Tag Archives: Aging

I’m an older woman…so now what?

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Younger and older women alike sometimes look at Titus 2:3-5 with varying degrees of emotion and sometimes more questions than answers:

3 The aged women likewise, that they be in behaviour as becometh holiness, not false accusers, not given to much wine, teachers of good things;

4 That they may teach the young women to be sober, to love their husbands, to love their children,

5 To be discreet, chaste, keepers at home, good, obedient to their own husbands, that the word of God be not blasphemed.

First of all, how old is “aged?” The ESV graciously says “older” instead. Sometimes women resist the admonition in these verses because they don’t want to admit to being an “older” woman (although I’ve often said we’re all older than somebody.) But being now on the far side of my 50s, yes, I have to admit I am probably getting there.

The second questions that comes to my mind is “How am I supposed to go about this teaching?” I don’t think the text means that older women are supposed to buttonhole younger women and lecture them. That would not go over very well at all!

I shared in a post on mentoring women that Paul probably did not have in mind classes or retreats when he wrote this. I don’t know if they had such things (as we think of them) then. We do have them these days, and they can be a great blessing. Even still, there would only be a small number of older women in an “official” teaching capacity. Are the rest of us off the hook? I don’t think so. I also mentioned there that some churches have formed one-on-one mentoring programs, or some women have specifically asked an older woman to meet with them regularly. For me personally, the best teaching I received from older women wasn’t necessarily done deliberately. As a Christian teenager from a non-Christian home, I mostly went to church alone unless I took my younger siblings. Another family in my church invited me over regularly, and God used them greatly in my life to show me how a Christian home operates. The wife, in particular, was a lovely example to me in every way: her relationship with her husband and children, her homemaking, her sweet spirit. But I don’t think they took me on specifically as a “project.” They were just hospitable, and their character and spirit came through everything they did. Similarly, often in the everyday activities of church life – nursery duty, baby showers, ladies meetings, ladies Bible studies, putting bulletin boards up, etc. – very often God would send me “a word in due season” from sometimes a seemingly chance remark by an older lady. One of the few times of specific instruction I remember was when a mom of teenagers was taking about one of them (favorably) while we put up a bulletin board and said something like, “When your kids get older, don’t dread the teen years. Don’t expect those years to be tense and rebellious. You can have a good relationship with your teens and they can grow a lot during that time.” That stayed with me through my own kids’ teen years, and I am so glad it did, because the worldly wisdom by then was that it’s a necessary rite of passage for teens to be rebellious and somewhat estranged from their parents. That lady’s advice probably saved our family from some grievous attitudes during that time. So, though there are other more official ways to teach, to me, to employ an overused phrase, “doing life together” is one of the best.

Then there is blogging and writing. Again, this may not be something Paul had specifically in mind, but it’s a great avenue to share truth in this day. Many of us won’t go on to write books, but we can share from our experiences through a blog. For me, again, some of my favorite blogs have not been specifically didactic, though I have learned from that kind as well. When I first started blogging, the blogging world (at least among the women I knew) was chatty and neighborly, more like visiting over the back fence. There wasn’t as much talk then of “branding” or finding one’s niche. Sometimes I consider whether I should make my blog a little more professional or focused, but for now, even though I do get a little teachy in some posts, I still prefer the “doing life together” aspect, and hopefully sharing a Christian view of handling life in the process. I do wonder whether that costs me some readers who don’t view a blog like this as a “serious” blog next to the didactic ones. I probably would never make any list of “Best Christian Women Bloggers Over 50.” But that’s not my goal. My goal is to blog about life and what God is teaching me along the way. As I mentioned, some of my favorite blogs were the same type. For example, my friend Dianna, who, sadly, isn’t blogging any more, wrote mostly about her home and family, but her sweet godly spirit shone through and was an example, and often a rebuke, to me, just in her writing about the course of her day or some project she was doing at home.

When it comes to what to teach, I am much relieved by what the text says. I don’t think this is an exhaustive list: I think older women can teach other women the Word of God in an expository manner and touch on other subjects than what is listed. Lisa Spence discusses this more fully in her post I am more than my motherhood. But what relieves me in reading about the specific topics listed is this: I don’t have to take sides in the latest “mommy wars” topic being debated or on any couple’s marital debate, but in my interaction with women, I can teach and encourage loving hearts and godly attitudes. I’m relieved that I don’t necessarily have to teach younger women how to raise their children, because I’ve been astonished at how much I have forgotten about some of the details, and some recommendations have changed over the years (even with my own three children in the nine-year span between the births of the oldest and youngest, I had three different official medical instructions about the position they were supposed to sleep in from the same doctor). Plus there is a lot of room for different opinions and methods even in Christian parenthood. I’m happy to share any specifics I might remember when asked or if I think of something that would be helpful. But above the details, I’m concerned with godly character.

I have read a number of times over the years the question from younger women, “Where are the older, godly, Titus 2 women?” More recently I’ve seen the question, “Where are the older women bloggers?” Lisa makes the point that older women can’t write about parenting their teens or adult children as they write about their 2-year-olds because we need to be circumspect about their privacy. They may not want Mom to share anything about their interactions, good or bad, even if it might be helpful to others. Sometimes older women hold back because they don’t feel qualified: they feel like they’d have to “have it all together” in order to say anything. Years ago at a ladies meeting when I wanted to set up a panel discussion and entertain some questions about how to love one’s husband, I had a hard time getting anyone to be on the panel for this reason: everyone felt their own need of instruction, no matter how old they were or how long they had been married.  Some things I wrote in an earlier post, Why Older Women Don’t Serve (in the church), come into play here as well: sometimes older women in the “sandwich generation” are taking care of elderly parents or facing their own health issues. Sometimes, honestly, they don’t feel wanted. I’ve shared before that I was stunned when a younger mom shared with me that the younger women didn’t come to our ladies’ meetings because all the ladies there were “older.” My first thought was, “Well, of course that’s the case if the younger women don’t come.” I was admittedly hurt and my confidence was shaken. We weren’t that much older: this lady was in her early 30s and most of the ladies who attended the meetings were in their 40s and 50s. I wrestled for a long time with how to make our meeting topics and luncheon themes and decorations more contemporary and appealing to younger women, but I’ve always had a little hesitancy since then in dealing with younger women, feeling that they don’t really want to be around me. Aimee Byrd touched on the fact that older women bloggers are out there, but they don’t get as much notice because everyone follows after younger women bloggers (many of whom are doing a wonderful job.). Perhaps older women just need to be encouraged that we really do want to hear them.

So to younger women who are seeking Titus 2 women in their lives, I would say this:

  • First of all, pray for God’s guidance, direction, and provision.
  • Second, look around among the women in your church or family.
  • Observe. In every stage and season of my life, God has placed ladies just ahead of me that I have learned much from just by observing.
  • Interact with them, whether going to ladies’ meetings, talking with them at baby showers, asking them over for lunch or dinner, etc.
  • Feel free to ask questions. They’re much more willing to share when they know their thoughts are wanted.
  • Don’t expect perfection. You won’t find it. No one is faultless. In addition, sometimes an older woman will share something with you that offends you. Sometimes that’s because we are not willing to change in an area we need to; sometimes it’s because the older woman was not terribly gracious. In a post that has stayed with me for years, Courtney Joseph told about someone confronting her about modesty in not the most gracious way, but to her credit, Courtney took to heart the things she said because truth rose above the attitudes (her follow-up post here encourages readers to extend grace even when others have not acted graciously towards us. That’s what grace does.)
  • Don’t expect a fairy godmother. In some source I forgot to note, one woman lamenting not having  Titus 2 woman in her life wanted someone to come into her home, watch her children, help her with housework, answer all her questions, and solve all her problems.
  • Be teachable. When I looked up the Greek word translated “teach” in Titus 2:4, the definitions listed were:

1. restore one to his senses

2. to moderate, control, curb, disciple

3. to hold one to his duty

4. to admonish, to exhort earnestly

Most of us wouldn’t mind that from a book or speaker, but would hold at arm’s length, or even be offended, at someone trying to do these things on a personal level. Incidentally, this is the only occasion this word is used in the New Testament.

  • Glean. Sometimes you’ll get different opinions from different older women whom you respect and who both love the Lord. This was hard for me as a young mom until I hit upon the idea of gleaning – kindly listening and then taking from their advice what would best work for our family and leaving the rest.
  • Read. I’ve probably benefited as much, if not more, from reading books written by godly older woman as I have from personal interaction, both books specifically designed to teach Titus 2:3-5 as well as biographies and even, in some cases, Christian fiction.

