“Don’t Call Me Spry”

It’s a shock to the system when you realize someone thinks of you as “old.”

For me, it happened when a fast-food cashier rang up my order with a senior discount—and I was only 50.

For Win Couchman, it happened when she ran into an old friend who commented, “You’re so spry!” “Spry” was a “compliment reserved for exclusively for old people.”

As the shock of this well-meant statement brought Win to tears, she began to consider aging.

I am at the young end of old: junior-high old. Youth is gone and now, also, middle age. My life at sixty-four is rich, adventurous, blessed, and full of joy (p. 2).

I am not only wrinkling. I am growing. And while I am forgetting some things, I am learning much that is new. This season of my life is as fearsome and exciting as turning fourteen. Nobody told me it would be this way (p. 3).

She decided to investigate “what it means to grow old” from the Bible, culture, the examples of older people in her life (“Not everything I learned from Grandmother about aging was glamorous, but all of it was valuable” [p.84]). She wanted to “notice and enjoy the perks that come with old age” (p. 4).

The results of her study and contemplation is “Don’t Call Me Spry”: Creative Possibilities for Later Life.

Win noted, “The halves of my life each merit my attention. The tension between the material and spiritual aspects of reality are normal. The struggle is to keep a balance: to live in light of the unseen while resetting the washer from ‘permanent press’ to ‘delicate fabrics.’ In order to live for God’s glory and not lose heart, I have the perspective of the eternal as a gift” (p. 4).

In their fifties, Win and her husband, Bob, began to pray and consider what to do when he retired. For many years, they had hosted a ministry called Forever Family which combined hospitality, mentoring, counseling, and teaching. But they were sensing maybe the time had come to do something different.

Through a series of events and contacts, the door eventually opened for them to minister in a variety of other countries eight months out of the year. They enjoyed the novelty and the opportunities to minister, resulting in some never-to-be forgotten experiences.

But they also experienced stresses with travel and continual adjustments, and they handled them differently. She liked to talk things out when stressed or anxious; he withdrew and became quiet. I’m sure those tendencies were always a part of their personalities, but these new experiences brought them to the forefront and required them to meet each other half-way.

Bob’s retirement brought other stresses and adjustments, like sharing space that she had previously had to herself.

Then new stresses arose when Win developed a heart issue which brought not only their international travel to a close, but their full-time active ministry as well. She had to rethink what she could do within her new reality. “It grieved me to give up thinking I could do anything anyone even a generation or two younger than I can do” (p. 45).

It saddened me to give up the illusion that I could always push myself a bit more if I needed to, that pushing was the thing to do. I could no longer be casual about getting too tired. I was newly aware of another true separation between me and those who are younger (p. 46).

She tells how God led her to other types of ministry, mainly mentoring, prayer, being involved with her grandchildren. She still taught and spoke on a limited basis.

One of my favorite chapters is “The Downside,” dealing with some of the negative aspects of aging. “When you ask me how I am, sometimes it is a little hard to know how to answer” (p. 107).

But even though Win describes herself as a pessimist, overall the book is hopeful and positive. The Bible assures that God’s care and love and grace will always be with us. In addition:

As I have looked repeatedly into the mirror of these verses, I have not only been provided with new assurance of God’s caring for me, but I have a greatly enhanced concept of the possibility of lifelong usefulness (p. 136).

While searching for more information about Win, I came across this video of her.

I had not heard of Win before until I read a chapter by her in The Wonder Years: 40 Women over 40 on Aging, Faith, Beauty, and Strength compiled by Leslie Leyland Fields. I didn’t discover until recently that her chapter, “The Grace to Be Diminished,” originally came from a magazine here. Then I found her poignant article, “The Beds I Have Known,” about living separately from her husband of 72 years when she could no longer care for him. I saw somewhere that she had written this book, so I searched for it. It’s out of print, but I found a used copy in good condition for $5 at Amazon.

I am glad to have found and read it. It gave me much encouragement as I look ahead.

“At least I’m still good for something.”

When we first moved my mother-in-law over 2,000 miles to live in an assisted living facility near us, we would have her over for dinner sometimes, take her to my youngest son’s basketball games, and take her to church and other outings.

At one dinner, a favorite family story came up. Some years ago, my mother-in-law inadvertently said something inappropriate, using a term with double meaning of which she was unaware. Everyone laughed because they knew she hadn’t meant it in the way people would take it today. The incongruity of such a thing coming from her made it all the more funny.

As we told the story to our kids, who had either not heard it before or had forgotten it, we all laughed, even my mother-in-law.

After the laughter died down, though, she quietly said, “At least I’m still good for something.”

I don’t know if anyone else heard her say it or caught the significance. But her sentence went like an arrow to my heart. She wasn’t complaining or blaming anyone, but she didn’t feel useful any more.

When we first moved her into assisted living, my husband told her, “You’ll never have to cook to clean again.” That sounded pretty good after 70 or years of those activities.

Her only hobby was reading, and she delighted in being able to read all day to her heart’s content. She had always been a homebody, and just going to meals three times a day with a room full of other people taxed her. When aides would knock on her door to see if she wanted to go see the musicians, the magicians, the church choir, or whomever, she politely declined.

I don’t think she was discontent with her circumstances. But we all want to feel we’re of use in the world. There is a feeling of satisfaction and pleasure when we’ve accomplished something, but she didn’t have anything to accomplish any more.

In “The Grace to Be Diminished,” Win Couchman wrote of turning 80 and having to give up driving, changing from their usual place in the balcony at church to a place on the main floor where they didn’t have to fear falling, her husband’s hearing loss and short-term memory loss which caused him to be “silent and isolated at social functions.” But the “diminishment” that particularly touched my heart was when “one of the women who coordinates the potlucks called me and said with winsome authority, ‘Win, enough already. You have been involved with these evenings for about twenty years now, I think. You have done your bit. We want you and Bob to be at every one, but you are not to bring any more food, you hear?'”

Only then did I realize how the slowness with which I function now, and the accompanying late afternoon fatigue, was beginning to color my anticipation with some dread.

Gladly I responded, “Okay.” It’s awkward to walk into someone’s house on potluck Saturdays empty-handed just as another couple arrives loaded with goodies. In that moment, I silently look to God for the grace to be diminished.

Win and her husband, and I am sure my mother-in-law as well, graciously accepted the decline that comes with age, knowing that:

 So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal (2 Corinthians 4:16-18).

Yet I think we should be careful not to diminish them unnecessarily.

In Atul Gawande’s book Being Mortal: Medicine and What Happens in the End, he writes of a woman who was responsible for her father’s care when he could no longer live alone. Yet her desire to keep him safe culminated in his living in a small room with nothing to do, “safe but empty of anything [he cared] about” (p. 109). 

What touched off this train of thought today was a section in Anthony Trollope’s The Last Chronicle of Barset, the sixth and last in his Chronicles of Barsetshire series. Mr. Harding was the main character in the first book, The Warden. Now, in the last book, he has become very old and increasingly feeble. He used to love to play the violincello, but can’t manage it any more. “He had encountered some failure in the performance of the slight clerical task allotted to him, and the dean had tenderly advised him to desist.” He loved going to the cathedral every day, to listen to the organ, read a theology book, or just walk around. But his feebleness caused his fearful housekeeper to write to his daughter, who came to encourage him that perhaps his days of walking alone to the cathedral might need to come to an end. He replied, “I do not like not going;—for who can say how often I may be able to go again? There is so little left, Susan,—so very little left.”

