caregiving

July 6, 2017

July 6 and True Love’s Kiss

abby_admin ALS, Caregiver, Caregiving, Disney, Grief, Uncategorized ALS, caregiving, Disney, grief 0 Comments

A PhotoPass photographer caught this moment in front of the Castle at Walt Disney World. It was actually the first time we returned after Ben’s ALS diagnosis in 2010

The beginning of July should be a great time for me. After all, I’m a teacher, and school ended on June 28. On the last day of school, I did my annual Snoopy Happy Dance and left the school building with a big smile on my face. The thing is, for me, summer is now filled with a lot of sad memories, even though I am reshaping my life and do have more joy. Today, July 6, marks the second anniversary of the day that Ben had a respiratory crisis and we ended up in the Emergency Room at Mount Sinai Medical Center, where we were met by Ben’s hero and doctor, David Muller, who would, over the course of that summer, become my hero, too. Today was the date when everything changed for us, because this was the summer where Ben succumbed to ALS.

I cannot help but think back to how that summer of 2015 began on a difficult note. Ben had decided, without conferring with me, that he would let go his private home health aide on the last day of school and that I would take care of him 24/7 for the summer, with a few hours of assistance during the week from a home health aide provided by hospice. To be honest, I was upset and I was also worried. Logistically, how would I even run any errands? Emotionally, I could not understand, and was hurt, that Ben did not realize how difficult-physically and mentally- it was to be his caregiver around the clock, or that he did not think it was something that we should discuss. Although, two years later, I can rationalize my thinking and my reactions, I still feel bad about it, because I would do anything to have him here and healthy today. As it turned out, that summer was spent at the hospital, I was at his side day and night, and I did not want to be anywhere else.

Yes, for me July 6 was the beginning of the end and the memories are still vivid. I remember being in the Emergency Room and meeting with teams of doctors, while also contacting our ALS chapter. I had spent so much time in Emergency Rooms with my dad that they were sort of my normal, but Ben being in crisis was not normal. I remember Ben having different masks on to try to find the most comfortable and effective one, while we struggled to communicate because he couldn’t speak and I could barely read his lips through the mask. And yet, I remember sweet moments, and laughing, too. I remember that I couldn’t kiss him when he had the Bipap mask, so we blinked our eyes tight to show a kiss. How ironic that July 6 is International Kissing Day! But, as the song from Cinderella goes, “So this is love” when you are dealing with ALS- a different kind of true love’s kiss.

Ben had always said that he wanted to do anything to stay alive, but once in the hospital, he wanted to rethink that choice. Many visits and emails with Dr. Muller helped us sort through a lot of that. I’ve written about this a lot on the blog, but it is worth repeating that I told Ben that I would support any decision he made, because only he could decide how he wanted to live and die with ALS (click here to read Sometimes the Right Path is not the Easiest One). It was not easy to grapple with the complications that arose during his hospitalization, and to have doctors explain that these complications were indicators that this would be life with a feeding tube and tracheostomy. It was heart-wrenching to have Ben say he was miserable and then, having made the decision to go to hospice, ask me to help him choose a good day to die. I don’t think those memories will ever become easier. I was not prepared to lose him because his drastic decline was so rapid. For the same reason, he was not prepared to have to make the decision to separate from the ventilator and leave.

It is touching and consoling that music proves to be so important to my healing and to my memories. Every single morning, I listen to a playlist of songs that Ben loved and that were significant during our relationship and that summer. Ben would love that. I cannot forget how the song “One Dance” was my reality check, and the song during which I completely gave in to the devastation. I am reposting the video with that song. To read my post about the song’s profound significance, click here.

Last summer was my first summer in many years without caregiving responsibilities. I felt lost and conflicted about all of the sadness mixed with the potential to actually enjoy the summer. The first anniversary of losing Ben loomed over the whole summer. I launched this blog during that time, and it has been invaluable in terms of thinking through my own emotions and feelings, dealing with grief, and interacting with so many incredible people who are also taking journeys with ALS or other illnesses, caregiving, and grief.