To older (however you define that) women, wondering how to go about living out Titus 2:3-5:

  • Concentrate on being before doing. Notice verse 3, which we often gloss over to get to the rest, talks about an older woman’s character. Holiness, self-control, discretion, concern for others, truthfulness, and being willing to share with others are all a part of what we need to cultivate in our own lives.
  • Be aware that younger women will probably observe your actions long before they ask you specific questions. Don’t do anything for “show,” but be mindful of your example, seek God’s grace to be a good one, and confess to Him (and anyone else involved) when you fail. Seeing how someone handles a failure can be as instructive as anything else.
  • Pray for God’s guidance, direction, and grace.
  • Remember the source of wisdom and the way He wants us to share it: “If any of you lack wisdom, let him ask of God, that giveth to all men liberally, and upbraideth not; and it shall be given him” (James 1:5); “But the wisdom that is from above is first pure, then peaceable, gentle, and easy to be intreated, full of mercy and good fruits, without partiality, and without hypocrisy” (James 3:17); “But of him are ye in Christ Jesus, who of God is made unto us wisdom, and righteousness, and sanctification, and redemption” (1 Corinthians 1:30).
  • Don’t wait for perfection. That won’t happen til you get to heaven. Women need examples and instructions from women with the same struggles and faults they have so they’ll know they can seek God’s grace, forgiveness, and help with them.
  • Seek ways to interact with and develop relationships with younger women. Show interest. Sometimes that might mean seeking them out at a church function rather than the friend you always talk to. Sometimes that might mean extending hospitality. A couple of women I know minister specifically to younger women, one by offering to babysit, the other by offering to help out at home for a few days after a baby is born. Those might not be your way of ministry, but God will direct you in what you can do. And He may not lead you into an “official” ministry, but just being available and encouraging, being a conduit for that “word in due season,” is a great help in itself.
  • If you feel a younger woman does need confrontation in some area, pray much about it first and seek to have a gracious attitude. Don’t assume her motives are wrong: maybe she was never instructed or hasn’t thought about the issue. It’s usually best to speak from the position of a relationship with the person rather than from that of an acquaintance, to talk with that person privately, and not to discuss their issues with anyone else.
  • Don’t fall into the trap of seeming as though the way things were done “in our day” are the only way they can ever be done.
  • Don’t cross the line into being a busybody.
  • Somehow we usually think of these verses in regard to newly married women or young moms. But don’t forget about single ladies and middle-aged ladies. I’d love to see more writing from godly women about handling an aging body, parenting adult children, being a mother-in-law, caring for aging parents, preparing for “old” age, etc.
  • Realize that younger women do want to hear from you.

May God give ladies of all ages grace as we seek His will and interact and learn from each other.

Related posts here at Stray Thoughts:

How Not to Become an Old Biddy.
Mentoring Women.
Why Don’t Older Women Serve?
Ways Older Women Can Serve.
“Despise Not Thy Mother When She Is Old”
With All Our Feebleness.
Finishing Well.

Sharing at Literary Musing Mondays, Inspire Me Mondays, Me, Coffee, and Jesus, Testimony Tuesday, Wise Woman, #TellHisStory, Works For Me Wednesday, Thought-Provoking Thursdays.

 

Am I Doing Any Good?

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Old Woman Dozing by Nicolaes Maes (1656), Royal Museums of Fine Arts, Brussels

As my mother-in-law has gotten older, she has been sleeping more. Usually when I went to see her when she was in assisted living facilities and then in a nursing home, she would be dozing in her wheelchair and I would have to wake her up to visit. She used to encourage me to wake her up because she could sleep any time, but she didn’t get many visitors and didn’t want to miss a visit because she was sleeping. Later she was more inclined to stay asleep. Once when I woke her up to visit, she actually told me, “Next time, don’t wake me up.” Usually, though, she did her best to be pleasant, but even then, after just a few minutes, she would start yawning and rubbing her eyes, her head would start drooping, and if she had a pillow propping her up in her wheelchair, she’d nuzzle against it to get comfy again.

When she was awake, though, many times our conversations would get stuck in a loop with the same questions and answers and comments over and over again.

Sometimes I was tempted to wonder if it was worth a 40 minute drive round trip to wake her up for 5-10 minutes of groggy conversation that she likely wouldn’t even remember, or to have the same conversational loops repeatedly.  I’d wonder what good it was really doing to visit her.

Other times, she’d be awake and we’d have a good talk, or I would be able to do some little service for her, like change her hearing aid battery, clean off her table, advocate for her with the staff over something, bring her mail, etc., and then I’d feel useful or feel like I had accomplished something with the time.

What I had to realize was that visiting her was not supposed to be about making me feel useful. It was supposed to be about letting her know she was loved and remembered and ministering to her in whatever way she needed.

A dear lady at church writes to my mother-in-law periodically and will occasionally check in with us to see if she seems to be getting anything out of her notes. I tell her that she may not remember who the lady is or that she wrote to her, and she wouldn’t know if she never wrote again, but for those few minutes that I read the note to her, she knows that someone was thinking about her.

I think perhaps this is why some elderly seem to be forgotten in facilities. We assume their needs are being taken care of, they won’t remember whether we’ve come or not, they might not even remember who we are, and our lives are filled with “important” things to do. But here are a few reasons why it is still good to visit or write them, even if it seems the visits or notes don’t seem to be accomplishing all that much:

Pure religion and undefiled before God and the Father is this, To visit the fatherless and widows in their affliction, and to keep himself unspotted from the world.  (James 1:27)

For I was an hungred, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in: Naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me.

Then shall the righteous answer him, saying, Lord, when saw we thee an hungred, and fed thee? or thirsty, and gave thee drink? When saw we thee a stranger, and took thee in? or naked, and clothed thee? Or when saw we thee sick, or in prison, and came unto thee?

And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me. (Matthew 25:35-40)

Now we exhort you, brethren…comfort the feebleminded, support the weak, be patient toward all. (I Thessalonians 5:14)

Whosoever shall give to drink unto one of these little ones a cup of cold water only in the name of a disciple, verily I say unto you, he shall in no wise lose his reward (Matthew. 10:42)

To do good and to communicate forget not: for with such sacrifices God is well pleased (Hebrews. 13:16)

There were a few gems in the aides at many of those facilities, but, in our experience, many of them were just punching the time clock, going through the motions for the day. We’ve actually witnessed some talking to each other over her while they tended to her, never once speaking to her, hardly even looking her in the eyes. You can imagine, then, what it would mean in a situation like that to have someone come to see you personally, to look you in the eyes and just be with you rather than bustling about getting other things done.

A couple of years ago, we brought my mother-in-law to our home. She had gotten down to about 90 lbs. in the nursing home and seemed out of it most of the time, and we thought we were bringing her home to die. But as she got off the medications they had her on and under one-on-one care, she started eating again, gained weight, became more mentally alert, and thrived. Now, though, she sleeps about 20 hours a day and doesn’t speak much at all any more. My “wondering if I am doing any good” takes a different tack now. We know we’ve done her good in taking care of her needs. Our ministrations have kept her alive. But to what kind of life? To sleeping interrupted by meals that are not always wanted, to baths that are definitely not wanted,  and to occasional episodes of The Waltons are Matlock? Who would want to live like that? Well, I suppose if that was the life I had, I would still value it over losing it. It would be unthinkable not to meet her needs even in such a condition. Life and death are in God’s hands. So why does He leave one of His loved ones to linger here in such a condition when they long ago prepared for heaven by trusting Jesus as Savior and are eager to joined loved ones there? We don’t know all the answers to that, but I believe a large part of it is what my friend Esther shared after caring for her mother-in-law with Alzheimer’s for several years: He works in us through them, teaching us what it means to honor a parent, to minister, to love unconditionally, to confront our selfishness, to stop bustling around and just sit and connect with one other person. I think He also shows us a picture of how we must look before Him: helpless, completely dependent, messy and unable to do anything about it. Yet He loves us. He doesn’t resent cleansing and caring for us. He knows how thoroughly we need Him even more than we do. Seeing my own helplessness and basking in His love and care for me helps love for others to well up in my own heart.

A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another.
(John 13:34)

So after [Jesus] had washed their feet, and had taken his garments, and was set down again, he said unto them, Know ye what I have done to you? Ye call me Master and Lord: and ye say well; for so I am. If I then, your Lord and Master, have washed your feet; ye also ought to wash one another’s feet. For I have given you an example, that ye should do as I have done to you (John 13:12-15).