That line was heartbreaking—that there was so little left. Eventually Mr. Harding made peace with the fact that God had given him a good life and he had a better one to look forward to. He found the “grace to be diminished” and decline.

Another line in Gawande’s book says, “Making life meaningful in old age…requires more imagination and invention than making them merely safe does” (p. 137).

Hindsight is always so much clearer, of course, but I wish I had made my mother-in-law’s life more meaningful. When she was still able, I wish I had thought of small tasks she could do to help with meals. Cooking had been her love language of sorts. Though we thought we were honoring her by doing for her, perhaps she would have felt more useful with a way to contribute. I could have made a project of putting her photos in albums with her. I did ask about her early life—high school, how she met her husband, etc.–and even learned some things I hadn’t known before. But I wish I had done that more. Although our visiting almost every day and then bringing her home for her last years showed how much we regarded her, I wish I had often told her that we loved her and were happy to have the opportunity to care for her. Though she had intrinsic value as a being created in God’s image, we should have let her know more often that she was valued and important.

As I look ahead to growing older, a couple of passages especially comfort me. One is Isaiah 46:4: “even to your old age I am he, and to gray hairs I will carry you. I have made, and I will bear; I will carry and will save.”

Another is Psalm 92:12-15:

The righteous flourish like the palm tree
and grow like a cedar in Lebanon.
They are planted in the house of the Lord;
they flourish in the courts of our God.
They still bear fruit in old age;
they are ever full of sap and green,
to declare that the Lord is upright;
he is my rock, and there is no unrighteousness in him.

During my mother-in-law’s last years, when she slept most of the time, I wondered what kind of fruit she was bearing in that state. A few came to mind. Her godly life—not perfect, but steadily walking with God and seeking to serve Him the best she could in her circumstances. Her uncomplaining patience. Her taking things with humor. Her willingness to “go with the flow.” Her testimony of peace and joy before her caregivers.

I wish these things had come to mind when she wondered what she was “good for.” I trust her Lord’s, “Well done, thou good and faithful servant” assured her that He was able to use her in many ways. And I hope that these thoughts will remind me to let others know the ways God used them in my life.

(I often link up with some of these bloggers.)

What We’re to Be Before We Teach

When Titus 2 is taught in any women’s gathering, we almost always hone in on what older women are instructed to teach the younger: “to love their husbands and children, to be self-controlled, pure, working at home, kind, and submissive to their own husbands, that the word of God may not be reviled” (verses 4-5).

But we either lightly touch or skip over what Titus 2 says older women are to be in the verses preceding these.

But before we get there, let’s zoom out a bit to see the context. Paul is writing to one of his coworkers, Titus, whom he had left in charge of the church in Crete. Paul had directed Titus to ordain elders in the churches from among those with certain godly characteristics in Titus 1. Paul sums up that instruction with verse 9: “He [an elder] must hold firm to the trustworthy word as taught, so that he may be able to give instruction in sound doctrine and also to rebuke those who contradict it.”

Then Paul describes those who contradict sound doctrine: “insubordinate, empty talkers and deceivers . . . upsetting whole families by teaching for shameful gain what they ought not to teach . . . their minds and their consciences are defiled. They profess to know God, but they deny him by their works. They are detestable, disobedient, unfit for any good work” (1:10-15).

Remember there are no chapter divisions in the original text. When we study chapters individually, we sometimes forget to connect them to what came before. The very next paragraph in Titus begins, “But as for you”—in contrast to the kind of people he was just talking about—“teach what accords with sound doctrine” (2:1). Then Paul gives specific instruction to older men, older women, younger men and women, servants.

So these instructions aren’t just nice thoughts or ways to have a happy church or for everyone to get along. These behaviors that Paul wants taught are “in accord with sound doctrine.” Our beliefs and our behavior should work hand in glove. Our actions shouldn’t contradict our doctrine.

So what are older women to be like?

Reverent in behavior.” Most of the non-paraphrased translations use the word “reverent.” The KJV says, “in behaviour as becometh holiness.” The commentary at the bottom of this page says, “The Greek word rendered ‘in behaviour,’ or ‘in demeanour,’ includes dress, appearance, conversation, manner; includes an outward deportment dependent on something more internal. The elder Christian woman in her whole bearing should exhibit a certain dignity of sacred demeanour; there should be something in her general appearance, in her dress, in her speech, in her every-day behaviour, which the younger and more thoughtless sister could respect and reverence–an ideal she might hope one day, if the Master spared her so long, herself to reach.”

Being reverent or dignified or holy doesn’t mean one never has fun, laughs, or tells jokes. Joy is part of the fruit of the Holy Spirit. Proverbs 17:22 tells us “A joyful [merry, KJV] heart is good medicine, but a crushed spirit dries up the bones.” Richard Baxter said, “Keep company with the more cheerful sort of the godly; there is no mirth like the mirth of believers” (The Practical Works of Richard Baxter, p. 24). Henry Ward Beecher said, “A man without mirth is like a wagon without springs, in which everyone is caused disagreeably to jolt by every pebble over which it runs.”

There’s a joy and humor in keeping with reverence and holiness.

But a godly older woman knows the things of the Lord are serious. She takes care to honor God in her life and teaching, whether formal instruction or just sharing passing encouragement.

Not slanderers.” Some translations say “false accusers” or “gossips.” Obviously we shouldn’t spread anything that is untrue. Lying and slander are definitely not in keeping with a God of truth.

Gossip is a little harder to define. It’s not always wrong to talk about someone else’s wrongdoing. Paul mentions people by name in his epistles who have erred in various ways. Sometimes talking with another Christian is a way to process whether someone’s actions are right or wrong. As we’ve encountered problems in various churches we’ve attended (and there is no church without problems), we’ve discussed the issues with our family. But discretion is needed as to what is discussed with whom and how. There’s a difference between needful processing and just gossiping. Gossip seems to have malicious intent.

As an example, years ago a couple who had been members of our church went out as missionaries to another country. They seemed exemplary in every way, having a real fervor for the Lord. After some years of seemingly successful ministry, the husband was found in an adulterous relationship with another woman. Their mission board called them home. When the church leadership met with the man, he refused to repent, saying he loved his sin too much to give it up.

Of course, this situation sent shock waves through the community he left, his mission board, our church, and probably everyone at every level that he had ever dealt with. It wasn’t something that could be kept quiet. There was much discussion. How should we respond to him? How can we minister to his heartbroken wife? And most of all, how could this have happened?

We all needed to work through that kind of processing. But to talk about the situation just to talk would have been wrong.

I think we have to show restraint sometimes even in sharing good news that might not be ours to share. Once at a church committee meeting I attended, one newly-pregnant lady lamented that she didn’t even have a chance to tell her closest friends that she was expecting because word spread so quickly. That convicted me. There’s something delicious about being the one with news to share.

So if our motive for talking about situations is to feel important because we have news, or to feel superior because someone has done wrong, we’d better put the brakes on. We need much wisdom and Holy Spirit leading that our conversation would be edifying and not destructive.

Not slaves to much wine.” I think, in context, this phrase is not just saying older women shouldn’t be drunkards. This verse uses the word “likewise,” pointing back to what had been told to older men, that they should be “sober-minded, dignified, self-controlled, sound in faith, in love, and in steadfastness” (v. 1). Self-control is also mentioned to the younger women (verse 5) and younger men (verse 6) with another “likewise.” So I think the larger picture is that she shouldn’t be enslaved to anything, that she should live a life of self-control (another part of the fruit of the Holy Spirit in Galatians 5:22-23).

