Monday, May 2, 2016

Coping With Verbal Abuse

I'm embarrassed to write about this subject, but I think it is one that others suffering the same kind of trial might need to think about with me.

I'd not thought of myself as a victim until recently, when I staggered out of my Mom's apartment, fell into a chair, and said to my husband, "I feel like I've suffered abuse." He didn't laugh, as I thought he would.

He looked sad, nodded his head, and said, "Well, you have." 

My husband's affirmation of my sense of being mistreated somehow made it real for me. Mom is often verbally abusive, and the shift in my thinking of our relationship as one in which verbal abuse occurs has helped me to see the unwise, victim-like behaviors I exhibit that make her more likely to berate me.

An abuse victim will repeat the behavior that elicits an abusive response. The psychology behind this is that we hope this time the loved one will respond with acceptance that heals past hurts. Of course this doesn't happen.  Behaviors I find myself repeating to no avail are to plead with my mother to stop saying mean things, tell her she is hurting my feelings, or worse, pull a power play and forbid her to speak (which seldom works). The pleading elicits a mocking response from Mom that is hurtful, and ordering her to be quiet makes me feel wretched and affirms her low opinion of me.

Here are some things that I've recognized I need to change: 
1. Respond as a caregiver, not as a daughter.  Assume a professional demeanor, stay calm, and use a neutral voice tone.
2. Recognize that physical discomfort can cause aggression. An Alzheimer's patient can't process information normally, and may feel that the caregiver has caused the pain.  
3. Remember that dementia patients may be unable to explain exactly what is wrong or why they are upset. This may result in agitation that focuses on caregiver as a target. 
4. Don't underestimate the power of kind touch; a back rub or a pat on the arm might help when words won't work (but don't put yourself within reach of a patient who is volatile). 
5. Leave the area as soon as you can safely do so and try again later to complete the task that elicited the negative response. Pick your battles, for example, dry shampoo can be used every other shampoo or so if your care recipient objects to hair washing.  
It's difficult not to receive heart wounds from a patient who is able to draw upon long term memory to outline the caregiver's faults and failures with devastating accuracy. We must pray for wisdom about when to seek other care options for our loved ones.

Many Scriptures minister to the needs of those who suffer. This shows us that suffering isn't such an unusual thing, and reminds us that God provides for us through the discomforts we must bear.


So if you are suffering in a manner that pleases God, keep on doing what is right, and trust your lives to the God who created you, for he will never fail you.
1 Peter 4:19 NLT

Tuesday, April 26, 2016

Loving Like He Did

I read this Andrew Murray quote the other day and it has troubled me since. I'd snapped a lovely phone photo of spring trees, and as I worked to create a word picture of Murray's quote superimposed upon that picture (see above), my sense of guilt increased.

I've read that we should treat one another as we would treat the Lord Himself, and I have failed.  "As ye have done to the least of these, my brethren, ye have done unto me..." is how I remembered the Scripture passage from Matthew 25:40.

To make matters more uncomfortable for me, I'd read a blogpost by a beautiful lady who spends most of her time with her Alzheimer's mom cuddling and telling her how much she is loved. But she also said that she is fortunate to have several paid caregivers for her mother. I, on the other hand, am my mother's all-in-all. I bathe her, shampoo, cut, and curl her hair, change her soiled adult diapers each morning, remind her to take bathroom breaks every two hours during the day, prepare and serve all her meals, do the daily cleaning chores in her apartment, etc. etc. We do have respite care once a week so I can buy groceries, and my husband and I usually go out to lunch together on that day.

All this isn't as bad as it sounds; my mother pays me a small salary, the work is fitted to my stamina level, and I've been spared the sorrow of putting Mom in a nursing home before she was ready for such a placement. However, I'm firmly cast in the role of "needs provider" in my mother's mind, and this is not conducive to her seeing me as a loved one. She resents me as a child might resent a strict teacher.  I rub her back with lotion, I see that she is bathed thoroughly, and I wash her feet, but the Lord sees the attitude of my heart. The actions may be loving but my heart does not feel kind, especially when Mom berates me as I carry out these ministrations.

I took my sense of failure to the Lord, and was blessed by His response.

First of all I felt the comfort of interpreting Matthew 25:40 a little differently than usual. Today it occurred to me that whatever I do for those in need, I do for the Lord rather than to the Lord.  Instead of thinking of Jesus as the poor victim of Alzheimer's, I was led to think of Him as standing beside me as I minister. Mom often lashes out at me, and my attempts to think of her as I would of Jesus  made me prone to receiving her condemnation as though I were receiving from the Lord Himself.

