The Care of Aging Parents: Making the Last Laps Rich (Part I)

This post is Part I of a 2 part series.  It precludes the practical detail of the action of mindful caring for our elders.

We are all born.  We all die.  And almost all of us have elders to consider as we ourselves age.  Without exception, that complex relationship, has its ups and downs (as well as karmic complications) through the relationship's continuum, and inevitably impacts our intentions to our aging loved ones.

At a certain point in a person's life, decision-making is necessarily abdicated due to advanced age or infirmity.  The decisions regarding the circumstances as to how their life will run its course is left to others:  adult children/family or institutions.  As adult children of aging parents, how do we consider what our relationship will be to our loved one's last laps?

For some, its a "no-brainer"; their parents have put into motion through long care term insurance purchase, or moving into an elder community that sees to the layered needs of the aging, or specifically voiced to their family how they would like to live the last years or decades of their life.  For these adult children, it's about follow through, respectfully adhering to their parent's wishes.  Even this ideal scenario is complex.  Possibly the adult children are not in a position physically, geographically or financially to honor these wishes.  Perhaps the aging community chosen is not so ideal, needs to be monitored on a regular basis.  Whatever the arrangement planned, the adult child's committed engagement is required, therefore, altering many aspects of their own independence.  Becoming clear to one's boundaries, capacity and level of commitment is essential.  Setting an intention that corresponds to the relationship you seek to create or maintain with the elder in your life is also required.

Many people claim there is a natural unfolding of this process, everyone involved takes their place.  Why make an intention if this is so?  Making an intention clarifies what you wish for in this relationship, shores-up the commitment with more of oneself.  The expected journey is long; challenges to the healing of a relationship, guaranteed.  An intention keeps us close to ourselves, and what we hope for, especially when the going gets rough and we question the endeavor.

Making an intention opens the field.  The field being one's perception, one's sixth sense.  It's possibly a growing up of the soul, an internal awareness of oneself and other.  It's a path of deepening oneself and one's possibility.  All the facts of the circumstance take a minor role and the relationship rises to the surface of prominent importance.  This is healing.  A possible healing of karma for those engaged and definitely a healing of what has been hard in the relationship.

With an intention, this is practically guaranteed.  How can I say this?  Because with an intention and a commitment to this journey comes a letting go of all that ultimately does not matter.  Whereas the details and circumstances are important, they are very secondary to what is shared. The cream rises to the top, a softening of oneself allows for perception to descend into parts of our self we didn't know we had.  This changes everything.  It also allows there to be this type of change in another.  If we only hold on to the details, the specifics, schedules and external needs-- and only allow that to run this lap, we miss the opportunity the  initial vow or intention created for us.

An intention might start with questions:  What percentage of my time do I want (not necessarily can) to spend with my parent?  With my parent's life affairs? What are aspects of our relationship that are  asking to be healed, would I like transformed? What are the grudges, resentments and hard parts we share?  How can I forgive?  How can I ask for forgiveness?  How much hands-on caretaking do I want to do (again, not necessarily can do)?  What is the necessary sacrifice on my part to do what I think I want to do?  Can I do this?  Can I get help with it?  All these questions are treated as an open inquiry.  Nothing is answered in a hard/fast, black/white way (at this point).  It's a beginning in fleshing out the feeling aspect of the proposed journey.  The decision-problem solving aspect of myself shouldn't jump in at this point, there will be plenty of time for that part to act.  In intention setting, its about allowing breath to enter the feeling center to create some room.

In this place of relationship a trust in something else besides the external occurs.  An adult child's anxiety and worry over the external details, the finances, the medical complications is background material.  It is almost always there, but for the most part doesn't take over our lives because the relationship's intention has helped us make it primary.  The connection, the vibration shared, the meeting and the healing is at the center.

Making the last laps rich, even under challenging and difficult circumstances is possible when this intention is in place.  Intention runs my actions.  I lose it, I return to it, I lose it again, but it is at the heart of what I want for my loved one and myself and steers me in the critical moments.  Our time, our financial resources, our individual direction; taking this on complicates our lives a little (or a lot) more.  Much like people making the lifelong decision to raise children.

