The New Normal

This week one of the residents in the facility, Mr. Irwin, caught a news segment about the violence taking place across the world, following by a blurb about an ebola patient in Texas. Even though his dementia, he recognized how the world has changed, for the worse.
“Back in my day, you didn’t see all those kinds of things. I am glad I am old and no longer out there.”
Wow, what a profound truth. The world has become a much more scary place than the Roaring Twenties, or even the Fabulous Fifties ……instead we migrated to Terrifying Two-Thousands. We have reached a place in our society where we live with drive by shootings instead of rival fist fights. We no longer walk away from a job, angry at our employer; but rather we whip out a Uzi and shoot them. We no longer simply divorce a spouse,; we hire a hit man to eliminate them. Our worst nightmares have become the reality in which we live.
As I walk through the facility, I see residents who have lived through so much. They battled some of the greatest wars ever fought, and came home heroes. They fought for our freedom, defending the Nation that once was “Under God.” Today, I am not sure what we are ” under”. It is my belief that the day the President proclaimed that we were ” no longer a Christian nation…”, we were doomed. Back in the 20s, Islam may have existed, but it was not the faith of our Founding Fathers. Back in the 30’s, I am sure no one could define “Muslim”. I don’t think there was ever a “school massacre in the 50’s. Even in the 60’s and 70’s, the psychedelic generations, no one knew what a ” terrorist attack”, was all about………. In the 80’s, we did not fear for our lives every time we stepped out of our front door. We didn’t worry about being beheaded or catching a disease that has no cure…..
Last weekend, I was at Washington Dulles Airport. I was caught off guard what I saw the police officers patrolling with dogs and machine guns. Machine guns. I looked around to see what was going on; assessing to see if we were under attack…hoping they would get the bad guy …but no, rather, this is the new normal.
I do not like the new normal. It was bad enough living in the Washington DC area when the Beltway Sniper roamed about shooting at, and killing people for sport. The entire Tri State area was on full alert. Gas stations placed tarps around the gas pumps so we could hide behind them as we filled up our cars. People ran for safety as they parked in grocery store parking lots; hoping to not be shot by the snipers. We truly lived in fear during that time. We all hoped and prayed that law enforcement would “catch the guy” who was terrorizing us. Once they captured the pair of shooters, all of DC went back to normal. The tarps came down; playgrounds were filled with kids playing and laughing and parks became overcrowded……we had returned to our normal lives.
Now with the possibility of random killings, beheadings, drive by shootings, flag burnings and “cell groups” laying in wait for their prey……I guess the police do need to carry machine guns….. I think the days of feeling safe anywhere….are over.
I remember starting the school day with the Lord’s Prayer and the Pledge of Allegiance. I attended Sunday School and memorized the Ten Commandments, the Beatitudes and Psalm 23. I was taught to say ” please, thank you, no ma’am and no sir.” I bowed my head and said “grace” before every meal. Before I went to bed, I knelt on my knees and prayed… ” Now I lay me down to sleep, I pray the Lord my soul to keep. If I die, before I wake, I pray the Lord my soul to take, amen”.
Now, the Ten Commandments are no longer allowed in Government buildings because they are “offensive and violate the freedom of religion”. Whose religion?????? Not mine. Children can not stand and say the Lord’s Prayer because ” it violates the rights of others”. Whose rights? Not mine. We live in world that is now more worried about the rights of others that we no longer have rights. We worry about violating other’s freedoms to the point where we have no freedom. We are no longer a ” Nation Under God”. We replaced our Fearless attitude with that of being fearful….. 

 

Mr. Irwin forgot what the news anchor reported and the images he saw shortly after seeing them. He shuffled on down the hall to bingo without a care in the world…………oh how I wish I could do the same………..

