How did you spend Christmas?

I usually have plenty of time to visit with my patients during their therapy session. Some really like to talk and others are more quiet. One of our topics of discussion this week was Christmas plans. One of my patients in the transitional unit seemed to have a room full of visitors all week long. They did some singing and shared their Christmas goodies with me. On Friday when I stopped in his room for our session, he told me the whole family had been there on Christmas and his ribs hurt because he'd been laughing so much the past few days.

When I sympathized with another patient about how hard it is to be laid up this time of year, he commented, "I've spent a couple of Christmases living in my car so this isn't so bad." Over the next 30 minutes he told me what it was like to live on the streets. Over time, he began to stop thinking clearly. All he focused on was where to get enough food to survive and as a result he forgot that he had family within 100 miles who might be able to help him. Thankfully he had a friend who realized he was going deeper into depression and knew he needed to get out of town and start over somewhere else. This friend gave him $100 and told him to fill his car up with gas and start driving. The only memory he has after that was finding himself on a state highway thinking he could drive in front of semi and end his life without hurting the truck driver. "I didn't see one semi for the over 100 miles that I drove." He ended up at an uncle's house who made sure he was treated for the depression and was able to get back on his feet. After all that, it isn't so bad to be recovering from surgery in a warm place where there is plenty of food and even a therapist or two to add some variety to your day.

Sights and personalities

You know it is meal time when you walk down the halls and all you see in the rooms are chairs in the "eject" position.

The only time I hear all the televisions tuned to the same station is when the Hawkeyes are playing. And that is the only time I've seen the TV on in the dining room. We must be in Iowa.

The best gift you can give a hard-of-hearing resident of any facility is headphones so no one else has to listen their loud TV.

It is a relief to walk into a patient's room and hear a conversation happening in normal tones, especially after having spent 35 minutes "yelling" at another patient and even then, having to repeat everything twice.

Dementia has it's advantages -- at least for the therapist. I have a couple of patients who have "thrown me out" but 10 minutes later don't remember I had just been there. With a change of approach I might even get them to agree to do what they just refused to do.

As an occupational therapist, I do my best to have my patients do things that they would normally do especially if they plan to go home. That however can be a challenge at times. One woman told me, "Of course I can dress myself, but I'm paying enough money here that someone else can do it for me!" After another woman made a sandwich she declared, "There! Do you now believe I can make a sandwich?! You do know that I've been making sandwiches for far longer than you've been alive!" Of course I had explained to her numerous times that the point wasn't that she couldn't do it. The point was to have her do things that she would do when she got home.

One of my patients who is in his 90s told me that almost all of his friends are in the cemetery. He had no idea why he had survived WWII and had been so healthy until recently and others hadn't. He concluded that life is short even when you live into your 90s so you'd better live for eternity. I couldn't agree more.

Transition

I've been through some major transitions in my life. Moving from the farm to the near-north side of Chicago at 18 was the first. Then I moved to France and learned a new language and culture. Four and a half years ago I moved to Minneapolis. And last month I moved to an area about 35 miles from where I grew up. You would think it wouldn't be that difficult. After all, I knew where the grocery stores, the YMCA, the library, and the courthouse were. I recognize people when I'm out and about. People have actually heard of my hometown. I'm enjoying the benefits of being in a smaller town and back in farming culture where people actually have known each other for a long time. It sounds like it should be an easy transition, but I've decided that no transition is easy.

Four years ago I was wondering how long the transition would take, when I would have friends, and when I'd feel at home. All of that takes time. After all, history can only be made one day at a time. Last weekend I went to Minneapolis to visit friends and was reminded of the type of relationships that can be built in a few short years. I am thankful for the people I have met at the church I've been attending here who have invited me to join them for Sunday brunch after church and to be a part of their missional group. Those small things have helped.

