Tuesday, November 29, 2011

A New Look ...

Hi everyone! Welcome to Caregiver Wellness Workshops' new look on the world.

Anyone who follows Caregiver Wellness regularly will have noticed that I have posted a new blog format pretty well every day this week - and, in some cases, even three or four times a day - as I've experimented with new templates for the site.

It's always a big decision to alter the familiar.  And that decision then leads to many questions. Does one change the layout or just the colours? Which colours are welcoming, which are peaceful, which are too intrusive or frenetic?  Which fonts are easiest to read? Which headers match the existing photos and which tend to clash? (I had decided on a lovely golden colour until I realized that it clashed with almost every photo on the site! And then there were the constraints wrought by the preselected options chosen by the Blogger folks - which were not always my cup of tea.).

All that said, I'm happy with the new look - it's familiar, and clean and clear, and bright and peaceful, and shouldn't be jarring to the tired eyes of helpers who are drawn to the site. So, enjoy!

Tuesday, November 22, 2011

Holiday Planning Near the End of Life ...

Whether you celebrate Christmas, Hanukkah or the Solstice, spending the winter holidays with a loved one who is dying feels poignant, fragile and precious.

The last Christmas I shared with my husband was probably the most beautiful ever - partly because of the thought we put into its planning and partly because we became willing to let go of the outcome once the planning was done. Here are a few of the things we learned:

1. Plan in advance but be flexible and hold your expectations lightly, remembering that there's a good chance that the plans will change.

2. Begin your planning with the person who is ill. Have a conversation about:

* his or her hopes and dreams for the holidays
* the themes that underlie those hopes and dreams - time with family, spiritual observances, gift giving, eating special foods, hearing traditional music
* what plans are realistic given their energy and abilities.

And don't forget to consider the same issues for yourself (and other family members living in the home) and share your thoughts with your loved one.

3. Have a conversation with extended family and friends once you know which activities matter most to you and your loved one and which will fit within your physical and emotional limits. Tell them about your limitations and about how you want/need to alter the celebrations this year. Make space to hear their responses with empathy and care. (Imposed change usually brings grief with all its sadness, anger, and efforts to control the uncontrollable.)

If the changes will be extensive, be sure to reassure people that they are still important to you and that it is the illness that is causing the constriction of activities and connection. For example, you might want to say something like:

* We'd love to have you here for the holiday meal but we don't have the energy to host it this year. If it's a particularly good day we might be able to join you for half an hour at someone else's house.

* We'd love to see you but we're moving into a time of quiet visits now. People who want to see Sam can come and sit with him for 5-10 minutes without speaking. On better days he may say something to someone but mostly its time for quiet visits now. If you're comfortable with that, you're welcome to come.

* We love you and wish we could see you but the time has come for us to protect our energy - the illness takes so much that the usual holiday visits aren't possible now.

4. Simplify rather than abandoning your traditions, for traditions are the glue that holds families together during hard times.

If your particular hopes and dreams are no longer possible, look at the important themes and values you identified in your initial conversations and use them as a guide for your new plans.

Going to the Midnight Service with family and friends on Christmas Eve and having our goddaughter and her family with us for Christmas dinner were the two traditions that were most important for my husband and me to maintain. Neither was possible in its usual form so we simplified and had a quiet, Christmas Eve service by candlelight at home in the livingroom on Christmas Eve and we all worked together to create a long, slow Christmas dinner on Christmas Day, so Derrick could go back to bed for a rest between each course.

It wasn't a perfect holiday but it turned out to be perfect in its imperfection, leaving us with cherished, loving, candlelit memories that will last forever. I hope the same will be true for all of you who face the end of life this year.

Thursday, November 10, 2011

Remembering the Invisibly Injured ...

Tomorrow, at the 11th hour of the 11th day of the 11th month, we will remember the thousands of Canadians who have been killed or injured in our wars, past and present.

However, there are some of the fallen whose names will not come to mind so readily, some whose injuries and subsequent deaths have never been acknowledged as being associated with war. Here I'm thinking, specifically, of those with the "invisible wounds" of Mild Traumatic Brain Injury (MTBI), Operational Stress Injury (OSI) or Posttraumatic Stress Disorder (PTSD), and the addictions and suicides that can come in their wake.

It wasn't until the past week, after hearing family stories at the funeral of my uncle, that I began to question the part that war injuries may have played in my own father's early death. A sergeant in the Canadian Army during WW II, he trained hundreds of soldiers in the risky business of bomb demolition. One cold prairie morning, a young trainee accidently detonated a bomb, believing that my Dad had already left the bomb disposal hut. My Dad was blown several feet in the air, lost consciousness, and burst both eardrums.

For the rest of his life, this quiet, kind and gentle man experienced hearing loss, headaches, dizziness, an exaggerated startle response and irritability, nightmares, emotional numbing and disengagement, and ongoing relationship difficulties. He used alcohol to cope with his physical and emotional pain and eventually died of his alcoholism at the age of 58.

With the benefit of hindsight and recent physiological research, I now suspect that my Dad suffered from the complex combination of MTBI and PTSD. He was officially diagnosed with neither and I imagine the same is true for many others, even today.

My father's "invisible wounds" had a profound impact on our family life and, while 12 Step programs were helpful for some of us, they didn't address the impact of the MTBI, itself. Fortunately, there are a growing number of supports available today. One of my favourites is Barbara Stahura's blog, Journal After Brain Injury. Here, one can find original blog posts by the spousal caregiver of a TBI survivor, sentence stems for both survivors and caregivers to use in healing through journalling, and many resources for survivors and caregivers alike.

Tomorrow, as I watch the annual cenotaph service, I will, as always, remember with heartfelt respect and gratitude, our war dead and wounded, our serving military, and the families who care for and support them. And this year, for the first time, I will include my own dear father, Jack, amongst the soldiers and merchant mariners we honour.

Wednesday, November 9, 2011

A Mindfulness Meditation Alternative ...

Whenever I teach a Compassion Fatigue workshop and we speak about the benefits of mindfulness meditation in reducing stress and autonomic arousal, there are always a few people who, because of the teachings of their particular faith tradition, feel uncomfortable about participating in the exercises.

My response to this discomfort is generally to offer the alternative of a Centering Prayer practice, which will bring about similar byproducts without the internal conflict. Centering Prayer is, in the words of Cynthia Bourgeault, Episcopal priest, author, and internationally-known retreat leader,

"...a simple form of sitting meditation, rooted in the Christian tradition but spreading its wings toward our universal human oneness."

I'm bringing this alternative to your attention, today, because I've become aware that the folks at the on-line educational organization, Spirituality & Practice: Resources for Spiritual Journeys, are currently offering a four week course called, "Centering Prayer with Cynthia Bourgeault". Cynthia's work is highly respected across faith traditions and she is an excellent educator.

The course has already begun, (the first two sessions of twelve have been completed and the third will be sent out by email on Friday), but there is plenty of opportunity to catch up for those who might be interested. If this includes you, you can find more information in the E-Course section of the S & P website at www.spiritualityandpractice.com.