To teach what is good.” To teach what is good, one has to know what is good. We can’t teach subjects we don’t know, can we? We need to spend much time in the Word of God not only so that we know what He wants to teach us, but also so that, as we have opportunities to share with others, we can direct them the right way.

To “train the young women to love their husbands and children, to be self-controlled, pure, working at home, kind, and submissive to their own husbands, that the word of God may not be reviled” (verses 4-5), we have to have enough experience walking with God to be able to share His truth in these areas.

That makes the whole thing scary. None of us has lived in this way in perfection. But God knows that. He doesn’t ask us to teach from our perfection, but from His. Sharing our own failures and stumbles helps other women to know that God gives grace. Pointing, not to ourselves, but to Him helps others to look to the only One who can enable them.

Older women have a reputation for being cranky, crochety, and critical of anything that’s not done like it was “back in my day.” Thank God, most of the older women I have known have not been like that. God has put some sweet, godly women of stellar character in my path over the years.

May we all seek His grace, whatever our ages, to please Him and to be a godly influence on those around us.

Some of my past posts related to these subjects:

(I often link up with some of these bloggers.)

The Middle Matters

I’ve often thought that the “middle-aged spread” refers not to an expanding waistline, but to the number of years we claim middle age. Because what’s next after middle age? Old? Elderly? We need some designation between the middle and the end.

At any rate, even though I’m on the far side of middle age, Lisa -Jo Baker’s book caught my eye when it was on sale for the KIndle app: The Middle Matters: Why That (Extra)Ordinary Life Looks Really Good on You. I had heard Lisa Jo’s name but never read her, and I’ve not often seen books for this stage of life.

Lisa-Jo discusses the impact of our middle years in eight areas: our bodies, marriage, parenting (which gets two chapters), our homes, failures, friendship, and faith. “Discusses” is probably too formal a word. Each topic is addressed in three to seven essays. Lisa-Jo writes in a breezy chatting-with-girlfriends style.

It’s hard to summarize a series of essays, so I’ll just give you some samples.

One of my favorite chapters is “When You Think Your Love Story Is Boring.” The epigraph of this chapter comes from a teenager quoted in Huffington Post who feels her love life will never be adequate “until someone runs through an airport to stop me from getting on a flight.” Lisa-Jo shares many examples of love demonstrated in the everyday rather than the once-in-a-lifetime grand gesture.

He lays down his life, and it looks like so many ordinary moments stitched together into the testimony of a good man who comes home to his family driving the old minivan, the one with the broken air-conditioning (p. 40).

And this is a love life: to live each small, sometimes unbearably tedious moment… together. To trip over old jokes and misunderstandings. To catch our runaway tongues and tempers and tenderly trust them to the person who now knows firsthand our better and our much worse (p. 41).

He’s never run through an airport for me. But he goes to Walmart at 9: 30 p.m. for back-to-school supplies that we’ve had all summer to get and of course have left till the last minute. When he walks into the living room at 11: 00 p.m. with bags full of the obligatory red, green, yellow, and blue folders and all the million pre-sharpened number-two pencils, it’s the sexiest thing I’ve seen all week (p. 41).

Another chapter that I loved told of a joyous night with Lisa-Jo’s daughter’s triumph in a school program. When Lisa-Jo looked at the photos taken that evening, first she saw the joy. Then, looking more closely, she noticed a picture of her “generous muffin top bulging over her jeans as she presses up next to her daughter” (p. 26). Instead of being embarrassed or deleting the photo, she decided “There was too much happiness to ever diminish it by worrying about waistlines” (p. 26).

In “What You Don’t Know About Parenting,” Lisa-Jo tells of a time her daughter was in another program, where she struggled with what Lisa-Jo thought was pre-program jitters which would be fine once the performance started. But her daughter had full-blown stage fright, tears streaming as she danced her part. Lisa-Jo struggled with indecision as to the best course of action—sweeping her daughter off the stage or letting her finish. “I don’t know if we can ever actually protect our kids from their own fears. Maybe all we can do is show them how brave they are to face them” (p. 90). After the program was over and everything settled down, Lisa-Jo called her mother-in-law to pour out her heart.

And as mothers have always done, she listened and loved me and then encouraged me with the deep understanding born of her own lifetime of learning what you don’t know by simply walking through it. This is what we mothers do for each other—we offer our own failures as proof that our sisters and daughters, our nieces and grands, will make it through the perilous journey of mothering too. Because no matter how many books you read or podcasts you listen to, nothing can prepare you for the fall you weren’t expecting (p. 91).

When heroes fall, Lisa-Jo wants her children to know, “fame is not where we go when we’re looking for something to believe in. Neither is the pulpit nor the soccer field, nor the stage nor the movie studios, for that matter. . . . power and influence and fame can be a slippery, lying slope” (p. 95).

When her son wants to race in the Olympics:

When they ask you if you believe that they’ll make their way to the Olympics someday, what do you—that mother behind the steering wheel who can’t see the future—tell your son?

Do I really want to be the anchor here holding him back? How do I cheer for him while also being a plumb line for truth? (p. 163).

Concerning a twice-monthly potluck hosted at her home: “Some weeks I look forward to it. Some weeks I’m exhausted at the thought of it. But we just keep opening the door no matter how we feel” (p. 136).

A couple more quotes:

Sometimes friendship is a deep conversation. Sometimes it’s a shared ugly cry. But sometimes friendship is the gift of not being afraid of silence (p. 204).

I don’t have easy answers to the hard questions, whether they’re on the news or coming from your doctor or your kid’s teacher or your coworker or a dear friend. I have only the hope of a hand in mine. The hand of this man, Jesus, who isn’t afraid and who builds things that don’t sink (p. 242).

I enjoyed this book and found it very easy to read. Lisa-Jo definitely has a way with words and weaves them with humor and poignancy. Some reviewers felt the book was more of a memoir or only appealed to women in the exact same stage of life–forty-something, married with kids. But I benefited from it even though I am an older empty-nester. Even though Lisa-Jo’s style is not didactic, readers can learn much from what she shares.

(This book will count for the Nonfiction Reader Challenge, where I am doing the Nonfiction Grazer track of basically doing my own thing. 🙂 But this would also fit in the “Linked to a Podcast” category a of the challenge since Lisa-Jo has a podcast [which I have not yet listened to] with Christie Purifoy called Out of the Ordinary.)

An Old Poem For a New Year

Last week, I listened to Elisabeth Elliot’s Gateway to Joy series about aging. In one episode titled Being Part of the Permanent, she quoted a stanza of a poem by John Greenleaf Whittier. The words so seized me, I had to stop and look them up.

The poem is titled My Birthday. Whittier was 64 when it was published, a significant age in the 1800s. Though all the poem is a touching look at an “older” birthday, the first few stanzas seem to me to apply also to a new year. We’re not so far from the beginning of this one, so perhaps they’ll speak to you as they did to me. The stanza Elisabeth quoted is at the end of what I am sharing here, but there are many more stanzas besides.

Beneath the moonlight and the snow
Lies dead my latest year;
The winter winds are wailing low
Its dirges in my ear.

I grieve not with the moaning wind
As if a loss befell;
Before me, even as behind,
God is, and all is well!

His light shines on me from above,
His low voice speaks within,–
The patience of immortal love
Outwearying mortal sin.

Not mindless of the growing years
Of care and loss and pain,
My eyes are wet with thankful tears
For blessings which remain.

