Sunday, July 13, 2014

On chaos and peace



The nurse at the Arbors called. Dorris was upset and was not to be appeased.

I found her in the hall sitting on her fancy walker with a look on her face that spoke volumes.

“What papers did you folks sign that put me in this loony bin?”

No manner of soft patient discussion could convince her that this place was not a loony bin, but instead a safe place to live.

“Why do I have to live in this place that has protection all around? I want to go home.”

But, when I ask her about home, she describes the farm of her youth. I gently tell her she has not lived on a farm in over 50 years and she looks at me in disbelief.

“Wait a minute, I am checking your math.”

I assure her this is a good place for her to live because her memory is no longer strong.

“I do not have memory problems, I just lie a lot.”

Nice try, but, no. 

Again, we talk and she agrees that the people are nice, the food is good, there are things to do, and people who visit.

But, it is not home – even if she can no longer really remember what her home was like, she knows this isn’t it.

“Trust me, Dorris, you are a perfect fit for a memory care facility. I know because I am teaching a class on cognition and memory, so I am an expert.”

Finally, a smile.

As I leave, she sternly informs me that this discussion is not over.

I counter with: "If by 'not over' you mean that you still hope to convince me to take you to the farm, it's not happening."

"We'll just see about that" she says, always with the last word. 

“If you abide in my word, you are truly my disciples, and you will know the truth, and the truth will set you free.” (John 8:31b-32, ESV)
 
As I drove home, I was reminded of a favorite song by Audrey Assad: You Speak. This line especially resonates today: 

“You liberate me from my own noise and my own chaos”

The Arbors is well suited to its name. It is a place of protection, of calm and of order. The chaos Dorris feels is not in her environment instead, it is created in her mind. The truth does not make sense for her, and it does not bring her freedom – freedom from where she lives, or  freedom from her confusion. 

This point in my life does not speak of chaos. Even though I have forgotten pretty much everything I learned about statistics, my memories are fairly well intact. I am nearing the end of my degree program with one big step remaining. My children are happy, healthy, productive, and live a life of faith. Paul and I rattle around in a peaceful house.

Yet, just as Dorris seeks liberation, so do I.

My chaos is my sin, my lack of trust, my need to control, my tendency to gripe and complain, my need to be needed and admired, my seeking after an earthly peace. Freedom from these things eludes me.

What I have is freedom from the eternal consequences of my sin. I have freedom from the power of the Law. I have the freedom to live a new life in Christ.

For freedom Christ has set us free; stand firm therefore, and do not submit again to a yoke of slavery. (Galatians 5:1, ESV)

It is a strange thing that we have both sin and freedom. Our sin still surrounds us and brings us grief, but we are not slaves to it. We serve a loving, forgiving God, a God of liberation.

Do you not know that all of us who have been baptized into Christ Jesus were baptized into his death? We were buried therefore with him by baptism into death, in order that, just as Christ was raised from the dead by the glory of the Father, we too might walk in newness of life. (Romans 6:3-4, ESV)

We are blessed to live in the freedom of a new life, a new purpose, a new faith.

Now the Lord is the Spirit, and where the Spirit of the Lord is, there is freedom. (II Corinthians 3:17)

Sunday, July 6, 2014

Where are we going?



I am preparing to teach a graduate class on human cognition – no really, it is a cool class. One of the things we learn about is memory. I was looking for an example of how memory systems are functionally separate when I remembered this conversation:


Dorris: Where are we going?
Kim: I am taking you to the Arbors, where you live.
Dorris: Oh, she said with no clue as to what that is.

(moments later)

Dorris: Where are we going?
Kim: I am taking you to the Arbors, where you live.
Dorris: To get rid of me. . . .that wasn’t very nice of me to say.

“Where are we going?” and “Where am I living?” are two questions we hear from Dorris on a frequent basis. This is an example of a problem with short-term (working) memory. Things she sees or experiences just do not move into long-term memory. This structure of her memory has a very short duration so that she does not even remember asking the same question a few moments before.

However, her sensory memory is intact. She still enjoys the sunlight, a beautiful tree, a sweet song, or the taste of her favorite green beans. She also frequently astonishes us with her long-term memory. The stacks of photos her sons have given her are new to her each day and it brings her joy to point to people, or things, and recall a story.

The aspect of her thinking that continually amazes me is her metacognition. This is the ability to think about thinking. When she gets a bit snarky and announces that she has no clue what “Arbors-where-you-live” means, she is assessing the situation quite nicely. Likewise, when she looks at me with repentant eyes after saying, “that wasn’t very nice of me to say” she is evaluating her words and their possible effect on me.

