Saturday, 14 December 2013

The small miracle of bad news

Bad new creeps up from behind and slaps you.
It is shocking. Painful. Paralysing.

But sometimes, while you are reeling and keening, good news puts a comforting hand on your shoulder and says. "I am here."

If you follow me at all, you know of the emotional last month with the Aviva Community Fund contest and Christie Gardens. We dreamed an incredible dream of winning $150,000 from the Aviva Insurance Company for our project.

We want to not only renovate the rest of our first floor, but to change the culture of eldercare. We have a vision. Care can go beyond respectful and kind to restoring purpose and growth, even in the end of life.

The journey was a wild ride. We won the first round, and advanced. The ten days of the semi-finals were a nail-biting, stomach-clenching experience, as we struggled in 12th place for days. With a final incredible push in the last three days, we gained over 1,000 supporters, and climbed to 10th and finally 8th place.

Voting closed at noon on Wednesday, and I didn't accomplish much that morning.  Incredibly distracted, I kept running back to my computer to click "refresh." The race was so close--only 150 votes separated the four contenders surrounding us. Could we maintain our position in the top ten?

Just before noon, I was assisting people to the dining room for lunch when I heard cheering. I ran to the  reception area, and saw a scene unprecedented at Christie Gardens. We are a conservative bunch, after all. Not that day. Residents, staff, visitors and family members crowded the area, and were screaming, crying, hugging. It went on and on. Our incredible dream was a huge step closer to reality, and we made it to the finals!

Thursday afternoon, we had a celebration. No, a CELEBRATION. Staff and residents together danced to the tune of "Celebration." Laughed. Cried. Cheered. Danced. Grinned with smiles that started in our toes. It wasn't just about Aviva or the money. There was a sense that something had shifted at Christie Gardens, and we would never be the same again.

Friday morning, a meeting of the Aviva committee was called for 10:00. Was there something we had to do to prepare for the finals? A group of 20+ staff and residents sat expectantly in a large circle.

That was when the bad news hit us.

Apparently, it is possible if you are tech savvy (which I definitely am not) to generate votes by computer. A computer rather than a person does the voting. This is, of course, against the rules. It is also possible for Aviva to discover which votes were generated this way. After checking and re-checking, they informed us that 700 of our votes were disqualified as fraudulent. Someone (or perhaps a few someones) thought they would "help us out." They didn't. Because of this, we dropped to 12th place, and were not qualified for the finals.

A hush filled the room. It's not fair. We worked so hard. Our project is so worthy. Why? Tears fell.

That was when good news quietly entered the room.

Around the circle, we began to share. We realised Christie Gardens changed, we changed, and culture change began though this experience.

  • The barriers between independent living and the care sections were coming down like never before. Residents living in apartments no longer felt that moving to the first floor was a "death sentence" but coming to a place for purpose and growth.
  • Residents and staff worked together in ways that had never happened before. Residents stood in Starbucks and Loblaws handing out bookmarks and talking about what we were doing, and people listened, and voted. Residents went to schools and the young people gladly got on board. So did their parents, their teachers, their office staff. And voted.
  • Residents and staff had fun together. There were no barriers. We were people celebrating together.
  • People in our community, across the country and around the world heard what we are doing. Many considered for the first time the possibility of caring for elders in this way. People caught the vision. As one resident said, "$150,000? That's nothing. You'd pay millions for this kind of publicity!"
  • Residents reached out to staff and comforted them. 
I was particularly touched by the comments of our chaplain. He remarked on the similarities between our story and the Christmas story. The first Christmas, Israel was looking for strength to overthrow the Roman rule. They were thinking in terms of  soldiers and an army. Instead, God sent a baby. What was He thinking? Yet, that wasn't the end of the story, and God had a plan.

And so with us.

This isn't the end of the story.

And God has a plan.

And that's good news.



Tuesday, 26 November 2013

The small miracle of not forgetting.


Where have all the poppies gone?

It's the end of November, and the poppies that were everywhere a few weeks ago have mostly disappeared. They've been replaced by holly and poinsettias. "To everything there is a season…"
Right?

I'm not sure.

We said "Lest we forget." We haven't forgotten, exactly, but life moves on. It's time to decorate and celebrate. The poppies have gone away for another year.

But the seniors haven't.

Those who served in the war, and those who stayed at home and prayed. Those who rolled bandages and knit socks. Those who grew food. The nurses, the mothers, the wives. Every one of them lived through unspeakable horrors with courage and even humour.

Today, they are our seniors. Many of them are quite elderly with multiple health problems. They need care. How do we honour them? How do we remember?

Let me first talk about what doesn't honour them. Putting them on long waiting lists to get into the more desireable homes where the care is less institutional. Encouraging them to live in the homes which have beds--the ones where conditions aren't home-like or personal.

Ordering their days based on the convenience of the staff. Getting up when they are told, eating when food is available (because it isn't available at any other time). Forcing them to wait to go to the bathroom, because they can't get there on their own. Sitting them in front of a television, because that's the entertainment of the day.

They deserve better.

I am so privileged to be working where we have the vision to be different. It is possible to respect person-hood, to be resident-centred and give resident-led care.

On November 25th, our second neighbourhood, Seaton Village, opened. Twenty seniors are delighted to call it home, and the staff serving them are excited to be a part of this new model. How does it work?

  • We place emphasis on resident's simple pleasures, where meaningful and spontaneous activities occur throughout the day.
  • Where residents are embraced holistically: Their past is honoured, their present is valued, and their future is validated.
  • Where Care Partners become students of the residents, learning not only their preferences in terms of personal care, but also their likes and dislikes, their personalities, their past, their talents, their skills, and their favourite things.
  • Where decisions about activities of the day are determined by the residents, both individually and as a group, and reflect their interests, needs and wishes.
  • Where work schedules of the staff and Care Partners are determined by those same interests, needs and wishes.
  • Where guests enter the resident's home by invitation of the resident.
  • Where the decisions about personal privacy are determined by the resident and personal space is respected by all.
  • Where conversations are with the resident, not about the resident.
  • Where residents' personal interests are being revived and where their passions and life experiences are being shared.
  • Where relationships are reciprocal and as a result where lives are being enriched in countless ways.
  • Where mealtime, bath time, bed time, interests and choice of engagement are determined by the resident.
  • Where health care is an invited support, not the determiner of the activities of the day.
It's not just about serving the resident who live at Christie Gardens, but about changing the culture of eldercare in Canada. It can be done. We are proving it. Others are watching.

On December 2, voting begins for the semi-finals of the Aviva Community Fund. We are competing to win $150,000. to build the next neighbourhood. Wychwood Park. The neighbourhood where I serve. 