As I faced the beginning of summer vacation, particularly today, I have dealt with tidal waves of emotion and difficult memories that are woven into my glee at the summer freedom from school. I wonder if the approach of summer will ever come anxiety. It helps me to reflect on memories and events, even though my emotions are Inside Out. Intellectually, I can see that despite being someone who cries easily, I have grown a lot in the past two years, in terms of my perspective and my devotion to caregiving and caregivers, with an especially deep connection to people dealing with ALS. I think that would make Ben and my dad happy. I do find comfort in my conviction that Ben is in a place where he is free from the constraints of ALS, and he is talking, eating, dancing, walking and playing his music. At the same time, I miss him and still find myself talking to him and seeing things through his eyes. These mixed emotions have become a way of life. I chose to write this post because although it has been two years and there are still, and always will be, tears and broad spectrum of memories, I know that this is the unsteady rhythm of life and death and love and loss, but it’s all okay. Summer will be okay. Ups and downs are okay. I’m okay, even if I don’t feel that way at this exact moment. My Disney connections still keep me focused and able to deal with the sad times and the loss. After all, “Love is a Song that Never Ends” and, as Belle’s father Maurice said, “It is love we must hold onto.”

June 5, 2017

New Chairs- Old and New Memories

abby_admin ALS, Caregiver, Caregiving, Disney, Grief, Uncategorized ALS, caregiving, Disney, grief 2 Comments

I’ve written about changes I made to my apartment after Ben passed away. The painting and recarpeting had to be done- the ALS battle scars were so huge. There are things I’ve displayed and put on the walls that remind me of him and of us and I love to be surrounded by these things and memories. But then there was his table, the ugly table he used as a desk that even he didn’t like. I thought it would be easy to replace it, and I picked a little dining table that I was excited about. But, when I started to think about not having his table anymore, it was very emotional for me. I decided to keep it and use it for baking, because Ben would love that. To read my post about what happened to that table, and things that matter, click here.

I have been looking for dining chairs since I got the new dining table. Imagine my delight when Ethan Allen launched its Disney line (click here to visit the site)! I fell in love with the Mickey Mouse dining chairs and had to order them. I thought about replacing Ben’s desk chair, because the foam on the arms is completely falling apart and it is not as sturdy as it used to be. That chair holds many memories, some good and some bad. I sit in it every day and remember how that chair functioned as Ben’s desk chair and, also, as his wheelchair, because it was narrower than a wheelchair and could get through the narrow doorway to the bedroom. I dragged the rolling chair to and from the bedroom every day. I transferred him from that chair a few times a day. We always worried that it would collapse, and thank goodness it never did. He sat in that chair all day. I fed him meals, shaved him and we watched tv and had our conversations while he was in that chair. I still find myself looking at the chair and talking to Ben when I need some kind of an answer or sign from him. The thought of not having the chair here made me cry. The chair is staying. The memories, good and bad, and the smiles and tears, are part of what our life was with ALS, and it all matters.

The chairs arrived on Saturday. They are beautiful. Ben would love them. But, right now I am coexisting with them. They don’t quite belong yet. It’s like the holiday ornaments I purchased when I went to London in October (click here for more about that.) I tried to create the tree exactly as Ben and I had it, with our ornaments in precisely the places where Ben liked them because he could see them from his desk. The new ones were jarring. Now, these chairs are jarring. It’s hard to enjoy them completely without Ben. I know in my heart that he would be happy for me. But, he’s not here to enjoy them with me, so it’s kind of bittersweet.

I know that I have to create new memories in my home. I still struggle with that. I hope that my friends will visit and enjoy the chairs and meals that I will prepare. And, as we look around the apartment, I do hope that they will also feel and celebrate Ben’s presence. As I find new ways to relate to Ben, I know and take comfort in that he will always remain a part of everything I do.

I always picture Ben like this, in his chair at his desk. The chair stays!