She is losing her ability to make new memories, but she is not losing her intelligence, her empathy, or conscience. She is still Dorris, she is just a bit lost in the here and now.

When she asks me why she lives at the Arbors, I tell her because it is a place that helps people with their memory. 

Her typical response to my reply is. "well, I certainly need that." 

The only perfect memory belongs to God. There are no limits to his sensory memory, his working memory, or his long-term memory. He is omniscient.

Great is our LORD, and abundant in power; his understanding is beyond measure. (Psalm 147:5, ESV)

Yet, once he has forgiven us, he chooses to forget our sin.

He does not deal with us according to our sins, nor repay us according to our iniquities. For as high as the heavens are above the earth, so great is his steadfast love toward those who fear him; as far as the east is from the west, so far does he remove our transgressions from us. As a father shows compassion to his children, so the LORD shows compassion to those who fear him. (Psalm 103: 10-13, ESV)

There are people who wonder if they could have the patience to answer a question repeated again, and again. To me, it is a bigger mystery how God can have patience with me when I repeat a sin again, and again.

 But you, O LORD, are a God merciful and gracious, slow to anger and abounding in steadfast love and faithfulness. (Psalm 86:15, ESV)

I have metacognition about my sin. I know it is bad for me, bad for my relationships, and needs to be stopped. But, in the short-term, or the long-term, that ain’t gonna happen.

Have mercy on me, O God, according to your steadfast love; according to your abundant mercy blot out my transgressions. Wash me thoroughly from my iniquity, and cleanse me from my sin! For I know my transgressions, and my sin is ever before me. Against you, you only, have I sinned and done what is evil in your sight, so that you may be justified in your words and  blameless in your judgment. Behold, I was brought forth in iniquity, and in sin did my mother conceive me.  Behold, you delight in truth in the inward being, and you teach me wisdom in the secret heart. (Psalm 51:1-6, ESV)
 
Instead of impatience, God responds with forgiveness and grace. He sends his Spirit to help me with this daily struggle. Some day he will welcome me to heaven with open arms.

Nevertheless, I am continually with you; you hold my right hand. You guide me with your counsel,and afterward you will receive me to glory. (Psalm 73:23-24, ESV) 

When I get to heaven, I will see Dorris and I will ask her “Where am I living?”

We will both get a good laugh out of that. 

(With a special prayer for my friend, Brenda, whose mother is a new resident of heaven. She is waiting there, for her loved ones, with a perfect memory.)

Sunday, May 25, 2014

Preserved faith



Preserve me, O God, for in you I take refuge. I say to the LORD, "You are my Lord; I have no good apart from you." (Psalm 16:1-2, ESV)


Dorris insisted she had never seen this highway before. Because it is the main route between Seward and Lincoln, I knew she had traveled it many times. When I explained this to her she replied that she had always wanted to erase her brain and start over and apparently today was the day. 

We spent the rest of the trip singing along to Handel’s Messiah.
Her memories are slipping away, but her sense of humor holds fast, and God preserves her faith.

You clothed me with skin and flesh, and knit me together with bones and sinews. You have granted me life and steadfast love, and your care has preserved my spirit. (Job 10:11-13, ESV)

As we drove to Seward, I struck with thoughts of Blackburn, Missouri. When Paul and I were newly married, we spent a week there with Dorris’ mother. Amalia had been a church organist and nearly every evening she would sit down at her piano and play hymns. If you saw her do this you would know she was a sharp as a tack and assume she was on top of things. She rarely missed a note and knew the words of many hymns by memory. However, each time she noticed us she would ask us who we were and why we were in her house. When we arrived back in Seward we informed Dorris that Amalia could no longer safely live alone in her home.

Thirty plus years later, when Dorris tells us she needs to live some place where people can remember things for her, we assure her she has found that home. 

Between Dorris and her mother there are so very many memories lost; memories of raising children and of raising crops, of playing basketball and playing organ, of running a home and running for office, of laughter, of tears, of hymns, of art. These are lost memories of an earthly life, but, disease and sin cannot take everything.

Blessed is he whose help is the God of Jacob, whose hope is in the LORD his God, who made heaven and earth, the sea, and all that is in them, who keeps faith forever; (Psalm 146:5-6, ESV) 

Because of the faith given to Dorris at her Baptism, God preserves her, even while so much of her life is crumbling away. She can no longer walk without help. She can no longer feed or care for herself. She is losing the ability to recognize her loved ones. But, her faith is, and always will be, preserved.