(I often link up with some of these bloggers.)

Goals for the Second Half

There’s always something to look forward to just beyond the horizon.

When we were children, we looked forward to high school and driver’s licenses. Then we couldn’t wait for dating and college. Then we longed for marriage and children.

Perhaps your life track has run a different course: perhaps your goals were tenure at your university, or making partner at your firm. Personal and professional goals intertwined.

And if God grants all of those gifts, we look forward to still more.

When we reach somewhere between age 40 and 50, we realize we’re at about the halfway point, if everything goes well. Soon we’ll be in the “second half” of life, with more days behind us than ahead of us. But there are still things we want to do. Some look forward to traveling during the “empty nest” years. Others finally projects off the back burner. We want to see our grandchildren grow, develop, learn, marry, and have children. We want to be here to have a part in influencing them for the Lord.

A few weeks ago, I was arrested by a couple of verses in the psalms reflecting the writer’s purpose for his remaining years:

O God, from my youth you have taught me,
    and I still proclaim your wondrous deeds.
So even to old age and gray hairs,
    O God, do not forsake me,
until I proclaim your might to another generation,
    your power to all those to come.
Psalm 71:17-18, ESV

I recently read of a man who was active in public ministry all his life. When his wife developed Alzheimer’s, he took care of her as long as he could at home. When she needed more care than he could give, she went to an assisted living facility. But he did not want the two of them to be separated: he joined her. He has an active ministry there leading Bible studies and services and talking with residents.

When my mother-in-law was in a memory care unit, I would feel somewhat down long after leaving the facility after visiting her. I can’t imagine voluntarily living in such a place while still in your right mind.

I think of this man’s national and even international ministries contrasted with his life now. His ministry is not evaluated by how many people he is reaching. He is faithfully serving the Lord right where he is supposed to be.

Many of us find that our “older years” turn out quite different from what we had expected due to illness (ours or our spouse’s), parents’ or children’s needs, financial considerations, or any number of issues. But wherever He has put us, we can proclaim His might and His power. We can share those with everyone, but the psalm above particularly speaks of “another generation…those to come.”

One generation shall commend your works to another,
    and shall declare your mighty acts.
On the glorious splendor of your majesty,
    and on your wondrous works, I will meditate.
They shall speak of the might of your awesome deeds,
    and I will declare your greatness.
They shall pour forth the fame of your abundant goodness
    and shall sing aloud of your righteousness.

Psalm 145:4-7, ESV

Psalm 78 also speaks of “things that we have heard and known, that our fathers have told us,” telling “to the coming generation the glorious deeds of the Lord, and his might, and the wonders that he has done,” “that the next generation might know them, the children yet unborn, and arise and tell them to their children, so that they should set their hope in God and not forget the works of God, but keep his commandments” (verses 2-7).

We can tell the next generation (whether our own descendants or others God brings across our path) the history of how God has worked in the lives of His people, as Psalm 78 goes on to do. We can share His Word, His law, His grace. And we can also share our Ebenezers, testimonies of how He ministered to us and provided for us. We can assure them that He is not just a God afar off in history, but He is God here and now, active in our lives and theirs.

Moses’s prayer in Psalm 90 asks God in the midst of the flying years (verse 10) to “teach us to number our days that we may get a heart of wisdom” (verse 12). Moses concludes:

Let your work be shown to your servants,
    and your glorious power to their children.
Let the favor of the Lord our God be upon us,
    and establish the work of our hands upon us;
    yes, establish the work of our hands!
Psalm 90:16-17, ESV

It was down at the feet of Jesus,
O the blessed, happy day!
Where my soul found peace in believing,
And my sins were washed away.

It was down at the feet of Jesus,
Where I found such perfect rest,
Where the light first dawned on my spirit,
And my soul was fully blest.

It was down at the feet of Jesus,
Where I brought my guilt and sin,
That he paid my debt and forgave me,
For He died my soul to win.

Refrain:

Let me tell the old, old story
Of His grace so full and free;
Let my heart keep giving Him the glory
For His wondrous love to me.

~ Original words by Elisha Hoffman

(Sharing with Inspire Me Monday, Literary Musing Monday, Let’s Have Coffee, Porch Stories, Wise Woman, Woman to Woman Word-filled Wednesday, Faith on Fire)

Book Review: Finishing Our Course With Joy

At 99 pages, J. I. Packer’s Finishing Our Course with Joy: Guidance from God for Engaging with Our Aging  is not a total treatise on aging. Its main thrust is that modern society tends to put older people on the shelf for a life of indulgence and idleness, but Christians should continue growing in our relationship with God as well as our ministry to others. Our ministry may look different from what it did in our youth, but God still has a purpose for us being here. He acknowledges that one fourth of the “oldest old” (over 85) will have some degree of dementia, but:

These pages address those who, by God’s grace, still have their faculties intact; who recognize that, as is often and truly said, aging is not for wimps; and who want to learn, in a straightforward way, how we may continue living for God’s glory (p. 14).

He says that for years, people have viewed older age as a state of decline, but we should view it as what he calls “ripeness” or maturity.

We know the difference between ripe and unripe fruit: the latter is sharp, acid, hard, without much flavor, and sets teeth on edge; the former is relatively soft and sweet, juicy, mellow, flavorful, leaving a pleasant taste in the mouth” (p. 18).

The Bible’s view is that aging, under God and by grace, will bring wisdom, that is, an enlarged capacity for discerning, choosing, and encouraging (p. 19).

[Racers] always try to keep something in reserve for a final sprint…so far as our bodily health allows, we should aim to be found running the last lap of our Christian life, as we would say, flat out. The final sprint, so I urge, should be a sprint indeed (pp. 21-22).

He discusses various ways to do that, living one day at a time as if it truly might be our last, with glorifying God as our “constant goal,” avoiding excessive daydreaming and nostalgia, ready to go whenever God calls us home.

The fact that one is no longer under any pressure to use one’s mind in learning things, solving problems, or strategizing for benefits either to oneself or to anybody else, will allow intelligence to lie permanently fallow, and this, so they tell us, may very well hasten the onset of dementia. The agenda as a whole turns out to be a recipe for isolating oneself and trivializing one’s life, with apathetic boredom becoming one’s default mood day after day (p. 30).

He discusses some of the temptations of old age, such as “going with the flow” of everything declining, even spiritually, or not acknowledging any decline due to pride and becoming “tyrannical” with family and friends after having to leave one’s sphere of work (pp 45-46).

He discusses how the church’s view too often mimics the world’s views of retirement:

Yet the common expectation, undiscussed but unchallenged, is that retirees will not continue the learning and leading that were big in their lives while they were at work. The most that the church will expect of them now is that they will continue to support from the sidelines, as it were, the modes of ministry in which others engage (pp. 62-63).

By moving us to think this way, however, Satan undermines, diminishes, and deflates our discipleship, reducing us from laborers in Christ’s kingdom to sympathetic spectators…(p. 63).

Still taking their cue from the world around, modern Western churches organize occupations, trips, parties, and so forth for their seniors and make pastoral provision for the shut-ins, but they no longer look to these folks as they do to the rest of the congregation to find, feed, and use their spiritual gifts. In this they behave as though spiritual gifts and ministry skills whither with age. But they don’t; what happens, rather, is that they atrophy with disuse (pp 63-64).

He encourages churches to balance acknowledging that there is bodily decline and ministering as needed to seniors with seeking to “cherish and continue to harness the ministering capacities” of older saints (p. 64). “And elderly Christian themselves should press on in the worship and service of God and in pastoral care for others, up to the limit of what they can still handle…” (p. 64).

