Sunday, December 14, 2014

Hope

A few months ago my daughter and I volunteered to teach the first through third grade Sunday school class at our local church. I was ambivalent about this new job assignment because caregiving duties for my mom can only be expected to increase, but my grandson is in the class and no other teachers volunteered. And so we took up residence in a tiny room scarcely large enough to accommodate a half dozen pupils and two teachers.

Our classroom's single table became cramped as attendance increased, and a week ago we realized that if there were no absentees in any given week, we would have more students than chairs or table space.  We discussed finding another small table and finally agreed that I should bring a card table.  But I didn't do it.  My card table was just too big for the allotted space.

When I walked into our classroom this morning, there sat a new little table, the perfect height and size. "Did you arrange to have this table put here?" I asked my daughter.  But she had not mentioned the need to anyone, nor had I.  We learned later that refreshments had been served from that little table at a function earlier in the week. Someone had pushed it into our classroom to get it out of the hallway and then apparently had forgotten it. We remembered to thank the Lord for providing for us and I was aware this was an affirmation that despite my stressful caregiving schedule, teaching Sunday School is something the Lord wants me to do.

Awhile later, I rummaged through a cupboard looking for additional Bibles for our classroom. I found a worn children's Bible, flipped open the cover, and was startled to see an inscription in my own handwriting. I stared at the date--December, 1982--exactly 32 years ago.  In that moment as my 60-year-old self stared at an inscription I'd written as a 28-year-old Sunday school teacher, my past juxtaposed with my present, and I saw that God has woven a theme of ministry to children throughout the fabric of my life.  For just an instant it was as though I was freed of my usual myopic fixation on the present moment and was enabled to share the Lord's perspective. I was reminded that He sees the whole of my life from birth to final breath, and is sovereign over all. 

Taking care of someone who has Alzheimer's disease can wreak havoc with hope. It is easy to focus upon my own fear, and difficult to avoid projecting possible future outcomes based on my present, limited perspective.  Today a new table and an old Bible reminded me that God knows exactly where we are on our individual timelines.  He sees our lives from beginning to end, and is present with us at every juncture. Nothing takes him by surprise--and He has made provision for us every step of the way.  It is safe to place our eyes firmly on a God such as this. It is safe to hope in Him, even in the midst of a journey through Alzheimer's. 

Thursday, December 11, 2014

Like a Dorm Room (Only Quieter)



My mother is in the tenth year since her Alzheimer's diagnosis, has the beginnings of macular degeneration, and is 90 years old. It is amazing that she manages to navigate her little apartment as well as she does. But recently, despite the nightlights in her bedroom, she has seemed disoriented as she's maneuvered her way from the bathroom back to her bed during the night, even though it is only a dozen steps away.

Taking care of someone whose condition is deteriorating requires the ability to adapt to increasing levels of need. I admit that flexibility is not my long suit, but there is another factor at work that sometimes causes me to ignore signs of Mom's diminishing abilities; I don't want to admit she is failing. Despite all I know about Alzheimer's disease, I have an emotional reluctance to recognize signs of Mom's physical and cognitive decline. 

When Mom began to complain of having trouble finding her way, her room conditions were exactly the same as they've been for the past ten years. There were two nightlights in her bedroom along with three nightlights in the living area.  Nothing had changed but her ability to function in her environment, which I was slow to admit. Thus, I essentially allowed my poor mother to stumble around in the dark for a few weeks before I gave careful thought and prayer to how her environment might be adjusted, not only to ease her confusion but also to decrease her risk of a fall. 

I'm pleased with our solution to this problem. Earlier this week I ran a strand of white Christmas lights behind Mom's two dressers, gathered the extra length into a clear storage box (being careful not to bend or put pressure on the wires) and pushed the box underneath Mom's bed. The result is a soft glow that outlines the shape of her bed clearly, but when she is in bed the light is behind her and she is not bothered at all.  In fact, she's been calmer and has seemed to feel more secure; last night she said, "It is so cozy in here."  And indeed, her softly lit quarters now boast a sort of dorm room ambiance.

