Monday, October 11, 2010

Beatitudes for Friends of the Challenged

I was once given this small poem by a therapist.  I have posted it in every nursing home I have worked since.  I make copies and hand it out to staff.  Many times, I find that staff carry it in their scrubs' pockets.

I share it with family members when they come looking for answers.  For more than any of us, families will often wear themselves out before they seek help.  Whatever your reason, whatever your thinking or your need to do this, remember that asking for help for yourself is also seeking help for your loved one.

Blessed are you who
take time to listen to difficult speech,
for you help me to know that if I persevere,
I can be understood.

Blessed are you who
never bid me to “hurry up”, or take my tasks
and do them for me,
for often I need time rather than help.

Blessed are you who
stand beside me  as I enter
new and untried ventures,
for my failures will be outweighed by the times
I surprise myself and you.
                               
Blessed are you who
asked for my help,
for my greatest need is to be needed.

Blessed are you who
understand that is difficult
to put my thoughts into words.

Blessed are you who
smile and encourage me
to try once more.

Blessed are you who
never remind me that today
I asked the same question twice.

Blessed are you who
respect and love me
as  am, just as I am,
and not as you wish I were.


Blessed are you.


Sunday, October 3, 2010

"...Do this in remembrance of me."

I like to say that I “grew up” in the healthcare field.  And many people have taken me by the hand, passed me on to others as I continued to walk through my journey.  These guides have given me much in knowledge and in intuition.

 “Your physical senses will tell you things about a patient, especially when they cannot.”
             ….Mrs. Sanchez, the first L.V.N. I worked with in my first Nursing Home job.

“Often, a resident/patient will let you know when they are ready to die, even those who no longer speak.”   
…Bill M., the first Orderly I worked with and who taught me all he knew.

“If you cannot hear with your heart, use your ears.”  
…A fellow student at a Mental Health Outpatient Center

Do not ever fear death.  Death is part of life.”
            …Isabel Pineda, my mother

“Listen to the silence between the words”.
…A Chaplain on the Psychiatric Ward at a County Hospital

“When one of your residents is dying, what do you have to do more important than to be with him/her at the bedside?” 
…The mentor who said this to me used to sit with a dying resident.  When the person died, he would shut the resident’s eyes and say, “Godspeed, my friend.  You have fought the good fight.”

“Paul, do you know the only thing I fear about dying is that nobody will remember me.”
…A resident in a rural nursing home said this to me, after having lost three roommates within a span of six months.  When she died, and ever since when a resident dies in my nursing home, we hold a “Celebration of Life” for the family, all staff and residents to honor and remember that resident.  And, every November 1st, (All Saints Day), we hold a Facility Celebration of Honor for all members of our nursing home family (residents, staff and their family members) who died the previous twelve months. 


These are but a few of the wisdom words that these friends and mentors have given me over the years.  Many more were the lessons of example by which they lived their lives, their vocations.

 Jesus said it best, “…Do this in remembrance of me.”  To all the patients, residents, clients, family members, doctors, nurses, co-workers, students, I say with gratitude,
“I pray that my life work will be in remembrance of all those who taught me so much.”

Wednesday, September 29, 2010

The Sacrament of Presence

Presence practiced meets the definition of a sacrament: “…an outward and visible sign of an inward and spiritual grace….”

It is in the listening that the “outward and visible sign” becomes “an inward and spiritual grace”, a blessing to “…him who gives and him who takes…”

The spouse or adult child, overwhelmed by the moment comes armed with lists, demands and questions.  As listener, I am aware of the dual conversation emanating from this person in pain.  I hear the words from the mouth, and I listen to the sounds of the heart expressed through the face, voice and body.  The family member may or may not know they are screaming at the bottom of their lungs for someone to offer them the solace of listening.  As listener, I extend the invitation to, “tell me about you”.  And it is at that moment that the sacramental grace occurs between family member and listener.

Finding shelter in the ears of the listener, family members are surprised at the ease in which they begin the journey of healing.  Most often, it is unexpected; always it is inward and spiritual grace.

“I always promised my parents that we would not put them in a nursing home”, the 40ish-looking young man said as he walked in.  He began asking for brochures, wanting to see the results of our last State survey.”  He rattled off questions as if afraid to take a breath for fear of imploding. “What is your staff-to-patient ratio?  Do you have a doctor in the facility five days a week?"  His elderly mother, by his side looked at me.  I could see the fear in her eyes.  Her silence seemed to be apologizing for her son’s barrage of questions.
As I introduced myself, I purposely did not let go of her hand and guided her into the conference room, which was the nearest safe place I could find.  I think I broke his train of questions, so he followed us.
In the safety of the room, I responded, “I did too.  We said the same thing to my parents.  And you just reminded me how painful it was for me. I never want to forget what that time was like.”  His whole body seemed to come to a standstill, as if he’d met an old friend for the first time.
The mother reached out and held her son’s hand.  They sat there in silence.  As they began again, to share of the precipitating moment that had brought them to us, the sounds of the heart drowned out the words of the mouth. And communion happened.  She talked of her fifty year marriage, their struggles to raise a family of four.  The son talked about fishing with his Dad.  Then and only then, were we able to begin talking about Dad and what he was going to need.

.  Human nature would have us label and assume that we know “where that person is coming from”.  Listening, however, keeps one from applying clichés and quick answers to the other person’s walk. 

As a woman on Face Book said, describing a story of two parents dealing with their child’s sudden illness, This is a beautiful story and if you've ever been there you appreciate the river of denial as a healing stream that keeps you afloat until you can find some footing.”

