Friday, February 26, 2016

Eldercare as Pastoral Work: Caring for Mother by Virginia Stem Owens

Caring for Mother by Virginia Stem Owens was my obvious choice for this Dewey decade. Caregiving is that form of pastoral work defined as "true religion" by James, and Paul says the absence of caregiving is the mark of someone who has, for all practical purposes, denied the faith. It also happens to be a rather all-consuming ministry, whether one is caring for a small child or an aging parent.

My mother is 74 years old. She can barely stand, and walking is out of the question. She has open wounds on her toes that are still not healed after more than a year of almost weekly visits to the podiatrist. She was in the hospital four times last year and moved from an "independent living" senior apartment to a "personal care home." So far 2016 has been quiet, but every time the phone rings I wonder if it's going to be inviting me back on the merry-go-round. I am in counseling and on anti-depressants, but I'm doing better than some people I know, who have lost the battle and altogether given up to depression, or disappeared completely into the demands of caregiving and lost their jobs, their friends and pretty much their identities. It's hard to believe there isn't a better way to walk this road, and that 21st century Western medicine isn't pretty much the worst way to die ever known to man, virtually indistinguishable from torture.

No one I talk to and no book I read dares to sugar-coat the long goodbye. We watch the most honored figures in our lives, bar none, descend slowly into dependence and, in most cases, some form of madness, and we know there is nothing we can do that can stop this from happening, and that it only ends one way. We drive, we call, we visit, we cajole, we cram up our evenings and weekends with obligatory trips to doctors and hospitals, or, on the rare week off, with outings to the movies or a museum so that our poor impatient patient will remember why life is worth living in the first place, and when the day or the week or the journey is done, "what never goes away, doesn't wear out or disappear, is the feeling-- no, the certain knowledge-- that I could have done more, could have done better" (p. 93). And this from Owens, who hung out at the nursing home for hours every day. I have friends who quit their jobs and moved in with their moms to keep them out of nursing homes. Listen, I just get together with my mom once or twice a week and problem-solve as needed, but I still feel both that I am taxed beyond my capacities and that I could do more, could do better.

All the reviewers agree that the most poignant and meaningful chapter of the book was "Thanksgiving at Fairacres." Owens' mother's nursing home sounds no worse than any other and better than some, so her description of it rings true to every caregiver. From the preschool-teacher-esque forced cheer at holiday events to the ring of wheelchairs around the nurse's station (they call it the concierge desk at my mom's place, but they're not fooling me) to the fact that almost every single person in that building is mad about something, I guess care homes are pretty much the same everywhere. And the caregiver's task is always the same: stay on the good side of the staff, because you need them more than they need you, but never give up and never surrender when it's your parent's health and happiness on the line.

There are weeks I have a vision of my responsibilities to my mother as a high calling. And there are weeks that I know for a fact I am doing a crap job of coming alongside at a time that, while it may not be a blast for me, is certainly her darkest hour. But I sure appreciate authors who have been able to share their stories of similar journeys. When I see their little ships in the distance through the fog, I know I am not alone.


Friday, February 5, 2016

250-259: Pastors and What They Do

Dr. Tournier talked about how working people are sometimes too tired to pursue creative endeavors, and that's my situation right now in the busy season of my job, so I'm cheating on the 250s and doing my research remotely. Here's a peek at our church library's holdings in that category: mostly sermons and training for pastors and other church workers.

                                                                                                                                                   I have read my share of sermons, so I checked out my public library, found and ordered this instead:



Now that's something that I can relate to. A few years ago I was reading books about youth ministry; now it seems like I can't get enough of aging and death. Circle of life and all that!

Friday, January 15, 2016

Growing Old, Part II: The Importance of Acceptance (More about Growing Old)

In my last post, I mentioned that Paul Tournier alluded to the value of acceptance in enjoying old age, especially with respect to the illnesses and chronic conditions that may accompany it. Psychologists, natural health gurus, and Bible teachers all agree: The person who is continually striving for a cure, who is always trying the latest medicine, diet, or alternative treatment, is really no better situated for mental health than the person who continually rails against God and man looking for someone to blame for his or her condition.

The only people who live well with chronic illness, which is a hallmark of old age for many, are those who have accepted that pain or disability or limitations or discomfort is their new normal.

This sounds like bleak advice, but it's really quite liberating. I myself know that when I stopped chasing a "cure" for my thyroid condition and started just working with it, and when I accepted my susceptibility to depression, I was able to enjoy the life I had, rather than continually wishing for someone else's life.

I think Christians struggle more with this kind of acceptance than those of some other faiths or of no faith, because we know that there is always a possibility of miraculous healing beyond what science can provide. If Jesus appeared to us and said, as He did to the man at the pool in Bethesda, "Do you want to be made well?" of course we would answer yes. But if He instead appeared to us and said, "My strength is sufficient for you, for My power is made perfect in weakness," as He did to Paul, could we accept that answer as well?