“The challenge that faces us is not to let that fact [that our bodies are slowing down] slow us down spiritually, but to cultivate the maximum zeal for the closing phase of our earthly lives” (p. 72). He then spends several pages discussing zeal and quotes J. C. Ryle as saying that “Zeal in religion is a burning desire to do his will, and to advance his glory in every possible way” (pp. 74-75).

He urges balance in families as well, encouraging seniors not to be “dictatorial” or “invade family circles unasked,” remembering that “loyalty to one’s spouse should trump the claims of parents,” and encouraging families not to “ignore mature wisdom that is available…in [their] older relatives and friends” (p. 97).

He also discusses nurturing the hope of heaven, letting that be a guide and inspiration as well as a testimony, and remembering that we will give account at the judgment seat of Christ that Christians will face (different from the judgment that unbelievers face).

There is a lot packed in this short little book, and it’s encouraging to be reminded that God still has things for us to do for His glory as we age.

(Sharing with Semicolon‘s Saturday Review of Books, Literary Musing Monday, Carole’s Books You Loved)

Problems, Blessings, and Dangers of Middle Age

Some time back, I saw a few people online lamenting that there weren’t many blog posts written for “middle-aged” women. There are a lot of “mom blogs,” particularly for moms with young children. But blogs for moms of teenagers and adult children or for women past that stage seem to be few. Part of that is because you can’t talk about your teens’ problems online in the same way you share about struggling with your two-year-old’s temper tantrums or refusal to eat anything but cereal. Then, too, middle-aged women are often the “sandwich generation” years, dealing with nearly adult children at the same time as aging parents, so time can be lacking.

It’s also hard to define middle-age. I have joked that the middle-aged spread doesn’t refer so much to a thickening waistline as it does to the number of years we consider ourselves middle-aged. I’m in the far side of my fifties, and “old” is at least another 20 years away in my thinking.

I’m not an expert, and my experience might not ring true for everyone, but I thought I’d share what I consider the good points, bad points, and dangers of middle-age.

Problems of Middle Age:

Might as well get the bad news over first. 🙂

Physical issues:

It’s easier to gain weight and harder to lose it.

Peri-menopause and menopause (for me, peri-menopause – the years leading up to menopause – were much worse than menopause itself). There are a number of sites dealing with the particulars and what you can do for them.

Staring to decline in strength, eyesight, etc. There are all sorts of “aids” for that kind of thing, from “reader” glasses to bifocals, to “reachers” that help us get out-of-the way things, to tools that help get lids off jars, etc. Instead of lamenting on how old I am that I have to use these things, I can be glad that they are available – some were not until fairly recently.

Beginnings of problems with blood sugar, blood pressure, arthritis, etc. Some of these are better avoided than corrected – I’m guilty of “Oh, I’ll deal with that someday” in regard to weight and blood sugar issues. If I had been dealing with it correctly all along, I wouldn’t be having the problems I am now. Of course, sometimes problems in those areas will crop up anyway because our bodies are not eternal. I heard one preacher say that one reason our bodies break down as we age is to remind us of just that and to urge us to be willing to let go of them and prepare for eternity.

Sleep issues. Middle-aged women often have trouble sleeping through the night and trouble getting back to sleep once they wake up. Sometimes that’s due to urinary issues. I am not sure of the other causes, but it’s a common complaint. That in turn affects us emotionally and intellectually.

Emotional issues:

Menopause has emotional as well as physical issues. But that’s not an excuse to just spew negative emotions all over our families: it’s an occasion to lean all the harder on God and draw strength and help from Him.

The “empty nest” usually occurs around this time, and while we rejoice in seeing our kids take steps toward adulthood, don’t really want them dependent on us forever, and know that the goal of motherhood is to work ourselves out of a job, it is still a major emotional adjustment when they leave the home. Even as we come to enjoy some of the perks of having the house and time to ourselves, we miss that everyday interaction with them that we used to have.

Some of the physical issues themselves affect our emotions, and sometimes just having physical issues affects our emotions.

Realizing that we have more time behind us than ahead of us can be depressing when there is so much more we want to do and less and less time to do it.

Intellectual issues:

I keep the post-it note company in business – if I don’t write reminders to myself, I’ll forget what I need to do.

Sometimes we’ll forget a name or fact we know perfectly well, or forget in the middle of a sentence what we were going to say, or enter a room and forget why we came there. Granted, that happens to everyone at every age, but it seems to happen more the older we get. These things in themselves don’t indicate dementia (and worrying about it makes it worse!) But it can be frustrating.

Lifestyle issues:

The empty nest has already been mentioned. Facing retirement, the possibility of needing to downsize and/or move due to declining income, dealing with aging parents and the medical and aging issues of spouses, are all often faced in the middle-aged season of life. I wrote extensively about caring for an aging parent in Adventures in Elder Care.

Pluses:

Settledness. Sure, there can be upheavals, as mentioned above, and sometimes the empty nest, the death of a spouse or parent, or the loss of a job can turn our world upside down and cause us to have to contemplate what to do next. But as a general rule we know who we are, and, if we’ve walked with the Lord for any length of time, we know to turn to Him for help. Previous trials help us face current ones. We know what our gifts are and aren’t. I used to have some pretty serious self-esteem issues, but once I got hold of being “accepted in the Beloved,” those seemed to melt away. One dear young mom I follow is constantly writing about coming to terms with who she is and what she is supposed to do and how she fits in the grand scheme of life and reinventing herself, and sometimes I just want to tell her, “Hon…just live your life. Enjoy your husband and kids, take the opportunities God brings to hand, and just live.” But I doubt that advice would go over well, and it may be that kind of angst leads to being more settled as we work through those issues, so I just pray that God would help her to be settled in Him.

When I see favorite photos of my kids as toddlers, I sorely miss those little ones. Yet I do rejoice in the young men they have become. Though we miss aspects of babyhood, getting to know our kids as they get older and then relating to them as adults is great fun. As they grow older, they become companionable friends.

Middle age can bring more time as kids get older and their needs from us decline. On the other hand, with aging parents having more needs, sometimes we have more demands on our time.

Likewise, middle age often brings more breathing space financially as the kids move away, at least until retirement and fixed incomes.

Perhaps you’ve seen this humorous list of “Perks of Being Over 50” (I don’t know who originally wrote it, but I have seen it all over the internet):

No one expects you to run a marathon.

 People call at 9 P.M. and ask, “Did I wake you?”

People no longer view you as a hypochondriac.

There is nothing left to learn the hard way.

In a hostage situation you are likely to be released first.

You can eat dinner at 4 P.M.

You have a party and the neighbors don’t even realize it.

You no longer think of speed limits as a challenge.

You quit trying to hold your stomach in, no matter who walks into the room.

Your investment in health insurance is finally beginning to pay off.

Your joints are more accurate meteorologists than the national weather service.

Your secrets are safe with your friends because they can’t remember them either.

Your supply of brain cells is finally down to manageable size.

Senior discounts!

Grandchildren are the best part of middle age. 🙂

Dangers:

The “we have always done it this way” syndrome. Being stuck in a rut. This can especially cause problems in church and in dealing with new in-laws as our children marry. There are bedrock truths that we shouldn’t budge on, but in other areas we can be open to new ways of doing things.