As for you, O LORD, you will not restrain your mercy from me; your steadfast love and your faithfulness will ever preserve me! (Psalm 40:11, ESV)
 
This brings new understanding to these words of Jesus:

Whoever seeks to preserve his life will lose it, but whoever loses his life will keep it. (Luke 17:33, ESV)
 
Thankfully, we will not all lose our life in small bits of memory that slip away. Yet, we must all lose our life to Christ. If we hold on to our current life, if we focus on that life, if we let our desires and goals for that life distract us from Life in Christ, we will lose all life.

Dorris reminds me, every day, of what it is like to lose your life and thereby gain Life. Life in Christ is what she has, and it is what she will never lose. Even when she can no longer talk, or sing, or walk, she will still have faith and in heaven she will hear these words:

And he said to her, "Daughter, your faith has made you well; go in peace" (Luke 8:48, ESV)

For now, I thank God for sending His one and only Son to die for me. I thank God for the Spirit that gives me faith. And, I thank the Father for preserving that faith.

The apostles said to the Lord, "Increase our faith!" (Luke 17:5, ESV)

Saturday, April 12, 2014

Trust for a member of the Sandwich Generation



Most of us in the “Sandwich Generation” are between parents and children. My husband and I are sandwiched between two moms. Dorris has fallen nine times since January. My mother has fallen twice in that time; on the second occasion, she broke her arm. So far, this is the year of falling.

Dorris has learned to relinquish control. This was not easy for her as she was the directing force in Paul’s family. She organized, she prepared, she took care of details. Because of this, the family ran smoothly. She also used this gift in her many hours of community service. As she aged, and her dementia progressed, she had to learn how to give up control.  This relinquishment started with the car keys. It was not easy. It took a drive through the front door of a restaurant and several conversations with her children and her doctor, but eventually she relinquished control over that part of her life. Throughout the progression of her illness she has been a coping model for how to let go of control and accept trust.

My mother’s situation is very different. She is mentally ill and when under stress, her view of the world is twisted and torn. She is currently at a rehab facility to receive physical and occupational therapy. Earlier this week I arranged to take her out to lunch. When I came back the next day to pick her up I found a very different person. She had been told that she needed to stay a few days longer than she hoped. This caused her stress and anger which when mixed with her bipolar illness and break through the threshold of her medication.  She accused the facility of giving her a faulty bed, which did not allow her to sit properly. She was certain that she alone was mistreated and that everyone was working together to make her life miserable. She directed her anger at me when I asked questions for clarification because this meant that I was on “their” side. She was so angry that she would shake her head in her balled-up fists when she talked making it impossible to hear her. This from someone who, 24 hours earlier, had no complaints about her care.

I tried several techniques that I have learned from my life of living with her illness. I tried to calm her down with a soft, reassuring voice, to no avail. Simply listening and accepting her distorted view did not ease her anger. Even asking her if she still wanted to go to lunch sent her in a tizzy because I “should have known” her answer. A change of environment did not distract her and when I tried to talk about a different subject, she simply redirected her anger. At the point at which she started talking to herself, I knew our lunch was done. I returned her to the facility and let the nurse know I suspected she had moved into a manic state.

When I was a young child I used to accept blame for my mother’s anger outbursts – even if they didn’t make sense.  When I became a young adult, I was able to realize that most people have emotions that come as a result of action or events. For my mother, she has an emotion and then looks for a reason to attach it to. She sometimes wakes up angry and because she does not recognize her anger as part of her illness, she convinces herself that people are against her. She also is unable to see that her view of reality is wrong. Even physical evidence does not dissuade her.   

My sister and brother also came to this realization and it is what helps us to survive these incidences. Often we are left with no choice but to walk away. 

The most difficult thing about these episodes is that when my mother leaves the manic state, while her anger will have dissipated, her “explanations” will not.  By next week, she will no longer be angry with me, but she will still be convinced that I was working with the people at the facility to make her life miserable. Over the years, she has lost all trust in me and my siblings because of what she believes about us from her manic states.

This lack of trust makes it nearly impossible to help her. She is at risk of losing her home health services because she does not trust her doctor, her physical therapist, the nurse, the safety inspector checking her apartment, or her children desperately trying to create a safe place for her to return to. She does not like what we are doing and that is no surprise. It is difficult to give up that kind of control to allow others to keep you safe. But, in my mother’s case, when she looks at her world through the twisted view of her manic state, she is convinced that she must be right and, therefore, the only explanation is that everyone else is out to harm her. 

