Thursday, December 1, 2016

Dangers of Food Aspiration in Elderly Dementia Patients

I want to pass on a word of warning from my blogger-world friend, Jennie, whose sweet Alzheimer's  mom recently entered into the Lord's rest. Jennie knows that my mother is in a nursing home, and wrote a thoughtful email encouraging me to monitor Mom's mealtime habits as her Alzheimer's progresses. Here, with Jennie's permission, is her quote about the care that needs to be taken with elderly dementia patients to help them avoid aspirating food: 
I don't think people understand (I didn't) how often oldsters succumb to pneumonia due to aspiration of food. Some people even privately hire people to come feed their loved ones at meal times. The aides are hassled and overworked, and just don't take the time to be sure the person has thoroughly chewed and swallowed before they put the next forkful or spoonful up to the mouth. People often also don't understand that one of the features of Alzheimer's is that the brain forgets NOT just memories and other cognitive things but forgets how to walk, how to chew, how to swallow. I think there needs to be more awareness of this and if there is a way for me to get this out there I want to do it.
 Jennie also mentioned an interesting study that has been done on the efficacy of soliciting volunteers to help elderly patients at mealtime in order to prevent choking, food aspiration, and nutritional deficits when patients become unable to feed themselves.  You can find that study here:

Thank you Jennie, for taking time to help others during this difficult time of grief.  Our prayers are with you. 

Sunday, November 27, 2016

Jealousy Blinds Us to Blessings

I took care of my mother in my home for 12 years following her diagnosis with Alzheimer's.  My one, repeated prayer during that time was "Please don't make me put Mom into a nursing home." I'd been horrified at my beloved grandmother's rest home experience, and felt that all my sacrifices on Mom's behalf would be worthwhile if only I could avoid enduring the agony of watching her go through a similar trial. But in the fall of this year, Mom's needs increased just at the time I was facing numerous small but strength-draining health challenges. I became physically unable to meet her needs and was forced to do what I felt I'd paid my dues against; we placed Mom into nursing home care.

As I watched Mom struggle to adapt to her new schedule, I suppressed resentful thoughts toward the Lord. I kept up a cursory morning devotion time but stopped praising or reading very much Scripture at all. However, resentment can't be repressed for very long; it is like bacteria that grows exponentially and causes infection. I began expressing anger toward my husband over inconsequential things. The past, no longer bathed in the clean light of the faith that had led me to the decisions I'd made, became darkened  by a vision-clouding haze of resentment that tainted every thought and memory. Years after the fact, I became angry that I'd  quit my job to take care of my mother as others kept right on building fat retirement accounts. I no longer thanked God daily for the many, often miraculous ways He has met my needs. 

We don't recognize jealousy for what it is; we think it is as simple as wishing that we possessed something that belongs to another. But true covetousness, the kind forbidden to God's people by the tenth commandment, is a deeper and more perception-bending sin than a mere, oftentimes fleeting desire that our possessions were as nice as those of our neighbors. It is when we withhold compassion and empathy from those who need it--justifying our hard-heartedness because they are more blessed than we--that covetousness becomes commandment breaking, God-displeasing sin. I coveted the lives of other people that I viewed as having had easier paths than my own. I dreaded my daily trips to the nursing home, and my appointed ministries not just to Mom, but to other residents there. In her classic book, The Christian's Secret of a Happy Life, Hannah Whitall Smith describes this resentful, covetous state of mind: "I felt as if any kind of manual labor would have been easier, and I would have preferred, infinitely, scrubbing all day on my hands and knees, to being compelled to go through the treadmill of my daily Christian work. I envied...the servants in the kitchen, and the women at the wash-tubs.”

Sometimes, before we can be truly thankful for our blessings, we have to repent of sin. My sin has been a bitter envy of other people's easier-looking lives; Lord forgive me. I haven't given God the praise that is His due even though I've been aware of His gracious provision for me through this hard time (for example, on a recent drive to the nursing home I plowed into a deer at 55 mph, with no damage to me, little damage to the car, and even the deer seemed ok). I have been like a child who eats a meal her parent has prepared, but complains that the food is not presented on her favorite plate.

Repenting of this jealousy and anger I've been carrying around is such a relief.  My vision has cleared and I am able to praise my Lord without reservation this morning.  Blessed be His Name!