May 1, 2017

What Olaf Knew about Love and Melting

abby_admin ALS, Caregiver, Caregiving, Disney, Grief, Uncategorized ALS, caregiving, Disney, Frozen, grief, Olaf 1 Comment

Walt Disney World’s Hollywood Studios (July 2014)

Frozen certainly became a phenomenon among Disney films. There’s romance, royalty, family strife, tested loyalties, an adorable reindeer named Sven and a really cute snowman named Olaf! What’s not to love?!

Of course, “Let it Go” has become an anthem for finding all kinds of strength. I know that it is healthier, and I feel better, when I can let go of anger, of bad memories, and of resentment. When I was caregiving and in grief there was a lot of that. I must admit that letting go, in general, is not always easy for me. I have found, however, that it is better to put my energy towards gaining perspective that allows me to let go of the things that are over and done, that I did not create and that I cannot change.

Who would believe that Olaf, the sweet and goofy snowman would so beautifully sum up my caregiving experience at its core.

We all know that we have to take care of ourselves. We have also heard that if we don’t take care of ourselves we will not be able to take care of someone else. After all, if we don’t take care of ourselves, we might become ill and will then be incapable of caring for someone else. I cannot tell you how many times I was told the airplane analogy of putting on your own mask first, so you could then help someone else. And yet, as caregivers, we do not always take care of ourselves. In fact, we rarely take care of ourselves. Hearing that advice became irritating because I knew that I should take better care of myself, but I also knew that I couldn’t. Why? Crises occurred, I was exhausted, there was not enough time, and the list goes on. Ultimately, love meant putting the needs of my dad and Ben first.

When my dad and Ben were ill and needed help, their needs were immediate. They had terminal illnesses. If my dad needed to go to the Emergency Room or if Ben needed to shift his position in bed or needed to use the commode, it didn’t matter that I needed sleep to be able to function at work or if my back hurt. I would find a way to catch up on sleep. I would go to physical therapy or take a pain reliever. Their needs could not be postponed.

I’ve written about the stresses and emotions of caregiving. I’ve explained that my loved ones were very concerned about me because I was running in circles, particularly when I was simultaneously caring for my dad and for Ben. It was my routine, my normal, and I just went with it. I do remember that during the time I took family leave, I enjoyed my time on the train, on the way to and from the hospice, because for those 5 hours every day, I was by myself, even though it was with phone in hand to manage any issues that arose during my commute. Enjoying my thermos of tea on the train while listening to music became my way of taking care of myself.

I don’t think that I realized at the time that I did not really have an opportunity to deeply feel the grief of losing my dad. I was taking care of Ben, who was also struggling with this loss because he loved my dad. Also, the death of my dad was a scary and sobering reality check for Ben, who lived in denial of that eventuality. For me, it was one step in the sad forecast of my lonely future. I couldn’t grieve with Ben because I did not want to upset him, but I also could not grieve on my own, because there was too much to do and I was working full-time. At times, I did feel like I was melting down, but I did not see any options, and I was so immersed in handling my caregiving tasks and full-time teaching that I just kept plodding along, with a few pity parties and venting to friends and family in conversations or emails and texts. Sometimes that was a distraction from the grief, but it also meant that the grief simmered within me.

I have to explain that although there were times when putting my own needs aside was the obvious and the only solution, it also caused frustration, sadness and anger. I felt depressed and lonely and frightened, and Ben and I were not always patient with each other, which led to resentments on both of our sides. Unfortunately, although I recognized that I was near a breaking point, I could not convince myself to shift my priorities in a way that changed my routines and accommodated my needs. I write this because saying that love is putting someone else’s needs first does not mean it is always done easily, graciously or without inner conflict. Everyone’s feelings matter, but they have to be prioritized. Even in retrospect, despite what reason may have indicated, my heart knows that it was the right and only thing to do.

While putting their needs first sometimes caused some melting, it was in the literal letting go of my dad and Ben that I truly melted. But, love meant supporting their wishes.