Forever Labeled

I was in the mall this weekend and found myself passing judgement on others based on how people looked, or were dressed.
” Check out the dude with blue hair…what a weirdo”….I whispered to my friends.
” Did you see that woman? She had to be at least 600 pounds”….another whisper. The whispering continued….
” Check out that guy over there with the tattoo on his FACE…”
” Wow, did you see that teenager with barely any clothes on? Her parents let her out of the house looking like that?”……….
” Look at that gangsta, he should invest in a belt or pants that fit…..”
” Aww, look at the older couple, holding hands, aren’t they cute?”……

Amazing how we define what we see, based on what we are looking for. We are all quick to judge based on what we see without thought to what we know. You know it’s true….and you know you are guilty of making assumptions and passing judgement; it’s only human to do so.

The same is true with dementia patients. We label them as “demented” and quickly forget that he/she is a person…We speak loudly to them, but yet, they do not have hearing loss. We direct them to “sit down”, “eat your food” and “let’s go to the bathroom” as if they are children. Yet, they are not children. We toss all dementia patients in the same proverbial hat and treat them all the same, without consideration for the unique person each was, is, or will be.

Look at Willie. He lost his wife, so he grieves. Since he has a diagnosis of dementia, we ignore his feelings of loss, sadness and grief, choosing to medicate with antidepressants to offset the dementia related disorder. Hmm. The label of dementia supercedes what is actually happening in his life. Labeled.

Look at Rev. Carmichael. He has dementia. BUT, he jumped out of a second story window before arriving at my facility. The documentation stated he jumped out of the window because of ” dementia and not knowing what he was doing”. After spending time with him, we learned that he wanted to die because he had no purpose for living. His wife had passed away, he was no longer a pastor, and he felt trapped inside of his 620 foot apartment. Yet,he was labeled as ” a dementia patient”……..

Look at Steve. Younger guy who recently moved in. He has dementia. But, at the psych hospital, someone asked him if he ever took illegal drugs. He said yes. So his chart reads, “dementia related to heroin and other mild altering drug abuse.” Ask Steve ” Is the sky red?”.. Answer “Yes”. “Am I an alien”? Answer “Yes.” ” Do you shoot Heroin?” Answer, ” Yes”. Are you the President of the USA?”……Answer…… “YES”. Now he is labeled as drug-induced onset dementia patient. Funny thing is, his family will tell you that he never took drugs, except for smoking pot in his younger days… yet he is not LABELED.

From all of this, I draw one conclusion. We as humans, need to stop labeling one another. We need to invest in the lives of others before we form conclusions, make casual assumptions or form opinions. Sounds simple. But is it?

K9 Kota Challenge

Recently I was reading an article about a police dog ,named K9 Kota. I must say I was impressed with his love for his handler. After reading the article, I found myself thinking, ” Wow, a dog did all of that for his handler and I’m not sure I have a friend who would have done that for me!” You see, Kota and his police handler were answering a radio call for a burglary when the incident that changed everything happened.
Upon arriving at the house, the officers were trying to locate and apprehend one of the burglars, while Kota sought out and attempted to subdue a second burglar who had hidden himself in an attic space. No one is sure what happened….but as Kota and the burglar struggled, Kota fell through the ceiling and sustained massive injuries to his leg, including broken bones. In the meantime, the officers were still trying to get the first burglar under control on the second floor of the house. They knew nothing of Kota’s injuries. They had heard a crash and a yelp, but they were not in a position to help him………

Kota, severely injured, knew his handler was still up there, scuffling with the bad guy. Without thought of himself, his pain, his injury or suffering, Kota climbed each step to make sure she was okay.
Such a selfless act of Valor……

The world today could learn so much from Kota and the traits he possesses. Loyal, concerned, devoted and selfless are just a few words that come to my mind…….Wouldn’t it be amazing if we all cared for and respected one another with such intensity? Can you imagine how peaceful the world would be if we always put others before ourselves?
There is an old expression, ” the world has gone to the dogs”…..My thought is this….if all the dogs were like Kota, that would be a dynamic statement to define the society we have become! Sadly though, I don’t think that old adage is meant in a positive way…………….
You know, people everywhere are taking challenges from Ice Bucket Dumping to Hot Dog Consumption to raise money for very worthwhile causes. I too, have a challenge that I would like to present, but not for any cause, except for the cause of kindness. We will call it the ” Kota Challenge”.
For 24 hours, replace negativity with positivity. Exchange hate for love. Kindness instead of cruelty. Understanding for judgment. Selfless instead of selfish. Patience instead of condemnation.