It helped me to think of Mom as being beloved of the Lord, and as though I'm caring for her on His behalf. It's as though He's standing next to me, giving instruction, nodding approval as I tend to her needs. And sometimes He gives me a hug of compassion when my heart gets hurt. On the occasions when she's crossed a line of verbal abuse to a degree I can't bear any longer, He's escorted me from the room, soothed my heart, and enabled me to go back and finish my assigned tasks.  

The difference in this visualization keeps me from feeling chastised by the Lord.  I had thought I was to imagine my ministry to Mom as being ministry to Jesus Himself. So if I lost my temper with her, or had to leave the room, I thought I was betraying the Lord.  Even for those who don't envision ministering to the Lord, ministering to a parent carries some of the same hazards. We aren't supposed to feel negatively toward our parents. But if we think of the Lord as being our helper rather than our chastiser, the burden lightens.

Here is what I'd say to someone facing similar caregiving emotions: 
The Lord is at your side. He is encouraging and helping you. When your heart is hurt, He feels compassion and love for you. He understands your sorrows, He supports you as you are being abused, and He is actively at work on your behalf. He sees that you have continued in ministry, even when it is difficult, for the sake of the love you know He holds for your care recipient. Minister, not so much on God's behalf, as in His strength. The Lord is with you. 

For those of you who have graciously supported Mom and me with your prayers, I'll share that I believe we are drawing near the time that I will place her in the care of others. Please pray for us that at the end of Mom's Alzheimer's journey we can have a season during which we effectively communicate the emotional and spiritual nurture of loving one another in the Lord, unclouded by those inevitable caregiving tussles. 

Saturday, April 9, 2016

Did you get Mom out of the drawer?

Baby monitors let us hear Mom call even if she is unable to reach her one-touch phone.
The title of this post probably has you a little concerned, but it isn't as bad as it sounds. Let me explain quickly, before you navigate away from this page in dismay.

My mom has her own living area attached to our house, a mother-in-law addition if you will. Mom's cat isn't allowed in our part of the house because of the grandkids' allergies, but when her door is closed I don't have confidence we could hear her if she called. And so we have a baby monitor in Mom's apartment with two parent units in our part of the house, one upstairs and one downstairs. But during the day, Mom's music selections emanating from the monitors bother me. She loves jazz, I do not, and I'm one of those people who have trouble concentrating if music is playing constantly (yes, doctors' offices drive me nuts...).

I have learned that if I will turn the upstairs unit to the lowest setting and slide it into the top drawer of a bureau in the hallway, I can still hear Mom's outside door alarm, her smoke alarm, and her voice if she calls loudly, but the music is blocked out. At night we always turn the monitor to it's loudest setting so we will be certain to awaken if there are unusual sounds from Mom's rooms. Thus, when my husband and I go to bed each night one of us usually says to the other, "Did you get Mom out of the drawer?"

This has made me think about how easy it is to be misunderstood when one is taking care of someone with dementia. Appointments with Mom's physician can turn into a comedy of errors as the doctor, following good patient protocol, addresses all questions to Mom rather than to me as her caregiver. With a short term memory of about 5 seconds but still very bright in the moment she is in, Mom utilizes her ample store of creative imagination as she replies. This has led to some interesting situations. The poor doctor often receives two very different accounts of the reason for our visit, and though inevitably inaccurate, Mom's version often sounds more credible. 

Mom is proud of her pretty apartment and has no idea she is not the one who works hard to keep it that way. If the windows are clean, she must have washed them; if the afghan on the couch is attractively displayed, she must have arranged it thus. She once told our pastor that she uses vinegar and water to wash the windows, which caused him justifiable concern because Mom is short and the windows are at a height that require a step stool. I could see by the concerned expression in his eyes that he believed I had allowed my 91-year-old mother (who uses a walker) to climb a ladder to do my household chores.

If any messes are apparent though, Mom is fully convinced I am to blame and doesn't hesitate to absolve herself of responsibility before guests. She knows she would never allow such a situation.

However, as the story at the opening of this post proves, my husband I are perfectly capable of fostering misunderstanding even without Mom's input. For example, in order to mute Mom's music in our downstairs area, the living room baby monitor is often pushed beneath a cushion on an overstuffed chair, a maneuver that allows louder noises to gain attention but mutes the offensive-to-me Jazz selections. This evening I was on my way into the kitchen to work and was afraid I might not hear the monitor. As I left the room I turned back toward my husband and said, "Would you get Mom out from beneath that chair cushion?"