Most of us struggle with a period of denial when loved ones lose the ability to function as they once did. Throughout the course of a an illness, the caregiver/patient relationship has to be renegotiated as the care recipient's needs increase. As we stand on the threshold of the final stretch of Mom's Alzheimer journey, I pray for wisdom to understand and grace to respond quickly to her increasing needs.



Sunday, December 7, 2014

God Has a Plan

I've blogged for a long time, about ten years now. Once in awhile--not often--I've been surprised by sweetness of friendship with someone I've met only through blogging and subsequent emails.  This happened for me recently when a series of coincidences between my life and that of a precious new blogger friend occurred, connections that seemed to shout "Here is a heart friend for you; one connected by His very hand for comradeship on your earth-walk and as a fellow child of God throughout eternity!"

News came this week via this dear new friend of an incomprehensible sorrow.  I'm not going to repeat the details here because the story is not mine to share, but even if you (like me) avoid reading newspapers you have not been able to avoid reports of similar grievous events that just make no sense to us.

I'm not going to spend time postulating reasons that bad things happen, I only want to share the phrase that came strongly to me as I began to pray for the family impacted by this sorrow: God has a plan.

How can I convey in mere words the overwhelming sense of comfort and rightness that came with this knowing: our Lord saw this event ahead of time and has planned for it since the beginning of the world. He has a plan for each precious life impacted by this sorrow. Things aren't going to be merely "all right;" they will be surrounded by His presence, shaped by His love, and in the end actually blessed not only despite this terrible grief but even through it.

No, I don't mean to tell someone who has lost a loved one that everything will work out and they'll even be blessed by this loss. This is so trite as to be untrue; our lives are incredibly precious and the Lord Himself wept when his friend, Lazarus, died. But we serve a God who possesses resurrection power, and He does not hesitate to use this power on behalf of His grieving children.  He disarms the enemy, provides healing balm for broken hearts, and is able to transform the saddest of circumstances into vehicles for His love to flow.

At the moment of a devastating diagnosis, a tragic event, or any other heartache that can come to us, God is present with us, and He has a plan.  We may not be able to see it when we are blinded by grief, but we can trust in the love of our God and know that He is going to see us through according to the beauty of His perfect power over every circumstance of our lives.  I've seen this in my mother's life; even a ten year trek through Alzheimer's disease is no match for our Lord. I have seen blessing upon blessing come to our lives not only despite Mom's Alzheimer's, but through it.  How like our hero, the Lord Jesus Christ, to use the enemy's ploys as stepping stones to victory!

We can trust our Lord's perfect love and His sovereignty over every circumstance of our lives. I'm praying the peace of this knowledge for people who are hurting today.  May our Lord meet your every need and provide you the comfort of His strengthening and healing love. 

Friday, November 28, 2014

In His Time

In the months before she was diagnosed with Alzheimer's ten years ago, my mother was in crisis.  I spent hours in prayer for her and helped her every way I knew how.

Mom's disease had already progressed further than we knew at the time. The devotions I wrote for her and the prayers I prayed seemed to bear no fruit; the opposite seemed true because Mom resented my interference in her life. This sort of response is not uncommon for new Alzheimer patients; it is hard to accept the need for change, and the confusion of early dementia exacerbates fear and shades perceptions.

Mom suffered a terrible fall the first winter after we brought her to live with us.  She broke her collarbone and then, sent home from the hospital to recover, suffered a cold that turned to bronchial pneumonia. I thought we were going to lose her, but instead the Lord brought healing.

For several years resentment toward me simmered throughout most of Mom's responses to my overtures.  She hated having to bathe, take a walk, or go to bed just because I said it was time to do so, and her Alzheimer's made her forget that she had lost motivation to do these things on her own.