The bigger transition for me is in my work. It's a new career, and though I've passed a test saying I know what I'm doing, in reality, I often feel like I don't have a clue. I told a friend that I don't know enough to actually know what I'm doing, but I do know enough to act like I do. I'm often searching my textbooks for answers to my questions when I get home. I guess I can only gain experience one day at a time as well.

It's hard to grow old

My grandma once said, "It's hard to get old." She must have been in her late 80s or early 90s at that point. In many ways she was very healthy for her age but her body was slowing down. My aunt encouraged her by saying, "Well, if you don't get old, you die young."

This week I've thought of Grandma's comment several times as I've listened to my patients and seen a couple of them cry. It's hard to have to wear Depends, to have legs that can't counted on to hold you up, to have a disconnect between your brain and your muscles, to not be able to bend over to pick up something you dropped, to realize you aren't going to regain abilities that were lost, or to not be able to dress yourself. It's hard to miss your spouse and wonder why you are the one who is left here alone after so many years together. It's hard to wait for family to come see you; even though you know they are busy, you still feel lonely. It's hard to feel like you don't have the energy to plan to be with family for Thanksgiving. It's really hard when your kids don't let you go straight home from the hospital but insist you get some therapy in a nursing home and you fear it's a ploy to keep you there.  It's hard to feel like you've lost control over so many of the basic things of life.

"All I want to do is go home." 
"I came here to get better, not to die."  
"Why am I still here?"

Three weeks into my new job, I still sometimes feel like I don't know what I'm doing. But my biggest challenge this week was knowing how to respond to some of my patients' emotional pain. I'm old enough to know that most words sound empty and trite. A listening ear, a touch on the shoulder or a hand held, and a few questions are probably the best thing I have to offer. Yet in my role as a therapist, I do need to say something and, from my experiences this week, I need to do a better job explaining the purpose of therapy up front and make sure my patients feel like they have a say in what we are doing.

Settling In

I started my new job last Monday. The first day was paperwork (and signing my names more times than I've done in a long time.) I came home with some policy manuals to read when I can't sleep at night. ;-) The other staff seem truly glad that I'm there since I am in a position previously filled by traveling therapists. By Tuesday afternoon my head was swimming with the difference between Medicare part A and part B, the right diagnosis with the right name with the right face, the details of the computer documentation... The traveling OT was very helpful the first several days but Wednesday afternoon I was on my own. Needless to say I was exhausted by the time I got home each evening. By Friday afternoon I felt more comfortable and managed to finish all my work for the week. It took me longer than 40 hours, but at least I can begin this week without feeling like I'm behind.

Saturday morning I moved into my new apartment. Most of my things were already packed up (and a few boxes haven't been touched since my arrival from France 4 years ago). Dad had most of my boxes in the garage by the time I got home Friday evening. Together we taped up the last ones and I packed the last couple of suitcases. Thanks to the help of Dan, Chad, and Carter we got everything loaded into the trailer, van, and my car. Thankfully unloading didn't seem as bad as I thought considering the spiral staircase that goes up to my 2nd floor apartment. Jeremy arrived to help make the last trips up the steps. Chad told me not buy a piano before I moved out if I wanted his help. This has the largest kitchen I've ever lived in. There is plenty of room for my minimal dishes, pots, pans, and other utensils. We did find the plates but the legs for my box spring have yet to appear. I guess that happens when things were packed up about 11 months ago. After Mom and Dad left, I put my feet up and enjoyed the colors in the western sky as the sun set and just relaxed. There are still boxes to unpack, but they can wait until another day.

Apartment Hunting

I've looked for a place to live numerous times in my adult life -- but where was I to find listings in an area where there is no "69" or Craig's list? Small town Iowa doesn't have such things, even in the Okoboji area. I did find a couple of web sites and began a list of places that might be appropriate. The first place I visited felt like an apartment in the hood. Nobody had bothered to do any cleaning and there was an air-conditioner-sized hole in the wall. That one was easy to cross off the list. It also made the next place look a lot better. The new flooring and remodeled bathroom made it seem far more livable. The next day I drove back over to the area to see an apartment in a new building. The quality of the construction was evident but I didn't really want to pay the price especially because the garage was extra. Friday morning I headed to the area for a third time to see a condo. This place was ideal in many ways -- an open floor plan, two bedrooms and two baths (come visit!), and a garage. It was also clean. I went home and filled out the application and emailed it in and received the lease in the mail today. It will be a new experience to move into an apartment with all the appliances and light fixtures in place and plenty of closet space.