Therefore all things whatsoever ye would that men should do to you, do ye even so to them: for this is the law and the prophets.  (Matthew 7:12)

Ministry to the elderly may not have the pizzazz or “results” that other ministries have, but it’s an essential ministry that we cannot forget, as individuals or as churches. Some elderly may have physical needs that we can help meet, particularly those still living alone. But for many, their main need is God’s love shown thrown human connection.

God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister (Hebrews. 6:10).

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(Revised from the archives)

(Sharing at Inspire Me Mondays, Testimony Tuesdays, Telling His Story, Thought-Provoking Thursday)

Laudable Linkage

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It has been a while since I’ve shared interesting reads I’ve come across online. Here are some from the last few weeks:

Moms With Hands Full Need the Church.

I’m Grateful That Lady Forced a Bible On Me, HT to Challies. “We have this idea that doing something significant for God requires huge planning, red letters in the sky, a parting of the sea, signs and wonders. But the truth is, He’s working through us in ways we could never arrange on our own.”

No Disappointment in Jesus? HT to Story Warren. “It’s in life, in the real world, down here where things do and do not pan out, that the just are supposed to live by faith. When we are honestly disappointed in the way the God we trusted has handled things, when what has happened was not at all what we wanted—then statements like “Not my will but thine be done” have powerful meaning. What a sinewy kind of trust old John the Baptist had as he lay in chains—captive, doomed, lonely, blessed, and not offended.”

Are You Letting Your Kids Walk All Over You?

I Don’t Know What to Say. What’s helpful and not helpful when someone is grieving.

What I Learned From Elisabeth Elliot in Her Last Years.

Elisabeth Elliot’s Writings. Ann gives a good overview.

Staring at Dementia, Fighting For Joy.

Where’ve You Been? Story behind a touching and beautiful song about a man’s grandparents, one with Alzheimer’s.

How Can I Have a Successful Blog While Raising Little Kids?

Father’s Days: A Cartoonist’s Journey Into First Time Fatherhood of a baby with a severe illness.

7 Things You Need to Know About Medicare But Probably Don’t.

A boy’s stuffed tiger goes on a grand adventure at Tampa International Airport. Thought this was so cute and sweet!

Of course, yesterday’s Supreme Court ruling is on many minds and hearts. I’m still processing the news and don’t know whether I’ll say any more about it, but the best posts I’ve read so far are But What Does the Bible Say? by Kevin DeYoung and CBMW’s Official Response to the SCOTUS Ruling, and then Nancy Leigh DeMoss has a video response here.

Melanie shared this recently – a real-life illustration of the sheep knowing their shepherd’s voice:

I don’t know how many of you are familiar with Ron Hamilton, aka “Patch the Pirate.” He’s fairly well known in the Southeast. I love this arrangement of his song. Ben Everson is a master at these mutli-harmony things:

Happy Saturday!

Adventures in Elder Care

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Eldercare

Seven years ago my husband and I moved his mother 2,000 miles to be near us when she couldn’t live on her own any more. She lived in three separate assisted living facilities, a nursing home, and then came home to live with us about 2 years ago. In the posts below I detail some of that journey and pass along tips and truths that have helped us during this time. I hope you will find something to help you in your journey as well.

Helping Parents As They Age.

12 Things You Should Know About Caring for the Elderly.

Decisions.

Assisted Living and Nursing Homes.

The Introvert in Assisted Living (Ideas for one on one activities)

Caring For a Parent at Home.

Dealing With Caregiver Resentment.

A few more thoughts about caregiver resentment.

A Plea to Caregivers

Ministering To the Elderly and Their Caregivers.

It’s Not for Nothing.

Am I Doing Any Good?

But That’s Not My Spiritual Gift!

Remembering the Loved One Who Has Forgotten You

Bible Verses For Caregivers

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A few more thoughts on caregiver resentment

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EldercareSeveral thoughts coalesced this morning to a realization. I wrote last week about caregiver resentment, and I may go back and add this in at some point.

We can get resentful or “weary in well doing” in just about any endeavor. But I think in most of them, you have every expectation of seeing improvement or completion. If you’re building something or involved in a big project, you know at some point it will be done. Some of the frustrations are easier to bear because you can see progress and look forward to the end results. With the frustrations and limitations of raising children, you also continually see them learn and grow and gradually get more independent and able to do some things on their own. Plus they’re cute, and there are moments of fun and joy along the way.

But with an elderly loved one who is declining, it’s not going to get better. It will likely get worse. And the only way it all ends is when that person dies (or goes to a nursing home, which we feel would only hasten my mother-in-law’s death. She was so low when she was there that we felt we were bringing her home to die – and that was almost two years ago). So wishing to be relieved or for it all to be over seems akin to wishing for that person’s death, which adds guilt to the mix.We backtrack and think, “No, no, no, I didn’t mean that.” We just wish it could be different. But it’s not going to be.

Some caregivers battle depression more than resentment, or maybe both. Besides all that is involved in caring for an elderly person, there is the sadness of seeing them lose mental or physical abilities one by one.

There are times I wonder at God’s ways. Last year we lost our pastor to a short battle with cancer and a young mom of two children to a very sudden and unexpected reaction to a medication. He was in his early fifties, two daughters had just gotten married, he was known for uniquely caring for everyone whose life he touched. He would have been a wonderful grandfather. The young mom left behind a grieving husband, children, and friends. Why are people like that taken “early,” as it seems to us, when they still have so much vitality and usefulness ahead of them, and other people experience a slow decline for years, some vacant and unresponsive in nursing homes, others no longer recognizable due to the alterations of Alzheimer’s?

I don’t know. But I do trust that God has His reasons. He’s doing something in the lives of all the people connected with each individual.

All we can do is continually apply God’s truth to our situations, as I mentioned previously, and depend on His grace day by day.

Something else that helps me a bit sometimes is when I think of my mother-in-law’s situation as analogous to how God sees me: helpless, completely dependent, messy and unable to do anything about it. Yet He loves me. He doesn’t resent cleansing and caring for me. He knows how thoroughly I need Him even more than I do. Seeing my own helplessness and basking in His love and care for me helps love for others to well up in my own heart.

A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another.
 John 13:34.

Dealing With Caregiver Resentment

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I’ve never tried to portray myself as anywhere near perfect or as having it all together, but one fault that seems abominable and embarrassing to have to admit is that sometimes I resent having my mother-in-law here and caring for her. I mentioned some of the disadvantages of caring for a parent at home about seven paragraphs down here.

I Googled caregiver resentment and came up with some practical, helpful tips, but nothing really for the deeper issues. One post even advised just accepting it as part of the whole package. While I can accept that resentment might naturally arise, I can’t accept that as normal and okay: it’s miserable to live with, but even worse, as a Christian, it’s an evidence of my own selfishness. So then I Googled something along the lines of overcoming resentment as a Christian and looked at several of the articles that came up, but most of them dealt with resentment against someone who has done you wrong and the need to forgive.

So I decided to write down some of the things that help me during those times both so it’s here for me to refer back to when needed and so hopefully it might be a help to someone else. And I am calling it “dealing with” rather than “overcoming” caregiver resentment because, although I’d like to have a conversation like this just once and have that take care of my attitude forever, I’ve found I have to go over these things periodically. I guess that is part of living with a sinful nature and needing to renew one’s mind.

So here are ways to deal with resentment, beginning with the practical and moving on toward the spiritual:

1. Take care of your own health, including getting enough sleep. Everything seems worse if you’re sleep-deprived or dragging because you’re not eating right.

2. Talk to someone. My husband and I feel free to talk honestly with each other, and he’s not offended that I do get frustrated with the situation sometimes. I know I have an open door to talk with him about it whenever needed.

3. Get away from the situation sometimes. I am thankful we do have a caregiver here in the mornings so I can run errands or take care of other things, and occasionally we’ll have someone come in for an evening or stay longer on a Saturday so we can have an outing.

4. Remember what brought you to this place. As we trace our history with my mother-in-law’s care, we come again to the same conclusion, that this is the best situation for her at this stage. There may come a time when one or both of us become unable to care for her or her needs become greater than what we can manage at home, but for now, this is best.

5. Remember that caring for a loved one at home used to be the norm before assisted living facilities and nursing homes became widespread, and it still is in some countries.

6. Remember her care of you or your husband for so many years, and look at this as an opportunity to repay her love and care.

7. Remember it could be worse. My mother-in-law is not hard to get along with at all. Some of the residents we encountered in assisted living or the nursing home perhaps made us appreciate that fact even more.

