August 18, 2019 Eldercare Discussion

We discussed eldercare & aging issues—including geriatric medicine, difficult care situations, unrealistic expectations, support groups for care partners, cultural approaches to end-of-life and Buddhist grieving.  

Aging & Elder Care

A member mentioned that geriatrician, Louise Aronson, MD would be speaking about her 2019 book on aging at the Decatur Book Festival over the Labor Day Weekend (see below).  Some members attended her talk and can report on it at our next monthly discussion.  One of her key messages was that older adults should seek physicians with at least some training in geriatrics or geriatric medicine.  Per WikiPedia geriatrics is a specialty that focuses on health care of elderly people.  It aims to promote health by preventing and treating diseases and disabilities in older adults. (https://en.wikipedia.org/wiki/Geriatrics).  

Elderhood: Redefining Aging, Transforming Medicine, Re-imagining life by Louise Aronson: New York : Bloomsbury Publishing, 2019; 449 pp. 

Publishers summary: For more than 5,000 years, “old” has been defined as beginning between the ages of 60 and 70. That means most people alive today will spend more years in elderhood than in childhood, and many will be elders for 40 years or more. Yet at the very moment that humans are living longer than ever before, we’ve made old age into a disease, a condition to be dreaded, disparaged, neglected, and denied. Reminiscent of Oliver Sacks, noted Harvard-trained geriatrician Louise Aronson uses stories from her quarter century of caring for patients, and draws from history, science, literature, popular culture, and her own life to weave a vision of old age that’s neither nightmare nor utopian fantasy. She challenges not only the way we look at aging but also the way we think and feel about medicine and humanity itself. Elderhood is for anyone who is, in the author’s own words, “an aging, i.e., still-breathing human being.”

The American Geriatrics Society website (https://www.americangeriatrics.org) states:

 Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Our nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists who are pioneers in advanced-illness care for older individuals, with a focus on championing interprofessional teams, eliciting personal care goals, and treating older people as whole persons.   …To find local healthcare professionals in your area who are sensitive to the special health care needs of older adults, see https://www.healthinaging.org/find-geriatrics-healthcare-professional

We discussed the challenges of being a care partner for a loved one with multiple physical and mental problems.  A participant said those facing such caring challenges might want to imagine themselves as teabags and that the hotter the water, the better the tea.  Another participant agreed with that metaphor, but said that smashing a teabag with a hammer was not ok, i.e., a care partner should not put their own physical or mental health at serious risk in caring for a difficult loved one.

In deciding how to approach a difficult care situation, one participant noted that it was important to consider your reason for getting involved—e.g.,

o  to assess the loved one’s needs and wants

o  to provide physical and/or emotional support

o  to arrange for personal care help or other services

o  to support other care partners who are already involved. 

He also gave some practical Buddhist advice: regardless of how you chose to help, you should go in peace, be present and monitor your intentions regularly.   

A participant said that she once worked as a geriatric case manager who specialized in challenging cases.  She said that the medical model approach to elder care had limitations and should be supplemented with a holistic spiritual approach.  An important part of the latter approach includes self-care for the care partner.  In cases where the loved one has an obvious mental or emotional problem but won’t accept help or change their risky or harmful behavior, it can be very stressful and depressing for the care partner.  In such situations it can be very helpful for the care partner to get support or therapy for themselves. 

Al-Anon (http://www.alanonatl.com/) and the National Alliance for Mental Illness (NAMI) (http://namidekalb.com/family-support-group/) are two national groups that host local support groups for friends and family of loved ones who have an addiction or mental illness

Other Caregiving and grief support groups include those offered by:

–  Spiritual congregations such as the DLM Eldercare and Aging Project

–  Large local employers like the CDC and Emory University

–  Elder health and social services agencies such as the Jewish Family and Career Services

We discussed the Buddhist approach to care situations that tend to make you feel frustrated, anxious or depressed.  It might be comforting to know that nearly all care partners have these feelings at times, but from a Buddhist perspective it’s a sign that you lack insight or information on how to resolve the problems or that you have unrealistic expectations about the outcome of your care.  One participant said that it was important to work on yourself rather than trying to get others to do what you think they should do.