Thank the good Lord no one else overheard that one. 

Saturday, April 2, 2016

Hug a Baby, Pat a Dog, Stew a Chicken....

Depression is a horrid side effect of taking care of someone who has dementia. I am worn down not only by my mother's illness, but also by wearisome physical problems of my own, and I have an embarrassed suspicion that some of those symptoms are magnified by depression and grief.  Why embarrassed? Because of long schooling that such suffering is not "real."

But it is.

Grief and depression can feel like a bad case of the stomach flu. Logic tells us it is temporary, but our suffering hearts and bodies don't really believe it.  I was weeping before the Lord this morning and was reminded--and want to remind my fellow caregivers--of His compassion. He knows our hearts. He loves us. He won't let go.

This morning I felt overwhelmed by upset over our messy yard, dandelions peeking through the grass, and a broken down chain link fence (courtesy of our great big yellow lab named "Moose").  Everything seemed horrid.  I can't even express the despair I felt over the hedges that will need to be trimmed and the stains on the side of the vinyl (vinyl-ugh!!)) siding.

I took a nap.

When I woke up I still felt despair. But I pulled out my phone and scrolled through the photos of our baby granddaughter. She visited for a few hours yesterday, and the photos show her full repertoire of expressions, which, for a four-month-old, are truly amazing. She is adorable whether pouty, flirty, mad, sad, or joyful. 

I then donned an eccentric looking sunhat (necessitated by my newly diagnosed Rosacea) and, averting my eyes from the mirror next to the door, went outside.  The dog-who-destroyed-our-fence came dancing up to me and bowed, hind end in the air, tail wagging. I relented and patted his head. He went into an ecstasy of blundering happiness and offered me his favorite bone (when I reached for it, he changed his mind, but still).

I wandered out to last year's flower garden. I couldn't pick up a hoe or get to my hands and knees because of a fibromyalgia/arthritis flare, but I found that the sage had overwintered and plucked a handful. And last year's rosemary is still fragrant; it was such a mild winter. I love the scent of rosemary.

I came back inside, cleaned the kitchen, and put a chicken on to stew. Onion, sage, celery, garlic, and rosemary--oh my goodness; aromatherapy!  I went back outside, shooed the dog away and sat on the porch.  It is absolutely amazing how much better things looked.  The lawn was still unmown, the fence looked terrible still, but I felt better. And I like my little yellow house, vinyl siding included. 

On some days the heaviness of sorrow nearly paralyzes me, but if I can just open my Bible, pray, and maybe go ahead and cry, I'm released to move forward.

God is good.  We are blessed. The Lord is with us in the sorrow and He will bring us through.

Strength for today, and bright hope for tomorrow, 
Great is thy faithfulness, Lord unto me.  
--from the Hymn Great is Thy Faithfulness

Friday, March 25, 2016

Our Hearts Will Warm Again

It is human nature to believe that whatever state our hearts are currently experiencing is permanent.

When we are content and our circumstances are easy, we feel things will always be that way, and this is the time we are most prone to forget the Lord. I've always thought we are safest spiritually when things are a little bit difficult, because it is when we are aware of our own weaknesses that we are more likely to depend on God's strength.

But there comes a time in most lives when our hearts are numbed by terrible grief. When a loved one dies, our lives are irreversibly changed, and sometimes the grief is so overwhelming that we are unable to pray. Sometimes, though, we suffer ahead of the final parting. Watching a loved one fade away due to dementia causes grief that is compounded by uncertainty; we don't know how or when it will end. 

I remember the Abraham Lincoln quote

Perfect relief is not possible, except with time. You can not now realize that you will ever feel better. Is not this so? And yet it is a mistake. You are sure to be happy again. To know this, which is certainly true, will make you some less miserable now. 

The Lord expressed this thought a little differently, emphasizing that our only hope for today or tomorrow is in Him:  "You will grieve, but your grief will turn to joy...Now is your time of grief, but I will see you again and you will rejoice, and no one will take away your joy" (John 16:20, 22). Because of the life, death, and resurrection of Jesus Christ, we don't have to suffer grief alone. He sent His Holy Spirit to us so that we will never be left without comfort.

Until grief eases and our promised joy arrives, we can rest in the certainty of our our Lord's abiding presence with us.

