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Archive for January, 2011

Published in ASA Aging Today Online
New York Zen Center Program Could Transform Healthcare for Elders
by Andrea Sherman

Our society has made demons out of illness and death. With tireless integrity and compassion, the New York Zen Center for Contemplative Care prescribes the Buddha’s medicine: sanctity of life, vows of service and letting go.”
—Roshi Bernie Glassman, Ph.D.

image via New York Zen Center www.zencare.org
In September of this year, I became a student in the Foundations of Contemplative Care program offered through the New York Zen Center. My motivation came from my desire to integrate spirituality into the training and practice of my professional and personal work in creativity, aging and person-centered care.
For 10 weekends during the year, students with varying backgrounds such as nurses, social workers, priests, hospice workers, doctors, therapists, caregivers, and other professions participated in this Buddhist-centered inquiry into the practice of service to others. The interfaith, experience-based program is geared to professionals with a wide array of experiences in life, caregiving, Buddhism and other spiritual practices.
To complete the program, participants must complete 100 hours of volunteer caregiving, supervisions, readings, monthly reflection papers, verbatim, doing advanced directives, and a final project. Each month there is a focus on a Zen Buddhist precept. This training structure offers ethical guidelines that “frame” each month. The precepts are:
  • Not killing.
  • Not stealing.
  • Not misusing sex.
  • Not lying.
  • Not giving or taking drugs.
  • Not discussing faults of others.
  • Not praising yourself while abusing others.
  • Not sparing the dharma assets.
  • Not indulging in anger.
  • Not defaming the three treasures.
Participants consider the precepts from three perspectives: literal, relational, and intrinsic. Another way to translate this is to pose three questions for the precepts: Does the action of my physical body uphold this precept? Does my action free others from suffering, and, not being separate (intrinsic meaning of no separation)?
Contemplative care is an approach to spiritual care and can be helpful to those caring for older adults who are ill, suffering, and dying.
The following excerpts from an interview with Robert Chodo Campbell, Zen priest, co-founder and co-executive director of the New York Zen Center for Contemplative Care, illustrate some of the program’s key concepts.
Question: What is contemplative caregiving?
Campbell: One can only be as intimate with another person as they are with themselves, to find intimacy with one’s self there has to be a capacity for deep introspection and reflection, or we could call that contemplating. I think it’s really important to know who we are on a deep psychological and emotional level if we are professionals taking care of others. Out of a contemplative practice we learn to realize that there is separateness and there is no separation with the other. I think that’s what contemplative caring is, caring for the other, wholeheartedly, without getting lost in their journey. This is their journey, not mine and yet we are companions. In a way we are guiding each other.
Question: What is presence?
Campbell: Presence quite simply is being present to one’s self and other, with no separation, presence is being fully aware of what is occurring in one’s self in each moment. Presence is breath. Presence is inhale-exhale.
Putting the Foundations Program into Practice
In the first meeting of the Foundations in Contemplative Care program, participants learn about the Three Treasures:
  • Not-knowing or formlessness.
  • Bearing witness of the relationships unfolding within and without us.
  • Loving action.
Not knowing is to give up fixed ideas about ourselves and the universe. Bearing witness is to see the joy and the suffering of the world, and the expression of loving actions to us and to others. This translates into practice as I learn to enter the room of the hospice resident, and to “greet the room” as I enter, not knowing, scanning myself before entering the room, and “reading the room energy” I enter, in, to be present. This is attunement, tuning in. The three wheels are:
  • Myself.
  • The person.
  • The time and space of our connection.
Then, I bear witness to the person and to myself, practicing “being” with joy, and with suffering. Feeling the courage, remembering that “it’s not what you do, it’s who you are.” We practice active listening to the person, an older person who is ill with chronic disease, and perhaps listening to someone who is actively dying, contemplating the images that are presented to us. Loving action can be the spiritual presence and energetic space of prayer, allowing the person to be where they are, and opening to the “tender and awakened heart.”
A goal of the program is for us to become “awake” for all of those that we encounter as caregivers, and to respect the dignity of all human beings. Since the program’s inception, contemplative care has been provided to 14,977 hospice and hospital patients, 3,839 healthcare providers and staff, 2,469 workshop participants, 21 units at Beth Israel Medical Center, and 8 hospice suites at VNSNY Hospice.
Question: Do health professionals learn to practice presence?
Campbell: When you leave one patient, before going to the next, take a deep breath. This simple ritual symbolizes being present to what you are fully in this moment—not taking the last patient into the room of the next patient. So where is your breath, where is your mind?
The important thing for any caregiver, particularly for those who care for a dying person is to be fully conscious of the fact that we are dying too. To think differently denies one’s truth. When we realize we are dying in each moment, life becomes that much more precious.
There is no separation between life and death. We are dying from the moment we are born. Life and death go hand in hand. If you could see that you and I are hand in hand then there is no separation. When I am taking care of you, I am taking care of myself. Simple.
Contemplative Care and its practices could transform care for elders and their concerns, fears, and ultimately their legacy and the meaning of life and of death. The contemplative care model includes providing compassionate care for the healthcare community, and creates an integrative and nurturing model of care that is self-reflective and transformative.
Andrea Sherman, Ph.D., is co-founder and co-author of Transitional Keys, a lifecycle transitions program that uses multi-disciplinary arts to ease, assist and enhance change and transitions. She is on the FORSA Editorial Board, and is a student in the Foundations of Buddhist Contemplative Care program.

Robert Chodo Campbell, HHC is a co-founder and co-executive director of the New York Zen Center for Contemplative Care. He serves on the Core Faculty for the Center’s Buddhist Chaplaincy Training Programs, and is a Senior Zen Buddhist Priest at Village Zendo in New York City.
For information about the New York Zen Center for Contemplative Care, please e-mail info@zencare.org or visit www.zencare.org.
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Interesting piece in New York Times, A Fighting Spirit Won’t Save Your Life, which reviews the history of popular attitudes and beliefs towards whether or not we can influence our personal health by our thoughts and “spiritual fitness.” This insightful opinion piece helps relieve the patient of the stigma that, due to some moral failing, they are sick.

The conclusion by the author Richard P. Sloan;

“It is difficult enough to be injured or gravely ill. To add to this the burden of guilt over a supposed failure to have the right attitude toward one’s illness is unconscionable. Linking health to personal virtue and vice not only is bad science, it’s bad medicine.”

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The New York Times shares new approaches in caring for people with Alzheimer disease with a focus on Beatitudes; a nursing home in Phoenix, AZ that favors giving chocolate over Xanax to the Alzheimer patients in their care. Based on current research  which reveals that  positive emotional experiences can diminish distress and problem behavior of  patients with Alzheimer disease, the staff at Beatitudes provide those in their care with personalized attention and options based on the patient’s  personal biography. Group Bingo games are replaced with small group or one-on-one activities rooted in memories that invoke happiness, love, and connectedness. The staff also integrates nonpharmalogical techniques that are proving to have positive benefits such as art, music, exercise and foods– all  that invoke positive emotions.

The point being that giving people what they like, through experiences which invoke loving memories tend to  result in good feelings, and a less stressed experience for everyone. Whether it’s when to eat, or what to eat, or what to wear, or how to bathe our memories can provide a path of ease during time of disease.

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