This past year I put the devotions I'd written for Mom into book form, and matched the readings with the hymns she loves. Though my name is on the cover of the book, Mom's Alzheimer's has now progressed to the point that she doesn't realize that her daughter wrote this devotional.  Last night I was in her apartment emptying trash cans and removing dirty dishes when she said, "Just listen to this wonderful devotion..." and she proceeded to read aloud words I'd penned, encouragement the Lord had provided just for her.  She closed with the Scripture reading at the bottom of the page and looked at me. "Isn't God good?" she demanded, as though daring me to state otherwise.

Not waiting for an answer she looked back at her devotional.  "Now I will sing the hymn that goes with this reading," she said.  Tears ran down my face as I listened to my mother warble Just as I Am, and my heart warmed with the Holy Spirit's presence.

During the early years of Mom's Alzheimer's, my heart ached from her rejection of the Lord in me.  She thwarted my attempts to help and said things that hurt my heart. I forgave her but I didn't think she would ever accept the blessing God had offered her through the anointing He gave me on her behalf. I couldn't see the use of having spent so much time in fervent prayer for my mom when those prayers seemed to have no impact on the course of her disease or her heart toward me.

But tonight it was as though God whispered to my heart, "You see? I heard your every prayer."

So often, the Lord asks us to trust in Him when we can't see where our paths will lead. When a loved one is diagnosed with Alzheimer's there is so much fear and uncertainty, but I am here to tell you that it is safe to place your trust in our God. At the time of Mom's diagnosis I never would have dreamed that the love and prayers I offered on her behalf then would bear fruit for her ten years in the future; I didn't think Mom would survive that long, much less still be able to think clearly enough to sing and to pray.

But God knew.  He always knows.  Blessed be His Name! 

For the remainder of the month of November and throughout December, my mother's devotional, Beautiful In Each Season, has been reduced to the lowest prices allowed by Kindle and Createspace, both eBook and hard copy formats.  This is a wonderful time to supply copies of a large print devotional to shut-ins, nursing home residents, and care recipients.

Wednesday, November 19, 2014

Pray in All Things

I suppose all mothers have pet bits of advice that, over time, become ingrained in family lore. "Wash behind your ears...put on clean underwear (in case you have an accident, the EMT's won't be appalled by you)...don't fidget in church..."  A small portion of my counsel to my children has been stellar, the greater part nonessential, and some downright ridiculous.

However, I stand by one of my oft-repeated instructions, first utilized in that moment of terrified desperation every parent feels when their teenager slips behind the wheel of a vehicle for a first solo excursion. When this transition came for my 16-year-old daughter I shouted one last word of advice after her rapidly retreating form: "PRAY IN ALL THINGS!"

This has become the customary parting phrase for me each time my adult children walk out the door; "I love you, call me when you are home safe, pray in all things!"

I have realized that although my "shouted advice" version of this counsel may be unique, the familial example of praying in everything did not originate with me. This was brought home to me recently when I delivered my mother's supper plate.  Mom loves macaroni and cheese. Her plate featured a generous portion of this favorite dish, and there was also a half sandwich and a cup of applesauce.  Mom began eating the mac and cheese with relish, inserting little comments of appreciation between bites. "This is so good...so creamy...I love this." After a few moments the timbre of her voice changed and I heard her pray, "Guidance, please Lord, for when to stop eating the macaroni and to pick up the sandwich."

My Alzheimer's mom truly does pray in all things. When faced with anything unpleasant she closes her eyes and prays aloud, "As you will, Lord, as you will." And with increasing frequency as her Alzheimer's progresses, I hear this repetitive prayer, "Guidance please Lord, guidance." 

A friend recently asked me how Mom was doing, and I replied, "You know for how little she has left cognitively, she continues to do amazingly well."  Understand that Mom often thinks I'm her granddaughter, sometimes believes she is in a facility rather than in our home, and recently mistook gas pains for labor pains (she told me it would be time to have the baby soon). Her Alzheimer's diagnosis was ten years ago and she is 90-years-old, but she somehow manages to function pretty well within the familiar environment of her little apartment. 