Tuesday, March 15, 2016

Connected by Love

The long goodbye of Alzheimer's holds a few blessings. One of these is that this slow progressing disease allows us time to adjust to the fact of a loved one's leavetaking; it is somewhat like removing a band-aid very slowly rather than ripping it off suddenly. I've come to accept that the Lord in His wisdom has granted me a good long time to release my mother into His care.  

After all these years of caregiving, I think I'm finally recognizing some truths that make this release a little less painful. All human relationships are tainted in some way by sin, and when a sinful pattern of interacting with another person becomes familiar--most often because it began in childhood--we may grieve its loss.  Haven't there been days as caregivers when we would welcome familiar sorts of arguments or critiques from our loved ones just for the sake of having them back as they once were?  But the Lord isn't with us in grief over what ought to be a release of the burden of human vices that are familiar and thus "dear." Dwelling in a human grief over these kinds of sorrows can separate us from the Lord and block our praises.  

When familiar, negative patterns of interacting endure into a caregiver/patient relationship, the results can be just plain awful, and so our challenge is to release human, sin-based ties while keeping the strong bonds of love that run beneath. Love is eternal, and when backlit by the Lord's presence, can bring beauty into the most broken of relationships.  This is how we can be sweet to a dementia patient who is displaying anger; we remember the love that runs beneath the negative behaviors and pray for the Lord's love for the patient to shine through us. I visualize His strong, supporting love as a brightness that illuminates what is positive in my emotions toward my mother and powers my own love for her into my behaviors. 

When our loved ones die, we aren't to grieve as those who have no hope. What is lost isn't worth keeping (anger, resentment and bitterness can't enter into Heaven) but what is blessed will remain.  People we love in the Lord aren't lost to us. We remain connected in the Lord even though Alzheimer's might mask the love a patient once was able to express, and even after our loved ones pass away.  In Christ, we remain connected by the strong cords of His love, even through the challenges and sorrows of Alzheimer's disease.

Sunday, March 13, 2016

Little Miracles

Mom with her great grandson, Isaac Lee. 
Our Lord interacts with us in unexpected ways, and I've come to believe that we miss a lot of little miracles because we aren't looking for them. Once in awhile, the Lord reaches out to us in a way that seems so strangely coincidental, we are prone to dismiss a God-connection because, well, it just seems too unlikely.

Discouragement can blind us to the little ways the Lord seeks to reassure us of His active presence in our lives.  Caregiving can be a discouraging job assignment, and it's good to be intentional about keeping the depression of discouragement at bay. One way to do this is to pray that the Lord opens our eyes to the many ways He shows us that He is not a God who is far off, but is intensely interested and involved in our everyday lives.

I was thinking today of one of those unlikely little coincidences that occurred when my daughter was about 4 months pregnant with her third son.  She had chosen a name that I just didn't think I liked.  It was a little unusual, I thought, and I wanted our newest baby to have a good strong name like his brothers, Daniel and Logan.  I had given the matter cursory prayer, but had nearly decided to urge my daughter not to name the child Isaac as she had mentioned. The baby's middle name would be Lee, after my father.

I was thinking all this over, and feeling conflicted about it, because I didn't want to be negative or interfering. But I knew I had influence with my daughter and that if she believed I thought her name choice not a good one, that she would probably go with another selection.  An episode of Antiques Road Show was playing in the background as all this was going through my head.  Suddenly, a snippet of dialogue from the program sounded crystal clear, "...cartographer Isaac Lee."

I grabbed the remote, skipped back, and listened again. Back in the 1800's, a man named Isaac Lee had done work on a map they were showing on the Antiques Road Show.  The name "Isaac Lee," as it fell from the narrator's lips, sounded beautiful to me. And this was more than enough impetus for me to keep my maternal mouth shut about my opinion of my daughter's choice in names.

Five months later, Isaac Lee was born, and I now truly do believe he has a beautiful name.

Here's the clincher.  My daughter-in-law was also pregnant at the time. She and my son decided to name their little daughter "Rebekah Ruth."  The middle name is in honor of my mother.  The two couples chose their babies' first and middle names without consulting with one another.

And so we have new babies in our family named "Isaac and Rebekah..." (you'll remember the Biblical account of Isaac and Rebekah) and as if that weren't a cute enough coincidence, their middle names, Lee and Ruth, honor my parents: Robert Lee and Anna Ruth.

Little miracles.  May our hearts be open to the ways the Lord desires us to receive reassurance of His active presence in our lives.  

Rebekah and Isaac