May 19, 2019 Eldercare Discussion

Report of the Drepung Loseling Monastery (DLM) Member Eldercare Discussion Group Meeting – May 19, 2019

We discussed eldercare & aging issues—including the environment and biodiversity, neurodegenerative diseases, walking, and several end-of-life issues from a Buddhist perspective.

Aging & Elder Care

–  A member mentioned a book she was reading by E.O. Wilson entitled Half Earth that describes the ecological effects of rapid species changes, as global temperatures rise and natural habitats are destroyed.  

Edward O. Wilson.  Half-Earth: our planet’s fight for life.  Liveright Publishing Corporation, 2016.

https://www.worldcat.org/title/half-earth-our-planets-fight-for-life/oclc/951070857

–  The Half Earth concept is that humans and their governmental policies are contributing to the rapid loss of species biodiversity and affecting our own survival as a species, but that this loss can be stopped by conserving half the land and seas as natural environments for future generations.  See https://www.half-earthproject.org/  and https://en.wikipedia.org/wiki/Half-Earth.

    In Buddhist terms, rapid ecological changes are contributing to the current and future suffering of many humans and other sentient beings.  These changes are partly caused by human actions. Humans can slow or stop this excess suffering. 

–  We discussed the difficulty of diagnosing neurodegenerative diseases in their early stages—in particular Parkinson’s Disease and Multiple Sclerosis.  One member, a Diplomate in Functional Neurology who has worked extensively with patients with neurodegenerative diseases, said that early diagnosis and treatment were very important in stopping or slowing their progression.    

–  Our member discussed the importance of a baseline neurological exam (ideally at a hospital that does research in these conditions).  She described the important concept of neuroplasticity, the ability of the brain to change continuously throughout an individual’s life.  https://en.wikipedia.org/wiki/Neuroplasticity   She also described some of the techniques she uses with patients having particular neurological conditions, including nutritional counseling, eye-exercises for Multiple Sclerosis, and face-tapping for Cerebral Palsy. 

– She added that there are now several recently-approved medical treatments for particular forms of early-stage Multiple Sclerosis.  One such treatment is interferon injection for relapsing-remitting multiple sclerosis (RRMS).   See also:

  o Multiple Sclerosis (WikiPedia)  https://en.wikipedia.org/wiki/Multiple_sclerosis   

  o Multiple Sclerosis (MedlinePlus)  https://medlineplus.gov/multiplesclerosis.html

   Managing Multiple Sclerosis – Treatment Can Delay Future Attacks. NIH News in Health; January 2019.  https://newsinhealth.nih.gov/2019/01/managing-multiple-sclerosis

–  We also discussed how elders are living longer and should adopt healthy lifestyles to help prevent the onset of chronic health conditions.  Another member stressed the value of walking and said that some public health professionals now believe that “sitting is the new smoking.”   To remedy this problem in our sangha, she and another  described a 4-5 mile dharma walk that they and others have been doing in local parks on the 3rd Saturday morning of each month.  We also discussed the importance of avoiding environmental exposure to pesticides, such as Roundup and toxic chemicals used to kill mosquitos, which can be potential contributors to serious health conditions.   

–  We discussed potential frustrations of being a care partner for loved ones who are not thinking clearly or who reject help when it is obviously needed.  For a friend or loved one who has become isolated, it’s important to try to build a good support system of health professionals, members of the spiritual community (if there is one), neighbors, former co-workers, friends and family members.  However, in these situations, one member said that it’s important to not have expectations that you will fix a care problem.  Another added that it was important to try to put yourself in the shoes of the loved one

End-of-Life Care

–  We re-visited our recent discussion of the sometimes difficult treatment choices for those who have terminal health conditions, such as late-stage cancer or other diseases that can involve invasive treatment or advanced life support.  It was also noted that each situation was unique, experienced clinicians and second opinions should be sought, and that harsh treatments for some cancers—including an initial round of chemotherapy—can be effective.  We agreed that such choices should be made by the patient after a careful consideration of the alternatives— not from attachment to one’s life, property, reputation or to others—but with consideration for the well-being and suffering of others.  When chemotherapy has little chance of stopping a cancer patient’s decline, one member stated that a decision to stop this treatment and to accept a natural death was not suicide

–  One member noted that Geshe Phende-la often reminds us that we must all die alone and only the dharma can help us to have a good death, so it’s important to study the dharma now while we are healthy and able.

–  A member recommended a book that chronicles how a young mother struggled with and triumphed over her diagnosis of terminal colon cancerThe unwinding of the miracle: a memoir of life, death, and everything that comes after.  Julie Yip-Williams; Joshua Williams; Emily Woo Zeller.  New York: Books on Tape, 2019.

https://www.worldcat.org/title/unwinding-of-the-miracle-a-memoir-of-life-death-and-everything-that-comes-after/oclc/1085664088

–  Another member recommended book that he found to be very interesting.   Per the publisher’s summary, the author shows us the power of responding fully and authentically to the death of a loved one through his Buddhist practice.   Guy Newland.  A Buddhist grief observed.  Somerville, MA: Wisdom Publications, 2016.  https://www.worldcat.org/title/buddhist-grief-observed/oclc/946276344

–  One member said that you can sometimes comfort a dying person, who feels they are a burden and has nothing to live for, by guiding them through a legacy project—a written commentary for their surviving loved ones on one’s life struggles and lessons learned.  He recommended a related book by Elena Zaiman that describes the forever letter.  Per the publisher’s description, the book provides a non-denominational way for readers to review their personal values and conduct a self-assessment of their lives. 

Elana Zaiman.  The forever letter: writing what we believe for those we love.  Woodbury: Llewellyn Worldwide, Ltd., 2017.

https://www.worldcat.org/title/forever-letter-writing-what-we-believe-for-those-we-love/oclc/970610372

–  One member added that love was like food; it was necessary for us to survive….and the better the quality of love, the better we survive.

–  Another member noted that the Legacy Project and forever letter were similar in concept to the ethical letter written by some Jews for their surviving loved ones.  In the 13th Century Moses ben Nahman (1194–1270), (also commonly known as Nachmanides or Ramban) was a leading medieval Jewish scholar, who wrote a very early ethical letter to his son.  https://en.wikipedia.org/wiki/Nachmanides

–  Per WikiPedia, Nachmanides was a Sephardic rabbi, philosopher, physician, kabbalist (practitioner of Jewish mysticism), and biblical commentator.  He also believed that a dying person’s soul could be reincarnated into another human body.  He was raised, studied, and lived for most of his life in Girona, Catalonia. 

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