8. Take it a day at a time, or a moment at a time. If we think, “How many years will I have to do this?” we can feel defeated and depressed. All we have to do is deal with this moment, this day, and trust God’s grace will be sufficient for all the days ahead.

9. Think how you would want to be regarded and treated if you were in the same situation.

10. Accept it as God’s will. Maybe you didn’t have time to sort through options, as we did, to come to the conclusion to bring an elderly parent home, or maybe there are extenuating circumstances that compound the resentment you feel. Maybe you don’t have a parent at home, but you’re the only sibling in town to visit them or oversee their care in a facility. Maybe it is even time to do something different. But for this moment right now, this is God’s will for you, and if you surrender it to Him, He will provide the grace to deal with it. “In acceptance lieth peace,” a poem by Amy Carmichael attests.

11. Pray. Sometimes just before going into my mother-in-law’s room to change her, I pray that I might be “Strengthened with all might, according to his glorious power, unto all patience and longsuffering with joyfulness,” part of Paul’s prayer in Colossians 1:9-13. Or, as the ESV puts it, “May you be strengthened with all power, according to his glorious might, for all endurance and patience with joy.” That encompasses so much: that I need His strength, longsuffering, and patience, that He has the “glorious power” to give it, and that He can help me to go beyond just acting out of duty, but He can enable me to serve with joy. I also frequently pray that He will help me have a more loving, unselfish heart.

12. Remember the Christian life is one of service, not self-focus. Claudia Barba said in The Monday Morning Club, “The Christlike life has nothing at all to do with satisfying, coddling, or promoting self, but everything to do with being poured out for others” (p. 55). You see it in the life of Christ and Paul and others in the Bible both in instruction and in example. That doesn’t mean we’re doormats or martyrs or that we can never we can never do anything just for fun. But our primary purpose is serving Him by serving others. Some verses that help in this regard are:

Now we exhort you, brethren…comfort the feebleminded, support the weak, be patient toward all. (I Thessalonians 5:14).

Whosoever shall give to drink unto one of these little ones a cup of cold water only in the name of a disciple, verily I say unto you, he shall in no wise lose his reward (Matthew. 10:42).

To do good and to communicate forget not: for with such sacrifices God is well pleased (Hebrews. 13:16).

God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister (Hebrews. 6:10).

So after [Jesus] had washed their feet, and had taken his garments, and was set down again, he said unto them, Know ye what I have done to you? Ye call me Master and Lord: and ye say well; for so I am. If I then, your Lord and Master, have washed your feet; ye also ought to wash one another’s feet. For I have given you an example, that ye should do as I have done to you (John 13:12-15).

With good will doing service, as to the Lord, and not to men (Ephesians 6:7).

And let us not be weary in well doing: for in due season we shall reap, if we faint not. (Galatians 6:9)

For I was an hungred, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in; naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me. Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me (Matthew 25:35-36, 40).

13. Accept this as my primary ministry. This is one area I struggle with the most. As the nest starts emptying, though we miss our kids intensely, we begin to look to other things that have been put on the back burner for a while: maybe now we can write that book, get that degree, travel, sew up all that fabric or complete all those projects. But now we’re tied down again. Or maybe some have had to step back from other ministries at church in order to care for a parent. We need to remind ourselves that this is not a hindrance to our ministry: it is our ministry. Even limitations set the parameters of our ministry. Elisabeth Elliot has said:

This job has been given to me to do. Therefore, it is a gift. Therefore, it is a privilege. Therefore, it is an offering I may make to God. Therefore, it is to be done gladly, if it is done for Him. Here, not somewhere else, I may learn God’s way. In this job, not in some other, God looks for faithfulness.

I don’t mean to reduce caring for a parent to a “job,” but I believe we can substitute “ministry” for “job” there.

I hope some of these are helpful for any reader facing any kind of resentment in your situation, and I’d be happy to hear any other thoughts or tips you might have.

EldercareSharing at Thought-Provoking Thursday. and Works For Me Wednesday.

Book Review: Being Mortal

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Being MortalI could wrap up my comments on Being Mortal by Atul Gawande succinctly by saying that if you plan on getting old or dying or helping a parent as they age, you need to read this book. But I’ll try to give you a bit more to go on.

I don’t know that I would have noticed this book at all except that Lisa and Joyful Reader both mentioned it. I knew they had dealt with deaths of parents and grandparents, Lisa’s mom had been in assisted living and Joyful’s grandmother lives with her, so with their experience, their praise for this book meant a lot.

I ended up marking many more pages than I can possibly share, but it’s safe to say that much in this book resonated with me.

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The subtitle of the book is Medicine and What Matters in the End, and it’s a frank treatment of end-of-life issues. Medicine, Dr. Gawande asserts, is geared to fix things. But in some cases the treatment is worse than the disease itself. And this tendency is part of what had led to institutionalizing people as they age and making it a medical matter rather than trying to give people in such situations the best days they can have in the time they have left.

Gawande notes that until fairly recently, most deaths occurred at home. Now most occur in hospitals and nursing homes “where regimented, anonymous routines cut us off from all the things that matter to us in life” (p. 9). In addition, it used to be that, unless you had a long, wasting illness like consumption, most deaths came suddenly like a thunderstorm. Modern medicine has been a marvel and a gift from God: many things that used to be fatal can now be treated. But like any gift, there are good ways and not so good ways to use it.

“The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn’t, someone who understood that the damage is greatest if all you do is fight to the bitter end.”

I appreciated his explanation of how the style of doctoring has changed over the years, from the authoritative “Dr. Knows-Best” who made all the decisions for you, to “Dr. Informative,” who merely laid out all the options and let you decide. The problem with the latter is that we don’t always know how to process the options. When the author’s own father faced a tumor in his spine, he, his father, and his mother were all doctors yet felt overwhelmed by the information and options they were receiving. A third kind of doctor is called “interpretive” and gives information as well as guidance after asking what’s most important to you and what your concerns are (pp. 100-102).

Gawande proposes a series of questions to consider when the diagnosis is terminal, questions concerning what’s most important, what one’s goals and fears are in facing the time they have left. One man said he wanted to continue to eat ice cream and watch football on TV, and he wasn’t interested in any treatment that interfered with those activities: life wasn’t worth living without them. Some are willing to live with different degrees of disability and pain: some don’t want to suffer at all. It’s good for a family to have these discussions so they have some idea what would be the most important to their loved one. Sometimes it requires more than one hard discussion: “Arriving at acceptance of one’s mortality and a clear understanding of the limits and the possibilities of medicine is a process, not an epiphany” (p. 182), and your preferences might change over time as well. But these discussions are necessary to find the best means of “living for the best possible day today instead of sacrificing time now for time later” (p. 229).

Gawande also details the journey from being independent to needing assistance to needing full time care that elderly and their families face. We’ve faced much of this with my mother-in-law over the last few years. I especially appreciated the history of nursing homes and assisted living facilities and the goals and purposes that Keren Brown Wilson, who “invented” assisted living, had when she started, and how those were originally implemented and maintained and then encroached upon to the point that she had to resign from her own board. Nursing homes themselves “were never created to help people facing dependency in old age. They were created to clear out hospital beds” (p. 71).

Many of the problems he lists in assisted living and nursing homes were the same as what we had found: loss of autonomy and privacy, loss of purpose, “tasks [coming] to matter more than the people” (p. 105), “safe but empty of anything they care about” (p. 109). “Making life meaningful in old age…requires more imagination and invention than making them merely safe does” (p. 137).

In older history and in other countries, the old are revered as having great knowledge and wisdom: “Now we consult Google, and if we have any trouble with the computer we ask a teenager” (p. 18). At least one sibling used to stay with the elderly parent(s) and help care for them, and then got a larger portion of the inheritance or perhaps the family home in place of what they gave up. Now both parents and adult children value their independence. But “our reverence for independence takes no account of the reality of what happens in life: sooner or later, independence will become impossible” (p. 22). Yet the author researched and visited several creative ways for an older adult to retain as much independence and autonomy as long as possible.

One problem is that even though geriatric specialists have been shown to enhance the lives of the elderly, geriatric units are shrinking or being closed rather than growing. “97 percent of medical students take no course in geriatrics” (p. 52). One reason is that it doesn’t pay well; another is that insurance doesn’t see the need for it. It remains for those of us who deal with the elderly or who look ahead to our own old age to be aware of issues.

