The Slow Goodbye

My mom turned 84 a little over a month ago. It was a milestone worth celebrating. When I visited with her in November I sadly thought she had a 50/50 chance of still being alive by April. When I saw her in March, I thought the odds had gotten even worse. Truth be told, when she was diagnosed with breast cancer 13 years ago only weeks after my dad had died, I never thought she would live to be 84.  I didn't necessarily think she would die from the disease, but just from the combined trauma of it all. But somehow she persevered and has continued to do so, overcoming obstacles and fighting to live on her own until just a few weeks ago. Her extraordinarily strong will may have finally met its match. 

Like many mother and daughters, our relationship has been complicated. Neither one of us met the expectation that we had of each other.  She wanted a daughter who lived close to her, who could be her go-to girlfriend and support person- unfortunately, I never lived closer than 1000 miles away. I wanted my mother to be an active, engaged part of my adult life. Instead, because she didn't like to travel she visited me only a handful of times during my almost 30-year marriage.  Sometimes expectations are hard to let go of. But given the obstacles, we have pressed ahead as mothers and daughters do. We tried to bridge the distance- physical and otherwise- as best we could. Sometimes we succeeded and sometimes we failed. 

A few weeks ago I got the call. The declining health that we had been so concerned about had finally come to a head. She had long been ignoring her doctor's concerns and had rejected any testing or treatment that would confirm a diagnosis. Calls ensued, my brother took the necessary action, and ultimately the decision was made to start hospice care.  I flew down a few days later to help and to spend time with my mom. She was frail and weaker than she had been even a month earlier and clearly needed help. I tried to do what I could. In a flurry of activity, we located important papers, made decisions on care, consulted with medical professionals, talked to the insurance company, arranged in-home care, made her house easier to use, cleaned, shopped, cooked, and I took my turn as primary caregiver mode.

There is no manual to walk you through this process. It is a titanic shift in roles. My focus on my mom was not unlike that of an infant or toddler- feeding her when she was hungry, helping her with her bathroom needs, making sure she didn’t fall, assisting with bathing and dressing.  I slept on a couch in the room with her so I could be there if she needed anything.  I slept with one eye and one ear open just as new mothers do. Somehow we found humor and light in unusual places because that’s what you have to do to survive. There were dark moments, overwhelming times in the middle of the night where I didn't think I could do it. Well timed text messages and emails offered encouragement.  Talking helped. My brother and I talked a lot about her care but we also took time to share old stories and talk about family nicknames and folklore, and we laughed. My sister arrived and we curled up in bed and talked and planned and laughed and shook our heads at the sadness of all of it.  I marvel at the resilience of the human spirit and the ability to do that which you never thought yourself capable of doing. 

As we figured out 24-hour care for her and saw some stability in her physical condition; we started to pay more attention to some cognitive changes. There had been some previous behaviors that were on our radar- stories that didn’t seem completely true, increased difficulty making decisions and managing her checkbook, incorrectly reading social cues. Perhaps because we were more focused on her physical decline, we didn’t really register the mental decline as significant. It was easy to explain it all away. Once I was there, I noted a few unusual changes in her behavior such as no longer watching tv or being extra sensitive to lights and sounds. I started noticing some periods of confusion. They would be most apparent after sleeping. She would have difficulty separating dreams from reality, but only for a short time, and given the amount of time she was sleeping it made sense to me that she would be confused. As I said, it is much easier to explain it away than to accept. 

At some point, my mom started asking questions. At first, I thought she was being philosophical- "how did I get here, what’s wrong with me"- but I soon realized that she was being literal. While these episodes were not the norm, I could see that they were happening more often than I had originally thought. I could almost see the clouds start to form in her mind. She would start blinking rapidly as if to clear her vision from whatever fog was descending on her brain. As sad as the physical decline had been, it was nothing compared to the heartbreak of the mental decline. It is perhaps our wishful thinking to assume that the patient is somehow shielded from the horror of this by virtue of their own fogginess. Perhaps in time, that will be true, but what I witnessed was someone who was keenly aware that something was terribly wrong but who couldn't quite get her brain to tell her what it was. When she started to say "I want out of here", she was not saying (as I had tried to convince myself) she wanted to go outside. I imagine she was saying she wanted out of this time and place where her brain was failing her at a rate quicker than her body. There is nothing to be done in those moments other than to reassure and try to explain what was happening. Even in the best of circumstances, it would be difficult to explain how a person went from living independently to needing 24/7 care in a matter of days, but adding the layer of mental uncertainty made it infinitely more difficult to explain. 

We are now in a race against time. We don’t know when the race will end. We don’t know if the physical decline will outpace the mental decline. In the end, there is little I can do besides provide her with good quality care and pray for her. I pray that God will be merciful, even as I know that millions of other families have prayed that same prayer without seeing the result they hope for. I do it anyway because it is the most and the least that I can do. In reality, we are already grieving. Even though my mom is still alive, we know what is coming and we can already feel the loss of her slipping away.  We understand that the best of times have already passed, and we grieve for what will never be. We are thankful for what we still have, but are broken-hearted at what we have already lost. We will continue on the long journey to acceptance. Thank you to those who are accompanying us with your prayers and words of encouragement. They are greatly appreciated.

Can't Stop the Noise

Do you ever feel like there is just too much "noise" in the world?

We are inundated with noise-- alerts, text messages, emails, social media updates, endless visual images, constant breaking news, any music we want at our fingertips, and the helpful (but annoying) voices of Siri, Alexa, and Google Maps-- from the time we wake up until the time we go to bed.  We are experiencing stimuli at a rate that we have never seen before. It has become a very noisy world and we have no way to know what impact this is having on our bodies and our brains.  There is a song and video by Kenny Chesney aptly title "Noise" that perfectly illustrates this new world we live in.