Paul Tournier, so many years ago, also advocated for acceptance in the context of old age. We must accept the limitations imposed on us by the 24-hour-day and by mortality-- only God, Tournier points out-- can say "It is finished" and sit down forever! We must accept our lives, our circumstances, our bodies and our age. Acceptance is different from resignation, and is more like consent-- we agree that what we are experiencing is acceptable. We live authentically in the reality we are experiencing rather than pretending that something different is happening-- that we are not ill or we are not old. Ideally, we will be able to focus on what we have rather than what we have lost.

Tournier believes that these habits of mind must be developed early in life. He believes that those who do not accept old age also did not accept adolescence, or young adulthood, or middle age. He believes that those who have spent their whole lives complaining about the responsibilities and limitations of their current situation and either nostalgically longing for a previous stage or looking forward to some supposedly more free future stage all their lives will be singularly ill-equipped to cope with old age-- even if, maybe especially if, it is the stage to which they were looking forward! Surely it is bound to disappoint, after all.

What a compelling point for me, surrounded as I am by high school students who constantly complain about how busy and stressed out they are, while what could be some of the most wonderful moments and opportunities of their lives pass them by.

Young mothers look forward to their children getting older... mothers of older kids look back with fondness to the simplicity of the preschool years, or look forward to their kids leaving. In middle age, perhaps we are still caregiving, or maybe the expectations of our jobs and community activities have become pressing, so we look to retirement for a relief of our pressures.

But why would these habits of discontent change when we turn 66? If we hope to enjoy our retirement, we must accept first that every age has its challenges and its rewards, and then seek to develop habits of contentment now, wherever we are, engaging with the world and with our lives as they are. Such habits of mind will empower us to live well during every age and stage.

Friday, December 18, 2015

Growing Old, Part I: The Golden Years and Why They're Not Always (Growing Old by Paul Tournier)

In Learn to Grow Old, Dr. Paul Tournier first diagnoses, then prescribes, treatment for the ills of the retired person in society. Although he is speaking about Swiss society of the late 60s and early 70s, I find a comment on almost every page that applies to me and my peers or to my parents and theirs. The central thesis of the first half of the book seems to be that if retirement is to be successful, preparation, not financial but mental and logistical, must begin well in advance.

I think I can't wait to not have to work, because I am exhausted, but I know that the contact with young people, the mental challenge, and the structure to my week are valuable to my mental health. I have seen some people just shrivel up in retirement, especially if it was a forced, "golden parachute" situation. But there are so many interesting and important things to do besides work-- how can I be bored in retirement??

Tournier  feels that when we are at the height of our earning powers, the time we have left at the end of the day often cannot include great challenges. Most people can't write a novel or paint beautifully in the 2 hours they have in the evening after work-- although I know some who do!

But the majority of working age people find their evenings and weekends consumed with caregiving, community service and the simple tasks of daily life, and count themselves lucky if they can get the chance to putt a few holes or stitch a bit on a needlework project over the weekend. Such people-- and I am sometimes one-- imagine retirement as a sort of earthly heaven consisting only of these hobbies and leisure activities that we can't get enough of now. But those same people find, when the day comes, that knitting, TV and golf are really not enough to hold their attention.

Tournier says we must instead imagine retirement as an opportunity to pursue employment of our time, our hands, and our minds that will actually challenge our capacities. He reminds me of Viktor Frankl, who taught that the wellspring of mental health was a sense of meaning. Just so, an older person needs a purpose, and leisure activities and hobbies may not be enough to satisfy this need. That is why preparation for retirement must begin well in advance, as we identify and begin to dip into the gifts, the passions and even the neglected skills we will be able to pursue when we have less structured days.

As Tournier says, "A second career is like a plant whose seed has been sown in the midst of a person's active life, which has taken root, which has developed tentatively at first, but which bears all its fruit in retirement." (p. 125)

Tournier does recognize that there are both societal and individual obstacles to living meaningfully during retirement. No amount of personal planning can overcome the prejudice against old people that was certainly present in the 70s and has by no means improved since then. We look down on those activities of our own that are not visibly productive, so we look down on those who are no longer able to be visibly productive at all.

We are consumed by technology, so we leave behind those who can't keep up. In family gatherings, we speak over our older members about swiftly-moving pop-culture topics, and don't give them time to contribute what might be valuable perspectives. We marginalize old people as we used to marginalize young people, as being messy, unattractive and uninteresting. We regulate retirement so that it must occur at a certain age and all at once, rather than through gradual reduction of the workload as each person is able.

With such marginalization and lack of recognition of the individual, how is a retired person to find meaning?