In this journey we make, while there are hurdles, there is also a satisfying ride, a relaxing into the sublime elements of being connected to oneself and another more fully, an allowance of a natural unfolding.  Witnessing the external decline of another, whether mental or physical, isn't what you were afraid it would be.  The other's hallucinations, disorientation, good/bad pain days are experienced in a different way as this more subtle relationship is taken on.  The distinct impression of seeing our loved one with one foot in one world and the other foot in another more opaque world is touching and awe-inspiring. We see more of each other, a broader spectrum beyond personality and that is gratitude personified.  It is in this healing relationship one feels one's fortune; and it is reflected back from our loved one, having been shared.

I bring up intention in this first part, because it must precede the nuts/bolts and problem solving of the circumstantial details.  Otherwise, the external drives our actions, not the intention.

Memory and the Body (Part I)

There are so many ways to look at a person.  As clinicians, we tend to look at clients or patients as being their deficits or their strengths (maybe as humans we tend to look at most everything and everyone in this way).  And with this assessment of deficits and strengths comes a clinical intelligence that tends to pigeonhole or make biased, non-elastic critiques.

"Clinical intelligence" becomes rather stupid in this way, mostly because it is rigid and non-curious.  It's the human condition to do this; to rely on a knowledge base (often skewed) to know someone.  We all do this, usually out of our cultural indoctrination. This is why the developmentally delayed, physically challenged, ancient/aged, person of "difference" becomes almost invisible, is ignored or discounted and easily subject to abuse or neglect.  They are not seen in their entirety.

What we all have in common as human beings is a muscle, cellular memory, an aspect of our being that stays intact even when the normal markers of "intelligence" (cognition, reason, memory) is no longer available.  One can experience this body memory through the event of having a practice (like yoga, qigong or tai chi), losing it for a time and then coming back to it.  While "away" from the practice, if one is somewhat sensitive, one notices the change in movement patterns, balance and general flow. Regaining the practice, it is notable to see the general improvement in respiration and agility.  It's remarkable.  The body remembers with repetition.  The cells rally and behave in concert, muscle tissue responds.  This is possible even in the ancient and infirm, the unfit and generally passive body. When a muscle is repeatedly required to mobilize itself, even in the most weakened self, it gets stronger, it does what it is supposed to do, because it remembers through repetition (practice). This cell/muscle memory doesn't forget entirely even in a dormant state.  A reminder (repetition) has it soon responding to its nature and its natural design.

This is a good argument for parents to encourage their children's natural propensities and for people in general to know their own natures, gifts and truths (and hopefully spend a lifetime exploring them).  The natural design in our neurons, chemistry and physicality is also present in our psych, spirit and soul's memory.  What is natural in a person, is the flow of the person.  What flows freely in a person is a manifestation of their natural cellular memory, which can be relied upon time and again. This is their true intelligence. Coming out of a surgery, experiencing terrible pain could be helped by knowing a person's nature.  Those who are kinesthetic-based, touch oriented would be supported by touch.  Those who are auditory, a musician, lover of music, could be distracted (pleasurably) by music.  Those who have a lifelong practice of yoga breathing, could be helped to return to that in that moment of need.

From this point of view, the loss of cognitive memory is but an aspect of the whole.  The "usual" (memory) is not accountable, but one's deep truth embedded in one's cells and muscle memory is reliable.  Much of the (subtle energetic) trauma present in institutional care is the disregard of this wholeness, the lack of recognition and hence denial of a person's natural Being.  When this is seen and allowed to manifest, a fuller healing, even a flourishing transpires.  In this significant period of vulnerability, the subtle (cell memory) can go unrecognized, even become invisible.

Who advocates for the Wholeness in a person in this vulnerable circumstance?  Healthcare providers are the mechanics of the medical nuts and bolts in the institutional stay. Realistically, they have their hands full monitoring the science and administrative factors of the healing.  For them to have an understanding of the energetics of healing, well then you've got a super person on your team. The subtler aspects of healing most often falls on family and trusted others. Their presence at the bedside is not to "protect" the mechanical medical care of the loved one (health professionals pretty much know what they are doing), but to ensure this internal flow, cellular memory is accessible in the healing process. The more a patient can access their flow (sense of humor, their joie de vivre, nature), the more complete their healing process can be.  Without it, healing takes longer and generally is incomplete, one's vital nature having not been included.

The deep seated memory in the body is for us to recognize, mine and appreciate.  But first we must remember and understand that it is ours to be had.