The “I know better than everyone else” syndrome in our words and attitudes. Not receiving suggestions from others. Griping about “kids these days.” We have been around the block a few times more than some, but we don’t know everything. And even in areas where we do know better, we can share that in a way that’s helpful or in a way that’s obnoxious and off-putting.

The “stuck in the past” syndrome. We can enjoy our memories and share them sometimes, but we need to pay attention to the people in our lives now and pray and consider ways to minister to them.

The “I’ve done my time” syndrome. “I’ve worked in the nursery/managed VBS/cooked for every event, etc., for x number of years now: it’s time to let somebody else do it.” Granted, for various reasons we might not be able to do all the things we once did. But there is no retirement from the Lord’s service. There is something He wants us to do, even if it doesn’t fit into the organized ministry of the church. See Ways Older Women Can Serve.

Bitterness over life problems, people not treating you as you’d like, etc. etc. The Bible has much to say about bitterness: “Looking diligently lest any man fail of the grace of God; lest any root of bitterness springing up trouble you, and thereby many be defiled,” Hebrews 12:15. “Take it to the Lord in prayer,” as the hymn says. Ask Him for wisdom in how to deal with the issues, do your part to keep relationships what they ought to be, and rest in Him.

Stagnation. Not learning, growing, trying anything new. Sitting in front of the TV all day.

Fear of the future. With health and financial issues, as well as potential loneliness, it can be easy to fear or dread what the future might bring. But God has promised to supply all of our needs. He may not supply them just the way I would have preferred. I don’t want to be dependent on my children some day, and I hope that doesn’t happen, but I have to trust that if it does, God has something for all involved to learn. God’s promises don’t mean that I don’t need to plan and use my resources wisely. But I can trust Him to work through and beyond my resources. “Even to your old age I am he, and to gray hairs I will carry you. I have made, and I will bear; I will carry and will save” (Isaiah 46:4).

Conclusions:

Come to terms with your mortality. Prepare for eternity by receiving Christ as Savior. Even though we mourn leaving loved ones behind, having our eternal destination settled takes much of the sting out of facing death. But salvation isn’t just about securing passage to heaven: it’s about having our sins forgiven and living now for God, having His help and grace through life and making His priorities ours. Knowing that we have His help for whatever we will go through and living for Him rather than ourselves will make our remaining years a blessing to ourselves and others.

Stay in God’s Word and prayer. We should never stop growing spiritually.

Look at aids (bifocals, magnifying glasses, cane, etc.) as something to help you and extend your abilities rather than something to get down about.

Stay active, mentally as well as physically.

Repair broken relationships.

Deal with regrets.

Confess and, forsake wrongdoing, apologize, move on.

Use money wisely in preparation for reduced income.

Take initiative. Once I heard an older lady lament that she hardly knew any of the teens at church and wished that the youth pastor would organize some way to get them together. Suggest that to the pastor rather than hope he thinks of it, or better yet, host a teen fellowship at your house or the church (ask a few other ladies for help) or just have a few at a time over to get to know them. If you feel alone and neglected, reach out to someone else. Don’t grouse that no one has called you: call them.

Keep learning. Trying new things is good for your brain!

Despite its potential problems, middle age can be quite an enjoyable stage of life.

How about you? Can you identify with these? Are there any other problems, dangers, or good points about middle age that you can think of?

(Sharing with Inspire Me Monday, Literary Musing Monday, The Art of Home-making Monday, Testimony Tuesday, Tell His Story, Wise Woman, Woman to Woman Word Filled Wednesday, Faith on Fire)

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12 Things You Should Know About Caring For the Elderly

Every now and then I come across articles like “Ten Things Your Plumber Won’t Tell You” or “12 Things Your Doctor Would Like You to Know.” Often they are pretty enlightening.

I’ve written extensively before about our experiences caring for my mother-in-law, almost four years in our home and five years before that in assisting living facilities and a nursing home, and shared some hopefully helpful tips for people in the same situation. But I got to thinking, if I ever had an opportunity to speak to a group or write one article on this topic, what are the top few truths or principles I would share? Probably among them would be these:

1. Preserve as much of their independence for as long as possible. It seems like often family members will see an elderly loved one’s need of assistance before that person does. Sometimes denial causes the elderly to think they can carry on as they always have: I think more often it’s fear of loss of independence. I’ve heard more than one person express dismay or impatience that their loved one won’t just go along with the program and make it easier on everybody and move into a facility already. But have you ever thought about what that involves? Depending on the facility and how much money is available, it means much smaller living space, selling the family home, departing with long-loved objects in order to downsize, communal meals, not being able to control your own medication or, to a certain degree, your schedule.  The first time we moved my mother-in-law into a facility, I thought it was something like a cross between a dorm room and a hospital. I liked the dorms in college: I wouldn’t want to go back to them in my later years. Think about having had your own personal space for 50-odd years and suddenly moving into one room that anyone in the facility can come into at any time. Granted, that accessibility, having the staff control medications, etc., is for one’s safety: but that doesn’t make it any easier or make one look forward to it.

2. If/when you do have to go against their wishes, be as gracious as possible about it. My mother-in-law is very much a “stay with the status quo” type of person, at least since she has been here. She has had hearing aids for as long as I remember, but when she first moved here, she couldn’t hear much at all even with the aids, even if we were sitting next to her and nearly shouting. She’d just smile and say, “You’ll just have to speak up!” Frustrating! My husband took her to an audiologist, and all along the way until she actually got the new hearing aids, she kept saying, “I’m doing all right with what I have: I don’t think we need to get new ones.” Jim just kept quietly insisting that we needed to explore the possibility, and once she got the new ones, she was pleased. She wanted to keep baking soda in her room because she used it as an antacid: Jim didn’t think the extra sodium would be good for her health. Once when I visited she just kept bringing it up and insisting it was fine. I had an “out” in saying Jim didn’t think she should have it, but we kept going over the same points of conversation. He finally compromised in letting her keep a pack of Rolaids in her drawer (which technically we weren’t supposed to do: all medication was supposed to be handed out by the nurse). I don’t think she ever used them, but it must have eased her mind just to have them. It’s hard to know sometimes when to insist and when to let something go. You have to choose your battles. But don’t make it a battle, if possible: don’t be confrontational or argumentative. Thankfully his mom was never combative, but I have friends whose parents are. It’s hard to bathe an 85-year-old adult who doesn’t want a bath and even resists it. You can let it go for a while, but eventually it has to happen. Distraction or diversion works for many things, so perhaps discussing something else while getting set up for the bath will get their minds on another track. (If any of you have tips along this line, feel free to share them!)

3. Convey to them that they are still important and useful. When we moved my mother-in-law into an assisted living facility, my husband told her she would never have to cook or clean again, and after having done those things for most of her life, she was glad to hear it! She loved having time to enjoy reading, her favorite activity. One day when she was visiting our home for a family gathering, and an old family story came up concerning something funny she had said years ago, we all laughed, including her. Then she said, “Well, at least I’m still good for something” (meaning, good for a laugh). I was stunned. I hadn’t realized that she hadn’t felt “good for something,” that she had kind of lost her purpose. One of my regrets is that I didn’t do more on visits with her, like ask her about her life and history and write the answers down to share with other loved ones, or go through a box of very old photos and arrange them in an album with her.