In addition to these discriminatory public attitudes, there are the many circumstances that conspire to prevent many older people from moving forward. As any of us discover if we are out of work for a stretch of time, or try to take a "stay-cation," there seem to be an infinite number of small tasks that instantly expand to fill our day, so all our well-laid plans for self-improvement, community service, learning and creating go by the wayside.

Some have been forced to retire before they could really afford it, while others are forced to keep working to the detriment of their health. Many really don't have the extra money that makes them both respected in the marketplace and independent with respect to their families. They may not be able to afford the tools or tuitions for the projects that would provide their free time with meaning.

Older people may become increasingly isolated-- especially if they are required to move to a facility. There, it is very difficult for all but the most socially gifted people to form true friendships, since people who have nothing in common except their age are just stuck in a room together. In real life, as opposed to in a movie, the other inmates of a care facility are not Judy Dench and Dame Maggie Smith-- they may have very different interests from oneself, and they are all, by virtue of their presence in such a place, more or less in medical crisis, which makes it difficult to reach out.

When one can't drive, one is completely dependent on the schedules and convenience of others to have a social life. Tournier talks about the villa he and his wife chose for retirement, walkable to town and family, but most parts of the US are not walkable, most families do not all live in the same town, and even so, excellent health is required to be able to enjoy this non-driving lifestyle.

Yes, it seems to me that health, or lack thereof, is a major determiner of how well one can enjoy retirement. I might plan all kinds of philanthropic and creative pursuits for my golden years, but if I become too ill to carry them out, will I have the mental flexibility to think of something I can do, like Tournier's friends who can paint, if not walk, or watch the winds, if nothing else?

Tournier is a strong advocate of accepting one's limitations and determining to work within them. He says, and I agree, "those who are most in rebellion against their misfortunes put up less of a fight to overcome them than those who accept them." I hope that if I become too disabled to do anything else, I will be able to find peace and purpose in prayer... but I can't promise anything.



Sunday, November 22, 2015

240-249: How to Be Good (Biblically)

The Dewey category 240-249 encompasses devotionals, "Christian living," Christian family life, Biblical ethical philosophy, and, inexplicably, a whole section devoted to church furnishings. If you are a Muslim or a Hindu, you will have to look much harder to find information about what kind of rugs or altar to buy for your place of worship.... so hard that I cannot provide you with your Dewey number offhand. But then, I can't give you your LCCat number either.

I picked three books from that all-encompassing Christian Living section found in my own church library. Just Courage, by Gary Haugen, is a challenge to take risks in the service of God's heart for the redemption of the world. Haugen is best known as the founder of International Justice Mission, of which I am a huge fan and supporter, but he cut his teeth in the Justice Department, investigating police misconduct in the US. I hope that role continues to be filled by smart, aggressive lawyers with a heart to protect the marginalized!

College Ruined Our Daughter, by Wesley Shrader, probably needs a new name. The subtitle is: "Letters to parents about the baffling world of the college student," the copyright is 1969, and I think the point is that college did not, in fact, ruin the daughters and sons in question. By just dipping into the letters, I sense that the issues students and parents are grappling with may not have changed much: sexuality, politics, drugs, hypocrisy, appear on just about every page. Only the clothes have changed-- love beads and Nehru jackets were mentioned!

Learn to Grow Old, by Paul Tournier, is the book that resonates most greatly with me at this moment as I progress through my 50s and walk with my mother through her 70s. The jacket blurb cheerfully assures me that "Dr. Tournier feels that old age and retirement need not be feared or hidden from."


230-239: Father, Son and Spirit

Fun fact: The idea that Father, Son and Spirit are three aspects of one God rather than three distinct individuals who still make up One is not within the scope of orthodox Christianity. Seems like splitting hairs to me, but there you have it. Whichever view you take, if you want to explore the trinity, this is the Dewey decade for you. May I recommend:

Father: The Return of the Prodigalby Henry Nouwen, that sweet, broken healer, is beautifully summarized here.
Son: The Everlasting Man, by the always entertaining, often in error but never in doubt, G.K. Chesterton, is now out of copyright and freely available in print and audio forms.
Spirit: The Forgotten God is by the one living author on my short list, Francis Chan, a man who, as far as I can tell, never wrote a word he didn't live out with shocking integrity.