Memory: Portals and Thresholds

The brain is a mysterious organ.  Medical people are the first to admit although they know an iota of its workings, for the most part, it's a mystery.  Why, for example does a historically belligerent psychopath become docile and non-manipulative after sustaining a brain injury?  Reasoning brings us to our anatomy and physiology texts to understand better why damage to one aspect of the brain jump-starts another part, changing personality sometimes in the process. 

There are lots of reasons and speculations behind what happens in the world of Alzheimer or dementia patients.  Those of us with experience working with people with memory challenges do a lot of watching and surmising.  But we really don't know what a person with this type of brain change is going through.  We can speculate, but we don't really know. Understanding that there is an atrophying in the synapses of the brain which impact neuro-transmission is information, but that knowledge does little to support the relationship at hand. Occasionally, there will be a moment when the portal door of their world opens up to the outside and one  sees the terror of their situation (only for a moment).  Something else is required.  In our trying to understand their reality, we can often end up becoming extremely limited in our observations, possibly because it's impossible to have a fixed knowing for ourselves in regards to their reality (and any one's reality if the truth be told).

The fact is, we are breathing the same air, eating the same food, but living extremely different realities (or are we?). As a dear mentor of old used to tell me, "What can you trust?  Most aspects of oneself are wholly unreliable.  But there is usually something which can be relied upon, something one can trust in oneself." Whereas brain function in the memory-challenged is mostly fully unreliable (and getting more so all the time), the experience and understanding the world through the experience of energy can almost always be trusted.  Much like a sense that has been lost, other senses pick up the sensitivity and awareness.  Hearing becomes more acute for the blind, touch and sight becomes acute for the deaf.  Possibly, energy awareness becomes larger when any part of the body loses function, especially mental capacity. Again, it is possible the body circumnavigates its loss into a win of sorts.

Most Chinese temples and ancient abodes  have elevated (about 18 inch) thresholds.  Legend says these raised thresholds were meant to trip up bad spirits from entering the temple. In this day and age this myth might serve to remind us to remember (the best parts of) ourselves as we high-step into the new territory of space.  And like the many maladies that will strike us over a lifetime, loss of  memory is that new space, whether it be our own or somebody else.

Having information or knowledge about the disease process or the function of the brain system is just that, its information.  Unfortunately its not all that helpful in having a relationship with memory challenged people.  Being with someone with memory changes requires another aspect of ourselves other then the part of us that is trying to figure him/her/the expression out, a part that isn't so entrenched in one's own reality.  It's an opportunity to high step it over that threshold and straddle both realities;  my own which I (delusionally) believe to be infallible and an other, seemingly anchored in a suspension of time and place.  Humble meets humanity and there is a breath.

Ego-comfort often demands of us to assume much.  For the ego, it's comforting to imagine what we think another is going through, thinking or feeling.  That is our sentimentality showing through, a type of romanticizing of the condition, probably due to the paradoxically perceived realities-- theirs and ones own.  It's also ego's self-soothing mechanism to believe my reality is somewhat more "real" than a memory-changing other.  The truth is their reality is just as real for them as mine is for me.  I need to find in myself that which can accept this.  Otherwise, energetically I will always read as patronizing to the mentally challenged and that would be an insurmountable obstacle to making a trust relationship with them. When approached energetically, other's manifestation is taken in differently because one's own approach has become different.  One becomes less concerned about cognitively understanding the sometimes startling behavior or pattern of thought ("lack of reason" as ego knows it) and more concerned with meeting the energy field of oneself and the other. 

This idea of seeing another through the momentary portals that materialize, stepping over those high thresholds to meet another requires a willingness to suspend one's entrenched belief in what reality is.
This approach calls for us to be more open, cultivate an intrigue and wonder of what is there, an energetic being who Is and the shared time.  Memory lapses are real, but they become less "the thing" to notice and more the terrain that is tread.  Attention is in the life present, not necessarily the organic manifestation.

Threshold  

By R. S. Thomas
 

I emerge from the mind’s

cave into the worse darkness

outside, where things pass and

the Lord is in none of them.

I have heard the still, small voice

and it was that of the bacteria

demolishing my cosmos. I

have lingered too long on

this threshold, but where can I go?

To look back is to lose the soul

I was leading upwards towards

the light. To look forward? Ah,

what balance is needed at

the edges of such an abyss.

I am alone on the surface

of a turning planet. What

to do but, like Michelangelo’s

Adam, put my hand

out into unknown space,

hoping for the reciprocating touch?