It's easy for me to honour those who served me in both wars. I work with them every day. I know their names and I love them. 

Now you have an opportunity, too. By registering and voting every day at www.voteforchristiegardens.com from Dec. 2-11, you can be a part of honouring our seniors and changing the culture of eldercare. 

Lest we forget.

photo: http://md-arts.deviantart.com/art/Field-of-Poppies-IV-184896587

Wednesday, 20 November 2013

Caregiver Wednesdays--Interventions


Geraldine was upset. Her regular caregiver was off today, and the staff member who was helping her wasn't as familiar with her routines. She didn't wash her the same way, and didn't talk about what she was doing. She was friendly and efficient, but it wasn't the same. By the time she was ready for breakfast, Geraldine was anxious and agitated. She refused to go to the dining room.

Her caregiver left her alone for a few minutes, and went to get trays for those who were having breakfast in their rooms. She also got a tray for Geraldine. This took about 10 minutes, and by the time she came back, Geraldine was crying on the phone to her daughter. "They aren't feeding me because I complained."

What went wrong? The caregiver was trying hard to please Geraldine, who was normally sweet and appreciative. How did this situation get out of control?

The dictionary defines "intervention" as "to involve oneself in a situation so as to alter or hinder an action or development."1 In caregiving, interventions are the actions (often by the caregiver) which reduce anxiety, anger or other behaviours.

The difficulty with interventions is the same ones don't work in each situation, for each person, or all the time. Interventions often seem more error than trial.

The great thing about interventions is when they work, they are brilliant.

In Geraldine's situation, the caregiver was using a common intervention. When a person is in the midst of escalating agitation, it's often helpful to give them some space. Leave them for a few minutes. The person may have forgotten the problem and often the agitation passes.

But with Geraldine, leaving her alone for a few minutes escalates her agitation. Even if she told the caregiver to "leave her alone" it would be better not to. With Geraldine, using a quiet voice and asking her what she wants ("would you like this blanket on your legs? Which slippers would you like to wear?") works much better. That and a cup of coffee with 2 creams as soon as she gets in the dining room!

Interventions work best when you know the person well.

1.http://www.thefreedictionary.com/intervention

photo: http://www.elderhomeoptions.com/images/Elderly_Woman_Outside.jpg

Wednesday, 6 November 2013

Caregiver Wednesdays--Tackling the triggers



Barbara was devastated.

Her gentle, refined auntie, who she had always loved and looked up to, had just "bitten her head off." Barbara had entered her room for a visit, and had hugged her as she had done with every visit since she was a child. Auntie had drawn back with a scowl and growled at her, "Get your hands off me!" Stunned, she backed out of the room and went to talk to the nurse. While in the medical office, she'd burst into tears. She knew her aunt had dementia, but in the two years since her diagnosis, she'd never acted like this. What had she done wrong?

Barbara had done nothing wrong, especially since she'd never seen this kind of behaviour from her aunt before. But now that she knew it was possible, she needed to learn how to deal with it.

Barbara learned from the nurse that although this wasn't common behaviour for her aunt, it had occurred before, and it seemed to be escalating. The staff was monitoring it, and if it continued to happen, they would mention it to the doctor. For now, they were documenting each time it occurred, and looking for patterns. Was it a certain time of day? Was there a trigger? Was she tired, ill or over-stimulated when the incident occurred?

Over the next several months, Barbara became a student of her aunt, as well as learning
 how to deal with aggressive behaviour. Here is what she learned:

1) It was a big help to know what kind of a day her aunt was having. She checked in with the nurse or the caregiver and found out how she slept the night before and if there were any problems.

2) She approached her aunt with a big smile and a cheerful greeting, identifying herself before auntie had to wonder who this was. Most times, this brought immediate joy to her aunt's face. She didn't touch her, though, until her aunt's body language invited her to do so.

3) If Auntie got angry for any reason, she learned to take a deep breath and back off. Sometimes this meant changing the conversation, distraction, or even Barbara leaving the room for a few minutes.

4) She learned not to show fear or even much reaction at all when Auntie got angry. She would lower her voice and make sure her face was bland and undisturbed.

5) She never argued. Sometimes Auntie said the most outlandish things, or seemed to be living in another time, but arguing with her or correcting her only made her angry. Instead, Barbara went along with the conversation. Sometimes she learned some interesting history through these conversations.

6) She learned to acknowledge her aunt's feeling. Feelings aren't right or wrong, but they are real.

7) Barbara learned her aunt's behaviour wasn't about her. Sometimes that mad it easier to take.

8) She learned to listen. Sometimes, although it was seldom clear at first, she could discern the problem if she listened to her Aunt's concerns.

9) She learned to put aside her agenda. She may have envisioned them having a cup of tea and a treat at the coffee shop, but remained open to what her aunt wanted or needed. There were times when a walk in the hall or even outdoors was exactly what was needed. If she'd tried to force the coffee shop, Auntie probably wouldn't have cooperated.

10) Barbara knew her aunt forgot about the anger as soon as it was over. She learned to, also.

Barbara was surprised, because what had begun as a huge problem, led her to greater insights. There were still difficult times when Auntie snapped and frowned and even shouted, but there were just as many times of laughter or reminiscing and smiles.

Most importantly, Barbara knew that her aunt was more than the behaviours she exhibited. Auntie was still there, and she learned to enjoy the person she was.


Monday, 28 October 2013

The small miracle of making a difference for eldercare


                       The welcoming dining room in The Annex

I probably won't have a gravestone.
But if I did, I know what I'd want it to say.
She made a difference.
And I'd want it to be true.

At Christie Gardens, where I work, I have the opportunity every day to make a difference for an amazing group of seniors. They are from every profession and background, and they have the most interesting stories. I see their kindness and their grace. They add to my life every day.

Change and innovation has always been a part of Christie Gardens, but this has never been more true than now. We are seeking to change the way eldercare is provided, going from a medical model to a social, homelike model.

How does this look? We are developing four "neighbourhoods" which have approximately 20 residents. Let me walk you through the first one, called "The Annex."

When you enter the area, the first thing you notice is the colours. The warm golds and rusty oranges are welcoming. The family room is inviting, and has a door leading to the garden. It's the perfect place for a cup of tea and a chat. Private rooms line the hall, which leads to an open area. A room on your left is the studio, where several residents with their care partners are preparing for a game of bowling. Cloe the cat wanders over, yawns, and heads for a resident's room to sleep on the bed. The open lounge is inviting, and leads right into the dining room, where residents and care partners eat together. The nutrition partner is there with her apron on, looking like "mom in the kitchen." She often sits and chats with a resident while they are eating. The shower and laundry rooms are on your rights. Two residents enjoy folding laundry (especially the clean, warm smell) and do that task every day.

