Caregiver

Always Let Your Conscience Be Your Guide

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Caregiving, Walt Disney World, Disney, Pinocchio

Pinocchio and Jiminy Cricket
Walt Disney World

Pinocchio was released on February 7, 1940. I do love this story of the mischievous little puppet who just wants to be a real boy. For me, so much of the film is about the song lyrics. They took on a special meaning when I was a caregiver.

When times are hard during caregiving, whether it is in the role of caregiving itself or in watching your caree struggle, it is easy to wish, as Pinocchio did:

I’ve got no strings
So I have fun
I’m not tied up to anyone
They’ve got strings
But you can see
There are no strings on me

There were times when I just wanted to stroll home instead of rushing to tend to Ben, or go to dinner with a friend, or watch tv without an interruption. For me, much stress came when Ben was feeling frustrated and took it out on me by being critical and difficult. Ben did not want to accept that he needed more care than I alone could provide. He did not want to admit that he was afraid to stay alone. I did not know how to approach him about the fact that he needed more care. I didn’t want to disappoint him and yet I was upset because his expectations were unrealistic. I was upset with myself for rarely standing up for myself. Frustration was perfectly understandable on both of our parts.

The truth was that I was attached not by actual strings, but by my heart. When I did have some time to myself, Ben was pretty much the only thing on my mind. If I went out, I constantly texted him to see if everything was ok, even when someone was with him. I knew he was most comfortable with me and I was most comfortable when I was there.

When he did finally agree to get a home health aide, we had our routines for when they would update me. I had my phone with me at all times waiting for his text telling me that he was awake and seated at his computer. Even when he was in the hospital, and I knew he had constant medical attention, I felt the need to be there. After all, he could not even move his hand to use a call button. The strings that attached us were heartstrings, and there was no breaking them.

I had a lot of support from friends, his medical care team and some family. Of course, they were concerned about Ben, but they were also concerned about me and that I was running myself ragged. I know the philosophy that if you don’t take care of yourself, you can’t take care of anyone else. But, it was impossible for me to prioritize myself knowing that Ben had ALS and it was progressing, and knowing that he could not help needing assistance. In the back of my mind, he was dying, so while he was here I had to do anything to help, advocate for and entertain him.

There are also certain realities that affected caregiving. Insurance does not cover home health aides. Since ALS is a disease that does not have a predictable progression, even when he admitted to needing help, he was afraid that he would completely deplete his savings. These are such stressful situations to deal with in the midst of dealing with the physical and emotional impact of the disease. It is tragic that better care and attention is not given to circumstances such as these and to supporting caregivers and carees. I could devote many blogs to that subject!

I had so many people tell me that I simply had to tell Ben that I could not care for him anymore, or he could not stay in the apartment anymore, or he had to begin to pay for care. People are very good at giving advice. And, in my experience, they really do mean well. Interestingly, they don’t always follow the advice they give. Some people who told me to take a hard line with Ben have been in caregiving situations where they were also towing the line without support and with unrealistic expectations from others. In grief, people have also told me what I “should do.” Again, they mean well. Some people think that blogging and pursuing opportunities to support other caregivers keeps me in the past. I disagree. I feel it is important, and even responsible, and it is also rewarding. It allows me to take my experiences that have shaped me and use them positively as I live. But, no one should really have to defend themselves. I say this here because, as caregivers, we all have to redefine our lives, and maybe my own experience will give other caregivers food for thought.  The bottom line is that we all know in our hearts what we have to do because our consciences are our guides. We can request and get advice, but only we know ourselves and our circumstances. And, until you walk in someone else’s shoes, you cannot clearly judge them. I mean this about caregivers and carees.

Jiminy Cricket was so right when he said, “Always let your conscience be your guide.” I had to do what I felt was right for Ben. I hope that I’ve come out of the experience with a stronger ability to communicate my feelings, but I still would not have changed my actions. Although I always worried that I was not a good enough caregiver, particularly when Ben was in bad spirits and critical of me, I let my conscience be my guide. I look back and am grateful that, in the end, Ben was able to stay at home with me until he went into the hospital, and I was at his side until he left this world.

As I wrote in a previous post, I still believe in making wishes, and I love the song “When You Wish Upon a Star.” I wished that Ben would find peace and I do believe that wish has come true and that he is in a place where he can walk and talk and eat and play his musical instruments. I wish for a cure for ALS. I will continue to wish until it comes true because, as the song goes

When you wish upon a star
Makes no difference who you are
Anything your heart desires
Will come to you

If your heart is in your dream
No request is too extreme
When you wish upon a star
As dreamers do

Like a bolt out of the blue
Fate steps in and sees you through
When you wish upon a star
Your dreams come true

All music and lyrics by Leigh Harline and Ned Washington

Caregiving, a Six-Act, 24-Minute Performance

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It was an honor to participate in Caregiving.com’s live broadcast, “Caregiving: A 6-act, 24-minute Performance.”

