Farewell Dear Voice

Farewell Dear Voice

In the early days of COVID, senior centers and adult day programs shuttered their doors abruptly. Nearby family members visited cautiously while geographically separated family members remained just that. Caregivers weighed risking their health to meet the daily needs of the elders they were assisting.

For this eldercare consultant, it was a telephone, and technology that were my methods of communicating with clients and their families. As spring and summer arrived, outdoor visits served as a means for re-connection.

And while the seasons gave me the opportunity to re-unite with current clients and meet new clients, there still existed a segment of the population that remained isolated. It was during this time that I received an email from a non-profit organization asking for volunteers to reach out to homebound seniors to “chat” as they called it, just chat. Within weeks, I was asked to call Rosemarie T. in Brooklyn, no last name given.

While less than an hour from New Rochelle, I only knew Brooklyn via the tales my husband had shared of his youth growing up there and my occasional visits to a great aunt who lived, well, somewhere in the boro. As for Rosemarie, I was not calling in my familiar role as a care consultant, but just plain “Micki,” as I am informally known. I was instructed to keep the weekly conversation at no more than thirty minutes and let Rosemarie take the lead.

And so, began the year and a half relationship between, Rosemarie T. and Micki Z. It didn’t take much encouragement to learn about her early life in Spain and then Portugal. Oh, how she longed to be back in happier and healthier times. She was frustrated and depressed by the infirmities that were besetting her. Talk of death was a familiar part of our conversations. But no matter how great her suffering, before we said our good-byes, Rosemarie would tell me how much she loved me and made me promise that I would take care of myself. Each time I assured I would.
Occasionally our weekly calls were interrupted by Rosemarie’s hospitalizations. With each return home, Rosemarie sounded weaker. Talk of death now became an impatient wish to die.

In December of 2021, Rosemarie got her wish. I was notified by the “chat” representative of her passing. They told me how much my calls meant to Rosemarie. But truth be known, the voice of this faceless woman had also become very endearing to me. Thank-you and farewell Rosemarie T. from Brooklyn.

A Good Life, a Good Obituary

A Good Life, a Good Obituary

I like to read obituaries, in death, as in life, I find it interesting to learn about people. And so, while returning to New Rochelle from Upstate New York, I read the obituary for Donald Lincoln (his middle named bestowed upon him by his paternal grandfather in honor of our 16th President) Burgess. He died on August 25, 2021, at age 102 years in Pittsfield, Massachusetts.

His family referred to him as “a scholar, musician, World War II veteran, business executive, gardener, friend and lover of the sea.” This care manager believes this description comes with certain characteristics which make for a good life. Among them, being a good person, courageous when the occasion calls, kind, helpful, loyal, trustworthy, selfless, generous and purposeful.

For Mr. Burgess courage and loyalty characterized his devotion to country. During World War II, on the U.S.S. Brough he made twenty-six North Atlantic Ocean crossings protecting convoys of troops and supplies. He continued another 18 years in the naval reserve, to his resignation at rank commander.

After forty-three years in the printing business where he worked his way up from office manager to president of Sutin-Burgess Printing Associates he retired. A life of purpose became most apparent. During this time and thru retirement, he was a gardener, taking pride in a backyard full of plantings he nurtured for many years. His generosity to community was highlighted by his love of music and using his piano skills to serve as the organist for his church. Perhaps most significantly he was the care-giver for Kathryn, his wife of sixty-four years. While I am not a fan of “single-handed” caregiving, the term used in the obituary, I can imagine his devotion to his wife, trumped all offers made to help him. He “surrendered his role to professional care-givers only as a last resort.”

And then came one of the hardest tasks older adults face, “letting go,” as his obituary read, of his home of over a half century. He entered Payn House in Chatham, New York. Its website describes it as “a sensible, affordable option for the independent retired person.” Here, Mr. Burgess drew on his strengths from times past. While adjusting to a new home and befriending residents, “he maintained ties with far-flung family” and dwindling friends. “Doug, found among new friends and activities respite from loss, and opportunities to give of his time and abilities.”

Besides his children, Mr. Burgess left behind ten grandchildren and nine great-grandchildren. Judging from his well written obituary, I think his family recognized all the pieces that made for a life well lived. Quoting the author, futurist and pastor Erwin McManus, “a life well lived is the most exquisite work of art.” Douglas Lincoln Burgess, you were a masterpiece.