When I was first looking at information about the book, I was wary that the author might promote assisted suicide for those with terminal illnesses. He does not promote it, but he would support legislation to enable giving people lethal prescriptions if asked, noting that half of them don’t use them: they just like the assurance that they could. He does note, though, that in countries where it is legal, use has grown: “But the fact that, by 2012, one in thirty-five Dutch people sought assisted suicide at their death is not a measure of success. It is a measure of failure. Our ultimate goal, after all, is not a good death but a good life to the very end. The Dutch have been slower than others to develop palliative care programs that might provide for it….We damage entire societies if we let this capability [assisted suicide] divert us from improving the lives of the ill. Assisted living is far harder than assisted death, but its possibilities are far greater, as well” (p. 245). (A good Christian source on some of these thorny issues is When Is It Right to Die: Suicide, Euthanasia, Suffering, Mercy by Joni Earacekson Tada.)

He also points out that it is difficult to know exactly where the lines are sometimes. “We also recognize the necessity of allowing doses of narcotics and sedatives that reduce pain and discomfort even if they may knowingly speed death” (pp. 243-244). Sometimes it is wrong to turn off a ventilator: sometimes it is right. If a 20-tyear-old was diagnosed with Type 2 diabetes and wanted to let “nature take its course” rather than treating the illness, we’d try to convince her that the quality of life she could have with treatment would be well worth it despite the complications: it would be ridiculous to die of diabetes when there is treatment available and the possibility of a long, productive, and happy life. On the other hand, when my father was dying of various other issues and they suspected he had colon cancer, they decided not to put him through what would be involved in diagnosing, much less treating it, because in the long run it would not make a difference in how long he would live and would only make his last months miserable.

The author writes from a secular viewpoint. As a Christian, I thought a lot about how a Christian worldview would affect this topic. As Christians we know where we and our believing loved ones are going, which takes some of the sting out of death. But we don’t take it lightly or flippantly, either. Death is still called an enemy. We hold life as a gift from God and believe He is the only one with the right to end it. It is to be given back to Him and used for His purposes. Sometimes that includes suffering, yet we’re also called to alleviate suffering if possible. While there are fears about loss of independence and abilities in older age, we can trust God to help us through that time: And even to your old age I am he; and even to hoar hairs will I carry you: I have made, and I will bear; even I will carry, and will deliver you.  Isaiah 46:4. But issues and question the author brings up are needful to consider, preferably before crises hit. In some cases there is no one right answer for what kind of treatment to pursue: the answer will vary depending on a number of factors.

I like this summation near the end of the book:

I am leery of suggesting that endings are controllable. No one ever really has control. Physics and biology and accident ultimately have their way in our lives. But the point is that we are not helpless either. Courage is the strength to recognize both realities. We have room to act, to shape our stories, though as time goes on it is within narrower and narrower confines. A few conclusions become clear when we understand this: that our most cruel failure in how we treat the sick and aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives (p. 243).

(This review will also be linked to Semicolon‘s Saturday Review of Books.)

How Not to Become an Old Biddy

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Crabby-Old-Lady

After I was married but before I had children, I worked for some years at a fabric shop. We had a variety of customers of all ages, but some of the ones that stood out to me were the older ladies. Some were very sweet. I remember one, after I had spent a great deal of time helping her (to choose some buttons, if I remember correctly), saying, “You’ve been so kind – here, let me buy you a cocoa” while she put some change on the counter. I don’t remember what I did in response: I remember thinking I probably shouldn’t take her money, but I didn’t want to offend her, either.

On the other hand, other older ladies were…cantankerous, to put it nicely. Really, all customers could fit into either of these categories, but somehow they seemed sharper and more focused in old age.

I remember thinking that I hoped when I became an old lady, I’d be one of the nicer ones. Then, of course, it dawned on me that I was in the process of becoming the kind of older lady I would be, and I needed to start working on that now.

Now I am in my “middle years,” but with “old age” looming some time in the future (when exactly it starts keeps getting pushed back further and further 🙂 ), I’ve started to think in a more concentrated manner about becoming the right kind of older lady. So I thought I’d preach to myself a little bit in preparation. You’re welcome to read along. Keep in mind I am preaching to myself, not older ladies – that’s not my place.

Avoiding the wrong kind of old age:

Having a know-it-all attitude. Years and experience can provide more wisdom, but we should never get to the place where we can’t humbly receive what someone else has to say.

“The way we always did it” syndrome. Every new generation brings with it new vocabulary, new technology, new methods. Older people can help younger ones discern between new methods and old truth and try to keep the latter from sliding into oblivion, but we shouldn’t insist that everything be done the way we always did it (or gripe when it isn’t).

Being busybodies. Many years ago, an older lady in our church at the time told one young mom of seven that she was having too many children too close together, and another young married lady, who with her husband wanted to wait until he was out of school before starting a family, that she needed to get busy and start having children. You can imagine that both women were hurt and offended. I am sure that was not the older woman’s intent and that she thought she was helping others with the benefit of her accumulated wisdom, but she overstepped. Before sharing advice, we really need to seek the Lord about whether it is really needed and how and when it should be shared.

Being quick to judge.

Gossiping.

Impatience. You would think a person would increase in patience over the years, but I have not found that to be the case for myself. This is one area I know I especially need to work on.

Forgetting what it is like to be young, to have small children. etc.

Sharp words.

Being caught up in our physical issues. I have mixed emotions about this one. One does start having more physical issues the older one gets, and we shouldn’t expect older people to try to cover that up: we need to listen and empathize. We know how we feel now when we’re ill or hurting for a few days or weeks: imagine if that was the norm and not the occasional occurrence. On the other hand, if I expand my horizons a little bit, it will probably help my own outlook as well as give me something else to talk about.

Developing into the right kind of old age.

Keep in the Word of God. If you’ve read it through several times during your life, you may feel like you’ve got it all down. But we always have room to learn and grow spiritually: we always need fresh communion with our heavenly Father.

Take an interest in others. One serious problem for older people in our churches, as they wane in energy or start having physical problems and can’t attend as often, is that we tend to forget them. Or we hope they’re doing ok but neglect taking the time to make contact, especially if they don’t have e-mail or aren’t on Facebook where we can do so easily. As we age we may get to a place where we can’t contact others, but until then, as much as possible we can take the initiative to make a phone call or send a note.

Look for ways to serve others. You may not be able to head VBS or organize a banquet or serve in the ways you used to, but you can look for ways you can serve in your present capacity.

Don’t stop learning and growing.

Come to terms with a failing body. I don’t mean that we stop taking care of ourselves, but we realize that our physical bodies come with a limited shelf life. Years ago I heard a radio preacher say that one reason God lets our bodies start failing us as we get older is to make us more willing to give them up when the time comes. Each aging problem is a reminder that I won’t live on this earth forever, and I need to be prepared for eternity.

Don’t be bitter. People have failed us and will continue to. “Let all bitterness, and wrath, and anger, and clamour, and evil speaking, be put away from you, with all malice: And be ye kind one to another, tenderhearted, forgiving one another, even as God for Christ’s sake hath forgiven you.” (Ephesians 4:31-32).

Seek God’s will and wisdom in sharing advice. The Bible does say one thing older women are supposed to do is teach the younger (Titus 2:3-5), but it’s not always easy to know how to go about it. Dispensing unwanted advice right and left is not usually received well, especially, when it is done with harshness and impatience and a superior attitude. We need to pray much and be sensitive to the Holy Spirit’s leading in speaking to others.

Remember God has a purpose for your being here. I’ve heard older women wonder why they are still here when many of their loved ones have passed on and they can’t do much any more. Perhaps God wants you to minister in prayer for others or to be a godly example in your circumstances: perhaps He want to bless and grow others as they care for you.

Throughout my life, from my teens until now, God has placed older women at the stage just ahead of where I am whose example I can learn from. From single college girls to young wives to young parents to parents of older kids and then teens, and now facing the almost empty nest years and “middle age,” I’ve had godly examples to look to. I was inspired by one older lady where we used to live who was put into a frustrating situation of having to retire earlier than expected from a job she loved. She could have become bitter at the situation, but she came to terms with it and went on to find other ways to serve. I watched her make a point to welcome new people at church and invite them to sit with her, have other women two or three at a time over to her house for lunch, and visit with a couple of ladies in assisted living a few times a month. A couple of older ladies in our church now are consistently cheerful and take an active interest in others. One writes notes to my mother-in-law and gets together regularly with another older lady (neither of them drives, but the daughter of one takes them to a restaurant and then picks them up when they’re done).

