"Mom's always been this way. It's just worse now."

I can't tell you how many times I heard that statement from the adult children of a dementia patient struggling with the issue of whether Mom actually had dementia or not. The behaviors were already there -- the constant anxiety about insignificant things that had progressed into paranoia, the constant nattering chatter that no longer had any censor on it at all or, conversely, the tendency to be depressed that had progressed into a complete withdrawal from the world. And now that I live in close proximity to someone who exhibits these characteristics I understand more fully the underlying question: if these obvious signs of dysfunctional behavior were there all along to a lesser extent is this really dementia? And if it is dementia were they always suffering from dementia? As a Family Consultant it led me to question what dementia actually is. And what, if anything, could have been done about it from a behavioral point of view?

There have been multiple studies that have correlated the incidence of Alzheimer's Disease with a much higher then average incidence of depression or excessive anxiety earlier in life. There is also fairly conclusive evidence that people who stay happily actively engaged in life and who use their minds more regularly are more likely to keep their ability to function -- even with the supposedly tell-tale indicators of Alzheimer's Disease that are used to give a more precise "diagnosis" after death. The famous Alzheimer's Disease Nun study is a good place to learn more about that.  I was fairly convinced as a Family Consultant that something could have been done, should have been done, but the "what" eluded me then, continues to confuse me now.

On what level is one allowed to confront a family member with the news that not only are they driving everyone around them crazy, in a very literal sense they might be driving themselves crazy, too?!!! Well, I don't have an obvious answer to that -- and when it's progressed too far, it's in many cases too late!

Perhaps that's why I'm sharing this with you right now. I don't have to do this. I no longer get paid to write these things. But maybe, just maybe, if this message is put out there well enough and often enough by people who do care the idea will get across. Having a happy healthy attitude makes for a better life. Cultivate yours. Help your friends cultivate theirs. And do what you can in your family of origin, too.

Everyone Has Value, Just Breathing

An old counselor friend of mine from India, who I lost touch with years ago when she moved back, had an enormous impact on the people she worked with when she lived in the United States. Her insight into the U.S. national psyche is that most people she met didn't feel good about themselves. Even worse, this was amplified if they were sick, disabled, unemployed or struggling. She took to asking her clients to lie down while she sat beside them and held their hands. She would tell them to just breathe and when they would protest that they weren't getting "enough work done" in their session with her she'd tell them to think of themselves as a young infant -- a newborn, unable to move or talk, or even lift their own head. And she would say

"Did your mama love you any less for that? No! She was so excited to have you, to welcome you into her life, to just hold you and look at you and smell you! She saw you as a perfect miracle when you were just born and unable to do anything but lie there, breathing. And she was thankful for that."

"Just breathe. You are of value to the world just being here. You are a miracle. You are loveable. You are welcome on this planet. You belong."

"Think of yourself as that little newborn. You are still that same child. And nothing changes that except what you have been taught to believe."

In this video is a graphic example of how valuable a being can be just lying there breathing. It's a tribute to Baxter, a dog who brought joy and comfort to people at the end of their lives even though he couldn't do anything anymore himself but lie in their beds, be held by them and lick their faces.

He died on Friday, October 16, on my birthday. I didn't know him personally but I know he is deeply missed.

Singing at the Threshold

I recently got an email from the Threshold Choir, a wonderful singing community I used to participate in founded by Kate Munger in El Cerrito, California. Choirs have now formed in many places throughout the United States and Sussex, England and new ones are being created all the time.

What makes The Threshold Choir special is that it was specifically formed to comfort the sick and dying. Choir members learn songs in 2-4 part harmony and "perform" them (offer them) at people's bedsides. They sing in pairs or in small groups at hospices, hospitals, nursing homes, and private homes by the invitation of the family or the person's caregivers. Sometimes the family is present when they sing, and they sing as much for them as for the person who is in bed. The service is provided for free although donations are gratefully accepted.

It's a wonderful experience to be sung to like this. All Threshold Choir members get to have the experience themselves and when I was a member of the group I remember it as moving, extremely peaceful and profound.

Here's a lovely video I found on Youtube featuring members of the choir I used to sing with in Santa Cruz. I still find it inspiring work.