Thursday, May 29, 2014

1,000 Weekends

A few years back, I read an article that said the average 63-year-old man had 20 or so years to live, a number of significance to me because I was 63 at the time.

I quickly calculated that I had about 1,000 weekends of life expectancy, a number that while quite substantial had a finiteness about it that caught my attention.

I realized that it was time for me to make some fundamental decisions about the quality of life I wanted to have during those thousand weekends, not to mention the other days of the week.

Rather than being depressing, this awareness sharpened by my focus on ensuring to the best of my ability that I use whatever time remained - however limited or long it may be - in ways that are aligned with my values and goals.

Being, not doing

Interestingly, my new-found appreciation of the finiteness of life did not lead me to list things I wanted to do (for instance, a "bucket list"), but rather to determine how I wanted to be. As a result, I found myself jotting down terms like these:
  • Gratitude: I wanted to be conscious throughout the day of the many things for which I am thankful.
  • Compassion: I wanted to be sensitive to the suffering of others and to do what I could to alleviate it.
  • Learning: My life is most satisfying when I am intellectually challenged through activities that stretch my mind and expand my perspective.
  • Contribution and service: I am happiest when I am more focused on others than on myself.
  • Mindfulness: The everyday moments of my life contain many riches that I can only appreciate if I experience them one by one.
None of us, of course, no matter our age, know if we will enjoy the satisfactions of 1,000 weekends or even just one.

Pondering these things recently, I decided it was time to update my longevity status, so I used the Social Security "Actuarial Life Table" to determine that I had a life expectancy of about 15.5 more years, which means I have just over 800 weekends remaining.

The clock is clearly ticking, as it is for each of us. To mix metaphors, I can hear the bell tolling in the far distance, but hopefully not yet for me.

What are the implications for you of acknowledging at a deep level that your life is finite, whatever its length may be? Does it affect the way you choose to live today?

This blog post was written by Dennis Sparks, Arbor Hospice Volunteer. You may contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

Thursday, May 22, 2014

Benefits of Massage Therapy on Parkinson's Disease

In addition to its tragic impact on voluntary motor skills, Parkinson's disease typically causes muscle stiffness and rigidity. Parkinson's disease is a fairly common progressive degenerative central nervous system disorder that affects about one in 1,000 people in the United States. Characteristic symptoms include tremors, rigidity, slow movement, poor balance and difficulty walking.

Parkinson's disease results from the degeneration of dopamine-producing nerve cells in the brain. Dopamine is a neurotransmitter that stimulates motor neurons, the nerve cells that control muscles. When dopamine production is depleted, the motor system nerves are unable to control movement and coordination. People with Parkinson's disease have lost 80 percent or more of their dopamine-producing cells by the time symptoms appear. While symptoms may appear at any age, the average age of onset is 60-years-old.

There has been an increasing number of those affected with Parkinson's that are turning to complementary therapies for help.

The benefits of massage therapy have long been recognized by people with Parkinson's disease.
Given that Parkinson's disease typically causes muscle stiffness and rigidity, it seems logical to receive massage to alleviate joint and muscle stiffness. As long as the person has sensation in the area being addressed, it is safe for bodywork to occur.

A 2002 study conducted by the Touch Research Institute at the University of Miami along with staff from the university's neurology department and Duke University's pharmacology department showed that Parkinson's disease symptoms were reduced by massage therapy. In this study, the group of adults with Parkinson's disease who received two massages a week for five weeks experience improved daily functioning, increased quality of sleep and decreased stress-hormone levels. The study's authors reported, "These findings suggest that massage therapy enhances functioning in progressive or degenerative central nervous system disorders or conditions."

This blog post was written by Michelle Chaves-Torres, Arbor Hospice Massage Therapist. You may contact Michelle by commenting below or emailing mchaves-torres@arborhospice.org.

Tuesday, May 13, 2014

What Do You Say To A Grieving Person?

What do you say to a grieving person, particularly when he or she is someone you do not see often?

I found myself facing that question recently as I set off to visit an acquaintance who I spent time with a couple of times a year and whose husband had died since our last visit.

Do I express sympathy, which may evoke sadness and tears? Or do I wait to see if she brings it up?

During Arbor Hospice grief support groups, I have heard participants express anger when others don't acknowledge their loss or say the name of a loved one. I have also heard participants express frustration when someone expresses sympathy at a time when they are unprepared or unable to acknowledge the feelings that they experience.

It makes sense that some of us are confused about what to say to our grieving friends and acquaintances. So, I asked Arbor Hospice Grief Support Coordinator, Melissa Schultz to offer her perspective based on her work with countless grieving individuals and as someone who has herself lost loved ones.

Here's what Melissa told me:

"First and foremost, be sincere. Don't try to force sentiment that doesn't exist and speak from the heart. I think it's important to acknowledge the loss, despite the fact that it can be uncomfortable. Pretending that everything is normal leads to an incredibly awkward conversation, or lack thereof.