My own mother-in-law has been a great example to me. I used to say I wanted to live until I was 100: after seeing what she has gone through in the last several years, I’ve amended that to “I want to live until I’m 100 if I can live in my own home, go to the bathroom by myself, and take care of myself.” I hope that will be the case, but God may allow something different in my life as He has in hers. So often when we’re changing her or positioning her or giving her a shower, I think, “You know, I would hate this – I would hate having other people have to handle me and take care of my most intimate needs and not be able to do anything for myself.” She probably would have felt the same way: everyone wants to be able to take care of themselves. But now that she is in this situation, she doesn’t complain (except maybe when our hands are too cold or when we have to wash a contracted hand that hurts) and is usually upbeat and cheerful. She thanks us for the least little thing we do for her. I remind myself that God gives grace for what we need when we need it: I don’t have the grace for old age now, but whatever situation God puts me in at that time, He will provide the grace then for it.

The Bible does have specific instruction for older women:

The aged women likewise, that they be in behaviour as becometh holiness, not false accusers, not given to much wine, teachers of good things; That they may teach the young women to be sober, to love their husbands, to love their children, To be discreet, chaste, keepers at home, good, obedient to their own husbands, that the word of God be not blasphemed. Titus 2:3-5

A godly example of an older lady is found in I Timothy 3:9b-10:

…having been the wife of one man. Well reported of for good works; if she have brought up children, if she have lodged strangers, if she have washed the saints’ feet, if she have relieved the afflicted, if she have diligently followed every good work.

Some of the older women in the Bible that stand out to me are Elisabeth, Mary’s cousin; Anna, who served God in the temple and told others about the coming Messiah; Lois, Timothy’s grandmother, whose “unfeigned faith,” along with that of his mother Eunice, surely influenced him.

And there is specific encouragement for that time of life:

Cast me not off in the time of old age; forsake me not when my strength faileth. Psalm 71:9

Those that be planted in the house of the Lord shall flourish in the courts of our God. They shall still bring forth fruit in old age; they shall be fat and flourishing; To shew that the Lord is upright: he is my rock, and there is no unrighteousness in him. Psalm 92:13-15

And even to your old age I am he; and even to hoar hairs will I carry you: I have made, and I will bear; even I will carry, and will deliver you.  Isaiah 46:4

Can you think of any other truths we need to keep in mind for our old age? Have you had any godly examples of older ladies in your life?

Adventures in Elder Care: Ministering to the Elderly and Their Caregivers

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I didn’t feel I could conclude this series without a post about ministering to the elderly. Some of what I wrote about how to help parents as they age would apply generally, but I wanted specifically to address ways to minister to an elderly person who is not your parent.

Neighbors. If you live near an elderly person who is still in his or her own home, just being a good neighbor is a great first step. Greeting them, talking over the back fence or the mailbox, sharing from your garden, taking them treats (after asking about dietary restrictions), etc., are all ways to keep in touch. Most would welcome a visit, but don’t assume that because they’re older and at home most of the time that they don’t mind if you drop in any time. Some wouldn’t, but some would: as you get to know your neighbor, you’ll be able to discern whether she likes to have company or not, or when might be a good time. You want to be alert for ways that they might need help, but you don’t want to run roughshod into their lives or make them feel useless and helpless. Some might love to have you cut their grass, for instance, but some might take pride that they’re still able to do it and might like the exercise. You might especially be alert to checking on them if you haven’t seen them out for a while.

Visiting facilities. If someone you know is in an assisted living facility or a nursing home, visiting them is probably the number one way to minister to them. Even if they have family that visits often, there are still a number of hours in the day when they don’t have visitors (and it helps the family to know that they are not the only ones who care about the loved one). Some will be more involved in the activities of their facilities than others: you might check with them (depending on their mental abilities) or their family members or even one of the staff members to ask when would be the best time.

Some churches have a regular visitation program for their senior members, which is nice. Just don’t do what one lady did: we happened to be visiting my in-laws at their home when a couple of ladies from their church came to visit my husband’s mom. I believe they brought her a flower, and after she exclaimed about it and expressed thanks for their visit (probably more than once), one of them said, “Well, you were on our list.” If you’re doing something for someone just because they’re on a list of some kind — there is no need to say that! It would be much better to ask the Lord before visiting to help you be a blessing and to have wisdom to know how to best minister to and encourage that person.

What might you do when you visit? Ask about the person, how they’re doing, what their day was like. I read a post about visiting the sick where the writer concentrated only on spiritual issues, like praying with them or reading the Bible or encouraging them with the Word, but left out anything personal. Yes, do those spiritual things: an elderly person might not to be able to or remember to read the Bible on their own, and even if they do, the fellowship of doing it with other believers is a great benefit. But don’t make them feel like they’re a project, like the ladies in the above paragraph. Show a personal interest in them. When you do read the Bible to them, remember some might be hard of hearing. It helps to sit right in front of them so they can see your lips moving and to read in a firm, clear, loud but not yelling voice. One friend used to read aloud and discuss something from the large print Readers Digest with my mother-in-law. Going through a photo album and talking about her loved ones was one of her favorite activities as well.

Often when visiting the person you know in a facility, you’ll have occasion to talk for a bit with other residents. Many in assisted living are fine mentally but can’t live at home for various reasons, and we enjoyed chatting with and getting to know some of them.  I mentioned in an earlier post that things can get a little more complicated when the other residents have a higher degree of dementia. The number one thing we were told was “Don’t alter their reality.” If you try to talk them out of whatever they think is happening, they can get greatly agitated, and that causes more problems not only for the person but also for the staff. When my mother-in-law was in a memory care unit made up primarily of Alzheimer’s patients, residents would often stop visitors to ask for their help in some way. Most of them were constantly trying to figure out a way to get out, not because it was so terrible, but just because they knew on some level that they were not home. When we couldn’t help them in whatever way they wanted, they’d get upset, which again caused more problems for everyone involved. Sometimes you can redirect them: once my husband told a resident who wanted him to help her find her car so she could go home, “Well, they’re just about to serve dinner – why don’t you eat with us and we’ll see about the car later.” She graciously accepted. 🙂 Other times we’d just say, “I’m sorry, I’m just visiting, but maybe that person can help you” and point them to a staff member. Honestly, in that place, sometimes we’d just try to avoid eye contact and go straight to my mother-in-law’s room. I felt bad about that, but that seemed the best way to keep the peace. In the nursing home, when someone said they needed help or wanted to get up or whatever, we’d just pat their hand and tell them someone would be along to help them in a few minutes. If someone seemed in real distress, we’d go find a staff member. I’d caution against giving a person other than your family member any physical help or even going into their room. If someone has fallen, you could do more harm than good and open yourself and the facility up to a lawsuit if something negative happened (or even if the resident accused you of something negative). I wouldn’t even help wheel a resident from one place to another without asking a staff member if it is all right: it may be they are supposed to be where they are rather than back in their room at that point in time.

Gifts. Sometimes people like to bring things when they visit. Most of the time it’s not necessary: just the time with you is the best gift. But there are things that make for good gifts and things that don’t. A lot depends on the individual person. Before bringing any food item, check on food allergies or dietary restrictions. Unless you know the person to be in sound mind, I’d check with someone other than them. Again, depending on a person’s abilities, a fruit basket may not be best. It’s healthy, but some might not be able to peel fruit or might not have knives in their room to cut them up, and it might spoil before they can finish it. I’d generally avoid decorative items unless you know the person could use them. Most have had to downsize their possessions to be able to live in one or two rooms and only have limited space on their walls or end tables. An exception would be anything that children have drawn or colored – most love that and can tape the items on a door or somewhere.

Some items that have made good gift baskets for my mother-in-law in the past:

All-occasion greeting cards (back when she was still sending cards)
Stationery and stamps (when she was still writing)
Pens and pencils
Lotions (some might have skin sensitivities)
Bath items: nice-smelling shampoo, body wash, powder. Avoid bath oils – too slippery
Large-print books, magazines, crossword or word search puzzle books
Small individually wrapped chewable candies
Small packages of cookies
Small throw blankets
Slip-proof socks
Magnifying glass
Tissues
Flowers or plants (see note below)

In our experience, cut flowers (even from the visitor’s own garden) worked better than plants. The staff in a facility doesn’t have time to care for a plant. I personally do not have a green thumb. Unless the resident is aware enough to care for one or has family members who visit often enough and don’t mind caring for a plant, cut flowers are best to brighten up the room for a few days and then can be discarded.

Most facilities do not allow any medication in resident’s rooms: all medication has to be dispensed by the staff (though we did get away with Tums), so I wouldn’t include medicine in a gift basket to someone in a facility.

