What's your plan?

This week I received an email from an aunt saying, "People rarely want to leave their homes, though I have known a few people to make the decision to move from home to assisted living of their own volition." She went on to mention two people who had decided to move. I work in a nursing home so most often my patients are facing the question of whether or not they can or should return home. There are more that want to go home when they really shouldn't than those who willingly stay.

No one wants to be in a nursing home even if it is called a care center. One woman I've worked with wants to go home. "I don't want to spend the rest of my life here!" Never mind that she needs two people to help her move from her recliner to her wheelchair. I think she would be happier if she accepted the reality of her physical limitations and was content where she is. Stir in a little dementia and it is hard to reach that state of acceptance. Another friend cared for her mother for a time in her home but there came a point when it was no longer safe to leave her alone for very long. Even after a year in a nursing home her mother still doesn't understand why she can't live at home even though she appears to be quite content where she is.

This week I had a conversation with one of my patients that went something like this. 

Me: What do you do during the day when you are at home?

Pt: I sleep a lot.

Me: Do you help your husband with the cooking?

Pt: Yes, we do that together.

Me: How about the laundry?

Pt: No, that's in the basement and I can't get down there any more.

Me: What did you do for fun?

Pt: (pause) I can't think of anything.

Me: What do you like doing here?

Pt: I like the exercise class, bingo. I've been going to all the activities and I like them.

As a therapist it has been wonderful to see the change in this woman. The first time I worked with her she couldn't hold her eyes open and it took two people to get her to the bathroom. Now her eyes are bright, she greets us with a smile and she just needs some supervision for safety when moving around. The marked improvement has come, in large part, because she has things to do. Sure, she still takes a nap or two during the day, but she isn't sleeping for hours at a time. And now she is talking about going home where it seems she will end up back in the same situation as before without the extra stimulation.

Last week another patient decided that she was going to stay in the nursing home. Could she have made it at home? Yes, she likely would have done fine. Her health has improved and she has family in the area who are helpful. But as she thought of being in that house all by herself, she decided that she would rather stay. Her family and the staff applauded her decision.

When I was a teenager, a woman in my church commented, "It is always better to make a move before you have to." I couldn't agree more. Making the decision to move to a higher level of care is easier when you feel like you are in control of that decision. Of course, life throws some curve balls at us that we don't expect and the move has to be made before we had intended.  But thinking through the different scenarios and talking with your family about different options before you ever expect to need them will likely make the move a whole lot easier -- even when dementia makes it harder to understand why you can't be at home.

A Silent Retreat

Since January I've been going through the book Sacred Rhythms which talks about spiritual disciplines beginning with silence and solitude. At first glance, more solitude isn't something I need as I already spend a lot of time alone. However, that time is usually not silent and I rarely think about the solitude as purposeful time with God. I found it difficult to be silent and listen in God's presence for even a few minutes, much less a whole weekend. Yet, I do long for deeper intimacy with him so when I came across a silent retreat sponsored by Christos Center I decided to sign up. I had little idea what to expect but as I packed, I resisted the urge to bring a novel along. My bible, journal, and some other paper should be good enough -- right?

We met at Villa Maria where several retreats were happening at the same time -- and they weren't silent. We began with getting to know each other over supper where I talked primarily with Julie, who had spent a year in France 30 years ago. After the meal we met together to go over the plan for the weekend. We went around the room and briefly introduced ourselves and what our expectations were. As we left the room at about 8:00 Friday evening we entered into silence. There were smiles of greetings in the hallways and at meals but for the most part we gave each other plenty of space. I had thought that meal time would be awkward, but that didn't turn out to be the case at all. We got our food in the main cafeteria which was full of chatter from the other groups. I had a sense of relief when I got into the smaller room reserved for us where relaxing music was playing "so you don't have to listen to each other chew." It was quiet and peaceful and everyone was lost in their own thoughts. I had no desire to break that for them or to have anyone speak to me. I was content to mull over whatever it was I had been thinking about before I came in.

There were regularly scheduled times of meditation where the leader of the weekend spoke briefly but none of it was mandatory. I only attended one of those which lasted about 10 minutes. I just wanted to stay where God was directing my thoughts as I spent most of the day outdoors. I talked for about an hour with one of the spiritual directors which was helpful. I went on an hour walk in the woods and the meadow which was part of a state park. There was a few times I was bored and was wishing for a novel, but in the end I was glad I could just sit. With my nose in a book I would have missed the soaring eagle in the morning and a soaring hawk later in the afternoon. It was also part of slowing down that I needed so I would stop thinking and listen for God's voice. I'm always doing something even if that is simply reading or listening to the radio as I fix supper. By the time it was over, I felt much more settled and peaceful. I was glad to talk again but I didn't mind silence on the drive home and my mind wasn't flitting from one thing to another.

Sunday morning we met for the Lord's Supper together and we broke the silence by giving a brief report on how God had met each of us. It was different for everyone. God wanted me to experience again that he loves me and he is with me. The passages that God brought to mind were:

He rescued me because he delighted in me (Ps 18:19)  and 

The Lord your God is in your midst, a might one who will save; 

he will rejoice over you with gladness; he will quiet you by his love; 

he will exult over you with loud singing. (Zeph 3:17)

On the way home I realized that God tells us that he loves us over and over again in Scripture because we need to hear it over and over and over again. The context of each of these verses show that God is with us and to what extent he will go to rescue us, to rescue me.

A silent retreat may seem like an oxymoron but for me, it was a precious time. I highly recommend it.