When my heart was grieved
    and my spirit embittered,
I was senseless and ignorant;
    I was a brute beast before you.

Yet I am always with you;
    you hold me by my right hand.
You guide me with your counsel,
    and afterward you will take me into glory.

Whom have I in heaven but you?
    And earth has nothing I desire besides you.
My flesh and my heart may fail,
    but God is the strength of my heart
    and my portion forever.

Psalm 73:21-26
In an amazing postscript, this afternoon when I visited Mom she was unusually, amazingly lucid. Much of the time, she is unaware that she is in a nursing home, but tonight she said, "You know, all my life I tried not to dread the possibility of being placed in a nursing home, but I did dread it anyway.  But this is so comfortable!  I am content, and grateful."  She was actually looking at me, with good eye contact, and so I snapped her photo and didn't realize until I got home and reviewed the photos I'd taken that a beam of light was falling on her, as though the Lord was showing me that He is with her, and she is under His protection, and that this is the way He is answering my long years of prayers that we could avoid nursing home care for Mom.  I have been relieved of the heavy burden of her daily care, and Mom is content.  I couldn't receive this blessing until I released my idea of how things ought to be, and repented of my vindictive jealousy toward people who don't have to deal with Alzheimer's disease. Mom's nursing home experience has been nothing like my grandmother's. God has taken such good care of us, and I'm grateful.  

Sunday, November 13, 2016

Not Only Survive, but Thrive

One of my current blessings: my daily trip to the nursing home offers beauty that nurtures my spirit. This has been an autumn of unusual, gold and green color, especially in the late afternoon when  I'm driving home after a visit with Mom.     
My high school home economics teacher taught us that whole cow's milk is such a complete food that one can live on milk, and milk alone.  "We can not only survive, but thrive on this food that offers everything our bodies need," she said. Although modern knowledge of nutrition would argue with her assertion, the phrase, "...not only survive, but thrive..." has stuck in my head over the years.

This morning, after my visit to the nursing home, I thought of how God's provision to us during adversity could be likened to what we once believed about the merits of milk; during hard times we can not only survive, but thrive because of His love.  Scripture says it like this: "You intended to harm me, but God intended it for good to accomplish what is now being done..."  (Genesis 50:19). This is from the account of Joseph, who suffered greatly at his brothers' hands, but was used by God to save his people from famine.

There is comfort to be found if we will look for God's hand even in things that break our hearts. It isn't that circumstances are magically made easy by this practice; I have encountered real difficulties during Mom's transition to nursing home care. However, I've also been provided the strength I need to meet those challenges along with some unanticipated blessings. For example, I've lost a good measure of my fear of nursing homes as I've spent time in the one that provides care for my Mom, and I've made some friends of several of the elderly patients I've met there.  I didn't know how much I missed being the youngest person in a room!  Their sweet smiles, kind gestures, and even their aged, gravelly voices have ministered to my heart in ways I didn't know I needed.

Now, I don't believe God has caused the hardship of Mom's Alzheimer's just to bring about these blessings.  But I have learned that if we look for His provision in the middle of difficult times, we will find what we need not only to survive, but to thrive.

Sunday, October 30, 2016

Joy Comes!

A few years ago, I attended a tractor pull during our little town's Fourth of July celebration. The tractors competed to pull a weight transfer sled, and the winner was the one that traveled the longest distance before grinding to a halt. Three months ago when I became unable to provide care for my mom,  I felt like one of those tractors that had become unable to pull a steadily increasing weight.

Placing Mom into nursing home care has only signaled a new phase of this 12-year-and-counting "pull." Don't misunderstand; we have been constantly aware of the Lord's provision for us throughout the challenges we've faced. There has been grief, but there has also been sustenance in the midst of the sadness; we have had oases of peace and laughter.

There have been multiple touch points of grace; incidents that have illustrated God's promise that there will be a season of peace and freedom from sorrow, even before that final going home we as Christians are promised.  One of these occurred at the beginning of my time of caregiving when our elder law attorney spoke words I've not forgotten:  "Linda, there will be life for you after your mother's Alzheimer's." This statement hit my heart with Holy Spirit fueled truth, and I received it as a promise from the Lord.