It's the atmosphere that I love. It isn't rushed, as care partners provide care and interact with their six residents. There is laughter and music. Everyone works together. The nurse comes in to deliver medications and treatments, but isn't a central figure. A resident arrives mid-afternoon and is served a cup of tea. It's home.

If you go down the hall, you will see the next neighbourhood, which is due to open late November, under construction. Excitement is high as it takes shape. The kitchen is in, sans appliances, and the wallpaper is up. Residents and staff peek as they go by, anticipating the opening.

I work down the hall from there. Our neighbourhood will be the next one to be constructed, and we are forever speculating where the dining room will be.

But it's not just about the construction, although the cosy, open atmosphere is integral to the model of care. It's a way to provide care that is respectful. It says, "You are a person. You have a choice. You can still grow and learn and be interested in life." So the residents choose when they get up and what they like to eat and what activities they enjoy. They interact and make new friends. They visit with family and old friends. They live.

All of this is expensive, and Christie Gardens is fully self-funded and non-profit. Our capital campaign has so far raised over $50,000 toward the project. Each neighbourhood costs approximately $250,000.

Here is where you can make a difference.

Aviva Insurance runs a contest each year through Aviva Community Fund. They invite participants to submit projects that will make a difference in their community. What was that? Make a difference?

You got it.

Christie Gardens has entered their project, not only to build the neighbourhoods, but to challenge the status quo of eldercare. We are pioneering a new model, and showing others that it is possible. You may not live in our area, or even in our country. But this revolution will affect you in some way.

What can you do? You can vote. Register once, and every day until November 4th, vote at www.voteforchristiegardens.com

Our support has escalated, and I believe it because people are catching the vision.

 It is possible.

Make a difference.

Today.

Wednesday, 23 October 2013

Caregiver Wednesdays- Finding the Trigger on the Smoking Gun



I don't know much about guns. I shot one once, at a target. I missed.

I know a gun has a trigger, and in order to shoot it, you have to pull the trigger. (Duh!) I learned that first from Road Runner cartoons. Wile E. Coyote would shoot his gun and then stand casually blowing the smoke away. That was usually when a stone or heavy weight fell on him. But I digress…

In dementia, anger and aggression can be caused by many sources, or "triggers." If you can discover the source of the agitation, it might be possible to intervene and remove it.  This isn't only true for anger, but works with many behaviours.

What could be possible triggers?

Is the person ill? A low-grade fever or a urinary tract infection or even a slight cold may not have shown itself in symptoms, but you know how it can make you feel. If you are feeling ill, you have less patience. How much more the person with dementia?

How are they sleeping? Sleep disturbances are common, and someone whose sleep has been interrupted is going to be more prone to anger the next day. Related to this are their medications, some of which might cause drowsiness.

Are they hydrated? This seems simple, but many seniors don't drink enough, and dehydration can cause all kinds of problems in frail elderly.

Beyond this, you need to become a detective. What happened immediately before? Is there something going on in the family that is making them sad or anxious?

Is the person frustrated or embarrassed because they know they aren't able to cope, can't remember or live in a state of confusion?

Is there too much stimulation? Too much noise, too many people talking, too much information to try to process?

Are they frightened or threatened by something real or perceived in their environment?

Here are some examples:

Laura's daughter just left on vacation. She is far enough away that there will be no communication for ten days. Laura doesn't understand why she feels anxious and angry. There are times when she forgets her daughter is away. But she lashes out much more frequently than is normal for her.

George hates to be touched unless he initiates it. If someone "helps" him to walk, or guides his walker away from danger, he becomes furious.

Mavis can't handle money any more, so she doesn't have any. However, throughout her life, she paid for everything, and it is a constant source of agitation for her that she doesn't have any money. Assuring her that everything is paid for doesn't help. She knows life isn't like that.

Florence knows that she can't remember how to cook. She used to love to create meals for her family, and not being able to brings her anxiety and huge embarrassment. She feels that she is failing in her calling. It makes her angry.

Roger loves family gatherings, but after a few minutes, he becomes impatient, and sometimes yells. The noise of everyone talking and the faces he knows he should recognise cause him embarrassment which leads to anger.

Every trigger is a fantastic discovery. If you can find the "why" behind the explosion, you can sometimes prevent it.

Next week: Tackling the triggers.


Wednesday, 16 October 2013

Caregiiver Wednesdays- Dealing with Anger pt. 1



Some of the best content on Facebook is when my daughter posts pictures of my granddaughter's visits to the Hallowe'en aisle of WalMart. Picture a  cherubic six-year-old who favours pink and anything with sparkles, wearing the most ghoulish masks imaginable. She loves blood dripping and skin hanging. When she's wearing one of those masks, I barely notice the rest of her. The mask is everything.

Of course, we all wear masks. Those firmly-in-place smiles that hide what lies beneath. I was recently yelled at by a woman who was furious with me. I had forgotten to do something, and she was disappointed. The reasons behind my memory lapse were of no consequence to her, so I didn't try to tell her. I took my lumps and tried to apologise. Inside, behind my mask, I had plenty to say, but it stayed inside.

People with dementia often lose the social masks we cling to so tightly. It can lead them to say exactly what they are thinking. There are times when it leads to anger or aggression. The mask which will keep my mouth shut and my hands folded in my lap when I am angry, doesn't work for them. Anger can be sudden, frightening and violent. Aggression even more so. What is a caregiver to do?

As with everything involving dementia, nothing works all the time, or every time. Every intervention is used with trial and error, and often in combination. Seldom is there one "cure."

One possible intervention is medication. Let me say up front what I feel about this.

Medication is sometimes necessary. I've seen it give relief when nothing else worked. If medication is used, it should be a) not the first solution b) given in the lowest dose possible and titrated up slowly if needed c) closely monitored by a physician who has this same philosophy. Most elderly people are on many medications for other conditions, and their frail bodies react more dramatically to drugs. Careful monitoring is key.

We are going to look at some of the causes for anger and aggression, because although it may seem like it came out of nowhere, the truth is, there is often a trigger. If you can identify the trigger,  a solution may present itself.

As caregivers, aggression and anger is exhausting to deal with, and takes a huge toll on you. If this is an issue in your situation, you need support, help, ideas and hope. You may even need to look at alternative care for your loved one.

It's a difficult journey. You are not alone.



Wednesday, 9 October 2013

Caregiver Wednesdays--When the Conversation Doesn't Make Sense


This is the final instalment in my series on communication with a person with dementia.