When I heard Mom pray about how she ought to proceed in eating her dinner, I realized why she is able to continue to manage as well as she does despite the confusion of Alzheimer's; the Lord has not departed from her. The Holy Spirit is described in Scripture as counselor and teacher, and He has not abandoned my mother.

When Mom inquires of the Lord, He does indeed provide her with help.  Following her prayer for guidance during the incident described above, she paused in her compulsive intake of the mac and cheese and appeared to be listening. She then picked up the sandwich with her other hand and began alternating bites of sandwich with forkfuls of the irresistible main dish. 

With my family's history of dementia, I find this evidence of God's continued presence in Mom's life wonderfully encouraging. Once again I've been reminded that the best preparation for a possible diagnosis of Alzheimer's disease in the future is to cultivate a relationship with the Living God in our present. Once we've made the decision to believe in what Christ did for us on the Cross and have asked to be adopted as a child of God, we belong to Him. The confusion of Alzheimer's doesn't cause God to depart from us.

...God has said, “Never will I leave you; never will I forsake you.”
--Hebrews 13:5

If you feel your relationship with the Lord isn't one that will afford you the peace and guidance my mom enjoys, check out this link. 




Thursday, November 6, 2014

A Practical Post

I recently received an email from a dear lady who deals with her Alzheimer mom's incontinence. "Do you have to deal with incontinence issues with your mom?" she asked.

Well, yes I do.

My primary ways of offering comfort to fellow caregivers are in the emotional and spiritual realms; this is my assignment from the Lord. "Nuts and bolts" advice is not so difficult to find, but the provision of heart-solace to caregivers is an oft-neglected area of ministry.  However, it occurs to me that those who read this blog regularly might appreciate knowing how we manage the day-to-day caregiving issues that so many have to face. This is not meant to be advice for anyone else; please clear all caregiving procedures with a health care professional who knows your loved one well. 

Bathing--Back in 2007 (where does time go?) I wrote a post entitled Bath Day that you can find here. About the only change we've made in the ensuing years is that I now have Mom wear her Crocs right into the shower and don't remove them until she is seated. After she has bathed she puts them back on so that she never has to walk barefoot on slick surfaces, which, even when she is leaning heavily on me, makes her feel insecure.

Incontinence--Mom wears adult diapers 24/7. I recently found that brands are important; Depends don't work for us, or at least the mid-absorbent pack I recently brought home definitely did not!  We use Sam's Club and/or Wal-mart's store brand. We are so blessed that she has healthy skin that doesn't chafe or get diaper rash easily, but when she does we use Boudreaux Paste, a product whose full name annoys me but is the best I've found!

Medication--Mom takes two Alzheimer's drugs (work out a plan with your doctor), an anti-depressant (I think this is so important for Alzheimer patients), an antihistamine for her severe allergies (most antihistamines are contraindicated for dementia patients, again, check with your doctor), and a cholesterol lowering medication that was prescribed off label for her irritable bowel symptoms (Colestipol/colestid). People who have had Cholecystectomy (gall bladder removal) as Mom has often need a medication such as this, but I've always thought it might also be useful for those who have lost bowel control or have irritable bowel symptoms as well. Let's repeat my litany: check with your doctor! 

Mealtime--Mom very much prefers to be served meals in her recliner.  When she moved in with us I very much felt she should sit at the table with us at mealtime. This became a "choose your battles" issue which I finally allowed Mom to win, and she is much happier.  We have a wooden lapboard that fits across the arms of her chair and a side table to hold her drinks. The chair is leather and has a cloth cover that has to be laundered regularly. But, the key words are she is much happier.

Entertainment--Music from Mom's own C.D. collection plays constantly on the "repeat" setting. It was difficult to find a CD player for her--everyone now uses their MP3 players--but I found a 5 CD changer at Amazon and hooked my iPod speakers to it (WHY didn't the CD player come with speakers?).  Music is vital for Mom's contentment level, and the familiarity of traditional hymns is the most powerful mood enhancer for her. Films that have very little dialogue are best; Mom can no longer follow rapid fire dialogue that characterizes most movies. Bambi is a favorite, and Mom loves the That's Entertainment films. 