I did not like to see my dad in a hospice, although he got such wonderful, compassionate care. I melted as I saw him slipping away, but letting him go as he wanted, and very peacefully, was more important than my desire to keep him with me on this earth.

Love meant dealing with the fact that Ben would have gone to a facility if he had chosen to stay on life support. With a tracheostomy and feeding tube, Ben would have needed 24/7 nursing care that could not be accomplished at home. It was a bleak option, but his needs were the priority and as much as it devastated me to think of him in a facility, and it devastated him to accept that he would not be able to be at home with me, we both had to come to terms with that reality. I worried about his being alone while I was at work. I worried that the staff would not be as attentive as I had been. I did not share those worries with him, but I melted when I thought about it.

When Ben decided to go off life support, I melted because I did not want to lose him. I stood by his decision to go off life support because only he could decide how to live and die with ALS. It was a conflict for me because although I was not prepared to lose him, I was relieved that he would no longer suffer with the disease. I was at his side the day he left, we said our vows, and he was surrounded by loved ones and music. It was worth my melting for him to feel loved and comforted as he left this world on his own terms.

I loved my dad and Ben with all my heart. Losing them, particularly so close in time (a year and a half), was very difficult. But, it was worth melting to have shared the love that we did and to let them go and find peace on their terms.

I would like to state the obvious and suggest to caregivers who are reading this that you take care of yourselves and put yourselves first. But, we all know that won’t always happen. Maybe sometimes. Try. Plan. Fantasize! Take moments for yourself, even if it is a mental escape, or a nap, or a quiet cup of coffee or tea on your way to an appointment! But, caregivers, like Olaf, know the true meaning of love.

April 16, 2017

Bambi and Thumper – A Special Relationship

abby_admin ALS, Caregiver, Caregiving, Disney, Grief, Uncategorized ALS, Bambi, caregiving, Disney, Thumper 2 Comments

Bambi
© Walt Disney Productions 1942

Easter seems a perfect time to honor my favorite bunny, Thumper, from Walt Disney Pictures Bambi. I’ve always loved Bambi, and have written about the song Love is a Song that Never Ends and how it resonated with me in caregiving and in grief. I recently watched “Bambi” again, and was touched by Thumper’s relationship with Bambi in a whole new way.

Thumper was the very adorable and lovable young forest gossip, and he certainly didn’t always say the right thing. He was the one to point out that Bambi was “kinda wobbly, isn’t he?” and “he doesn’t walk very good, does he?” This is not exactly the positive reinforcement someone wants when struggling and self-conscious! And while his mother had to remind him that “if you can’t say something nice, don’t say nothin’ at all,” Thumper was a child making an observation, albeit tactlessly, but his heart was in the right place. He was quite devoted to his new friend, the young prince Bambi.

Thumper and his siblings (also incredibly adorable little bunnies) play with Bambi but also watch out for him. They anticipate where he is going to struggle and they gather around to help him so they can play together. Thumper was Bambi’s motivation. I especially love this clip, in which Thumper assesses the situation on the ice and tries to position Bambi’s legs, advising Bambi to “walk both ends at the same time.” It doesn’t go so well and they both end up skidding and falling. It reminded me of the way I had to work with Ben to help him up and figure out the best way to get around. We each had to trust each other and there were times we were nervous and other times it was fun. There were times that I managed to keep him from falling and got him safely onto the bed or a chair. There were also the times that we both ended up on the ground, fortunately unharmed. And, like Thumper, we often found ourselves saying, “Gee whiz, what happened that time?” I always loved this scene in the film, but now I see it in a new light.

Thumper never gave up on Bambi or their friendship in the same way that as caregivers, we never give up on our loved ones. And, Thumper was so happy when Bambi did have an accomplishment like walking steadily. Though Bambi is first learning to navigate the world and Ben was adapting to new ways to do some tasks and dealing with losing the ability to do others, I could relate to Thumper’s positive attitude of problem solving and encouragement.