Yesterday I returned home from a truly awful session at the nursing home that had to do with some neglected caregiving issues and miscommunications. By the time I reached home I felt battered and worn.  I had nearly forgotten that my adult son had asked if the wives and young children of his 3 closest friends could "hang out" at our house while the men did some skeet shooting on the hill above our house. I had gladly agreed; I love having these wonderful young people in our home.

When I opened my front door, the first thing I saw was a beautiful 13 month old baby boy toddling across the carpet. He stopped and gazed at me with wondering eyes.  A four-month-old was laying on a blanket having "tummy time," and my own precious 11 month old granddaughter toddled from her mother's arms to mine.  She blew kisses, wrinkled her nose, stuck out her tongue, then obligingly tilted her bowed head toward me for Grammy's customary "kiss on the head."  Finally, three little boys ranging in ages from 2 to 3 came tearing around the corner brandishing light sabers. It would have taken a deeper depression than the one I was harboring to have resisted such a greeting. My mood lightened.

I am grateful for these years of caregiving. I've learned so much of God's faithfulness through trials, and it is a testimony to His virtuosity that the very things Satan designs to destroy us become stepping stones to blessing. But I am also grateful for promised joy when sorrows come to an end.

...weeping may endure for a night, but joy cometh in the morning.
Psalm 30:5 KJV

I remain confident of this:
    I will see the goodness of the Lord
    in the land of the living.
Psalm 27:13 NIV

Monday, October 24, 2016

When Heaven Touches Earth

Anna Ruth and her great granddaughter, Rebekah Ruth

This is a sad time but there are joys interwoven amidst the grief I am feeling.

The photo above touched my heart deeply not only because both people in the picture are precious to my heart, but also because it reminded me of a series of little miracles the Lord has done for us in the past couple of years, miracles I had actually, if not forgotten, dismissed in some way so that they had lost their power to encourage.

I think it is important to recognize small coincidences as being God's way of touching our earthbound timelines with a little bit of Heavenly light, and that we ought to treasure these small miracles in our hearts, tucked away as protection from the discouragement sorrows can bring.  Our memories of how the Lord has blessed us in the past build faith that He will continue to bless us in the future.

I have shared this story before, but as I've received new understandings of the depth of the Lord's love through these seeming coincidences, I want to share it again!

Our little miracles arrived in this way: About 18 months ago both our daughter and our daughter-in-law announced their pregnancies.  Our grandson and granddaughter were born in the fall of 2015, one month to the day apart. Independently of one another, these two couples chose Biblical names for their children.  My daughter awoke with the word, "mirth," in her mind one morning and after thoroughly researching boy names that might mean mirth or laughter, she settled on the name Isaac.

Our daughter-in-law wanted her daughter named in remembrance of a beloved aunt who spelled her name Rebekah, like Isaac's wife in the Bible story.  And so our family welcomed Isaac and Rebekah, and we smiled at the coincidence, and we felt the Lord smiling with us.

But the little miracles didn't stop there.  Again, without consulting one another or me, my children decided to give Rebekah my mother's middle name, while Isaac received my father's middle name. Imagine the fullness in my heart when, in the midst of my grief over losing my mom and the always present sorrow of missing my dad, we welcomed little Isaac Lee and Rebekah Ruth.

I did not know myself, at the time, how I would feel to lose the last member of the older generation on my side of the family.  I will be the only one left when my mother passes away; there will be no remaining older relatives who share my maiden name and history. I have cousins, and cousins are great blessings, but it has been several years since I saw my closest cousin for a face-to-face visit.  I have no siblings. Having grandchildren who bear my parents' names means more to me than I first understood. My dad and mom have great grandchildren who will carry their names to a new generation, but more than that, my heart is comforted on levels that only the Lord knew I would need as I traverse my mother's transition to nursing home care and the rapidly approaching end of her journey through Alzheimer's.

Wednesday, October 19, 2016

Mom's Wallet

I've been cleaning Mom's apartment, preparing for its transformation from "Mom's room" to "family room." It is a bittersweet time as so many of you have experienced; sorting through old photos and possessions and making decisions about items to send to Goodwill is heartrending.