Reading material--sometimes people are surprised that Alzheimer patients may continue to read. Mom's short term memory is indeed shot, but in the moment she is in she is still able to comprehend a sentence or two of meaning. She loves the My First Little House books, and is not offended when I offer her beautiful children's picture books, but she also very much enjoys devotionals such as Richard Carlson's Don't Sweat the Small Stuff  and Max Lucado's writings.  She also peers intently for long periods at a daily newspaper, so I guess she retains some meaning or at least a feeling of being a part of the world from that. And, of course, I have her read a daily selection from the devotional I wrote just for her, Beautiful in Each Season.  The selection of music and reading materials depends entirely on the individual preferences of your patient. What did he/she enjoy pre-Alzheimer's? Find straightforward or simplified versions of what was enjoyed in the past. 

Schedule--I've printed her daily schedule on a piece of posterboard and placed it within her line of vision, along with her clock and whiteboard that has the day's date written in large letters. These things help her very much. Further and more detailed information is available in the post entitled How We've Managed Thus Far,

Phone--Mom loves her one touch phone. She can call me any time by lifting the receiver and pressing the key printed with my name. She is still able to read so instead of photos I printed names of family members on each key and programmed the phone with their numbers so that she is always able to reach someone.  When she calls several times in an hour I put a sign on the phone: "Linda is taking a nap, call if there is an emergency." This has worked so far. 

How I cope with "Why has this happened to us?"--A real change in my perspective occurred with the experience I describe in this post entitled Farther Along...
 Further information of the practical sort is available in the post entitled How We've Managed Thus Far. 

I'm praying now for every caregiver who reads these words, and also for your precious care recipients.  My heart goes out to you.  Let's pray for one another as we walk this caregiving path together. 

Monday, October 27, 2014

Healing Balm

I have suffered an attack of hip bursitis, which, as a helpful internet source tells me, occurs mostly in  middle-aged and elderly women. 

Sigh.

Bursitis often erupts following unaccustomed physical exercise. I had begun a brisk walking program, and in a burst of overconfidence chose to do my middle-aged/elderly version of a jog up and down a small hill adjacent to our house.

My right hip now hurts, especially at night. I am biding my time and praying to avoid things like doctor visits and cortisone shots, and if you would pray this with me I would be very grateful.

This morning I made my awkward, grumbling way out of bed and staggered over to the mirror that hangs above the old oak dresser. I'd not slept much, and though I ought to have reached for my Bible, had spent fruitless time worrying about my Alzheimer's mom and the future instead.  I leaned toward the mirror and examined the circles beneath my eyes in close detail, which did not improve my mood. Quoting Gideon, I addressed my reflection:  "If the Lord is with us, why has all this happened to us?" (Judges 6:13).

I now feel silly and melodramatic as I confess how upset I felt over an aching back and my healthy, albeit dementia-impacted, 90-year-old mom.  But there it is; this morning I placed my relatively minor trials on a par with being under siege by Midianites, and I felt I understood Gideon's plaintive question. Why, Lord?  If You are with us why do these things happen?

I wept a little (self-pity, no doubt) and then reached for a tin of Cloverine salve and applied the comforting stuff to my reddened nose. My poor nose is often irritated this time of year with seasonal allergies, and I'm always a little surprised at how much discomfort a stinging, chapped nose can cause. But when I carry my trusty container of Cloverine with me and reapply often, I have no discomfort at all.

At this I felt the little heart nudge that tells me the Lord would like to make a point, although I admit I was a bit hesitant to accept an analogy between the healing balm of Gilead and my humble pot of Cloverine. But the connection is obvious, even to a middle-aged (or elderly) woman who has a hitch in her get along and an Alzheimer's mom: I can receive healing and strength if I will liberally partake of Scripture and reapply as needed.

Cast all your anxiety on him, because he cares for you.  
--1 Peter 5:7