We often hear people say, 'I don't want to make them sad.' The fact is, they're going to feel how they do regardless of whether you bring it up. When you acknowledge the loss, it tells them that you truly care about how they're doing, and you're not just asking to be polite.

Keep in mind that context is key. If you start to discuss your friend's grief and she tears up, ask if she would like to continue talking. Let her know that you may not understand what she's going through, but that you're willing to listen.

Offering your presence to a grieving individual is one of the greatest gifts you can give."

What did I do? As my acquaintance and I greeted one another, I said, "You've been on my mind. How are you?" She took care of the rest.

This blog post was written by Dennis Sparks, Arbor Hospice volunteer. You may contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

Thursday, May 8, 2014

Music Therapy for Depressive Symptoms

Music therapy can be an effective method for addressing depressive symptoms among hospice patients. Music can be prescriptively applied for patients in various ways to address physical, emotional and biological markers of stress, anxiety and depression.

In music therapy studies, researchers have noted that the use of music can result in cerebral blood flow changes in brain structures that are associated with reward and motivation. These researchers also noticed in opioid-mediated reward and pain relief. These studies illustrate that music, especially music with highly positive associations, can activate areas of the brain that help a person feel reward and motivation.

Additionally, music can be used to address pain and anxiety, which may impact a patient's perception

of their overall situation and can, in fact, address depressive symptoms. Music is strongly associated with emotion and memory, thus providing many opportunities for patients to engage in emotional expression and reminiscence to improve their overall quality of life. Music can promote relaxation and a sense of well-being.

Many of hospice patients may be participating in fewer pleasurable activities. This could be due to physical limitations preventing them from participating in activities, or it could be more related to a mood disturbance. In either case, music therapy interventions can be applied to help promote feelings of pleasure, autonomy and success through instrument playing, singing, reminiscence or songwriting. Additionally, helping patients find new hobbies and activities to take part in as their functioning declines can be useful to stave off depressive symptoms. Listening to, and learning about music can be a fun new hobby for patients who may be bedridden but still in need of cognitive stimulation.

Patients experiencing feelings of worthlessness or guilt may be engaging in self-criticism or an exaggerated sense of responsibility for a negative event in their life. They may be grieving about their loss of independence or guilt for putting a burden on their family. These feelings are common, and can be addressed through positive feedback, and successful music therapy experiences. If a patient is able, they may benefit from music and movement techniques, but they would also have opportunities for self-expression, and gaining a sense of well-being through instrument playing, songwriting and music-facilitated relaxation techniques.

Finally, if patients are withdrawing from interpersonal interactions with family and friends, they may benefit greatly from music therapy interventions that stimulate social participation. Music is a naturally social medium. Bringing a group of people together to sing and make music can increase cohesion and encourage socialization. Additionally, music can be a great starting point for storytelling and reminiscence. Whether there is family members or other residents of a facility nearby, isolated patients may benefit from being engage in music-making with others.

Tuesday, May 6, 2014

Making the Most of Long-Distant Caregiving

When you are living far away from an aging loved one, it can be challenging to find ways to help, and difficult to decide when the situation is serious enough to visit. If you are a long distance caregiver, you are not alone. Approximately 7 million adults are long-distance caregivers, caring for a parent who lives an hour or more away.

Arbor Hospice social workers often speak with patients and family members living with this reality. While it may seem impossible, there are ways to overcome the distance and find a way to help. Unfortunately, it is not as easy as someone telling you what to do and when to do it. However, the following list contains suggestions that our social workers give to both local and long-distance caregivers:

  • Share information about your loved one's illness, prognosis and condition with other family members. It is easier for someone to feel involved when they know what is going on.
  • Find ways to stay in touch. If your loved one is able to communicate, use Skype to visit regularly. And, if your loved one is unable to communicate, ask a family member or friend to hold the phone to your loved one's ear. Even if he/she cannot respond, it is likely that he/she hears you.
  • Follow the lead of your loved one when determining what you can do to help. Once you turn to hospice care, it may seem as though there is less for you to do. You no longer have to worry about doctor's office visits or medication pick-up. Keep in mind, that your presence and continued communication is very significant.
  • If deciding when to visit is a concern, think about what you want your remaining experiences with your loved one to be like. Is it more important for you to visit while your loved one can communicate with you, to be present at the end or attend the funeral or memorial?
  • Remember that everyone has a different way of handling difficult situations. Do not expect all of your family members to agree with you or act the same way. Each person copes and grieves differently, and that is okay.
This blog post was written by Jaclyn Klein, Arbor Hospice Communications Specialist with input from the Arbor Hospice Social Workers. You may contact Jaclyn by commenting below or emailing her at jklein@arborhospice.org.