After a few weeks of activities at the Manor, Villa, Memory Care Center and the Health Center Fr. Jacobsen gave us a new list of people to visit. The list contained names of people receiving hospice care, and therefore in the final stages of their earthly life. Judy (not real name) was on the list.
Pam and I went up to visit her room late on a Friday night. We did not know what to expect. The door was open and a very kind hospice nurse was sitting with her. We introduced ourselves and asked if we could come in for a few minutes. The nurse was very glad that we were there. We walked in and Judy was lying in bed. She was in her late nineties and had a very small frame but with a lovely head of beautiful white hair. She was curled up and obviously in a lot of pain. Pam and I sat with her and I struggled to find words to say. In so many ways I felt helpless. She was not able to respond to anything that we asked but we felt that she was aware that we were there.
We asked if we could pray for her, we held her hand and I managed to pray what felt like a clumsy prayer, but one from the heart (note to self: never leave home without a bookmarked BCP). We then said the Lord’s Prayer and at the end I swear I saw her say “Amen”.
This is where we were meant to be, helpless but present, lacking but adequate.
We said goodbye and left the room. We both felt that the time of passing was very close and went home subdued.
The next day we returned and whilst still in pain Judy clearly was in a better condition than the night before. Armed this time with both the BCP and Ministry to the Sick our prayers were more coherent. On the Sunday she was brighter still and we said one of the daily devotions with her and she responded multiple times. Judy’s time of passing is close, and we continue to visit her every time that we are at the Villas. Walking softly, being present, praying that she feels the blanket of Christ’s love as she journey’s home.
St. Paul’s Senior Services has a complete range of facilities for seniors from Residential Living (at the Manor) through Assisted Living (at the Villas) to specialized memory care (at the Memory Care Center) and a lot more in between. My mentor and supervisor for this summer, Fr. Leigh Jacobsen, one of the chaplains at St. Paul’s, recommended a book Creating Moments of Joy by Jolene Brackey as an introduction to working with residents with dementia or Alzheimer’s disease. I did not have a chance to read any of it before my first visit to the memory care center. Pam and I arrived at the center and saw that our names were on the daily activities list as Reflections with Pam and Richard. Taken a little back by this but eager and willing to do whatever was requested of us we asked the staff what was expected of us. We were told to go into the dining room which also doubles as the activity room and just sit and talk with any of the residents. So off we went.
All of the residents at the center have some memory issues but there is a wide range of functionality from resident to resident. With some residents I struggled to find words when the response back was confusion and at times fear. With other residents I could hold a conversation to some extent. One resident, Mary (that is not her real name) seemed to be having a good day and was quite coherent and we chatted about her sons and how she was going out to dinner with them the next day. Then, all of a sudden she looked out of the window and seemed to be focusing on some buildings across the street. “Do you see my husband over there?” she asked. “I don’t I’m afraid where is he meant to be?” I replied having no idea why her husband would be outside waiting for her. “He should be on the steps over there with his mates, you know he is always trying to organize a game of something, can’t you see him?” I couldn’t and I suspected that the husband was not real, maybe a memory but not in the present. I had no idea how to respond. It was clear that if I told her the truth she would get upset but it felt wrong to lie to her and play along with her fantasy.
When I got home that night I started to read the book that had been recommended and I couldn’t put it down. The book is split into small sections, each with little suggestions on activities and responses appropriate for interacting with people experiencing loss of memory function. A central theme of the book is that we must accept when the memory has gone and meet the person where they are. In that moment and in that location we try to create a moment of joy. Not for us, but for them.
In the case of Mary, her memory is now somewhere to a point earlier in her life. Maybe she remembers looking out of the kitchen window and seeing her husband out with his mates on the street at night. There is no harm in creating a moment of joy back at a time that for the rest of us was long ago but for Mary was now.
The next time I was at the center, Mary was all dressed up and was indeed waiting for her son to take her out. As I sat with her (she was ready three hours early and had little concept of time) she again asked me about her husband. “Yes, I think he is over there, I saw him a few minutes ago heading over to Balboa park with a bunch of guys and a football” Mary’s eyes lit up in a moment of joy. “Oh good, now I know he won’t get into too much trouble whilst I go for dinner”.
Both Pam and I have become regular visitors with Mary. I know that she loves to cook pork chops and she promises me that next time I come she will cook them for me. The knowledge of the happiness of her planning the meal is a delicious moment of joy.