"Noise" by Kenny Chesney

Twenty-four hour television, get so loud that no one listens

Sex and money and politicians talk, talk, talk

But there really ain't no conversation

Ain't nothing left to the imagination

Trapped in our phones and we can't make it stop, stop

This noise

Yeah we scream, yeah we shout 'til we don't have a voice

In the streets, in the crowds, it ain't nothing but noise

Drowning out all the dreams of this Tennessee boy

Just trying to be heard in all this noise

Every room, every house, every shade of noise

All the floors, all the walls, they all shake with noise

We can't sleep, we can't think, can't escape the noise

We can't take the noise, so we just make

Noise

Link to video: https://youtu.be/k-VAXRC_hxk

How do you get away from it all? How do you know when you need to get away?

As one who enjoys quiet, I would expect that I would intentionally add more of it to my day, every single day. What I have noticed is just the opposite.  More and more I seem to be filling my days with "noise".  From checking my phone first thing in the morning, to scrolling through social media throughout the day, to frequently monitoring the news, to researching various topics on the internet, to watching favorite television programs, to shopping online, to texting or talking to friends, to doing a combination of all of those--I am living in a state of near constant noise.  Even if the noise is good or worthwhile or necessary, it is still noise.  There are times when we need to clear our heads.  We may not always recognize the signs, but they are there.  

One of the ways I like to escape the noise is by going for a walk outside in nature.  When I go outside, I can focus on the good noises- chirping birds, running water, crunching leaves, rustling wind. Those noises don't overwhelm, they cleanse. As I walk, my mind becomes noticeably clearer.  I tune in to the rhythmic sounds of my feet hitting the ground and look up at the vast sky above me. I pause by the water and watch the current flow. I start to notice the little things around me.  Soon I am part of nature and not separate from it. Problems that have troubled me start to find solutions.  As my mind opens up, creative ideas flow in.  I can't really explain why it happens, but there is something about the quiet that changes my mind.  I can only assume that there is also something about the noise that changes it in a different way.  

Recently, I took advantage of a warm day to go for a walk. The sky was heavy with clouds, but I decided the fresh air would be worth it.  I was enjoying a relaxing walk when it unexpectedly started to rain. I wasn't dressed for rain so I picked up my pace and headed for home, but along the way I observed something interesting.  Although I could hear the rain hitting the ground, I couldn't see it right away.  Then, I could see the rain in the air long before I could feel it on my skin.  I could watch the rain accumulate on my jacket, but I didn't yet feel wet.  It took awhile before all the little raindrops accumulated and built up to a point that made me feel wet and uncomfortable.  It was surprising to me how subtle the change was. I expected to be soaked right away. 

This made me wonder if this is similar to what happens with the noise in our life. We hear  sounds all day long, but we don't feel anything. We see all of the images coming at us, but we don't notice any immediate effect. We put up with the steady drone of noise until we are vaguely irritated and upset or worse, but we still can't quite put our finger on what is wrong.  As it is with the rain- we don't get wet immediately, but we all get wet eventually- it is with the noise.  We are fooling ourselves if we think this constant daily mental onslaught isn't having an effect on us. 

Most of us are drowning in a sea of noise.  We have gotten so used to the steady stream of noise and visual stimulation, the constant hum of traffic and technology, the never ending habit of multi-tasking, and the urgent drumbeat of news and information; that we no longer know what to do with quiet. In fact, we make excuses for why we don't need it.  We convince ourselves that we work better with background noise, that having headphones on with music is comforting, that checking our phones frequently is calming, that staring at a screen is relaxing.  We fill every moment with activity, images, and sounds; and then resign ourselves to the idea that quiet is for other people.  We are too busy to be quiet, we aren't wired to be quiet, we function better in noise and chaos.  Although ALL of our brains need it more than ever, quiet seems to become more elusive each day.  We need a brain break!

How do you find time to add quiet to your day? And what does it take to be truly quiet?  
There is not one right answer for everyone.  But, as the noise in our life continues to increase  finding quiet is something we need to become more intentional about.  Can you spare two minutes for silence? That's all it takes for real health benefits to kick in!

"Take time every day to experience quiet. Research shows that silence has measurably relaxing effects — even more so than listening to relaxing music. As little as two minutes of silence reduces heart rate, breathing rate, and blood pressure. If there are no quiet places for you to retreat to, consider getting a pair of ear plugs or invest in a set of noise canceling headphones or ear buds."

Overstimulation: Taming A Modern Problem that Leads to Anxiety, Deane Alban

Walking outside is one activity that helps me to become quiet, but there are so many other ways to embrace silence.  Here are a few examples of how you can create pockets of quiet in your day:

Sitting silently wherever you are

Praying

Practicing mindfulness
Meditating

Walking/being in nature
Committing to technology free times/zones in your day

As I have become more committed to periods of intentional silence, I have seen personal benefits such as feeling calmer and experiencing more mental clarity.  But science is also on the side of silence!  Here are some notable benefits:

1. Silence relieves stress and tension
2. Silence replenishes our mental resources
3. In silence we can tap into the brain's default mode network that helps us think deeply and creatively
4. Getting quiet can regenerate brain cells 

Source: "Why Silence is So Good For Your Brain" by Carolyn Gregoire

If you are feeling a little overwhelmed in your day, or just vaguely out of sorts; I would suggest you try adding in some times of silence- even if it's just a few minutes.  Try one of the above suggestions or come up with one of your own. It might be the easiest thing we can do to decrease the stress and tension in our lives and increase our mental well being.

 Embrace the silence!