In case you missed the presentation, you can view it right here!

To summarize, six caregivers presented their experience in different stages of caregiving, from anticipating becoming a caregiver to after caregiving is over.

The Performers:
Andrew Koch, The Expectant Caregiver
Tami Neumann, The Freshman Caregiver
Carolyn Grant, The Entrenched Caregiver
Lisa Riggi, The Pragmatic Caregiver
Abby Kass, The Transitioning Caregiver
Colleen Kavanaugh, The Godspeed Caregiver

Please click here for more information about everyone. Listening to the other presenters was enlightening and inspiring. The performance goes beyond textbook explanations of caregiving and takes you into our lives and through the difficult and the heartwarming aspects of being a family caregiver.

My own presentation as a Transitioning Caregiver focused on when I knew the end was near for Ben. It’s a journey my close friends and family know about and it was a difficult one. I continue to be in awe of Ben’s bravery.

Deciding what to share in the presentation was actually a valuable and interesting process. When I first talked to Denise Brown, the Director, and narrator, of the performance, I recounted the details of what transpired from the time Ben went into the Emergency Room until he left this world. Denise pointed out that I was telling Ben’s story and not my own. Until that point, I never really thought about that. I had thought of the journey as Ben’s, although I was his caregiver. However, this process prompted me to think about my own journey as Ben’s caregiver and as the person closest to him as I watched him succumb to ALS.

I’ve said before that being a caregiver changed me. It is who I am. I embrace all of the emotions associated with it- good and bad- and continue to sort through some of my feelings and memories. My blog’s Disney-sprinkled reflections on these experiences help me in this process and will hopefully inform, inspire and/or validate other current and former caregivers.

I welcome your comments on this presentation.  And, please visit www.caregiving.com to learn more about its many services.

Think Happy Thoughts? Listening to Peter Pan

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ALS,Caregiving,Grief,Walt Disney World

Ben and I with Peter Pan and Wendy
Walt Disney World 2006
Pre-ALS days

Peter Pan was originally released on February 5, 1953.  Ben and I loved the film. What adult has not chuckled at how they spent their childhoods waiting to grow up just to wish that they had stayed children?  I am a firm believer in embracing my inner child. Ben also loved to tap his inner child. Walt Disney World is a place where it is a requirement! Maybe that’s why Ben and I loved it so much!

The phrase “think happy thoughts” took on a whole new meaning when Ben was struggling with ALS and I was struggling with caregiving. ALS is known to be a very isolating disease. I’m sure that even when he was not literally alone, Ben felt isolated. I felt so helpless when Ben hurt because sometimes, it was so hard to speak to explain himself and be understood, that he just shook his head and stopped trying. Also, with every day came the dread of what ability he would lose. Sometimes he simply had a bad day and other times there was an obvious change in his health. There were days when I was able to care for him without any problems, but then there were the days when it was exhausting and overwhelming, and if I was having back issues, it was physically painful. We cannot walk in the shoes of our loved ones, we can only love them. Love is a lot. Thinking happy thoughts is a lot, too, because, along with love, it lets us remember who we were and what was important before illness changed things.

For us, happy thoughts almost always included memories of our visits to Walt Disney World. Ben spent so much time every day looking at the videos and photos from our visits to Walt Disney World. We loved to listen to the music from the parks, too. He went on their vacation planning web site to plan fantasy trips. I liked to see him planning because I felt it kept his head in living and focusing on what he could do. I truly believe that helped him manage the disease pretty well for about four years.

On those very difficult days when eating was a challenge, or there was a fall, or some other accident, or even just a lack of energy to transfer or be transferred, we had to remember, “All you need is faith, trust and a little pixie dust!” So much happens with illnesses and caregiving that is unpredictable and beyond our control. For me to maintain a certain state of calm that allowed me to be a problem solver, I needed to have faith and trust that things would ultimately be okay. The pixie dust was the whimsy that always let my inner child thrive in the midst of very grown-up, complex circumstances. Sometimes it was just a loving moment between Ben and me that would make us laugh. Sometimes it came from friends, sometimes it came from caring strangers, and sometimes it came from both of us taking a moment to remember the good and loving times. And, with faith, trust and pixie dust, we even made it back to Walt Disney World four times during his illness.

I named my blog Pixie Dust For Caregivers because quotes like this, as well as many Disney characters, films, lyrics and attractions from the Parks were the pixie dust that gave me perspective, inspiration, and comfort during the caregiving years and now, as I work through grief. They helped Ben, too. At times, they simply gave us much needed entertainment.

