find preverbal communications? Would it be helpful for a daughter caring for her mother in the end stages of dementia to have someone tell her that yes language as she has always known it is gone, but in a broader sense there may be more to the dying parent’s interaction than meets the less-aware eye?

Preverbal together with verbal language create the experiences of our human reality. As the aged veer further and further away from words it is up to us to move into their reality and look towards the energy and information conveyed in so many other ways so that interaction continues and thrives as long as life does.

Staying After The Stroke

Why do families fall apart after a CVA? Strokes devastate those around them, not just the person suffering from this trauma, but the entire family. Each person plays a role in the dynamics of a family, and when suddenly one member changes, without discussion, warning, or preparation, overwhelming effects occur. In 1994, the US Department of Health and Human Services, as part of the National Health Interview Survey, found a 7.6 increase in the rate of divorce in adults with acquired disabilities. I have seen quite a few marriages and relationships crumble after a stroke. It is hurtful for all involved, makes depression even more likely, and to be honest until faced with the situation we don’t know if our relationships could survive such a drastic change.

Back to my question: why does the breakdown of relationship happen? I have a few speculations. After a stroke the person recovering will be more dependent on caregivers. They will often need assistance with even the basic tasks of living, like getting dressed, feeding themselves, and even once they recover function for these tasks there may be some residual impact, leaving the spouse different in personality. Even when my husband has a cold or the flu, the change in our interactions can be frustrating. The caretaker of our home, the man who is active, full of life and love for his art becomes lethargic, instead of being out on the snow taking photographs, or in his studio painting, he is in his recliner with tissues around, covered in blankets. I can deal, his illness is limited, but if there were no end in sight I imagine it could be quite the scary prospect for a marriage’s future. On another note, emotional support may be altered. The unwavering wife, the rock of the family, now has episodes of uncontrolled crying, and where does that leave her husband who used to lean on her? One of the most crucial aspects of change that contributes to the breakdown of relationship following a stroke is altered communication. Aphasia is very common, and so even the simplest words, phrases can’t be spoken, not to mention the fact that understanding of questions or conversation becomes difficult. Think about trying to talk to your husband, he just keeps repeating the same word, it seems like nonsense, and you can see that he is clearly trying to get a point across. Frustrating, right?

Now the question moves to what do we do with this situation. The problems outlined all contribute to a collapse of the family unit after suffering a stroke. Part of the problem lies on our inability to step out of traditional roles with our loved ones. Recognizing that the essence of the relationship has shifted is essential. Lack of communication can also must be dealt with by reframing, watching for gestures, facial expressions, and body language. The nonverbals will often tell you more than the jumbled words could ever convey, and communication is crucial to allowing parties adjust to a new relationship. The person who had the stroke has changed. Personality, characteristics that often define a person, may no longer apply. If the goal is survival of partnership then the mindset of all parties has to change, and preconceived expectations must be released. The advice I like to give is that a path less traveled has appeared. Do you navigate your way through the changing terrain, the rocks and boulders, to find the beautiful sunset at the peak of the mountain? There is no right answer for dealing with these devastating situations, but I have seen the most amazing couples emerge, maybe a little shaken, but stronger nonetheless, and not regretful for extending their love to encompass a different concept of what marriage can be. Are you a person who has taken on a great challenge such as this? Or do you know someone who has? Let’s talk. How did you/they cope?

Aging or Living

A few hours ago I spoke with a friend on the phone. We had a great conversation about healthy living, our belief systems about our bodies, our abilities at any age, and the power our minds hold over changing the way we live.

Somehow our society cultivates a belief that once we reach a certain age, our capabilities diminish. Mental capacity, physical agility, as we age, everything about our being changes. Working in a medical setting I know that some of this is true, but I also realize that we are largely responsible for the vitality or arrest of ourselves. Who makes these rules anyway? I know there is some science to back up symptoms of aging. On the other hand, I have encountered 70 year olds who are very fit, and 30 year olds who are on the verge of heart failure. Honestly, I live a much healthier life now than I did at 21. There are exceptions to every rule. So, who are the anomalies and what make them go against the norm?

I saw a patient in therapy a couple of years ago who was in her 90s. She could no longer swallow. She was weak, has been ill, had a feeding tube, and stayed in bed most of the day. She was asking for water, food, typical things that would be missed if after nearly a century they were suddenly taken away. I was the swallowing specialist; so, what could it hurt if I tried? Her family had no hope, but this woman told me from day one that she was sure she could eat and drink if someone would just give her a chance. Disheartened by her horrible quality of life I decided to give therapy a shot. We worked together, she began drinking water again, then food came. She refused to accept that 90 was the age for her to give up. She believed that she could do it again, and with a little help she did.