Jesus Himself set the standard for how we should live and how we should treat other people. Look at this :
• Ephesians 4:32 Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you
• Luke 6:31 And as you wish that others would do to you, do so to them.
• Matthew 7:12 So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets.
• 1 Peter 3 8-12 Finally, all of you, have unity of mind, sympathy, brotherly love, a tender heart, and a humble mind. Do not repay evil for evil or reviling for reviling, but on the contrary, bless, for to this you were called, that you may obtain a blessing. For “Whoever desires to love life and see good days, let him keep his tongue from evil and his lips from speaking deceit; let him turn away from evil and do good; let him seek peace and pursue it. For the eyes of the Lord are on the righteous, and his ears are open to their prayer. But the face of the Lord is against those who do evil.”

• Philippians 2-4 Let each of you look not only to his own interests, but also to the interests of others.
Lastly, my personal favorite:
Romans 12: 10 Love one another with brotherly affection. Outdo one another in showing honor.
Imagine that….OUTDOING one another with kindness……Wow.
That’s the theme for our Kota Challenge. Outdoing one another with kindness……….That is my challenge to each of you.

One last thing, good deeds don’t always go unnoticed. Kota is up for an award. The Hero Dog Award. Please consider going to this website and casting your vote for him..

http://www.herodogawards.org/vote

This is a photo of K9 Kota, used by permission from his handler. You can follow him and his healing progress on Facebook at http://www.facebook.com/k9kota

Don’t forget to take the Kota Challenge!

See Spot Run

Do you remember when you were back in grade school, learning the difference between nouns and verbs? We were taught proper nouns, improper nouns, pronouns and action words…. I can still hear my second grade teacher asking; ” What is the noun in the sentence , See Spot run.? Well, that’s simple. Spot.
Pleased with our correct response, she challenged us further. ” What is the first verb in the sentence?” Ah, that too is simple. Run. The teacher turned back to the chalkboard and underlined the word ” See”.
” Run is not the first verb. The word see is the first action word……………… How can it be? See is really an action word? In the mind of a small child, it’s a thing we do with our eyes not an action word…………..
Over the years, I clearly have come to understand how indeed, it is an action word. From the moment we open our eyes in the morning and begin “seeing”, actions follow. Seeing triggers action. This morning when I opened my eyes and my feet hit the floor, my eyes led me to load the dishwasher, mop the kitchen floor and pay two bills that were laying on my counter. I opened my laptop, sent 9 emails, read 111 more and quickly scanned FB and Twitter to see what I had missed overnight.
Driving to work, my action word based eyes caused me to yield to oncoming traffic, stop at red lights and pass Sunday drivers.
Arriving at work, I began the task of making visual rounds, quickly pointing out the things I saw wrong.
” Why is the TV on this channel?”
“Who left this chart here?
” What exactly is this we are serving for breakfast?
“Why is this resident sitting here and not in the dining room?
” Who dressed Mrs. Smith in red and pink, seriously?”
My action based ability to ” see,” certainly found what was wrong in every setting. From the moment I got up, I was correcting things, fixing things and following my eyes every direction…….Yet, my eyes did not point me to the beauty of the things around me, the positives, the pleasantries……………How could that be? My verb (seeing) led me to a another verb…”judging”.
We all do it. We judge based on what we see. We form opinions based on what we think we know, based on how things appear, based on what we see……..it’s a domino effect.
Regardless of whether we are dealing with friends, family or dementia patients, we need to temper our “seeing” with a noun ( compassion) and a adjective ( understanding).We need to stop seeing so much of what we think we see and take notice of the beauty and the positives that are around us.
Many times what we see, depends on what we are looking for……..If we wish to see the negatives, guess what? We will find them. If we wish to be critical, judgmental and bias based on what we think we see, we will find ourselves miserable, depressed and in a constant state of anger.
Let’s go back to the questions I drilled my staff on this morning.
” Why is the TV on this channel?” Because the staff was taking care of the residents and did not notice the TV or it’s channel.
“Who left this chart here? The doctor. He is in the room with the wife of a resident who is dying; providing her with comfort and reassurance.
” What exactly is this we are serving for breakfast? It’s a new recipe given to us by a resident’s daughter. It was her mother’s favorite dish.
“Why is this resident sitting here and not in the dining room? ” Her son is taking her to breakfast.
” Who dressed Mrs. Smith in red and pink, seriously?” It’s her birthday, and red and pink are her favorite colors. She picked the outfit out herself.”
“Oh”. What else I could I say, but oh? You see, I allowed my eyes to pass judgment before I knew the facts. How many times in life, are we all guilty of jumping to conclusions, based on what we think we know or see? How many times have we been proven wrong after the fact?
” See Spot Run.” Maybe we should find out why Spot is running….maybe he is running to his owner, full of joy, excitement and elation! Maybe he is running from a bear! Maybe is running after his ball…..