We did love the Peter Pan attraction at Walt Disney World. We loved to soar over Neverland on the pirate ship. Unfortunately, it is not accessible and has to be boarded while it is in motion. Ben had trouble with balance and walking early on, so it was the first ride we had to give up. Still, we never lost our love for Peter Pan and Tinker Bell.

After a respiratory crisis, Ben landed in the hospital, and life with a tracheostomy and feeding tube was not going well, including infections and pneumonia. After six weeks, Ben chose to go to the hospital’s palliative care unit.

It was painful beyond words to know that Ben was miserable. Tragically, ALS was not going away. He was not going to get better. But, to know that he had only days left in this world was devastating. At the same time, there was a certain relief that he would be free from the physical and emotional pain and constraints of the disease that rendered him unable to breathe on his own, speak, eat, walk, use the computer or play his instruments- things he loved. A line in the song “You Can Fly,” is, “Think of all the joy you’ll find when you leave the world behind and bid your cares goodbye.”  I wanted Ben to have peace and to feel comfort he had not felt in the nearly six years he bravely battled ALS.

Peter Pan said, “To die would be an awfully big adventure.” I don’t know that I would call ALS an adventure, but it was a journey. A very difficult journey that Ben navigated with much bravery. Now, I put faith, trust and pixie dust in the belief that Ben has “bid his cares goodbye” and he is in a peaceful place where he can walk and run and eat and talk and sing and use his hands to use the computer and play his instruments. That gives me peace.

Opening Doors

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Disney, Mary Poppins, Grief, ALS

Quote from Mary Poppins
Disney and Cameron Mackintosh Musical Based on the Film

 

Maybe I am still in new year, new thinking mode, but this quote resonates with me in a special way. I feel that I have opened a door and stepped out of intense grief.  Caregiving for my dad and Ben, especially when I was juggling care for both of them- literally going between Long Island and my home in Manhattan- was exhausting, challenging and devastating, but it was also the most loving, meaningful and rewarding experience in my life. After it was over, I floundered. Grief has been hard, and it has been grief times two. I’ve spent this time with many lows, then highs followed by extreme lows, and now I finally find more balance. I am always careful when I say this, because I never want to convey that I’m “over it” or I’ve “moved on.” But, I think I’m learning to coexist better with grief. And I’ve been opening some new doors.

After Ben “left” as he called it, I was so often told that it is now time for me. Well, that was fine, but I was not exactly sure how to fill that time. I missed my dad and I missed Ben and I even missed the caregiving. If you’re immersed in caregiving and its ugly parts, it may be difficult to see  how I missed caregiving, but you must realize that I am writing this after nearly a year and a half of losing Ben to ALS, and almost 3 years of losing my dad. Time, reflection, and perspective gained are important. Nothing comes easily.

Life as a caregiver was stressful, exhausting, and it certainly kept me busy and on my toes! When I was the caregiver for my dad, at one point I took family leave and traveled about five hours every day to visit him, first at the hospital and then at the hospice. During this time, Ben was fairly comfortable staying alone during the day, and we had friends who could help if needed. And, indeed, there were occasions when they were needed- sometimes he could not stand up, other times he fell. Not being there was very difficult, because I was wondering, hoping that Ben was taken care of, until I would get an update. When I was at work, I kept my cell phone with me at all times, in case anyone needed to reach me.

I probably don’t need to say that I was devastated by my dad’s passing away. We were very close and I had also lost my mom. Ben was also distraught by this loss. I think Ben lived in such denial of his ALS and its ultimate outcome, that losing my dad made it too real for him. Although his daughter stayed with him on the day of the funeral, that night it was back to caregiving for me. We were both sad, but I was too busy taking care of Ben to really reflect on my loss. And, I was worried about Ben being too preoccupied with death. I resented that somewhat, because I did need time for my own feelings, but it was not Ben’s fault that he needed help and his immediate needs had to be the priority. Emotions can always be dealt with later, right? Well, not really. If you try boxing up your feelings, they are going to show up in any number of ways, including attitude, behavior and physical ailments. If you’re a caregiver, please remember that you matter.