A person with dementia lives in a different reality from yours. What is real and true and makes perfect sense to them may sound like disconnected babble to you. Or, the words and even the concepts may make sense, but you still have no idea what the person is talking about. You need to leave your reality behind for a while and enter theirs.

How do you do this? Here are a few examples.

"I'm going home, now." or "I have to catch a bus and get home. Mother is waiting."
("Tell me about your home. What does it look like? What will Mother be doing when you get there? Will she have a snack for you? What do you like to do together?)

This conversation doesn't try to convince the person that they can't go home to a house that is long gone, or a mother that has been dead for 50 years. That kind of conversation only causes agitation and anger. Instead, listen and pick up on some part of what they are saying. Turn it into a reminiscence. Gradually change the tense from present to past.

"They are stealing from me. I can't find my purse/nightgown/money"
(That must be frustrating for you. Can I help you look for it?")

Again, this listens and validates the conversation. During the "looking" the conversation could be turned to other things ("That's a lovely blouse. Do you like to shop?" and the "missing" items might be forgotten. For now. It may resurface, possibly several times a day, and the same technique would need to be used.

"Can you bring me some knitting needles and wool? I want to start knitting again" (Lady is blind.) ("Sure, I can do that. What would you like to knit? What did you used to make?")

"Is Mother okay? I haven't seen her in such a long time."
("Yes, Mother is fine. What do you like to do best with mother? Where did she used to take you? Was she a good cook?") Notice I changed the tenses. People often move in and out of the understanding that their parents are dead. This person may be able to talk about memories of her mother from the past and not remember she was thinking about her as alive a few minutes ago.

When "conversation" is disconnected words or phrases that make no sense at all, make liberal use of conversational noises "uh huh, oh really, is that right, um hmm" etc. Occasionally the person may say something where you can pick up a conversational thread.

The bottom line--respect. This is a person who deserves it, and you are able to give it by entering into their reality and communicating with them.


Wednesday, 2 October 2013

The small miracle of Mrs. B.




Today I made a cake, but my chief mixer wasn’t there to help.  She left early in the morning, and won’t be back. Although I will miss her terribly, she has left so many parts of herself with me, there are ways in which she will always be there.

I met Mrs. B. many years ago when she was living in an apartment with her husband. They were contemplating moving to the care sections because he needed more care, and she was virtually blind. Although she walked with a walker, her mobility was poor, and there were other physical issues. After her husband died, she moved into my unit, and into my heart.

She was a strong person, and fought against the physical changes in her body. She wanted to move back to her apartment. She wanted to walk independently. She wanted to knit again, and other activities that involved sight. It irked her that she couldn’t do these things. But she didn’t let it overcome her.  Her insatiable zest for life and her humour rose to the top.

Today, I put ingredients in the bowl and realised that every time I do this, she will be there. When I planned to bake, I would let her know. After breakfast, she would search in her room for her apron and arrive in the kitchen with it on. She was the “Chief Mixer.” She couldn’t chop because she couldn’t see, but she mixed with finesse. Often when we were enjoying our treats later in the day, she would turn to the person next to her and say, “Did you notice how well it is mixed?”

I’ll never eat chocolate without thinking of her and the time we made chocolate covered pretzels. She was pretty much covered in chocolate, but she had a blast. I said, “Mrs. B., people are going to eat those pretzels. You really shouldn’t lick your fingers.” She grinned at me, and slowly licked each finger.

I’ll never pass a box of Kraft Dinner in the grocery store without thinking of her. One of my favourite stories was about how, as a young bride, she couldn’t cook. She discovered Kraft Dinner (which was probably a brand new product at that time) and made it for her husband. He liked it, so she made it again. And again. After a few weeks, he complained, and she was indignant. “I thought you said you liked it!”

When I dress up for a special event at work, she’ll be there. Last Christmas, I went to talk with her, and she felt the fishnet stockings I was wearing. She liked them, but didn’t approve of my calf-length dress. “You’d better shorten it. You’ll never get anywhere with it like that.” There were days she made me howl with laughter, and other times when she left me speechless.

She followed my romance and marriage with great interest, and the nurse in her wanted daily reports about my husband’s progress after heart surgery. She gave me a wedding card that she had signed, a treasure I will always keep.

 And she wasn’t above flirting with my new husband. He brought her flowers when he came to visit at Christmas, and she was delighted. Almost every day when I came home, he would ask about her. Then I’d go to work, and she’d ask about him.

Two years ago, her daughters and I launched a campaign to get her to go on our camping trip. She loved to be outdoors, loved people, and we knew she’d have a great time. Her excuses where a mile long, but we had an answer for each one. Her daughter packed her suitcase, and Mrs. B. unpacked it. Her daughter repacked it and we kept it in another room. Right down to the last minute, we weren’t sure if she would go, but in the end, she got on the bus. I used to joke with her that there were heel marks in the carpet from where she dragged hers on the way out the door. From the first moment she was there, she loved it, as she sat in the sun and chatted with the other ladies. I still remember the look of horror on her face when I brought the (little, tiny) fish that I’d caught to show her, and the look of delight when she ate her s’more. She had such a great time, and the minute she came back, she became a “camping apostle” and told everyone she saw that they had to plan to go next year. She went back a second time, and loved it even more.

And she wrote a book! This amazing lady didn’t let lack of sight hinder her, but dictated the stories of her life over the phone to her daughter, who was her editor and publisher. I felt so privileged when she let me read it and make a copy. “I’m not sure why you would want to. It’s just my story. Nothing interesting,” she said. On the contrary, it was funny and poignant and showed her personality on every page. I treasure it.

She loved people, and enjoyed her table mates in the dining room. There were six ladies who sat at the table which my co-worker and I called (only to ourselves) the “queen table.” They pretty much ruled the dining room, and Mrs. B. was right in the centre.

So she is gone, and I am here. But every day I take with me the many gifts that she has given me.
Thanks, Mrs. B.





Saturday, 21 September 2013

The Small Miracle of Renovations


For years, I've sat in my living room and surveyed the landscape.

Paint job at least 20 years old. Dated colours. Stained "cream" carpet that would never be pristine again.

Tired.

But so was I.

One problem was the paint job extended through the living room, dining room, hall, up the stairs and into the upstairs hall. My "roller arm" ached at the thought of it. I had no energy for a huge job, and no money to pay someone else.

"I like the walls the way they are. Hunter green and dusty rose are lovely colours." That's what I told everybody. If I waited much longer, I would be retro, and retro was "in."

Then, after almost 5 years of widowhood, I remarried. "Those are old lady colours." my husband said.