What we see, depends on what we are looking for.
________________________________________________________________________________________________
“What we do see depends mainly on what we look for. … In the same field the farmer will notice the crop, the geologists the fossils, botanists the flowers, artists the colouring, sportmen the cover for the game. Though we may all look at the same things, it does not all follow that we should see them.”

― John Lubbock, The Beauties of Nature and the Wonders of the World We Live in
_______________________________________________________________________________________________

Ummmm…Hmmmm

We live in a very strange world. Admit it, you agree with me. Yesterday while I was in the grocery store, I saw a man wearing a nice dress shirt, neatly tucked in his skirt. Yes, you read it correctly; skirt. I stared for a moment….you would have too! Then I thought, well maybe it’s a new style of a kilt, maybe he is Scottish and honoring his Motherland. That thought was squashed when I caught a glimpse of his black Sunday-best heels…..okkkkk.

This morning, I stopped at Burger King for a cup of coffee, only to have a young woman with more facial piercings than she had face, taking my order. Her lip had this bright shiny metal thing that resembled a hoop earring. Her nose, well honestly, I’m not sure what it was, or what it’s called. It looked like a staple with both points sticking outward. Her eyebrows, well, hmmm. I can’t even find the words to describe either of them. Let’s just call it a weird interaction…….

I arrive at work and open my email, and this was the first thing in my inbox.

Hello,

I am a spiritualist originated from Cote d’ivoire. I have sent this same message to you but it seems you did not receive it.

I write to inform you to be careful. A man and a lady came to me and told me to prepare voodoo that will harm you and all your family but I couldn’t do it due to your good heart.

The reasons they gave me to harm you is stupid and baseless and I warned them not to come to me for such thing again.

You should seek for protection from any spiritualist you know because right now I am 100% sure that they are making arrangement with another spiritualist to get voodoo to harm you.

I do not wish to get involve on this because of my engagements but in the event you need advice do contact a very powerful spiritualist or you can contact me through my private email xxxx@gmail.com so that I can introduce you to a good spiritualist in your country.
Hariako
The Great of Ogwuta Kingdom

Great, a voodoo spell. Now what? Obviously this fellow thinks I need a “”spiritualist”. I didn’t even know what that profession does. Matter of fact, I don’t even know where the Great of Ogwuta Kingdom is, or if it’s the fellow’s name, title, address or country!

Let me get this straight. I don’t have 55 piercings covering my face. I have zero! My hair is only one color. I have a job. I wear clothes that are suitable for my gender. I try to live in peace and harmony with others……yet, I am the odd person out and need a spiritualist because somebody wants to cast a spell on me? Ummmmmmmmmm. Ok.

Oh boy, things CAN get worse. Maybe I do have a curse……read this email that was next in my inbox.

—
Attention:

I am Barrister Chukwu Ikenga, by name and I am writing you this email
message regarding your unpaid Fund, My Dear; I wish to inform you that
the people you are dealing with are not the real people that is in
position to release your Fund to you that is the reason why it’s
impossible for you to received your fund, why can’t you deal with the
bank appointed to handle the Transfer of your Fund instead of sending
money to people that will not help you get your fund.