Also touching was that he never left Bambi behind in pursuit of his own fun. ALS is known to be an isolating disease, particularly because you lose the ability to communicate. Thumper was determined to have Bambi join him with their other forest friends. It is an important lesson for all caregivers, friends, relatives and others to find some way to remain engaged with our loved ones. Visits, cards, texts, emails, photos, videos and a simple presence can all help a person feel remembered and included in life. Ben and my dad always enjoyed hearing that people thought of them.

Bambi was so frightened, confused and sad to lose his mom. He did not know what the future and the world held in store. But, time went on and winter turned to spring, and Bambi grew up. He reunited with Thumper and Flower and the rest of his friends and all their families, and none of them forgot the friendship they shared. Thumper and Bambi- and a dose of Disney- remind us that love never dies and beautiful memories stay strong and sustain us as we move through life’s good and bad times.

(f you haven’t seen the film, or haven’t watched it in a while, treat yourself. It is a beautiful story.)

To everyone who celebrates it, I wish you a Happy, Peaceful and Healthy Easter!

April 1, 2017

What Pocahontas Knew About Walking The Footsteps Of A Person With ALS

abby_admin ALS, Caregiver, Caregiving, Disney, Uncategorized ALS, caregiver, caregiving, Colors o the Wind, Disney, Pocahontas 2 Comments

ALS,Caregiver,Caregiving,Disney,Pocahontas,Colors of the Wind

Lyrics from the song “Colors of the Wind” from the Disney film, Pocahontas”
Lyrics by Stephen Schwartz and Composer Alan Menken

These lyrics are from the song Colors of the Wind from Pocahontas. In the context of the film, the song relates to people learning to accept and open their minds to people of other cultures and races. I found myself thinking of the many people we may judge without really knowing them, their stories, and what it is like to be in their lives. I think about the way people responded to the way Ben chose to live and die with ALS. It is easy to have opinions, and it’s fine to have them. I have them, too. We were fortunate to have many people close to us who put aside their opinions to create a solid support network. But, there is a line that is crossed when opinions become harsh judgments that are made without full knowledge of a situation, and, more importantly, without an attempt to see a situation through a different lens and get a glimpse at what it is to “walk the footsteps” of another.

When Ben was first diagnosed, suggestions were offered by his ALS team, who had followed many people on the sad and excruciating journey of this disease. There were opinions from our friends and family. I had my own thoughts. But, Ben had to choose his own path. No one could really know exactly how he felt about facing the loss of his abilities and, in essence, his freedom, as he faced death. I lived with him every single day and talked to him about these things, trying to walk his footsteps, and I still could not truly envision what it was like to be him. Still, there was a lot of “what you should do” and “what you have to do” from people who had much to say, yet did not ask Ben (or me) questions that would have given them insight into his experience and allowed them to acknowledge and comfort him, rather than simply judge and direct him.

Shortly after his diagnosis, Ben told me that he would understand if I wanted to leave him, if I could not handle what was happening to him and if I wanted to have a different life. From his perspective, he loved me and wanted the best for me, at the same time that he feared and wanted to prepare for the possibility that I might leave him. Indeed, some people told me that I should leave him. To walk in my shoes would mean that you perceived my overwhelming fear, anger and sadness but knew that I would never leave this man whom I loved and who needed me. And, to walk in my shoes would mean that you would realize that even when he was harsh and unkind, I would either defend it because of his illness, or believe him and think that I must not be a very good caregiver, or feel helpless because he was a dying man and I was devoted to him.