Well then.

I had a week off in January, and decided to get started. I thought I could get half of it done if I worked every day.

I am such a dreamer.

The first job was to remove the wallpaper border that separated the hunter green and dusty rose in the living room area. I planned half a day for this.  (Refer back to the "dreamer" notation) Three gruelling days later which involved soaking and scraping and a little under-my-breath swearing, I removed the last piece of wallpaper.

The walls were close enough to the kitchen to require the removal of 20 years of grime and grease before painting. Washing, rinsing, washing, rinsing. And who knew I had so many pictures on the walls? After several years, they become part of the wall, and you don't notice them--until they are removed. Not only is there a much cleaner square behind them, but a hole in the wall. Multiply that by, oh say, three million, and you get the picture. (Sorry, weak pun.)

My vacation was long over, and we hadn't picked up a paintbrush. I work every second weekend, and no one wants to spend every free weekend working on the house. Weeks and months slipped by. We didn't entertain, because we were living in a construction zone. Cleaning was a necessary but discouraging exercise. Nothing looked clean when I finished.

Nine months later, our renovation was born--er, completed. Along the way, we learned a few valuable lessons.

The Top Ten Things I Learned From Renovations

10. My husband hates painting. This was a frequent topic of conversation at various times. While driving in the car. Before going to sleep. While painting. I got it.

9. Our marriage survived renovations, but it was tricky at times. When we were nearing the end of the painting phase, there was a day I spent much longer than I should have on it. I was exhausted when he came home from work and went upstairs to change. He paused outside our bedroom door and casually said, "You know you have a drip here?" I will draw a curtain across the rest of the conversation. Suffice it to say, he saw a new, seldom-visible side of his sweet wife.

8. Renovations grow. Maybe some people plan out every detail before they start, but for us, what started as a fresh paint job turned into new curtains, hardwood floors, 11 new doors and a new couch and chairs (yet to be purchased). We seemed to always get it backwards. After I carefully taped and painted the baseboards in the living room, we decided to rip out the carpet (and of course, those same baseboards) and put in hardwood floors. When I taped around the door frame and carefully avoided any paint on the first door, we decided to get new doors. Sigh.

7. Math is not my thing (to the same degree you would say, "Chicken pox is not my thing.") but I have discovered a new equation. Each change in your renovation plan requires an amount of time and money infinitely greater than you expected. New doors need to be painted. It took two full weekends and three evenings, not the one weekend I planned.

6. When renos are done, the rules change. For the dog: no more sitting on the furniture. (Okay, it's still the old furniture, but he needs to learn before the new arrives.) For us: slippers must be worn on the hardwood floors.

"But we don't own slippers."
"Then we need to buy some."

5. Which leads me to my next learning curve. The cost of the renovations is only the beginning. There are new switches (which could technically be classed as part of the renos) and cushions (because the deacon's bench was moved into the living room, and looks bare) and a wooden table for the printer (because the plastic one looks gauche) and on and on. It's fun as things come together, but expensive.

4. Renovations changed me. I used to hang pictures with abandon, but now realise that a slightly bare look is more spacious. There will be pictures, but each requires serious consideration. And the purchase (see #5) of some of those picture-hanger-thingies. I have an absolute horror of putting a nail in a wall. I now know the repercussions of that.

3. Renovations fill your life, and are a fascinating topic of conversation. To you. Friends and co-workers were kind, but I got the impression they wanted to stick their fingers in their ears and chant "la la la la la..." when I talked about our progress.

2. It was all worth it. I sit in my living room and survey the new landscape. Fresh paint in classy, updated colours. Beautiful floors that match the wood of my furniture. Wonderful doors that close and aren't kicked in at the bottom. I'm glad God doesn't allow us to see the future. I'm not sure I would have had the courage to face what was ahead of me if I'd known. But having given birth to this baby, I am delighted with it.

1. I will never, under any circumstances, do this again. Next time, we pay someone. I have learned time is a precious and limited commodity. You choose how you spend it.

If you see me with a paint brush in my hand, or even lingering in the hardware store, remove the offending object, and buy me a cup of coffee.

The insanity will pass.


Wednesday, 18 September 2013

Caregiver Wednesdays- Communication pt. 5

Thank you for your patience, readers! Our house has been "under construction" for nine months, but the last two weeks were intense, and I made the decision not to write until it was done. We are finished, and I am back. Look for a blog about renovations soon...



Learning to communicate with someone with dementia is like learning a new language. You have to practise, sometimes you get it wrong, and it takes great patience.

But when you actually communicate, it's immensely satisfying for everyone.

Here are some tools for your box.

1) Ask questions that require "yes" or "no" answers. For someone with limited speech, this may be the only way they can communicate. It's difficult, so if you know you are going into that kind of a situation, go armed with several questions to carry the conversation. When you are using these, intersperse monologue, Again, think ahead of cute or funny stories, or reminiscences to which the person may relate. It doesn't matter if they remember. Just tell the story as if for the first time. I am always telling stories about my dog, or funny things I have done. My reward is a huge smile.

2) Don't correct information. It doesn't matter if they get it wrong, and you risk making them angry or sad through pointing out their mistakes.

3) Ask questions about the good old days. Besides having conversation, you may find out some valuable information.

4) Related to #3--ask advice. "Mom, I have to make Thanksgiving dinner this year. What would you serve? What do you think of squash? Should I have turnip too?"

5) Have your radar up. If communication isn't going well, watch for clues. Are they tired? Do they need to go to the bathroom? Are they ill? Watch for non-verbal clues.

6) Sometimes you go down a conversational path that doesn't work, and the person becomes angry or agitated. Try agreeing with them. I agree in all kinds of situations, "Yes, you're right, that was stupid." and then distract if possible. "I feel like going for a walk. Would you like to come with me?" "Should we have some ice cream?" (Remember this--ICE CREAM IS A GREAT DISTRACTER!)  Not to be overused, but it's amazing how a person will calm down with a bowl of ice cream in front of them.

7) Don't get discouraged by a conversation that doesn't work or an unsuccessful visit. If it's possible to come back later, do that. If not, try again next time. Some visits will be magic!

8) Be patient.

9) Be patient.

10) Be patient.

Next week: How to communicate with someone who lives in a different reality from you.


Thursday, 29 August 2013

Caregiver Wednesdays- Communication pt. 4



"Do you have any knitting patterns? I want to knit for my granddaughter, and I need to look at some patterns."

I looked at her helplessly. This lady couldn't knit any more, let alone follow a pattern. What should I say?