At the nursing home just recently. 
I opened Mom's top dresser drawer today and found her wallet.  When she came to live with us twelve years ago this month, I remember hesitating as I emptied her purse and billfold.  In a moment of wisdom that was surely from the Lord and not of me, I reassembled her wallet and included some money, her library card, a blood donor card, and other items that would not be missed if she threw them away or hid them.  I put the wallet in plain sight on her dresser, and whenever Mom asked if she had any money left, I was able to show her that familiar wallet.  Sometimes she wanted to hold it awhile, but usually she just handed it back to me, reassured.

It is important for dementia patients to retain as much of a sense of dignity and adulthood as possible.  Although Mom is past the need for such reassurance now, I am glad that as a fledgling caregiver I had the wits to preserve an appearance of independence for her during the time such things provided her comfort.

Mom has transitioned to nursing home care as well as can be expected. My heart tells me that we are traversing the final days of her journey through Alzheimer's. While I would much prefer to avoid this present sorrow, the sweetness of the Lord's presence and solace provides comfort that nourishes and strengthens.  Thank you for praying for us.

Monday, October 3, 2016

Imperfect Christians

Most of us spend a tremendous amount of energy constructing and maintaining our personae. I'm talking about outward appearances: lawns that are mown, cars that are washed, clothing and hairstyles that are, if not fashionable, at least clean and acceptable. We follow rules set down for us by the culture in which we live, and fall to self-condemnation when we begin to drown in the overwhelm of our impossibly ambitious lists of endeavors.

A depressing number of conditions can cause our carefully constructed veneers to erode. Sickness can do it; any determination to "be nice" quickly falls away when our bodies are in pain. If we've maintained our exteriors at the expense of our spirits, it's worse, because all the vexations that we've secretly harbored toward others--those things we've bypassed through strength of determination to appear kind or Christian--quickly boil to the surface. We lose the ability to contain irritation. Sickness, old age, or physical pain peel away an outward mask of good appearances.

There is a misconception that Christians ought to be exempt from such petty, human vices as irritability or venting of negative emotions, regardless of difficult circumstances. A few days ago, my mother was angry with her caregivers at the nursing home, and, utilizing the only effective weapon she has left, was criticizing every person who had the misfortune to have been assigned duties on her behalf. Mom is still able to use words as barbs, and her young caregivers received the hurt. One of them rolled her eyes heavenward and said, "And she's supposed to be so religious!" I was stung, because I could see the enemy at work, undermining the Lord's transforming power in my mother's life.

The idea Satan wants to put forth is this: "What's the good of a religion that doesn't make you nice?" This marginalizes the miracle of salvation; deliverance through Christ does not make us instantly nice; it makes us instantly saved. Through Jesus we are exempted from the terrible penalty we would otherwise suffer for all eternity because of sin that goes well beyond the parameters of being merely "not nice."  

We are a broken people. We are sinful, but when we accept the cleansing blood of Jesus Christ, we become children of God. From that moment forward (and perhaps, because of prevenient grace, even before) He begins to form and sculpt us according to His will. We aren't yet whole but we are being made whole. We aren't perfect but we are being perfected. One of the enemy’s strategies against us is to point out our remaining imperfections and say, “Oh my, how can that person say he is a Christian when he acts like that?”  It is no more appropriate to refer to a Christian's sins and say that because of them, that person is not a Christian, than it is to point to a partially melted ice cube on a sidewalk on a 99° day and say, "It's not water because there's still some remaining ice." Once we place ourselves in the path of God's healing light and love, his work begins. Sin that remains is melting away.

The enemy knows his time to condemn is limited. His only recourse is to point out the rapidly diminishing block of sin that remains and attempt to use it as evidence that no transformation has begun. I want to say to my mother's new caregivers, "Take a closer look. She sins with her words, but even in her current state--elderly, brain-damaged and nearly blind--the Holy Spirit is at work in her heart. The next time you go into her room she will say, "Thank you for all you do for me," or "I love you." And in her prayers she often says, fervently, "Lord help me speak and act as you want me to do. Forgive me when I don't."  

My mother isn't yet perfect but she is, even at age 92 and 12 years into her journey through Alzheimer's, still being perfected by the Holy Spirit's power within her. I pray for her caregivers understanding that evidence of remaining sin does not negate the work of God in her life.