If only you will response back to me upon receipt of this email
notification and follow my instruction, I will personally direct you to
the appointed paying Bank were you will be paid instead of wasting your
hard earn money and time on these hoodlums.

As it may interest you to know all this money you have been sending
would have completed your payment transmission before now if you heard
contact the appointed paying Bank. Email me back only on this email{
xxxxx3@qq.com } for more information on how you will received
your UN-paid Fund from the appointed paying Bank.

I shall be expecting to read from you only if you needed my assistance
on this matter.

Regards,
Barr. Chukwug

——-
So that’s why I haven’t received the 40 billion dollar inheritance from my relative that I didn’t know that I had in some country I never heard of…..I have been dealing with people that aren’t real!!! This fellow thinks I am dealing with hoodlums! Mystery solved! Wow.

Just when I thought it was safe to open the next email that was flagged, “URGENT”, I again, realized that maybe this whole voodoo spell thing is legit.
—–
Dear Jessi,
Your willy is the main source of relaxation! So you should take care of it.
Check out our HOT SUMMER OFFERS and save HUGE on the best medications . Order Viagra here! Thanks, Tammy
—-

My what? Okkkkkkkkkkkk……ummmmm.

You know, I can sit and talk with dementia patients all day long, regardless of their cognitive skills. For the most part, I follow their stories, understand what they are talking about and can relate to them…..but oddly enough, it is obvious that I can not understand the “outside world.” Maybe it is the vodoo spell….maybe its the fact I am not taking care of my “willy”, or maybe it’s because I have corresponded with “hoodlums” …or maybe, just maybe I do indeed need a spiritualist from the Kingdom of Bamfamskamascooo…………Hmmm.

The first thing I am going to do when I get the 40 billion that is due me, I am going to fly over there to Bamsasakammania and take care of the curse…..Im going to look it up on the globe now and start planning the trip!

HMMMMMMMMMMM.

Forgotten Hurt

When I admitted Mr. Harris into the facility, I didn’t know a great deal of his personal life or history. I could tell something wasn’t quite right, based on how his son behaved. At first, I assumed that maybe the son was just not close to him, or maybe they just had never gotten along. The son signed all of the documents, and seemed hurried to leave.
I moved through the admission process as quickly as I could. The continual tapping of the pen on the desk caught my attention.
” I am sorry, but cannot help but take notice of your nervousness. Are you sure you are comfortable with your decision to place your father here? Are there any questions I can answer to make this more comfortable for you? ” I asked. I explained how difficult these types of decisions are……but before I could finish….his son cut me off.
” Difficult? You think this is difficult? Listen lady, I am do what needs to be done. Nothing difficult about it. You think this man gave a cuss about my mother or my brothers or I? Hell NO. Listen, I am doing right by him even though he never once did right by us, not as kids, and certainly not as adults. Is it in his paperwork anywhere that describes him as a monster? That’s what he was, and still is. You can sit there all day long and tell me about how he doesn’t remember the past, well, whatever. Guess what lady? I do remember. I remember it all and don’t think for one minute that I will just have to understand that he doesn’t know what he is doing. He sure as hell knew what he was doing when he would beat us. He was an abusive father and just because he is old and demented doesn’t make it excusable. So, no, I am not nervous as you think. I just want to get away from him. So can we speed this up?”
Wow. Just wow. The anger in his voice; the look on his face and the way he pointed his finger at me, all indicated to me that certainly wasn’t anything I could say other than, ” Okay.”
We completed the documents, shook hands, and off he went.