Cards and notes. My mother-in-law has also been blessed by friends and family sending cards. That is a highlight of her day when I bring in a note or card someone has sent and read it to her.

Value. Sometimes we might wonder how much good we’re doing when we visit or send cards, especially if the person has dementia and might not even remember who we are or that we visited or wrote. They might not remember, but for those few minutes you’ve brightened their day and brought them joy, so I’d say, yes, it’s worth it. I wrote in an earlier post, when I struggled whether it was worth it to drive for 40 minutes round trip for 10-15 minutes of groggy conversation, “But really, visiting her shouldn’t be about making me ‘feel useful.’ It’s about letting her know she’s loved and not forgotten and ministering to her in whatever way she needs.” Remember to minister “with good will doing service, as to the Lord, and not to men” (Ephesians 6:7).

Ministering to caregivers. I wanted to mention ministering to caregivers briefly, rather than a separate post, because I don’t have that much to say about it. It has greatly ministered to our hearts when someone have ministered to my mother-in-law in any way. I can’t tell you how much of an encouragement it is when someone goes to see her or writes to her. It’s encouraging when people ask about her, too, but if I can say this without it sounding wrong – ask about her, but ask about other things, too. When my husband was going through months of issues with his eye after a detached retina, he said that all anyone ever talked to him about was his mom and his eye. It’s not that he didn’t appreciate those questions: he did, but it would have been nice to talk about something else sometimes. Often when asked about my mother-in-law, there is really nothing new to say. When people ask me how she’s doing, I generally say, “About the same.” Some seem a little perturbed by that, so sometimes I go on to say, “She sleeps a lot, eats well, talks a lot sometimes but not at all other times.” I figure they don’t really want to know about bowel difficulties or things like that. 🙂 That’s pretty much her life right now. I don’t want people to forget about her and I appreciate their asking, but just understand there is often not much to say. “About the same” is at least a better answer than “She’s declining,” which is what we had to answer for several months before we brought her home. Sometimes people would seem startled by that response, but as a person gets older, that’s what happens.

A few times, especially when we first brought my mother-in-law home, it greatly ministered to me when someone asked, “How are you doing?” and listened with empathy and without judging when I said I was struggling with the idea.

It also helps when people understand that people caring for a parent might not be as available as they once were. A friend’s mother still lives in her own home an hour away and has had so many medical needs and procedures that my friend has had to lay aside some ministries she was involved in to be able to take her mother to various doctors and help her after procedures. In our case, my mother-in-law can’t be left alone, so we can only do things during the morning and early afternoon while we have home health care here, or we have to take turns or just have one of us go to events in the afternoons or evenings. Some times that’s fine, other times I’d rather stay at home than go by myself, and I don’t like to be out too often and leave my husband to spend his evenings or weekends caring for his mom alone after working 50-60 hours a week. Occasionally we’ll pay extra for home health care to be here in the evening, usually when the family is all here so we can go out, but otherwise we just accept that this is going to be a quiet and somewhat limited phase of life. It’s similar to having a new baby in the home: for a period of time, caring for that family member is one’s primary ministry.

Besides showing an interest in my mother-in-law, there is not really much that we need personally. We haven’t needed meals or errands run or that kind of thing. I did come across one article with some ideas along those lines, and Sandy, whose husband received a heart-breaking diagnosis of early-onset Alzheimer’s while in his 40s, has mentioned in passing things that people have done that have blessed her family.

I’d love to hear more ideas from you. If you have an older loved one, what are some things that people have done that have been a help to you?

Other posts in the Adventures in Elder Care series:

Helping Parents As They Age.
Making Decisions for a Parent’s Care.
Our Experiences With Assisted Living and Nursing Homes.
Caring for a Parent at Home.
A Plea to Caregivers.

Adventures in Elder Care: A Plea to Caregivers

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EldercareIn previous posts from my Adventures in Elder Care series, I discussed helping a parent as they age, things to consider when making decisions about care, our experiences with assisted living and nursing homes, and caring for a parent at home.

As we’ve dealt with my mother-in-law’s slow decline, we have had her in three different assisted living facilities (she had to move from the first when we moved to another state, from the second when she could no longer get herself where she needed to be during a fire drill in the allotted time, the third when she was hospitalized with a septic infection and her facility said they would not take her back because her needs exceeded their abilities), a nursing home, and now we have her at home with home health care aides coming in a few hours a day. We’ve seen a variety of caregivers, some very good, and a few, not so much. I wanted to bare my heart with a plea to caregivers.

But before I do, I want to say that I know you don’t have an easy job. We saw a fairly quick turnover in all the facilities where my mother-in-law was. I assume people get into this profession because they have a genuine desire to help people, and I can imagine the daily toil burns some out. I know you’re underpaid and overworked, that your job can be messy and trying. I know some residents are unreasonable or argumentative, some say or do inappropriate things, some are even violent. At my mother-in-law’s facility, one resident always cried if she wasn’t asleep, several were always trying to escape, one often yelled from her room, the TV was always blaring, and once as I sat and listened for the time I was there, I thought, “I would go stark raving mad if I had to work here for hours every day.” I know doing the same tasks, having the same conversations, dealing with the same problems every.single.day. can wear on you.

But still I plead with you to remember a few things as you care for folks. I’m reminding myself of them as well since I now help take care of my mother-in-law in our home:

1. Do unto others as you would have them do unto you. The Golden Rule. The teaching of Jesus. This one principle would take care of a number of issues. Some times, when I’d see my mother-in-law bent over double in her wheelchair or with red splotches on her face due to food that hadn’t been completely washed off after a meal, I’ve wished I could say to someone, “What if this was your mother? grandmother? How would you like to be treated if you were a resident here?” Most times these things are oversights rather than willful neglect, but still, in our experience those things became a pattern that affected the quality of life of residents.

2. Remember the residents are people, not tasks. It’s so easy to get caught up in all the things that need to be done that we can forget that we’re dealing with real people rather than a list of tasks to accomplish.

3. Take care-giving tasks as opportunities to interact socially with residents. Take time to show personal interest in your residents, even if they aren’t responsive. After we brought my mother-in-law home, I found several training videos on YouTube about using a Hoyer lift, changing someone’s position in bed, etc. Most of the videos taught the caregiver to greet the patient/resident first, say hello, ask something about them, and then explain what they were going to do. I’ve seen some caregivers do this, but usually in limited fashion. I did see some come in in pairs and talk to each other during the whole procedure of whatever they were doing without saying anything to my mother-in-law at all and without really looking at her except for the task they were doing. When she was in a nursing home, on a pureed diet, and losing weight, we found that caregivers would sometimes watch TV while feeding her and not interact with her at all, but would just mindlessly shovel food in. Can you imagine being on the receiving end of meal times like that? We asked if they would turn the TV off, make sure her hearing aid was in and working, and talk to her a little while they fed her. When they did that, her eating improved.

4. Put yourself in their shoes. This overlaps with the first one, but what I mean here is to think about what it would feel like if someone came from behind you and started moving your seat suddenly. That’s how it feels if you start moving someone in a wheelchair without letting them know what you’re doing. (I know – I spent a bit of time in one.) It’s even disconcerting to have someone speak from behind you as they’re starting to push you: the suddenness can make you feel very disoriented. It’s better to come around, look the resident in the eye, and say, “I’m going to take you back to your room now,” or “I’m going to move you over just a bit.” Understand that they are usually either arthritic or stiff and slow-moving: don’t pull or jerk their limbs in an effort to get sit them up straight or moved where you want them. Sometimes they can move where you want them to, but it just takes longer. Don’t treat them like children. You can apply this principle to any numbers of factors.

5. Don’t neglect the quiet ones. My mother-in-law never liked to be any trouble. Usually if she had a need, she’d wait until we got there to ask. She liked to keep to her room. She didn’t yell or make demands. There were some residents who honestly could’ve used one full time person just to assist them, like the man who kept trying to sit down without checking to see if there was a chair behind him or the woman who was constantly calling for someone to come into her room and help her or the woman who’d wheel her chair into other people’s rooms and go through their drawers. The squeaky wheel tends to get the oil, as the saying goes: there were times we felt like my mother-in-law was neglected because she wasn’t demanding.

