July 21, 2019 Discussion Group

We discussed eldercare & agingissues—including our good karma, strategies for encouraging positive lifestyle changes, helping frail older adults move to safer housing, support for families with special needs children, strategies for helpingimpaired elders know when to stop driving, and end-of-life guidelines and medical care advice for Buddhist practitioners.      

Aging & Elder Care

–  We began by discussing our good fortune (or rather karma from a Buddhist perspective) to be able to pursue the spiritual paths of our choice due to our country’s freedom of religion and, in particular as Atlantans, to learn Buddhist wisdom (dharma) from three highly-qualified DLM teachers (Geshes).

–  One participant mentioned the use of a Buddhist calendar to keep track of Buddhist holy days and other auspicious days.  Per WikiPedia, “The Buddhist calendar is a set of lunisolar calendars primarily used in mainland Southeast Asian countries of Cambodia, Laos, Myanmar and Thailand as well as in Sri Lanka and Chinese populations of Malaysia and Singapore for religious or official occasions. … Today, the traditional Buddhist lunisolar calendar is used mainly for Theravada Buddhist festivals, and no longer has the official calendar status anywhere. The Thai Buddhist Era, a renumbered Gregorian calendar, is the official calendar in Thailand.”   https://en.wikipedia.org/wiki/Buddhist_calendar

-Another member reported a clever tip for helping loved ones with a planned household move that involves downsizing.  A geriatric care manager suggested giving them color-coded stickers to put on items that the loved ones want to keep or give to another family member.  This could be especially helpful for those who have memory problems or anxiety about a move.

–  For care partners whose frail loved one is reluctant to move to supportive housing when unable to live safely in their current residence, we re-emphasized the value of paying a geriatric care manager for at least a few hours of assessment and advice on suitable housing and moving tips.  For thosewho belong to a spiritual community, it could also help for the care partners to speak with a leader of this community who perhaps could provide encouragement and/or arrange an introduction to a similar spiritual group in the vicinity of the potential new residence.   

–  We discussed helpful versus unhelpful strategies for encouraging positive lifestyle changes by at-risk loved ones—especially those with a strong sense of independence who oppose care partner efforts to impose their wishes on them. An apparent need to move to safer housing or the loss of ability to drive safely were two such common elder issues.  One participant said that it was important to avoid scolding or shaming with statements that begin with words like “You’re crazy…” or “You’re making a mistake…”  Rather it was better to describe how you feel about the situation and what might result without the change, e.g., “I’m worried….” 

–  For resolving a driving dispute, several members suggested the possibility of asking the loved one to take an elder driving evaluation, such as ones offered by the AARP and American Automobile Association (AAA).    

–  The AARP website has an Assessing Driving Ability page (https://www.aarp.org/auto/driver-safety/driving-assessment/) with links to some excellent training and assessment resources for impaired elders and their loved ones, including…

o  Fitness-to-Drive Screening Measure – How do you know when to take the keys — or give them up?  Try this online screening measure… developed by researchers at the University of Florida.  [It] is a web-based tool for caregivers and/or family members of older drivers and occupational therapy practitioners to identify at-risk older drivers.

o  We Need to Talk  – How do you know when it’s time for your loved one to limit or stop driving?  It’s a tough subject for most families, but it’s a serious matter.  Now there’s help.  AARP offers a free online seminar… that will help you determine how to assess your loved ones’ driving skills and provide tools to help you have this important conversation.  And since it’s online, you can set your own pace.  (Produced by AARP based on information created jointly by The Hartford and MIT Agelab.)

o  Driving With Hearing Loss – How to stay safe behind the wheel when you don’t hear well.

o  AARP Smart Driver Course is one of many programs offered by AARP Driver Safety.   It’s the nation’s largest classroom and online driver safety course and it’s designed especially for drivers age 50 and older.  Find a location near you by searching [via the web page above].  You can also register for the driver safety online course.  [There are several locations within 10 miles of our DLM Center.]

–  In a discussion of parent and family support resources for care partners of special needs children, a participant said that Focus Georgia was an excellent non-profit program.  Focus is an Atlanta-based organization started by affected parents in 1983 and now serves over 3000 families with children who are medically-fragile or have significant developmental and/or physical disabilities.  Per their website, they comfort [such] children with hospital visits and support groups, offer hope by information and education, provide fun activities for parents and kids [including camps] and help to make equipment available to children in need.  (https://focus-ga.org/)

–  A member mentioned a nationwide company called Mobility Works, which sells and rents various powered wheelchairs, lifts, ramps and wheelchair-accessible vans for persons with a mobility limitation.  https://www.mobilityworks.com

End-of-Life Care

–  We discussed the need to acquire additional sources of information on state and local laws that apply to the handling, reporting and pronouncing the death of a Buddhist practitioner, who would like to their body left undisturbed for up to three days.  Following our meeting,we posted information on our https://www.BuddhistEldercare.com blog. [Those who have signed up for these blog posts by entering their email address on the blog homepage got this information as soon as it was posted.]

–  It was also noted that some basic end-of-life guidelines for practitioners and their loved ones were developed  by our eldercare and aging discussion group two years ago with help from Geshe Dadul-la and Geshe Phende-la (Guiding Principles for Buddhist End-of-Life Practice and Care – June 16, 2017).   An online copy of these guidelines will be sent to those who subscribe by entering their email address on the home page of our blog  https://BuddhistEldercare.com   

Other Matters

–  During the closing portion of our discussion, one member described her earlier emergency room scare and overnight hospital stay following a fainting spell, which gave her an unexpected chance for some Buddhist end-of-life practice.  While in the hospital, she said she had the good fortune [or karma] to be visited by Dr. Brad Priddy, who is a DLM Sangha member, a physician and the husband of her primary care doctor.  She said that he wrote the word Om on the whiteboard of her room to remind her to concentrate on being aware and having a clear mind, while helping to inform the hospital staff that she was a Buddhist who wanted to remain as alert and undisturbed as possible during her treatment.  

Based on his combined medical and Buddhist knowledge, she asked him to be what she called her death doctor, i.e., a designated health care agent who could advise the other medical staff in the hospital or hospice about the particular end-of-life wishes of a committed Buddhist practitioner, if she were unconscious or unable to communicate effectively by herself.  

At our meeting, Brad described the role and value of a health care proxy (aka, designated health care agent) and stressed the selection of someone you could trust who shares your values.  We discussed the importance of having a current signed advanced directive for the stateof your residence with copies given to your health care providers and your designated health care agent.  It’s also good to give copies to close family members or loved ones and discuss your end-of-life wishes with them. 

For instructions and a current copy of your state’s Advance Directives form, see this National Hospice and Palliative Care Organization web page: https://www.nhpco.org/patients-and-caregivers/advance-care-planning/advance-directives/ .

We also discussed our August 20, 2017 Special Discussion on Buddhist Views of End-of-Life Practices and Care event at the DLM Center and the Buddhist end-of-life guidelines that were distributed to attendees of that event. (An ecopy of these guidelines was added to our https://BuddhistEldercare.com blog)

We agreed that a Buddhist physician or other experienced health care professional with a working knowledge of emergency medicine, hospital intensive care, and palliative care would be a great member of an end-of-life support team that would include palliative care specialists and death doulas.

Brad discussed how to communicate end-of-life preferences regarding medical procedures and therapies that could affect mindfulness in life-threatening circumstances or at the end of life, as well as preferred handling of the body following clinical death.  

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