His father, Mr. Harris has severe dementia. He is not aware that his family does not visit. He spends his time talking about fixing cars, deer hunting and going to work. He is quick to hug anyone, willing to accept his act of kindness.
” Well good morning good looking lady! How are you doing today? Have you seen my car? I know I need to put brake shoes on it, but I don’t feel up to it right now. Look here darling, can you get me something to snack on? I don’t think I have had a bite to eat all day. I was deer huntin’ most of the day, and I am worn slap out”…… his voice trails off as his thoughts change. I give him and hug and carry on.
His son is right, whatever his past behaviors, mistakes, poor judgments or just plain old mean streaks were, they are not excused by the diagnosis of dementia. But at the same time, until his son can find it in his heart to forgive his father, he himself will forever be held captive by the past.
I have a friend who is almost 50 years old. Recently he sat down with his dad, and told him all the things that bothered him throughout his childhood. His father was a workaholic, and never home. This young boy grew up on his own, with an absent father. 50 years later, he wants an apology from his father……which I assume took place….I don’t really know. The point is, for 50 years, this guy has harbored whatever animosity towards his father because he worked too much . Hmmmm. If Mr. Harris’s son is waiting on a similar apology, how will it happen when Mr. Harris doesn’t remember?
 

I know the two stories are very different circumstances. I am in no way meaning to compare an abusive parent to a workaholic parent. But I think at some point , we ourselves , must let go of the past for our own benefit. Mr. Harris will never be able to remember what he did or didn’t do, or be able to verbalize his feelings…..so where does that leave his son?
What will happen to Mr. Harris as his health declines? Who will make the right medical decisions for him? Will ever decision be made quickly, in haste to hurry to get away from his father?
There is an old expression, “As a man soweth, so shall he reap….”. Does that apply to Mr. Harris? He has long forgotten the hurt, yet his son has not.
I don’t know how this story will end. I just wish there could be a fairy tale ending……………..

Happiness

Luther Burbank once said ” The greatest happiness in the world is to make others happy”.  What a profound truth this is. We as workers in long term health care often spend most of our time meeting the needs of our residents, but rarely focus on making the residents happy. How can one “make” happiness for a dementia patient?

Well, I think there are several ways we can achieve this. First of all, we must know the resident well enough to know what they will find happiness in doing. Secondly, we must be creative to compensate for the physical and cognitive defiects the resident has. Thirdly, we must put forth an effort to create the atmosphere of happiness.

Just because a person has dementia does not mean they cannot express emotions, including that of happiness or sadness. If you looked at the statistics of depression in the elderly; the use of ant-depressant medications in long term health care facilities and the overall rate of suicide rates in the elderly population, I think we could all agree that happiness is not a common emotion felt by this population.

Dementia patients tend to live in a world that is limited to their own reality. However, if we focus on what they focus on; engage them in meaningful conversation, regardless if what they are saying makes sense to us, we can give the person  validation. Validation leads to a sense of self worth and self esteem.  We have become  a nation of pill pushers, including those of us working in long term care. We pass out pills to make the resident ” feel better”. How about take the resident outside for a ten minute walk, or wheelchair ride? Fresh air, sunshine and one on one human contact that does not involve feeding, dressing or changing incontinence briefs? How about greeting our residents with a hug instead of a “let’s go to the dining room Ms. Jones”.  How about listening, really listening to what they are saying, instead of redirecting them because “they don’t make sense?” How about offering the resident a cup of coffee, not the half cold cup that is leftover from breakfast? How about we speak kindly to the resident, every time we pass by, complimenting them on their clothing, their shoes or their hairstyle? How about we smile when we provide care instead of moaning about how many hours are left on shift? How about we show interest in the resident, talking to them about their former occupations, former  places of travel and the things they did “back in the day”? Even if they cannot remember, we should be able to remind them of the highlights of their life. We should know Mr. Jones served in the US Air Force for 43 years. We should know Ms. Smith has 32 grandchildren and 9 great grandchildren. We should know Mr. Davis raised pure bred German Sheppard, of which 4 were world champion show dogs. We should know Mrs. Saber won not 4, but 5 ribbons at the county fair for her blueberry pie. We should know Ms. Daisy grew up on a cattle ranch in Montana, and can identify every type of cow known based on its bellow.

Kindness. Caring. Consideration. Respect. Understanding. These are the ingredients to happiness when caring for our dementia patients.  We must put forth a better effort to make our resident happy. Effort. Effort does not come easy, but neither does making another person happy. Until we chose to determine ourselves to change the way we provide care, we will remain a yellow pill, blue pill, red pill society.