4. Treat them with dignity: don’t treat them like children. Very old age does have some things in common with childhood, but it is not the same. In I’m Still Here: A New Philosophy of Alzheimer’s Care, John Zeisel writes, “It’s not right to think of Alzheimer patients as entering their ‘second childhood.’ They have knowledge and life experience children don’t have.” That’s true of any elderly person. Once when my husband came to pick up his mom at her facility, the aide with her said, “It’s almost like you’ve switched places, isn’t it?” and then turned to his mom and said, “Your daddy is here, honey.” No, it is NOT like that. He had to ask her not to say things like that. Yes, the son or daughter will have to make major decisions and handle things the parent used to, and the parent may be incapable of doing many things any more, but that’s not the same thing as reverting to childhood. Especially fingernails-on-the-chalkboard grating is talking baby talk to them.

5. Do NOT put them in a facility without checking on the regularly and frequently. You would assume that everyone who works in assisted living or a nursing home is kind, professional, skilled, and will take the best possible care of each resident. We learned, sadly, that that’s not the case. I could tell you stories…my husband has said often that he’s going to write a book about this some day. Each place had some jewels in their workers, but each place also had some who were neglectful, who handled her roughly, who paid no attention to her posture, who talked over her to their coworkers and didn’t even look her in the eye while handling her in some way, who didn’t clean her face well after a meal so that she got red, rough irritated spots on her face, etc. Once I walked in to a facility, and they had her in her wheelchair in the common room with the other residents, she was bent over the side of her wheelchair at a 90 degree angle, even though there were several aides in the room, even though we bought some small pillows to help keep her upright in the chair. Plus the employees are overworked and underpaid and the facilities understaffed. On top of that, the residents might not be able to verbalize what’s wrong, either due to dementia or possibly even fear. My mother-in-law had a “don’t rock the boat” personality, and the more she declined, the more help she needed, the more her care declined. “The squeaky wheel gets the grease” is as true here as everywhere else. There were some residents who really needed a staff member with them almost 24/7 for various reasons, and that left the quiet ones like my mother-in-law unattended for too long too often.

6. Don’t forget them. Whereas #5 was more concerned about their safety and well-being, here I mean don’t forget them on a personal level. Continue to interact even if they don’t remember who you are. A lady in our church who writes notes once or twice a month to my mother-in-law checks in with me from time to time to see if she still enjoys them or gets anything out of them. I tell her, honestly, I don’t know if she remembers who the writer is, and I don’t know if she remembers anything the note said five minutes after it’s read to her, but for those few minutes, she knows someone thought about her and cared enough to jot a few lines to her. It’s incredibly sad to us when holidays or her birthday go by (and the days in-between as well) and she hears from almost no one.

7. The best thing you can give them is your time and attention. When my mother-in-law was in a facility, we tried to visit her every day. We usually sat and visited, but I’d run out of things to talk about after a while. I felt more “useful” when I could pick up or straighten her room or do something physical, but that tended to embarrass her. Likewise, gift bags, flowers, etc., are nice, but don’t feel you have to bring anything. What’s most valuable is for someone to face them, look them in the eye, talk directly to them and focus on them, or, if you live away from your loved one, a personal note, perhaps an new photo, or Face Time or Skype if possible.

8. All eating problems do not mean the end is in sight. Whenever I have mentioned eating problems with my mother-in-law to almost any health care professional, they’ll say, “Well, you know, when they get near the end, they’re just not as interested in food.” That may be true, but that doesn’t mean other factors might not be involved. When we moved my mother-in-law to our home from the nursing home, she was around 90 lbs., and we thought we were bringing her home to die. That was four years ago. I think a combination of food prepared and seasoned well, warm and not cold from sitting on a cart while food is distributed, and, most important, someone to feed her who takes time with her, all contributed to her eating well again and gaining weight. We learned that eating tires her out, so sometimes you have to give her a few bites, give her a drink, wait a bit, then try a few more bites. Even now she’ll have certain meals, or even certain days, where she’s just not interesting in eating. Since she doesn’t speak much any more, we don’t know if the food is too hot, too cold, doesn’t taste good, or if she’s just tired or doesn’t feel well. Sometimes I think she’s just not going to open her mouth because eating is the one thing she can control in her life. But that usually lasts just a day or so, sometimes a few days, and then she’s back to eating normally.

9. It is probably going to get worse. My mother-in-law has been on a something of a plateau for a couple of years now, but for a long while, if anyone asked us how she was doing, the response would be that she wasn’t doing very well. Sometimes people were taken aback that we didn’t have a positive cheery answer, like when people say, “How are you?” and expect no other answer except, “Fine, how are you?” in return, and they’re jarred a bit at any other answer, especially a negative one. Once we said, “Well, she’s declining,” and the person responded, “Well, we’re all declining.” (Sigh.) I’ve wondered what people expect when they ask that question in the waning years of a person’s life. The person may have many wonderful days, but in the long run, they are either losing abilities (in my mother-in-law’s case) or multiplying health issues, and things are steadily going downhill.

10. The caregiver needs care. Even if the loved one is in a facility rather than the home, often one of the adult children is primarily in charge of seeing to her care and needs. And of course, if she is being cared for at home, obviously that person or family is taking on the bulk of her care. The caregivers need to know they’re not alone, that everyone else cares. They may need advice, emotional support, financial support, respite. I’ve known some cases where one is the primary caregiver, but the other siblings take the parent home for a weekend or a few days. Distance or the parent’s condition may prevent that, but it’s nice if it can happen. Thankfully we’ve had friends both in church and online who have cared for parents in their home, and they’ve been highly valuable and helpful to confer with, even just to have that fellowship of someone understanding exactly what’s involved.

11. I’m not a saint, except in the Biblical concept that everyone who believes on the  Lord Jesus Christ as Savior is called a saint. Some people put caregivers on a pedestal or overly praise them, but we’re just ordinary people struggling through what we’re called to do. Appreciation or encouragement are more welcome than unvarnished praise, but it’s hard to know where the dividing lines are sometimes.

12. It’s hard. It’s hard to see one’s loved ones decline and to see their circumstances and quality of life reduced. It’s hard to feel the weight of their care. It’s hard to feel guilty about feeling that their care is weighty or about occasional resentment. My husband feels guilty that he doesn’t spend more time with his mom, but she sleeps about 20 hours a day, and it doesn’t do either of them any good for him to sit in her room while she’s sleeping. It’s hard to feel limited. It’s expensive to hire outside help – the agency we use charges $17 an hour, and we already have them here forty+ hours a week just so we’re free to run errands, make appointments, or just have a break. But we can’t just pick up and go out to eat, go on vacation, go to our son’s house, etc., without making arrangements and incurring more expenses. One friend who lived alone with her mom had people who could come over for a few hours or even a couple of days, but, still, that’s a lot to ask of someone, so the caregiver doesn’t feel the freedom to ask that often. In our case, my mother-in-law’s situation and the care needed is such that just having someone come and sit with her would not be sufficient. We’re limited even in ministry: we can’t go to everything that happens at church. My husband was a deacon when we first brought his mom home and submitted his resignation to the pastor because he just couldn’t be away for long meetings, etc., at that time. It’s hard to feel like even mentioning these things sounds like complaining.

I’ve written about this before, but what helps most is just accepting that this is our ministry for now, just like having a new baby in the house is a mother’s primary ministry. As Elisabeth Elliott has said, our limitations just define our ministry: “For it is with the equipment that I have been given that I am to glorify God. It is this job, not that one, that He gave me.” Each ministry carries its own responsibilities, weights, and cares, but “God is able to make all grace abound to you, so that having all sufficiency in all things at all times, you may abound in every good work” (2 Corinthians 9:8).