She was the mother of our neighbours at the time. Both our townhouses were on either side of the parkette, and we often met there while watching our children. Sarah's mother had Alzheimer's and had been deteriorating. When she could no longer live alone, Ralph and Sarah built an in law suite in the basement and had her live with them. She often accompanied them on the trips to the park. She, like my own mother, was one of those unfortunate people with early onset Alzheimer's. She might have been 60.

This was long before I had much experience with people with dementia, but miraculously, I did the right thing. "Sure, I don't have much, but I'll bring what I have out the next time I come." The next day, I came out with a fistful of pattern books, and she was delighted. She poured over them like holy grail, and eventually asked to borrow one. "No problem. Take as long as you like with it." Sarah returned it a few days later. Her mom had forgotten about it, and about her desire to knit. But for those few moments in the park, she was doing something she loved, and it gave her intense pleasure.

Isn't that what it's all about?

Communication with someone with Alzheimer's is different. Reality therapy used to be popular a few years ago. The best thing for people with dementia was to bring them back to reality. What day it is, what time, and what is really going on. Reality therapy would have said, "You can no longer follow a pattern. You don't knit any more. You have no use for a knitting pattern." The philosophy was that bringing people back to reality somehow grounded them and brought about less confusion and anxiety. The truth was, the opposite occurred.

Here are a few more communication tools:

* Don't press for an answer if it causes confusion or anxiety.
I love to give people choice, because it maintains their independence and allows them to express who they are through choosing what they like. This is no more evident in the dining room. The key is to go slowly, and break it down. "Would you like chocolate, strawberry or vanilla?" If there is no answer, I say, "Do you like chocolate?" and on we go from there. Occasionally, making a choice causes stress. Maybe they like all three, but don't know how to tell me to make a triple scoop. If I see anxiety starting, I drop it. I'll give them vanilla and try again next time.

* If you hear the same story or comment more than once (or twenty times) answer it as if it was the first time. "Am I knitting a square?" "Yes, I put the sample on your leg there." "Do I just keep knitting?" "Yes, you can follow the sample that's on your leg." "Is it supposed to be a square?" "Yes, see the sample on your leg? You can tell how big it is to be from that." "So I'm knitting a square?" "Yes, you are. You can measure it against the sample on your leg." It takes patience, but it gives the gift of respect.

*Don't grill for information. "What did you do today? What did you have for lunch?" All you are doing is putting an underline on their disease. They can't remember. Don't ask. Instead, be more creative. "I see spaghetti was on the menu at lunch. That was always your favourite." This may lead to reminiscing, or at the least, a happy memory of a plate of spaghetti! The goal is to communicate, but on their terms, not yours.

It's like learning a new language, but the list of vocabulary words and what they mean changes frequently.

Next week: more tips for meaningful communication


Wednesday, 21 August 2013

Caregiver Wednesdays- Communication pt. 3


I've learned to wait for answers.

For me, it's a sign of respect that I wait for the resident to tell me how they like their coffee. If they are struggling, I may say, "Do you like cream?" That is usually answered immediately. Then I add, "What about sugar?" This separates the answer into manageable pieces, and usually makes it possible for the person to answer for themselves. That's important.

Today, I was getting a cup of coffee for a resident while he waited to get his hair cut. (He's not great at waiting, and this was to help.) I looked him in the eye and said, "How do you like your coffee?" He opened his mouth, but before he could get the words out, both his daughter and his caregiver answered, "Cream, no sugar." I can't tell you how annoyed I was. Let him tell me!

Don't take communication away from your loved one when you know what they are trying to say. Unless it is distressing them, give them the gift of time to answer.

Here are a few more communication tips:

1) Did you know a hearing-aid, when it isn't working, is an effective ear plug? Check batteries every day, and replace them weekly. Leave the casing open at night to make the batteries last longer. Check for wax--some types get plugged easily. If you suspect a hearing aid isn't working and you've checked these other areas, immediately take it to your provider. Not being able to hear causes confusion, isolation and frustration. And there's NO communication.

2) Speak slowly, calmly, and use simple, direct statements. Don't speak as if addressing a child, but slow the speed of your sentences down. This takes a conscious effort, but is more effective in getting your message across.

3) Listen with your heart. Sometimes the words aren't the message.

4) Use concrete rather than ambiguous words.

5) Simplify your words.

6) Give one instruction at a time. "We're sorting the cutlery here. Can you put all the knives in one pile?"

7. If you hear the same story or phrase several time, act like it's the first time, every time. It is to them. Never, but a word or a look or a raised eyebrow, make fun of the person. People with Alzheimer's can be incredibly perceptive.

Remember, it's all about respect.

More next week.


Wednesday, 14 August 2013

Caregiver Wednesdays- Communication pt. 2


Every lunch, I assist two ladies with their lunch. Isabel can do a little for herself, such as take a sip of soup when it is in a mug. Sometimes she struggles to get the mug to her mouth, and my hand gently guiding it makes all the difference. She prefers salads to sandwiches, and doesn't like fish.

 Freda needs her fluids thickened and her meat minced because of a swallowing problem, and can't feed herself at all.She doesn't say much, but she communicates. At first, her diet was limited, but we have been trying new flavours and textures, and it is clear from the first mouthful what she thinks. She is the judge and jury, and I wait anxiously for the verdict. At the first mouthful of strawberry crepe with cream filling, she beamed. After a spoonful of cold melon soup, she looked troubled.

"Freda, do you like it?" Her brow furrowed, and she concentrated on the answer. After a full minute, she replied, "No!"The soup was removed. Freda had communicated.

Communication can be challenging, frustrating and incredibly rewarding.

Remembering that not everything works all the time, and what worked yesterday might not be effective today, here are some principles:

1. Body language is important. Learn to read the other person. Do you see joy, physical pain, pleasure, fear, anxiety? When you know the signals, you can communicate.

2. Touch is often helpful (although not with everyone and not all the time. Read the signals. See #1)
A light touch and a gentle, non-threatening voice can calm anxiety and assuage fear.

3. Check the environment. Often, a quiet spot without a lot of outside stimulation enhances communication. A television, music or other conversations in the room can be confusing and frustrate communication. If there is a hearing deficit as well, communication won't occur.

4, Identify yourself. "Hi, Mom, it's Brian." Never play the guessing game ("Do you know my name?) which is demoralising. Don't be offended or hurt if they don't know you, or mistake you for another family member, or even another generation.

5. Make eye contact. Don't start to speak until they can see you.

More next week.

In the meantime, think about this: "The most important thing in communication is hearing what isn't said." Paul Drucker


Monday, 12 August 2013

The small miracle of saying "Good-bye"



I hate saying "Good-bye."
I guess few love it, but I hate it with a passion.
Which is unfortunate, because my work involves a lot of good-byes.