Grief Support

A participant recommended a book.on grieving from a Buddhist perspective:  

A Buddhist Grief Observed  by Guy Newland.  Somerville, MA, Wisdom Publications; 2016, 115 pp.

Publishers Summary:  Amid the world-shattering pain of loss, what helps?  In the tradition of C.S. Lewis’s A Grief Observed, Guy Newland offers this brave record of falling to pieces and then learning to make sense of his pain and grief within his spiritual tradition.  Drawing inspiration from all corners of the Buddhist world–from Zen stories and the Dalai Lama, to Pema Chödrön and ancient Pali texts–this book reverberates with honesty, kindness, and deep humanity.  Newland shows us the power of responding fully and authentically to the death of a loved one.

A new movie: The Farewell was recommended.  It’s about a dying grandmother and her family’s Eastern approach to caring for her.

The Farewell is a 2019 American comedy-drama film written and directed by Lulu Wang, based in-part on her own life experiences.  The film stars Awkwafina, Tzi Ma, Diana Lin, Zhao Shuzhen, Lu Hong, and Jiang Yongbo and follows a family who, upon learning their grandmother has only a short while left to live, decide not to tell her and schedule a family gathering before she dies.  https://en.wikipedia.org/wiki/The_Farewell_(2019_film)

In discussing Eastern versus Western approaches to dying, one of our participants said that when asked what he thought of Western Civilization, Mahatma Gandhi Gandhi replied that he thought it would be a good idea.  For an interesting investigation of the origins and veracity of this quote, see the Quote Investigator Website: https://quoteinvestigator.com/2013/04/23/good-idea/   See also Mahatma Gandhi (WikiPedia) https://en.wikipedia.org/wiki/Mahatma_Gandhi

Also recommended is The Year of Magical Thinking, a memoir by Joan Didion about grieving for the sudden death of her long-time husband and the death of her only (adult) child.  Didion is an American journalist and writer of novels, screenplays and autobiographical works.  Based on the publisher’s description, it describes a challenging caregiving situation with lessons about attachment, emotions and impermanence.  

The Year of Magical Thinking by Joan Didion.  New York, Alfred A. Knopf; 2018; 227 pp.

Publisher’s Summary:   [In this book, the author] explores an intensely personal yet universal experience: a portrait of a marriage – and a life, in good times and bad – that will speak to anyone who has ever loved a husband or wife or child.  Several days before Christmas 2003, John Gregory Dunne and Joan Didion saw their only daughter, Quintana, fall ill with what seemed at first flu, then pneumonia, then complete septic shock. She was put into an induced coma and placed on life support.  Days later – the night before New Year’s Eve – the Dunnes were just sitting down to dinner after visiting the hospital when John Gregory Dunne suffered a massive and fatal coronary. In a second, this close, symbiotic partnership of forty years was over.  Four weeks later, their daughter pulled through. Two months after that, arriving at LAX, she collapsed and underwent six hours of brain surgery at UCLA Medical Center to relieve a massive hematoma. This … book is Didion’s attempt to make sense of the “weeks and then months that cut loose any fixed idea I ever had about death, about illness … about marriage and children and memory … about the shallowness of sanity, about life itself.”

Help for this Blog!

If you haven’t done so already, please enter your email address under “Subscribe” on the homepage of our new blog https://www.BuddhistEldercare.com to get additional info about Buddhist eldercare and aging through the blog and via periodic posts about relevant resources and events.  Before we can promote this new resource to a broader community, we need more participation so please share and encourage.

At our June discussion of this underutilized blog we agreed that our next most crucial need was to recruit someone who shared our goals and was willing to take the blog to its next stage by building content and marketing the blog and website to a wider community.  This volunteer might be:

1)  a Buddhist practitioner on our DLM Eldercare list;

2)  a local practitioner in the broader DLM member community;

3 ) a graduate of the Emory CBCT program; or an Emory, Agnes Scott, Oglethorpe, or Georgia State graduate student majoring in gerontology, chaplaincy or Buddhist studies

Now that schools are back in session. if you know someone who might be qualified and interested in volunteering for this role or know faculty at one of these schools who might have a qualified student who would like to do it for their dissertation or class project, please let us know.   

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