There were many times throughout Ben’s illness that I would have liked to tell people – strangers and those close to us – to try to walk in our footsteps. At Walt Disney World, when Ben did not have visible signs of disability in the early stages of ALS, some guests treated him as if he was simply lazy by using a scooter, and were clearly annoyed when loading the scooter delayed a bus and when it took up seating space. Instead of being defensive and angry, we were anxious and unnecessarily apologetic for the delays. That said, there were many people who also offered assistance if they saw me helping him to stand or transfer from the wheelchair, and they were kind and good humored with Ben. Try walking in the footsteps of someone who does not have the freedom to easily step on and off a bus and has to awkwardly and anxiously enter and secure a wheelchair while being watched impatiently by other riders. Imagine knowing that this is only the first of the abilities that you will lose and that this may be the last time you will ever be able to travel. We never know the big picture behind what we are seeing, so it is important to suspend snap judgments. Ironically, though there are often controversies regarding visitors to Walt Disney World who illegitimately request disability passes to get to the front of the lines, Ben never wanted special treatment or to take advantage of having a special pass for the attractions. I must also add that the Disney cast members on the grounds and transportation were always fantastic.

There were many instances in which people bypassed Ben and only addressed me. When his speech became impaired, he joked that if they heard him speak they assumed he was somehow mentally challenged, and, although it did bother us, I was glad that he had a good sense of humor. However, I was quick to involve Ben in conversations, because I wanted people to know that he was fully capable of communicating and understanding, even if he needed my help. Then, some people realized that they could engage with Ben. Think about how it must feel to be ignored when you are vibrant, able and wanting to be a part of a world that is becoming increasingly distant. Just acknowledging someone’s presence with just a smile can lift a person’s spirits. It certainly lifted mine to see him respected and happy. Compassion goes a long way.

Seeing things through another’s perspective is not always easy, especially when you are dealing with someone who has a terminal illness, like ALS. Among my biggest frustrations was that some of the people with the strongest opinions, arguments and accusations were also the people who were not actively or consistently involved in Ben’s care. They promised to visit and did not. They did not try to gain a clear picture of his medical and emotional situation and dilemmas or ask how they could help, but they were vocal with their criticism, even if completely unfounded. Instead of walking in his footsteps, they stepped on his feet and tripped me up with the unnecessary drama they created. It is imperative to be honest with yourself about the role you have had in someone’s care and life, and to recognize when to put aside your own needs and agendas, in order to watch and listen, and to “learn things you never knew you never knew.” With that insight and knowledge, you are more able to play a meaningful part in someone else’s journey.

In Ben’s fifth year with the disease, he made the choice to proceed with plans to get a feeding tube but those plans were interrupted by an urgent respiratory crisis that landed us in the emergency room. Then, admitted to the hospital with a biPAP mask and being fed intravenously, he had to decide for sure if he wanted a feeding tube and a tracheostomy. It took him more than two weeks to make that decision. I held his hand, I tried to answer his questions and to get a sense of what he was feeling, but I could not tell him what to do. I was worried about what his quality of life would be in a skilled nursing facility, which was where he would have to go with a tracheostomy. However, talking to him helped me to understand that Ben was focused on living and the things that he would be able to do. I could not begin to imagine all he was experiencing, but talking to him helped me to see his viewpoint and gain insight into his thoughts. I embraced his beliefs and supported him.

Ben did decide to get the feeding tube and tracheostomy, but things did not go smoothly in the hospital. He quickly developed an infection and then pneumonia. He was miserable. After a few weeks, he made the decision to go to the hospice unit of the hospital and to be removed from the ventilator, which was his life support.

Life and death decisions can be debated based on a range of convictions, from emotional to clinical to religious. Ben navigated his journey with ALS in a way that was right for him. I respected that and I admired his bravery. I had to see his situation through his eyes, and although I did agree with him, I understood that agreement with him was not the issue. I was there for him. Whether you are a caregiver, friend, family member or even a patient, it is so important to try to walk someone else’s footsteps. Maybe I did not handle being a caregiver the way some people thought I should and maybe I did. Maybe Ben did not navigate his life with ALS the way some people thought he should, and maybe he did. Keeping an open mind, even if we do not agree, helps us to “paint with all the colors of the wind” and support each other with a more positive, meaningful, loving and helpful connection.

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