I meet residents in the last season of their lives. The season may last surprisingly long, but inevitably, there is a time to say good-bye. And it hurts.

"Maintain a professional distance. Protect your emotions from this kind of pain." I am professional, but I'm not about distance. These incredible, interesting, special people open my heart and come inside, making me vulnerable when the time comes. The best I can do, after a time of private grieving, is to closely gather the memories of who they were and cherish them. I am always enriched when they leave, and always bereft.

Even short, temporary good-byes are difficult for me. My husband is away for the weekend, fishing in the bush with his son. I'm glad he was able to go, glad they are together and glad he is having fun. But I miss him, and will be glad when this good-bye is over.

Some good-byes change everything. When I had to say good-bye to my first husband after 30 years of marriage, I was left confused and disoriented. His death changed my status. I was a widow, and I didn't know how to be a widow. Everything about my life changed, and for a time, I spun in emotional circles, trying to figure it out.

I began thinking about good-byes because this week, I am facing another one. My supervisor is leaving to further her education in another country. This is a great thing for her, and I think she is brave to take on this huge challenge. She will be awesome. But a selfish part of me wants to stand on a chair and scream, "NOOOOOOOOO!!!!" She is incredibly smart and gifted with people and has a huge heart of compassion. She has become a friend, which is odd, because she is 34 years my junior. But there you have it. Tears flow just thinking about it.

The thing about good-byes is that they are a reminder to us. Take nothing for granted. Every relationship is a gift to be cherished. Open your heart and give yourself today.

Tomorrow you may have to say, "Good-bye."


Thursday, 1 August 2013

The small miracle of music

I've never been a music person.

I can't sing, for one thing. And although there are a few songs that move me to tears or make my heart soar, I seldom listen to music. I never think of it.

I've seen what music can do, however, and it awes me.


Music reaches into hearts and touches brains muddled by disease. It reaches to the soul and ministers. It brings memories that were long hidden, to the surface where they can be examined and enjoyed. It lightens the spirit. It makes us laugh. It makes us dance.

Today, we had a sing-a-long. We have many sing-a-longs, some more successful than others, but today was magic. There were small miracles everywhere.

Marie* got out of bed for the first time in a week. She has multiple physical issues, and has been listed as palliative more than once. Today she sat up in her wheelchair and sang for an hour. After it was over, she said, "Those songs bring back memories. Memories I can't remember on my own. The songs bring them back, and I can spend some time with them."

Thomas gets angry and shouts a lot. He's been known to throw things. He sat quietly and sang with a staff member.

Lottie is often depressed, but she was laughing.

Donna used to play the piano. With a grin on her face, she moved her fingers over an imaginary keyboard in time to the music.

Victoria, who's dementia is profound, smiled and sang with the others.

Millie danced through every song, waving her arms and encouraging others to participate.

It was a day of miracles.
Music and small miracles.

*all the names have been changed

Wednesday, 31 July 2013

Caregiver Wednesdays- Communication pt. 1


Enid doesn't talk much. Dementia has stolen many of her words. They come slowly and with effort.
But Enid communicates.
Because of a swallowing issue, she eats only soft or minced foods. Her fluids are thickened. Sometimes, her choices are few, and she doesn't have much enthusiasm for eating. But today, she ate a strawberry crepe. It was soft enough to be tolerated.
When she tasted the first mouthful, her face lit up, and tears sprang to her eyes.
Enid communicated!

As dementia progresses, communication becomes more difficult. Words are harder to find to express thoughts, and both parties can be frustrated. It's important to recognise there are many aspects to communication, and words are only one feature. Learning to communicate with someone with dementia means you must become a student of the person. Is that "worried" look really worry, or is it pain, or confusion, or constipation? All are possible.

To begin our discussion of communication, I want to challenge you to look at the world through the eyes of the person with dementia. Each of these won't apply to everyone, or at every stage, but there is truth here.

The World from My Perspective


  • Sometimes, the world is clear, and I understand what is happening. Sometimes, in the middle of an enjoyable experience, I don't know where I am or how I got there. This frightens me, and affects how I communicate.
  • If I can't get my ideas across, I think it's your fault. How can you be so dense? I may get angry.
  • I may communicate only with body language. It's still communication.
  • Time means little to me, so I may be living in a different time today (such as remembering the house I grew up in as "home")and another one tomorrow. Or five minutes from now.
  • I may have all kinds of ongoing physical challenges beside my dementia. My sight, hearing and mobility may not work well. I may have issues with my heart and breathing. All of these affect my ability to communicate.
  • I react to stimuli differently because I have dementia, and I don't always react in the same way. Something that usually gives me pleasure, may one day (because I am tired, or not well, or all kinds of other reasons) upset me or make me angry.
  • a lot of things that used to be true of me, aren't any more.
          Even with all of this, I'm still here. Inside, in the core of me, I am still here. 
          Your challenge is to find me.


Communication challenge:
As you go through your day, watch the non-verbal cues people are giving. What are they saying? Watch yourself. Is there a non-verbal way you respond? (Here's a hint about me--when someone hurts me, I go quiet and don't meet their eyes.) Explore non-verbal communication with your family and peers, before you try to apply it to people with dementia.

What did you learn?

Wednesday, 24 July 2013

Caregiver Wednesdays: Knowing the signs

                           My mother, Florence Everson, who
                                  died with Alzheimer's at 66

It's always there, in the background. Just there.
Then something will happen. I will search for a familiar word, or put the rice cakes in the fridge or forget an appointment. That's when it sits up and takes notice.

Because my mother had early onset Alzheimer's disease, and I am the age she was diagnosed (although she probably had it for a few years before that--they weren't as skilled at recognising it back then) the fear lurks. I don't think of it every day, but it's always there.

Knowing the signs matters to me. Because I know those behaviours I mentioned are normal, I grin and go on with life. Knowing the signs can allay unnecessary fear, as well as alert when there should be concern.

Poor hygiene
My Dad complained my mother had become a messy eater, and was always spilling things on herself. This was an early sign in our family. Sometimes people resist showers or bathing, and someone who was always immaculate in what they wore starts to look unkempt. Everyone can have a bad day, but we are looking at patterns.

Memory Loss
This is the most obvious sign, but it's important to understand what this means. Surprisingly, a percentage of people with AD don't experience memory loss at first, and this can lead to a misdiagnosis. Usually past memories are intact, and it's the most recent ones that are affected. Anyone can forget some details of a recent dinner party, but when you have no recollection of attending at all, that is a concern.