Resistance and Seniors: A Care Manager’s Tale

Resistance and Seniors: A Care Manager’s Tale

Like in the childhood game, “telephone,” the first call came from the neighbor across the street, who called the son in Texas who, in turn, called his sister in New Mexico, who, in turn, called me, the eldercare consultant in New Rochelle.

It seems the neighbor across the street observed their eighty-two-year-old mother taking her garbage to the curb. How, she inquired of the son, could he and his sister be so neglectful, not her words exactly, it was more the tone of her voice. I imagine, the neighbor was trying to be helpful. Given the adult children’s geographic distance, perhaps she thought they were not aware of what was taking place during these thrice weekly jaunts to the curb. The truth be known, the son and daughter had been trying, unsuccessfully, for over a year to persuade their mother to just give a companion a try. Just a try.

Despite hints of early dementia, the mother was readily able to reiterate to her children all the reasons for not wanting anyone coming to her house. To start, she was not having difficulty managing on her own. Regarding her shopping needs, what she was not able to pick up in the supermarket, there was a COVID volunteer from her local church she could count on. A companion would interfere with her privacy. Hinging on that, she had her sentimental belongings throughout the house, and she was certain they would disappear within a week of the companion’s arrival. And so, it was with this background that a daughter, undaunted by her mother’s past refusals, called this eldercare consultant, confident that what she and her brother were unable to do, I could accomplish.

With the weight of the adult children and the neighbor accompanying me to her house, I met with the mother. She was welcoming and showed me around her home. I was slightly suspicious. Tours usually come after a client gets to know me. Perhaps the unsolicited tour was to make a point about her capabilities or maybe she was just being hospitable. With the sightseeing out of the way, we got down to the reason for my visit. Mom was well rehearsed. She conveyed to me all the same reasons she had shared with her children.

This type of resistance is not unusual, as an eldercare consultant I have come across it repeatedly. The mother recognized that accepting help brings with it relinquishing privacy and adjusting to a new routine. She saw it as a sign of weakness to acquiesce. What she was indifferent to, was a little bit of help could go a long way to ensuring her continued safety and longevity in her home.

While empathizing with each of the mother’s reasons for refusing help, I used one of my tried-and-true strategies. “Give it a try, just for a few weeks,” Not a budge. “How about if you think about it?” I asked. Affirmative. And with that I said I would give her a call in a few weeks.

“I’m happy you didn’t forget about me,” she said two weeks later. In the same breath, she said she would be in touch with me when the time was right. Will the time ever be right I thought to myself? Or will the next call be from the daughter, all her mother’s excuses banished, replaced with an urgent request for help.

Making Your Bed and Other Strategies for Lessening Caregiver Stress

Making Your Bed and Other Strategies for Lessening Caregiver Stress

Covid-19 has thrust many of us into new or expanding caregiving roles. Medication management, arranging doctors’ appointments virtual and otherwise, making sure a senior is eating more than tea and crackers, and doing our best to ensure our elders feel connected in a world where quarantine and isolation have been the keywords of these last nine months.

Alongside these caregiving responsibilities, we have family and work commitments and, yes, an obligation to keep ourselves healthy. While the initial reports are promising for vaccines, we are still awaiting that GPS to give us clear and consistent direction.  While waiting for those directions to appear, I would like to share five strategies to help you, the caregiver, lessen the stress that accompanies the increased role you may be assuming:

  • Accept the feelings that come with this time. Your anxiety doesn’t have to control you when everything around you feels so uncertain. Focus on what you can control: you, your thoughts, your actions. Speak with those friends who offer you reassurance and comfort and let the other incoming calls go to voice mail, especially when those unsolicited advice-givers are on the other end.
  • Have an emergency contingency plan. Try to organize what the National Alliance of Caregiving calls a “care squad” or simply a caring support team that can help in the care of a loved one in the event you become ill. Identify trusted people who can provide help such as bringing over groceries, picking up medications, offering technical guidance for virtual doctors’ appointments, and making those all-important outreach calls to a parent.
  • Practice self-talk. Remind yourself that you have coped with difficult situations before and think back to how you handled them. Re-discover that strength and confidence. Extend to yourself the empathy that you would impart to a friend in need.
  • Stay in the present, ask yourself: “What do I have to deal with right now?” “What can I control right now?” Think about all the times you worried about the future and the outcome was not as dismal as you imagined it would be.
  • Stick to a routine. As Gretchen Rubin speaks of in her book The Happiness Project, start your day by making your bed. You may say why do that, I’m just going to unmake it at night? Making your bed sets the tone for the day, it takes little effort and goes a long way in making order out of chaos. Holding on to a routine brings a sense of normalcy during very abnormal times.