With only Ben to care for, you would think that life got easier. Unfortunately, his ALS was progressing. Ben was very reluctant to get additional home care. Some of it was due to his lack of acceptance of the progression of ALS. He told me that I didn’t do much for him, or have to do much, which was untrue and, since I want to be honest here, it hurt and upset me, and left me wondering if I was good at what I was doing. Ben was not entitled to home health aides through insurance. I missed a lot of days of work if we were up all night or if I woke up and he was not feeling well, or he felt uncomfortable staying alone. When he awoke one morning and finally admitted he was afraid to be alone, I stayed home from school and made a lot of phone calls, finding him private care for just a few hours a day during the week, which was some of the time that I was at work. We put all kinds of systems into place for him to contact me, including a medic alert system, texting me at certain times. He was still alone at times, so I ran home after work, where I was then on duty until I left for work the next morning. In fact, I was never really “off duty,” I was just not physically present at times. And, our systems were not fool-proof. He texted me through his computer and an on-screen virtual keyboard, and if the mouse got away from him he did not have enough range of motion to get it back. Also, his voice was not strong. Once, he set off the medic alert device by accident. They did speak to him through the system but they called me to let me know that he had activated the alarm but seemed fine. However, I did not get any response from him when I texted to follow up. I dropped everything and ran home to find him sitting at the computer, absolutely fine, but had had been unable to respond to me because he could not reach his mouse. A few more gray hairs for me!

Even when he was in the hospital, I remained Ben’s caregiver. I was with him at least 12 hours a day, and sometimes overnight. ALS is very isolating. Ben could not use a call button and it was hard for people to communicate with him. He depended on me, but he also took that out on me, which was all understandable, even if upsetting.  I supported, advocated for and comforted him on on the ALS journey throughout his experience in the hospital. Looking back, continuing in my role as caregiver was necessary and helpful to the staff, but it also gave me a sense of purpose in the midst of a tremendous feeling of helplessness.

After a summer entirely spent in the hospital and concluding with his loss, I had to return to work (school) in just over a week. I was not prepared. People told me it would be good to return to my routine. What they did not realize was that it was not my routine. My routine at work involved caregiving. It was texting with Ben. It was being in touch with the doctors and teams who worked with him. It was coordinating with his home health aides. It was walking around with my phone. Many a day that I left school, I cried because I missed my rituals of calling my dad and saying, “I’m free!” and texting Ben to see if he needed me to run any errands.

I did not want my memories of ALS to define my relationship with Ben, but I found that I did define myself as a caregiver. I joined support groups where the people said they would never want to be a caregiver again. I, on the other hand, missed not the illnesses and their ugliness, but the caring in the caregiving.

Maybe as a teacher I am a nurturer, but caregiving is something I cannot let go of.  I started this blog as a way of sorting out my own thoughts, but also with the hope of helping others by sharing my experiences and things that supported and inspired me. Of course, with me it has to have a Disney twist! I did not realize that I opened up a new door when I began to blog.  In a way, through Pixie Dust For Caregivers I discovered that caregiving is ingrained in who I am. Social media connected me with several wonderful caregivers and caregiving organizations and forums through which I have been able to exchange ideas and give support. I wish I had known about them when my dad and Ben were here and I was struggling in so many ways.  I also enrolled in a caregiving consultant certificate program offered through Caregiving.com. There is a sense of responsibility that I feel to other caregivers, and camaraderie that I feel with them. It is also important to me that I remain engaged in the fight to defeat ALS and I feel strongly that supporting the emotional needs of caregivers of people with ALS is one way that I can do this. Through this certificate program I have been given an opportunity to participate in a unique virtual “performance” of the six stages of caregiving, to be broadcast online by Caregiving.com on Sunday, February 5. Learn more here. Please join us.

Another door I opened is that I have volunteered to work with my local chapter of ALS to create and deliver events for children who have a parent with ALS. My background is in arts and education and I am passionate about the power of the arts in our lives. When I heard that they have done crafts and other events for these children, it felt so right to me to be a part of it, and I am grateful and excited that I will participate in these efforts.

I could never have jumped into these endeavors immediately after I lost my dad and Ben. I could not have written my blog while I was going through the difficult experiences. I did write in my journal, but when I revisit those entries, I see that my thoughts were very scattered. I take to heart my favorite quote, from Christopher Robin to Winnie the Pooh: “You are Braver than you Believe, Stronger than you Seem and Smarter than you Think.” I am an emotional person and I easily cry, but I am strong and I lived through and handled challenging caregiving situations creatively, and hopefully, at least somewhat intelligently and successfully.

For people who believe that blogging and maintaining such a close connection to my relationship with Ben and with caregiving keeps me in the past, all I can say is that I disagree. I have taken my experiences and I am now ready and able to grow from them. I am learning about myself in ways that I believe are helping me to face the future, while maintaining my commitment to honor those I’ve loved and lost and, in this process, hopefully, helping others. I am emerging from intense grief and letting more light into my life.

I have begun to open different doors to begin to reshape my life. I hope you’ll join me on this journey and make some discoveries of your own! Always feel free to share and comment here!

Walt Disney World, Mary Poppins, Grief, ALS

Ben took this picture during our second visit to Walt Disney World, 2002
Mary Poppins is the first movie I ever saw in a theater. It will always have a most special place in my heart.

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