6. Keep good lines of communication between administration and staff. Sometimes we’d talk to the administration about an issue, and they’d assure us it would be taken care of, but either it was never relayed to the staff or it was ignored. Sometimes the administration would tell us certain things would be done that were just impossible. For instance, when we toured one assisted living facility, the administrator told us the staff could curl my mother’s hair before we picked her up for church on Sunday mornings. Not only did that never happen, but I would never have asked anyone on a Sunday morning to do that: it was just too busy. They’d brush it and pin it, but no one had time to curl it. This is something I usually did on Sundays and I was fine with it, but it just made the administrator seem a little out of touch with the reality of life on the floor.

I don’t know if any care-giving facilities do this, but I would love for them to have regular meetings where the staff can be reminded of some of these principles and also let the administration know some of the problems they’re dealing with.

7. Use the TV but not to the point of deadening. In the memory-care unit especially, it seemed like the goal was to get everyone clean and dry and then seated around the TV in sitting room. I know the TV can be very helpful in occupying their minds and keeping them still and out of trouble, but keeping them herded around it all their waking hours is mind-numbing. Most of the assisted living facilities and even the nursing home would have some activities for residents, but in the memory care unit they pretty much just used the TV except for one time when someone brought out some balloons and had them tap them back and forth to each other. They loved it: their faces lighted up and they got excited. I know this group is probably the hardest to come up with activities for, but it is so helpful to have something different to do for even just a few minutes a day.

8. Breaks might best be taken in another room. Sometimes when we’d walk in and all the residents were around the TV and all the staff were sitting at the dinner tables, it just looked like no one was working. We’d tell ourselves maybe they were just taking a break, but when that seemed to be the case nearly every time we came in no matter what time of day, it just didn’t look good. I don’t begrudge anyone taking some time to rest in-between meals and baths and bathroom needs, and I understand that at times that’s best done where you can still keep an eye on everyone, but just be conscious of what it looks like, especially if a family member has an issue with something that hasn’t been done for their resident and it looks like people are taking it easy or chatting instead of working. It might be best if one or two staff members at a time took breaks in another room so they could fully relax for a bit and so it didn’t like like everyone was visiting while the residents were watching TV. I appreciated that the nursing home my mother-in-law was in did not allow anyone to use their cell phones on the floor: they had to be in the break room or at lunch to do so. That kept the main areas looking professional and free from distraction.

9. Put people’s needs over decorations. It is important that the building and facilities look nice. These are these people’s homes, after all. It can be very depressing when things look run down. On the other hand, the decorations and such shouldn’t be overly elaborate. In one of my mother-in-law’s facilities, their Christmas display rivaled that of the mall’s. Maybe all that stuff had been donated, I don’t know, but my first thought was that I’d rather have a little less in the decoration department and use the money to hire an extra staff person. Paying for an elderly loved one’s care is expensive, and it can be a little galling to see hard-earned money used in such a way. There needs to be some kind of balance between making it look nice and cheery but not overdone.

10. Don’t expect visitors to watch out for residents. In one facility, the main doorway was off the main sitting area, and the residents on one side or the staff sitting at tables on the other couldn’t see the front door from where they were. They had a number of residents that were always trying to escape. When you visit there often you get to know some of the residents, so when some of them were at the door when I’d come in, I’d be very careful to shut it behind me, or if they were there when I was leaving, I’d use another door even though it was out of my way. Once as I was coming in, a lady with a purse on her arm came out. A few minutes later one of the staff came into my mother-in-law’s room and told me I had let one of the residents out. Well, how was I supposed to know she was a resident? She was new, so she wasn’t familiar to me; she didn’t look as old as some of the other residents; and the purse on the arm threw me. The doors should be set so that the staff can see them. Most of us visitors don’t want to accidentally let residents out or endanger them in any way, but we can’t be expected to police the doors or to know every single resident.

11. Be clear about what you do or don’t do. Some of the fine points of grooming we weren’t sure about. It would have been helpful if, when we first interviewed, the administrator had shared what things they did and what things we were expected to have done on our own.

12. Refer to the care plan regularly. Sometimes we were asked to fill out a detailed care plan in the beginning, but then after a while several items on it would be neglected. It’s easy to get into a routine and think you’re doing everything and not realize something is being overlooked. Some facilities kept these in the room, others kept them in folders in the office, but either way, take time to look at it occasionally just to be sure.

13. Don’t blow off the family members. Please understand that when family members bring something to your attention, they’re not just trying to be nit-picky and gripey. They do so out of concern for their loved one and a desire to see the best care for them. If what they want is beyond the boundaries of your job, kindly let them know, or tell the administrator about the conversation so she can let them know. In one facility, the staff kept putting my mother-in-law in her recliner in such a way that her back was at an angle in the chair rather than having her lower back flush against the back of the seat. When she began to need two-person assistance, sometimes the aides would each pick her up under one arm and lift her from her wheelchair to her recliner, something that was quite uncomfortable in her severely arthritic state. My husband asked, “Can I show you how her physical therapist showed us to position her?’ (like transferring her with a gait belt around her waist, facing her with arms around her and holding onto the belt to help lift and transfer, and seating her in her chair in a way that was better for her posture). Some were very receptive, but some were not and said that they were trained and knew how to do their job.

The problems I’ve mentioned are some that we have experienced personally, and I am sure if we have, others have, too. That’s why I mention them. Sometimes we have brought an issue to the attention of the staff not to have them do something immediately (often we had already taken care of the problem), but just so that they could be aware and improve their services. We do know that no person or facility is 100% perfect, and sometimes mistakes will be made or concerns overlooked: we know everyone is only human (including ourselves). But being aware of some of these principles, especially the first few, would make a world of difference.

Please know that even if we’re discussing a problem, we are thankful for you and the work you do on behalf of our loved ones. And those who go beyond just punching the time clock and doing their job to taking an interest in and genuinely caring about their residents are worth their weight in gold, and we’re very thankful.

I wanted to add just a few thoughts to caregivers who work in private homes. Much of the above applies, but there are some particular factors involved in someone’s home.

1. Be on time. People plan their day around your being there.

2. Be professional. This is a job. Don’t take it casually. Give plenty of notice if you can’t be there for some reason.

3. Duty first. In someone’s home you will likely have some down time. It’s understood that in most cases you won’t have work to do every minute. But whatever you’ve agreed with the family that you will do while in the home, make sure that is done first before reading, using your iPad, or talking on the phone. It’s galling to have to do some of the tasks the caregiver was supposed to have done while she was there – not that we are above those tasks, but we paying $17 an hour for work that was neglected while she chattered on the phone.

4. Give the patient your full attention when feeding, changing, etc. Don’t use that time to talk on the phone. You should really be on the phone only when there is a pressing need: you’re being paid to work, and talking to friends and family just to chat should be done on your own time. And though your patient likely won’t need your attention 100% of the time – there will be time when he/she is asleep or watching TV, etc. — don’t just leave them in bed or their wheelchair unattended for long stretches of time while you sit separately doing your own thing. Part of what you’re being paid for is companionship.

5. Clean up after yourself. The family shouldn’t have to clean up your spills in the microwave or sticky residue on the end table where you set your coffee or food, etc.

6. Adapt to the people in the home. The other people in the house, usually family members, will differ in various homes. Some are extroverted and gregarious, some are private.

7. Don’t resent situations where the family members are watching TV or playing solitaire on the computer while you’re working. They may be paying for you to be there so they can work or run errands, but they’re might be paying you just so they can have some time “off.” They have care-giving duty all the rest of the time you’re not there, or they may hire full time caregivers because they don’t feel comfortable or able to do ti themselves.

In closing, since I am a Christian, I want to share with you some verses that have helped me in care-giving. Maybe they will be inspirational to you as well.

Now we exhort you, brethren, warn them that are unruly, comfort the feebleminded, support the weak, be patient toward all.
(I Thessalonians 5:14.)

Whosoever shall give to drink unto one of these little ones a cup of cold water only in the name of a disciple, verily I say unto you, he shall in no wise lose his reward (Matthew. 10:42).

To do good and to communicate forget not: for with such sacrifices God is well pleased (Hebrews. 13:16)

God is not unrighteous to forget your work and labour of love, which ye have shewed toward his name, in that ye have ministered to the saints, and do minister (Hebrews. 6:10).

So after [Jesus] had washed their feet, and had taken his garments, and was set down again, he said unto them, Know ye what I have done to you?Ye call me Master and Lord: and ye say well; for so I am. If I then, your Lord and Master, have washed your feet; ye also ought to wash one another’s feet. For I have given you an example, that ye should do as I have done to you (John 13:12-15).

With good will doing service, as to the Lord, and not to men (Ephesians 6:7).

For I was an hungred, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me. Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me (Matthew 25:35-36, 40).