I also spent several days last week looking for a place to meet a friend who now lives in central South Dakota. We wanted to spend a weekend together and she has been putting in some long hours at work so I volunteered to find a place for us to stay. With the late notice, several places were already full. Others catered to hunters. We ended up staying at an old feed mill in Herrick. It was definitely unique but also comfortable. We enjoyed some good conversation, laughter, and a nap every day. Saturday afternoon we took a long walk which took us through Herrick, which had no paved streets, a bar, a church, and plenty of dogs who advertised our presence.

Grateful!

Last Thursday I became officially certified as an OTR. I can not yet begin working until I'm officially licensed and can put OTR/L behind my name. As I've reflected on the four years this journey has taken, I'm very grateful for many people who walked with me and helped along the way.

• Housemates: Kathryn gave me my first address in Minneapolis when I was a friend of a friend. She was a former non-traditional student herself, so I actually believed her when she said my brain would remember how to study. Staci graciously took the tiny bedroom for the year we lived in an apartment together. While she struggled to stay sane, I was grateful for the extra space as I spent so much time there. Jan had some mutual friends vouch for me before she let me move in. She put up with my amazing ability to use every burner and pan while fixing supper and welcomed me into her relationships. 
• Minneapolis family: Though I didn't live very close to my extended family, it was nice to have "family" 45 minutes away. Barb and Wes welcomed me as part of their family around their table. They and cousins helped me move on the hottest day of the year. 
• Twin Cities Church: During the first few months I was in Minneapolis, I especially enjoyed the meal we had together as a house church each Wednesday evening. The time we spent around the table helped me get to know people and was often the only time during the week I ate a meal with someone else. Over time, these people became family. They helped me move, provided a place to stay between more permanent addresses and let me love on their kids. We shared each others joys, sorrows, and stresses and grew together in the grace of the gospel. This group of people reshaped my view of church.
• Former ex-pats: Within a month after I moved to Minneapolis, I met a couple who had moved back to the US after spending over 20 years in Europe. I no longer remember their names, but they told me it takes three years to adjust. That stuck with me and helped me be patient with the transition. Oscar and Cathi understood some of the quirks I picked up while in France and always seemed to delight in my stopping by unannounced. An added bonus was watching their son play rugby. I will never forget how they walked with me as I grieved John's death.
• Free housing: Jean and George, old family friends, welcomed me into their home while I was in Fergus Falls for three months. Scott and Kelly opened their home to a complete stranger when I was in St. Cloud. Their generosity saved me a lot of money and made that time of transition much easier.  
• Grandma: It was far easier for me to embark on this adventure because of Grandma's savings. From the time I was quite young, she had put money aside for me to use for college. I had enough left over to use as a down payment on an apartment in France. Between the increase in the market value and the drop of the dollar, it ended up being a very good investment that allowed me to pay for my schooling and live for 4 years without going into debt. My part time jobs and some help from my parents means I still have enough money in the bank to survive until I get my first pay check.
• Mom and Dad have always been my biggest cheerleaders. Mom did ask once if I had a plan B if I didn't get accepted into OT school. I didn't -- and I was accepted. More recently they had no doubt I would pass my boards, even though I had plenty. (Plan B was to study some more and take it again.) They have come to visit, filled up my gas tank and refrigerator, handed me checks, moved my stuff, stored my stuff, and welcomed me back into their basement. Through all the transition and changes, they have remained steadfast.

Every good gift and every perfect gift is from above, 

coming down from the Father of lights 

with whom there is no variation or shadow due to change.

(James 1.17)