Dorris’ Alzheimers also distorts her sense of reality. She calls us several times a week certain she is at a zoo, at a restaurant, at a hotel, at a library, even a bowling alley. Her brain is certain it has figured out the situation and even when we point out the fact that her “hotel” room has her own furniture, she still does not quite believe us. 

But, she trusts us and that makes all the difference.

Because of trust, she will calm down. Because of trust, she will obey when I encourage her to grab her walker and walk down to the dining room for dinner. Because of trust, she is able to find ways to survive her always-new environment. She never argues with me when I assure her that there is no reason to travel to Blackburn Mo., as her parents are not waiting for her. Even though her brain tells her otherwise, she trusts, and moves on. 

Her life is better, her life is safer, her life makes better sense, because of trust. And because of this trust, it is possible for others to help her. 

Because of sin, my brain is in a constant state of distortion. The fruit from the tree in the Garden of Eden, removed my ability to rest in perfect trust. Because of that sin, I erroneously think I know better than God does. Because of that sin, I have to twist things around in order to explain why they happen. Because of that sin, I fool myself into thinking I know what is best, that I know what to ask for, or that the world needs me to make the “right” thing happen. 

I have replaced trust with manipulation, and that makes all the difference.

We cannot know the real picture. The only way we can survive the world we have fashioned – a world of sinners and sin – is to trust in the Creator instead of the ones who created the mess.

Yet, we are certain that we know better:

If I could do this . . .

If only he would . . . 

When I finish . . .

Yes, but. . .

No, way will I . . .

I’ll give her a piece of my mind . . . 

Why doesn’t God . . . ?

In our efforts to be good stewards, to follow God’s Law, to share His love, we still think we can direct the world. Sin makes us think we need control. Our sin makes perfect trust impossible. 

When cleaning my mother’s apartment, my brother and my son moved a dresser. Underneath I found a card and when I picked it up I realized it was written in German.  I soon realized that it was my mother’s baptismal certificate.  A beautiful reminder from my Heavenly Father that God loves my mother, not because of her actions, but because He is her Father and she is His child.

God loves us no matter what. 

He loves us even when we complain and try to take control:

And the whole congregation of the people of Israel grumbled against Moses and Aaron in the wilderness, and the people of Israel said to them, “Would that we had died by the hand of the Lord in the land of Egypt, when we sat by the meat pots and ate bread to the full, for you have brought us out into this wilderness to kill this whole assembly with hunger.” (Exodus 16: 2-3, ESV)

He loves us even when we think we know better:

“Woe to him who strives with him who formed him, a pot among earthen pots! Does the clay say to him who forms it, ‘What are you making?’  or ‘Your work has no handles’? (Isaiah 45: 9, ESV)

He loves us even before we come to Him:

Blessed be the Lord! For he has heard the voice of my pleas for mercy. The Lord is my strength and my shield; in him my heart trusts, and I am helped; my heart exults, and with my song I give thanks to him. (Psalm 28: 6-7, ESV)

He loves us when we are finally ready to relinquish some control:

But I trust in you, O Lord; I say, “You are my God.” My times are in your hand; rescue me from the hand of my enemies and from my persecutors! Make your face shine on your servant; save me in your steadfast love! (Psalm 31: 14-16, ESV)

He reminds us that our best example of trust comes from children without the knowledge and experience to think they know better:

O Lord, my heart is not lifted up; my eyes are not raised too high; I do not occupy myself with things too great and too marvelous for me. But I have calmed and quieted my soul, like a weaned child with its mother; like a weaned child is my soul within me. O Israel, hope in the Lord from this time forth and forevermore. (Psalm 131, ESV)

He loves us, no matter what. He loves us with a perfect love. We trust Him with an imperfect trust.

At this point I must make my confession. Circumstances in my life have greatly interfered with my imperfect trust. I need God's forgiveness and your prayers to remind me that God has a plan for me to navigate responsibilities and requirements. I need to relinquish control, to humble myself, to obey. 

Thank you for your care and for your prayers. And praise be to God for the blessing of unconditional love.

 Humble yourselves, therefore, under the mighty hand of God so that at the proper time he may exalt you, casting all your anxieties on him, because he cares for you. (I Peter 5: 6-7, ESV)