Finally, some years ago at a tag sale, I picked up a small 4X4 framed piece of embroidered needlework, never knowing how relevant it would be for these times. It reads: “Long is Not Forever.”  I hope you will hold on to those words as I do.

The Art of Listening: Achieving Successful Communication

The Art of Listening: Achieving Successful Communication

As Aging Life Care specialists, we are called upon to provide an assortment of services. The needs are as varied as the families we are helping. We continuously strive to be experts in our knowledge of homecare, entitlements, senior residences, elder law attorneys, and providing skilled and supportive counseling. But we are only effective if, throughout our dialogue with families, we listen. Effective listening combined with effective communication sets the foundation for successive and successful outcomes.

The art of listening, sometimes referred to as “active listening” requires two essential tasks. First, that we as care managers, listen, making a mindful effort to hear the words that seniors and their families are saying. Second, we must concentrate on what is being said establishing a virtual stop sign that leaves no room for our own assumptions and prejudices. We cannot assume or anticipate conclusions. With these two tasks as starting points, our listening is enhanced by four other components.

We listen mindfully, putting aside any distracting (as opposed to professional beliefs) thoughts. We listen without having an inner dialogue that will have an automatic response to a situation that is verbally evolving.

We listen without interrupting, knowing it may disrupt a client’s train of thought, especially if the person is cognitively compromised. A semi-smile (think Mona Lisa) or an encouraging “uh-huh,” lets the person know we are with them, we are listening.

We ask for clarification at the appropriate time. Siblings may finish telling of their conflicting feelings about what they each think is best for mom, and we reply: “So let me make sure I understand.” It is that clarification that allows for modification and affirmation.

Finally, after all information has been shared, the Aging Life Care specialist summarizes what has been said and listens for what has not been said, the latter perhaps a clue to the issue at hand.

Our listening skills remain strong as we adapt to the challenges brought on by the COVID-19 virus. Historically, families have sought the guidance of an Aging Life Care specialist as they pondered whether a parent would be better served in assisted living or remain at home with help. Now, families are asking our guidance as they question if a parent should return home or remain in their senior residence. Whoever would have thought? Thru this crisis, we will stand strong with our families, listening deeply and fully, a north star during uncertain times.

End of Life Decisions: A Broken Promise

End of Life Decisions: A Broken Promise

As a geriatric care manager, in the early part of my journey with senior adults and their families, I ask about advanced directives: a living will, power of attorney and a health care proxy. There will be one of three responses: 1. No, my mother refuses to talk about these documents. 2. We are planning to go to an attorney or 3. Yes, there has been a designated POA and health care agent.

If you fall into the number three category, it may be with relief that you have these documents in place. As the health care agent, you have had the “discussion” and understand the wishes of the person you will represent. You are certain that you can march forward through the complexities of end of life decision making. Yet for some, when the time arrives, that confidence becomes clouded by doubt. It’s not unusual. Such was the case for Lorraine, Anne’s daughter.

Anne, my client of nearly five years, confided in me with weekly regularity that she wanted to die. She knew she was losing her memory and was humiliated by what was happening. Other indignities followed. An extremely anxious person, the only comfort she took was that Lorraine knew her wishes and would do right by her.

Lorraine did not visit her mother with any frequency despite living just over the Westchester County border in Connecticut, a thirty-minute trip. Watching these meager visits and equally few telephone calls, I was sure that when Anne’s doctor called Lorraine to suggest hospice care, she would readily agree. To my surprise, Lorraine would not acquiesce. She acknowledged to me that she knew what she was supposed to do as her mother’s agent. The problem was she could not bring herself to make those final decisions about stopping advanced medical treatment, nutrition, and hydration. “Who am I to make those decisions?” she said to me. I wondered, was it unspoken hope or unease?

Anne lingered with time becoming the final decision-maker. In the days before Anne’s death, I said to Lorraine, with no suggestion of judgment, that she would carry with her whatever decision she made. I recognized that those who generously take on the role of health care agent do so with a full heart. But sometimes, good intentions can be superseded by last-minute questioning. Doubt fogs the road we thought we could readily take.