And so the “outward and visible sign” of trust becomes the “inward and spiritual grace” of healing. And, we are both blessed.

Sunday, September 19, 2010

There is something about looking at someone eye-to-eye.


I have found that to do so, I must be willing to meet that other person wherever they may be at that moment.  It is like praying the Lord’s Prayer and saying , “…thy will be done..”
It can be like falling into the softest, gentlest puddle of tears.  And, it can be like being body-slammed by obscene anger.

Both have taken my breath away and left me feeling totally unworthy.   I say unworthy because either is a gift, an honor that families bestow, are willing to bestow, if we are but willing only to receive.

The only gift I offer at this point is my willingness to be present.  When it is time, you will gift me with your vulnerability and trust. 


I do not take that gift lightly.

Thursday, September 16, 2010

Journeys

In school, they used to tell us that the family member who has the most problem with their loved one in a Nursing Home (or hospital, Assisted Living Facility, or Hospice) is the granddaughter of a male resident/patient.
This explanation given was simple, if not simplistic.  This young woman was the grandbaby who sat on Grandpa’s lap; who had Grandpa wrapped around her little finger, and so forth and so on.  Usually, this child has avoided/denied that Grandpa is getting old, so she has not visited in a while.  And when she finally, comes to see Grandpa, he is not the same Grandpa she remembers.

And what happens, usually?  The denial explodes and her life shatters into pieces.  Her eyes see he who is left in front of her.  Her heart and her mind cannot wrap themselves around this frailer, more wrinkled and more stooped image of Granddaddy, Poppi, Grandpa.

And often times, the staff become the target of her disbelief in the form of anger, rage and often unrealistic expectations.  That is understandable.  I promise you, it may not seem right or fair.  We cannot even honestly say we understand.  That would be a lie.  It is a lie.  All the staff can do is allow themselves to be the focus of those feelings until.  Until she can catch her own breath, release and recover from the blow and sooner or later began the journey of grief.

These and other experiences, too many to count have given me the opportunity to come to a point in my life where I want to give of what has so freely been given to me. 

I offer myself as a guide to families, no matter where they may be in this journey.  I have experienced this journey personally, when my parents began their journey home.  In my work experience, I tried to help families walk through their emotional, mental, physical and spiritual journey of walking their loved ones home.

Wednesday, September 15, 2010

A Poem

Years ago I wrote this poem when I was the Administrator at a small rural Nursing Home.  It came to me as I watched one particular wife come to visit her husband. 

As is my practice, I always meet the families.  As much as they will let me in, I become part of this time of their life.  And so, she came in.  We talked briefly and she admitted today was particularly painful.  "To tell you the truth, I don't want to see him.  Is it horrible, for me to feel this way?", she asked pleadingly.

And so, this dutiful wife walked out of my office and saw her husband sitting in the Living Room.  There was that split-second delay on his part, as if looking through a fog and spotting someone familiar.  Without seeing her face, I knew the pain that hesitation caused, and she knew where it came from.

They held hands.  And then, she walked with him as he got up and left.  She followed him.  She followed him.  And as he went in and out of his disease, she became alternately, wife and then, stranger. 

And so, the words came to me.

Fear not for me



black and white stills,
8 millimeter,
color polaroids,
                                    video,
digital.
images of then.
cobwebs shimmering  and glossy, yet true;
blocks of time or precious moments
are anchors to the otherwise gossamer reality of my now.

This parallel universe haunts,
confuses and diffuses
                                    and even excuses me.
for me, one moment is here and now
the next who knows where.

You follow, or so you think ,
the wispy, milky, silky strands
of polysyllabic nonsense that betray me

Be not pained for me.
                                    Acceptance came gratefully included.
In my two worlds you exist–
                                    I whirl you around –so beautiful in your wedding dress.
                                    I wipe your brow as you breathlessly encourage our child into life.

Sliding, gliding I inhabit then and now
                                    not at my whim, but swept acceptingly about.
Like the gentle slide of a whirlpool
                                    with its inevitability of no-refund and no-return.
Know that I slowly leave, though in body I remain.

Be not pained for me.  I am here and I’ve already left.
I am a memory in a physical presence.
Adieu.




© paul pineda
    san antonio – fall ‘02

Tuesday, September 14, 2010

The beginnings

It has been said that a vocation is "where life's greatest needs meet my greatest joy".

As I look back in my life, being of service has always been my vocation.  And working with the elderly (and their families) has always given me this joy.  I don't have to look far to know where that spark came from and where it has been nurtured. 
Three salient parts of my life formed that vocation:
     * We had older parents - my father was 65, when I graduated from high school
     * In high school, I worked in a Nursing Home, as part of a work/study program, and
     * In my mid 40's, after the death of my parents, I returned to Nursing Homes as a Social   
     * Worker and eventually, a Nursing Home Administrator.

And so, for the past eighteen years, I have been  been privileged to be with these elders and their loved ones.  It has never been easy.  It has often been messy.   But messy is good, for it is in that mess that we come face-to-face with life.  Scary, hurting, ugly, painful, alone life.  But in that mess is often a personal "resurrection", where physically, emotionally, mentally or spiritually, we experience an awakening to life.

I know from personal experience that in this "mess", is when I most need community.  I need help.  I may not know what, where or when, or I many not even know I need help.  My hope is that my journey can be a resource for those who are in this transition - elder, disabled, friend or family member.