I’ve written from our experiences and that of friends, but, of course, every experience is different. People have widely varying capacities as they age: we know a 90-year-old who still lives at home, drives, is active at church and with her hobbies, an 80-year-old who still travels internationally and even recently remarried. I had one friend whose mother-in-law had Alzheimer’s but was physically fine, and she was able to take her mother-in-law with her wherever she went, at least in the earlier stages of the disease. And there is much, much more that could be said. But I hope you’ve been able to find some degree of common ground here and something helpful.

(Sharing with Inspire me MondayLiterary Musing Monday, Testimony Tuesday, Wise Woman, and Woman to Woman Word-filled Wednesday)

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Book Review: I’m Still Here

still-hereI first came across I’m Still Here: A New Philosophy of Alzheimer’s Care by John Zeisel at Lisa’s review here. One of the main points she discusses there, of not “testing” the person with Alzheimer’s (Do you know who I am? Who this is? Do you remember…) but rather giving them the information they need first hand (Hi Mom, it’s your daughter, Barbara, and this is your grandson, Jesse. We’ve come to visit you today) was so simple and practical and yet so good and helpful, I wanted to read the rest of the book. My own mother-in-law in our home does not have Alzheimer’s, but she has had bouts of dementia, and I thought some of the general information about aging might be helpful as well as the specifics about dementia.

One of the overriding themes of the book is to concentrate not so much on what the person has lost, but to deal with what they have now. “Those living with Alzheimer’s who use parts of their brains that still function well, feel enabled and competent, and are less apathetic, agitated, anxious, and aggressive” (p. 9). Those last four “A’s,” he says, are not so much symptoms of the disease itself but rather reactions or results that can be minimized.

Another theme would be to “discard old expectations and role relationships that limit our ability to see the person and relate to him or her in a new way” (p. 11).

Another would be that Alzheimer’s is more complex than just short term memory loss. For instance, a patient “doesn’t ‘forget’ how to get dressed or brush his teeth; it is just more difficult to put all the steps in the right order for multistage activities” (p. 70). Likewise, socially, it’s not so much that they “forget” how to act, but rather “losing control over naturally occurring feelings” (p. 71).

The author discusses the medical aspects of Alzheimer’s, which parts of the brain are affected and which still work well but may need help to be accessed, and gives multitudes of ways to help access that part of the brain and reduce some of the negative reactions. So many of these are so helpful and practical, such as the supplying of information rather than asking questions I mentioned earlier, or the birthday party he described for a person who angered easily. He suggested having it in a dining room, so the setting helps the person know what is expected (rather than a living room or community room where they don’t know what to expect), seating them next to a grandchild, which “evokes hardwired caring instincts,” and having everyone wear name tags (pp. 71-73).

One chapter dealt with arranging living spaces to facilitate patients’ movement and avoid problems. One good idea was “landmarks located at points where a decision must be made, such as a corner or a doorway.” Another was “camouflaged exits.” This was a big problem at one facility my mother-in-law was in. The main doorway was set off by a hall, making it so the workers couldn’t see it unless they walked that way. A lot of the residents accumulated at the doorway, making it hard for visitor to get in and out (in fact, I got scolded once for letting a resident out, but I didn’t know she was a resident. Visitors shouldn’t be expected to police the doorways). Another tip here would have helped this facility: have walkways that are safe and go somewhere, so the patient walks instead of wanders (p. 145). This particular place had no place for patients to “go” – they just had hallways to rooms and a big sitting area, and the aides tried to herd everyone in the sitting area to sit brain dead and silent in front of a TV to keep them under control and out of trouble (as you can surmise, I do not have good feelings or memories of this place). By contrast, the first facility she was in had walking paths that made a circle through the building (she was still using a walker then, and when my husband visited, they would “take a walk” around the circle). They also had a nice screened-in porch (without a door to the outdoors) so residents could enjoy the weather and view and fresh air and still be safe. “The hormone oxytocin is released in the brain when people feel safe. This in turn contributes to lower stress and to greater trust and sociability” (p. 138), so setting up an atmosphere as safe and wired for success as possible helps.

The author asserts that one area of the brain that still works well is creativity, and he spends a good portion of the book discussing the use of the various arts. My first thought was that that would not have been helpful with my husband’s mother, as she was never one for museums or art galleries or plays and such. But as he presented it, I saw ways they might have been useful earlier in her life, though I can imagine she would not have been excited about a trip to the museum at first. But many might find these tips helpful. I did appreciate some of the helpful, thoughtful tips scattered throughout this section, like not asking “What does this painting represent,” but rather asking a specific question about something in it, explaining why they were in the museum or gallery without being asked, not asking them what they saw a half-hour ago, not pursuing a line of conversation if they get anxious, and others (pp. 96-97). Some of these would translate well to other excursions.

One of the most valuable sections is on communicating with a person with Alzheimer’s. The author puts forth these rules and elaborates on them:

  • Hear and respond to the other person’s “reality.” Don’t try to talk them out of it.
  • Be honest.
  • Always address the person directly.
  • Don’t test (as discussed in the first paragraph).
  • Don’t say “don’t”; divert and redirect instead.

A few other important points:

It’s not right to think of Alzheimer patients as entering their “second childhood.” They have knowledge and life experience children don’t have (p. 10).

“Be sure to ask the person with Alzheimer’s for expressions of emotions rather than cognitive data. Ask how they feel about a topic, not who was there a little while ago, or someone’s name” (p. 190).

When moving someone with Alzheimer’s into a new living situation, don’t buy all new things for them or their room (p. 185). Make sure they are surrounded by familiar items, clothes, wall decorations, etc.

I admit near the end I got a little frustrated, because it seemed as if the author were saying that if we just did all of these things, everything would work out fine and Alzheimer’s would be a beautiful and rewarding experience, and I know from many friends experiencing this with loved ones that it is not that way, no matter what you do. But he does advocate, in a section on caring for yourself as a caregiver, having someone you can safely “vent” to, to “pour out your heart with all its anguish and fear” and share “the ‘terrible’ feelings you have” (p. 213). It helped to see this admission that there will still be those times. These tips won’t eliminate every difficulty with Alzheimer’s, but they will help in many ways.

There were a few places I disagreed with him. In one place discussing different types of health care and aid available, he mentions nursing homes as an option as if one can just choose and make arrangements to go there. I don’t know how it works in other states, but here, it’s pretty much impossible to get into one unless you’re coming from a hospitalization. One social worker said she could put us on a waiting list, but they almost never admit someone from a waiting list because they have so many admitted from the hospital (much of this due to Medicare regulations). A few pages later he mentions staff members in both assisted living facilities and nursing homes “who want to work there because they have a natural empathy with elders living with Alzheimer’s” (p. 206). As much as we would hope so and like to think so, that is just not the case (I could tell you stories….). Maybe they started out that way but got burned out, I don’t know. Finally, there is a New Age-y/Zen/Buddhist feel to parts of the book, culminating in a chapter on mindfulness meditation that I would personally be uncomfortable with and even find harmful.

But the strength of the book, and what I appreciated most about it, is the gracious and thoughtful approach to communicating with and dealing with those with Alzheimer’s that permeates every facet of the book.

Genre: Non-fiction
Potenti
al objectionable elements: Buddhist-type philosophies
My rating: For what I mentioned in the last paragraph, I’d give it a 10 out of 10, but due to some of the philosophical differences, overall I think I’d give it a 7 out of 10.

(Sharing with Semicolon‘s Saturday Review of Books and Carol‘s Books You Loved )

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