Wouldn't it be nice if we could reframe our view of what aging should be? Should it include losing something as basic as food and water? Wouldn't it be nice if everyone had the philosophy of being able to do anything you set your mind to. We could look at each year of life as an opportunity to outdo our previous selves. I would love to see us serve as inspiration to those aging around us to thrive, and live their most fulfilled life right now. Seriously, we aren't kidding anyone. We are all "aging." Maybe it would be better stated as we are all "living". It is really that simple.

If we believe we are getting older then guess what, old it is. If we hold the perception that our bodies, our brains are breaking down then guess what happens. Just like my patient who knew that path was not the one for her. She believed she could change direction, so her last years were more pleasant and fulfilling. We can do the same. Imagine if every person on this Earth chose to "live" instead of "age" what a different world it could be. Do we simply grow old, or do we live amazing adventures and make the most of each day, month, year, decade? They pass by quickly. You make the choice.

Too Old??

You are never too old to try something new…

A concept proven today as I watched a group of elderly men and women experience their first “Mexican Meal”. We planned for days, talked about the different foods served in Mexico, and all of my senior friends said that they were unsure of how it would turn out, but were willing to give it a shot. They filed in, with Pandora pumping mariachi music, and spirits high, the lunch preparation began. We had a blast stuffing tortillas and faces alike. Everyone loved their lunch and 75% of the people had never tried this type of cuisine. The comments ranged from “better than I thought it would be” to “a real treat”. My personal favorite was when I asked one person who happened to be hard of hearing if she was ready for a Mexican dance, and was met with the exclamation of “I don’t want any man, Mexican or not”. Hahaha. The laughs kept coming, our bellies were full, and we all thought the fiesta was a success!

New experiences keep us fresh. We all get stuck in the same old patterns, but let’s take a lesson from these kids and remember that you never know until you try.

95 and Counting

We started the conversation talking about specific memories this elderly woman wanted to share. She prefaces our discussion with a statement that, in her mind, sums it up. With a high pitched voice, and rich Appalachian dialect Mary tells me, “Things just don’t come back to you like you’d think they would. Ain’t got much memory. I’ve about forgot it all.” Then she defies all she just said and remembers her story. Detailing life as a young woman, a wife, a mother, a farmer, she talks of days in her life before the nursing home, days before, as she says “my bones started to give out”. This petite elderly lady with long, wavy, barely gray hair holds the information of what life has been like for nearly a century. I am fortunate enough to get a slight glimpse into the mind of a woman who has experienced nearly a 100 years of change, and hear her talk about the transformation and the constant aspects of life over the years.

Mary tells me “I remember the milk cows, sheep, goats, hogs, a team of horses, and things like that. That is what took up my time. That is what I know. I knowed how to plant corn, potatoes, all kinds of little things in the garden. That is what took up your days.” She recalls more in-depth stories of tending her garden, helping her animals, herding them in to shelter when weather turned bad, and staying up into the midnight hours to make sure the baby animals, lambs in particular, were saved from the fate of freezing to death. She tells me of her childhood as an orphan, as her parents died and left 9 children, to “manage the best they could”, when Mary was not yet a teenager. She can’t recall her exact age, but tells me that she was pampered as she was not one of the oldest. Her face and words reveal shock when I tell her that average life expectancy in the United States is 77.7 years. Her family did not live this long and she feels like she is the exception.

Speaking easily of the days of past she recounts events in her life, but tells me that around the time her great-grandchildren came along there “must have been something happened to my mind”. She explains that currently, “It is hard to concentrate and sometimes I get scared because I am confused about where I am.” This happens most often when she wakes up at night, and she is able to “get straightened out” once she fully wakes. She regretfully tells me “If you’ll notice, I can’t tell you anything of benefit.” But what Mary fails to realize is that her presence, her story, the wisdom gained in her years are of benefit to us all.

What I see when talking to Mary is a person whose brain is in very good shape after 95 years of hard work, living, and thinking. She has normal age related memory change. Precise details are decreased, and the particulars of events happening in present day tend to fade more quickly. When I ask her to let me in on the secret to living such a long and fruitful life she explains how she took care of her body, working hard and walking a lot. I learn that they never called it exercise, as activity was just a way of life. I posed a question to Mary that required a bit of thought on her part, as it would for anyone. I wanted to know the best and worst thing about being a woman 95 years of age. The best, she tells me, is being able to “eat all you want because nobody pays attention if you need to trim up”. This statement, coming from the smallest woman I’ve ever met, reveals a great deal about how some components of our belief system and self image, deeply ingrained, carry throughout the span of our lives. The worst thing is a concept she can’t quite put her finger on. She simply states “I’ve lived through it all and there’s not much use to try and sort it all out, I am just here and that matters.”

Mary is very kind, beautiful, and grounded. When speaking of tomorrow she tells me in a quiet voice “The future will take care of itself. I like to be where I am and not waste the day with worrying about tomorrow.” This is how she has lived her 95 years. Her story is intact, the important parts, her ties to the past remain, but today is where she stays.

Cheers to Mary.