Repetition
Sometimes I think, "Did I tell you this, or did I just think about telling you?" Or, "I've told this to a few people, but I can't remember if I've told you." That's normal. Asking the same question or telling the same story over and over again, sometimes minutes after the last telling, is not normal.

Doing Strange things
The minute I opened the fridge with the rice cakes in my hand, I "tsk-ed" myself and put them in the cupboard. My mind was on other things. I often get distracted as I work out a problem, or think out the next section of my novel. We had a pastor once who had the police follow him home because he forgot to pay for his gas at the gas station. (This was in the days before you could pay at the pump.) This happened twice, to his wife's huge embarrassment. He was thinking about a sermon, and got distracted. Distraction is normal, but if you put the dish soap in the freezer, and don"t realise there is a problem, that is a problem.

Word finding
Everyone has those "tip of the tongue" moments. You go to say a word, and it's not there, but it is hiding just behind a corner of your brain. The more you try to coax it out, the more it hides, until you give up and think of something else, and out it pops. That's normal. People with AD have profound difficulties with language, and as the disease progresses, conversation is a tangled ball of wool, where the listener is struggling to find the thread.

Changes
You may not notice this one at first, but over a period of months, you may see a pattern of withdrawal from activities that used to bring pleasure, or increased anger with someone who used to be easy going.
Often, the person is aware of a problem, and increasingly frightened by it, which leads to withdrawal. The unconscious thinking is, "no one will notice my problem if I don't spend time with them." Fear of what is happening can also lead to unprovoked outbursts of anger or sadness. It seems to come from nowhere. In reality, the person is shaken to their core with what is happening. Depression should also be explored medically if these signs are present.

Confusion
This is often the first sign of trouble. When my mother stopped cooking (which used to be her passion) we thought she was just tired of it. It took several months to realise she didn't know how to cook any more. The day she phoned and asked how to prepare a boiled egg, I told her, and sobbed when I hung up the phone. This is difficult to watch. Getting lost in familiar neighbourhoods is another common occurrence. "Familiar" becomes a foreign word as the disease progresses.

Why go to the doctor to get a diagnosis? Many reasons.

It may not be Alzheimer's, and could possibly be treatable. There are other reasons for having some of these changes in your life.

If it is Alzheimer's, there are medications to improve function, and many supports to help you and your family deal with it.

There is no cure at this time for AD. The focus should be on knowledge, and providing the best possible quality of life for the person suffering.

Because even with Alzheimer's, every day is a gift.

Thursday, 18 July 2013

I am bigger than my disease


When a person is diagnosed with a debilitating, progressive disease, it can become huge in their life. For their caregiver, there is so much to learn, it is all-consuming. A new language, how the medical system and the systems of care work, medications, interventions--it goes on and on. If we aren't careful, the disease can become bigger than the person who has it.

It's not. Bigger.

The purpose of this blog post is to challenge you to think in a radical way.

The person you are caring for is still in there, no matter how far their disease has progressed. They still have a contribution to make. They not only take. They can give.

I can still smile
I assist a lady with her meals who has the most amazing smile. I love to say something that causes her face to light up, because it is brilliant. Every time she turns that smile on me, I am blessed.

I can still warm your heart
A gentleman with dementia attended a luncheon with his wife, His confusion is profound, but whenever he attends these kind of events with her, he relaxes and enjoys himself like anyone at a social event. As he left the luncheon, he thanked me, saying, "You fill my life with surprises and my stomach with ice cream." I've held those words close to my heart since then.

I can enjoy
Speaking of ice cream, there's nothing like this delicious treat for calming anxiety. A resident was crying and anxious, and no attempts to calm her were effective. I had just brought out a cart filled with ice cream. "Would you like ice cream? I spoke in her ear. "That would be nice." she said through her tears. A few minutes later, I was feeding her and we were laughing together. It's amazing the power of this simple treat.

I can notice
I tend to wear bright colours to work, especially in the summer. I can't tell you the number of residents, men and woman, who have noticed and commented. Yesterday, and profoundly demented woman turned to a co-worker and said, "I like your eyes."

I can respond
There is nothing like a baby, no matter what your age, mood or mental state. Today, a staff member on maternity leave brought in her three-month-old bambino, and the room just radiated. They talked to the child and gave the mother parenting advice.

I can care
"Where is your lunch? Here, take part of mine." The gentleman whose dementia was far advanced, refused to eat unless he knew I had something, too. It made sense. I started bringing my lunch along.

I can give
Every day, I rub shoulders with all kinds of people with dementia. Sometimes they are fun and we laugh together. Sometimes they are upset and angry. They are often confused, and ask the same question over and over. But every day, without fail, they give to me.

I am richer because of it.

Friday, 12 July 2013

The small miracle of emergency fun


A young couple was sitting in the kitchen, working on their budget as their two young boys played near them. They were discussing their emergency fund, when the three-year-old piped up, "I want that! I want some of that emergency fun!"

Now, there's a concept.

I've never been good at fun. My mother taught me to finish all my work before I had fun, which is an excellent Protestant work ethic principal. It's how I was brought up.

The problem comes with people like me, who never get the work finished. Never. With a demanding full-time job, a second writing career, a house and a husband, there's always something to be done. Preparing items for work, an article to write, a load of laundry-- it's always there. Fun often has to wait. Indefinitely.

But if I had a list of emergency fun things, how cool would that be? I think emergency fun has certain characteristics. The cost should be minimal, and it should be accomplished with a nominal amount of planning. Exhausted? Had a really rough week? Pull out some emergency fun and have at it.

So I made the beginnings of an emergency fun list. I'm sure I will add to it, and I bet my list is different from yours. We have this in common--we need fun in our lives, and sometimes we neglect it.

Ann's Emergency Fun List

(These are not in any order of priority)

1) Time with my granddaughter. She makes me laugh, and she gives wonderful hugs.

 2) Bubbles- I love blowing bubbles. I need to have a really interesting bubble wand on hand at all times.

3) On the bubble theme, there is nothing funnier than putting bubbles from the bath on the top of Bailey's nose, and watching him try to get them off.

4) Go for a walk. Being in nature almost always restores my soul.

5) Exploring. Although I hate shopping, exploring interesting little stores (possibly without buying anything, or very little) is delightful.

6) Cemeteries. I LOVE walking through old cemeteries. It's like participating in history.

7) Read a book, especially one of my favourite authors.

8) A hot bath.

9) Watching a really good movie while snuggled into bed.

10) Sitting and talking together about things that matter. making plans. Dreaming dreams.

"A merry heart does good like a medicine." Prov. 17:22 So pull out your emergency fun and start laughing.

What's on your list?