All of these I have read at other times in my life. For this project, I returned to the theme of the Father of the Prodigal Son with Abba's Heart, by Neal and Matthew Lozano. They have preached in my church, and I have attended their retreats, so their concerns and the format of the book are very familiar to me. Stories of people they have met are interwoven with devotional meditations on Scripture, all with a therapeutic focus. My favorite story in the book is this one:

I always had a hard time believing that God loved me. I knew He loved everyone, and that included me, but I was loved as one of the multitude. My dad often said wonderful things to me to communicate his love, like "You are my favorite daughter." I knew what he meant, but I was his only daughter! I met those words with disbelief, not allowing them to penetrate my heart....
I was on a retreat when I faced the insecurity and emptiness in my heart. The worthlessness speaking from within was louder than the voice of God. How could you love me? I thought. For days I was overwhelmed by these lies. Suddenly the voice of the Father broke in: You are my favorite.
First of all, I have a favorite niece who is also my only niece. But she really is my favorite, too! So I get how this works. I also love how this narrator takes responsibility for her own responses, as it were. She doesn't blame her father for choosing the "wrong" way to express his love for her... she acknowledges that it was her own human limitations that kept her from accepting those expressions. Likewise, it's not our heavenly Father's fault that we don't trust Him, feel loved by Him, or understand what He is doing half the time. These roiling emotions are just our lot as humans, and we have to keep making better choices, opening our hearts again to Him, doing that work of repentance none of us likes! The Father has done and is doing His part to love us, even coming into the world to experience the same obstacles we deal with. Now it is our turn, by the power of His Spirit, to receive what He has given.
 



Friday, October 23, 2015

More Questions without Answers: In the Beginning by Karen Armstrong and Abba's Heart by Neill Lazano

Karen Armstrong's In the Beginning doesn't begin at the beginning. She opens with the story of Jacob wrestling with the angel to illustrate her main point: God is confusing, it takes work to understand Him, and you may get hurt in the process.
It is a hard struggle to discern a sacred reality in the flawed and tragic conditions in which we live, and our experience will often be disconcerting or contradictory.
My faith tradition tends to emphasize answers: Jesus is the answer, love is the answer, on the day I called, He answered me. And in previous posts I've talked about how aggressively I pursue answers.

The Bible is also really good at answers that are not what I wanted to hear, for example:
Me: "Why can't I just try harder and be better?" The Bible:"Because you're a sinner by nature; trying harder will never work." Me:"What can I do about my mistake?" The Bible:"You are going to have to apologize." Those kinds of answers are okay too, I mean once I get over the initial disappointment, because at least now I know what I'm working with.

But I've also talked about how okay I am with realizing there is no answer, and that's a space Armstrong likes to operate in. In fact, sometimes I wish she'd stay in that space more frequently; I'm very distracted by her constant references to two authors of Genesis and an editor. I think I would be similarly distracted by constant references to the "real" identity of Homer in a discussion of the Odyssey. But when she's not referencing this to my mind overly complicated and somewhat outdated interpretation of the origins of Genesis, she does something I really appreciate in a Biblical scholar: she encourages you to see what is actually there in the words themselves.

Of course other Bible commentators do the same. I've also been reading Abba's HeartNeill Lazano discusses Luke chapter 15, where Jesus talks about the lost sheep, the lost coin and the lost son. He talks about a shepherd who leaves 99 healthy sheep out in the open so he can go retrieve one that has wandered; he talks about a woman who spends all day looking for a coin, and then throws a party when she finds it; he talks about a man who allows his son to blow half the family legacy on partying and then welcomes him home with open arms; and he talks about them all as if they are perfectly normal people! In Sunday school we just draw pictures of shepherds carrying lambs; we don't face the fact that the behavior described is actually kind of strange. Jesus, surprise, is not teaching platitudes, and Karen Armstrong feels that Genesis also is a story that, if we are really paying attention, is meant to unsettle us.

For example, Armstrong writes about Cain: "God gave no reason for his rejection of Cain and his gift; he simply told him that he had the power to resist the surge of anger and rage rising in his heart." Not so unlike that father of the prodigal son, who had a similar message for the resentful elder brother who had always done everything right. Now, commentators and Sunday School teachers have come up with many ideas about why Cain's offering was rejected, but Armstrong is strictly correct: in the text, God does not tell Cain or us. I imagine myself opening gifts from my kids and saying, "Yeah, I'll wear this scarf, but not this other one." I would never do that, but God does, and doesn't seem to think there's a problem.

This point particularly resonates with me because I have been thinking a lot lately about the fact that in the Bible, envy is called a sin. From the Ten Commandments to the letters of Paul, wanting what someone else has, whether their cow or their position in the family, is just plain wrong. Being jealous of someone else for any reason (other than to protect monogamy) is not, in the Bible, an emotion that you need to learn to control, like anger or worry, but a sin you need to choose against. So already in the 3rd chapter of Genesis, God seems to be bringing up this point, saying to Cain: "So I liked your brother's gift better than yours. It happens. Get over it." And honestly, couldn't Cain be overreacting just a tiny bit? It's not like God said he liked Abel himself better. Cain and God were obviously still in relationship, so what was Cain's problem?

See, when you dare to see what's actually in the passage, it does make you look at the story differently. The story of Cain and Abel becomes not some kind of convoluted foretelling of the necessity of blood sacrifice for sin, but just the first of many times that life is not going to be fair, materially or relationally, and that God is trying to give us the tools to cope with that inescapable fact.