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Archive for the ‘End of Life’ Category

I once saw a short Italian film about a 10 year old boy whose widowed father, a highly- regarded author, was killed by a pig. The father was walking under a balcony in an old Italian village. The balcony crumbled due to  the weight of a huge hog – which spent its life sunning on the balcony and consuming leftovers.

When at boarding school everyone laughed at this boy when they heard how the his father died. The boy was mortified and ashamed.

Fast forward in the story.

A young man- let’s say…. a young teen,  he falls in love with a young woman. He is deeply smitten. So smitten  he invites the young woman to visit with is dour, maiden Aunt, his only living relative.

His  Aunt has deified her late brother, having built an altar-like centerpiece in her living room featuring all the books her late brother wrote, celebratory reviews, photos, etc.  The shrine creates  a haunting, stuffy, and sad  atmosphere.

Prior to  this visit, all the girl knows is that her beau is fatherless. So, upon seeing the altar she is motivated to ask, “Exactly; how did he die?”

You have to remember that this young man has become a withdrawn and hesitant fellow due to the barrage of laughs shot at him whenever he had to recount that his illustrious father was killed by a falling pig.

In the climactic scene, the girl’s innocent, and perfectly reasonable question hangs in the air.

Our hero gazes at her, swallows hard. His  Aunt proceeds to recount the facts.

The young couple remain staring  at one another. Her eyes register some question-but she hesitates, and they remain silent.

After the meal we see the young couple walking, holding hands, glad to be out the tomb-like cage of the Aunt’s flat. Then the young woman turns to him, and with love in her eyes asks, “ Is it true? Is that really how your father died.” He hesitates…. We feel his tension, but, love is at stake. Trembling with newly found, never-before-used  courage  he says,  “Yes, that’s how it happened.”

Their eyes locked;  she laughs…… and so does he(!!) for the first time.

This same sentiment is the theme of the compilation Exit Laughing, How Humor Takes the Sting Out of Death, edited by Victoria Zackheim (North Atlantic Books, 2012).

This comforting book makes the reader feel as if she has been invited to a dinner party to share not only good food, but personal stories about how humor appeared at times of death of a loved one.

Most of the stories are written about the author’s experience of caring for an elderly parent. The stories reveal how humor arises, unplanned and unchoreographed – it just happens in the juxtaposition of dealing with one of the greatest mysteries of living- that of dying.

Through the stories we experience  the power humor has  to dissolve old competitions between siblings, and long-held grudges against parents. Moments of profound tenderness and love make surprise appearances. These are not contrived tales or overly sweetened messages. Each entry is written with clear eyes and an opened-heart.

This “generosity of spirit” can empower and inspire the rest of us to step into the role of caregiver, free of old  and petty arguments, eager to feel the unique sort of love that is only possible when caring for a dying parent.

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It’s a great time to be a lifelong learner. Technology is creating an explosion of platforms and opportunities to take courses from colleges and universities at your own home computer— for free! And there are webinars, Youtube tutorials, Skype options and apps  — all delivering a cornucopia of content ranging from the classics to the avant garde.  This explosion of  learning opportunities has also opened up the channels of traditional delivery systems – think books- to extend their reach.

Shambhla Publications, recognized for bringing a wide range of books on Buddhism to the general readership has bested itself with their new title; Confusion Arises as Wisdom: Gampopa’s Heart Advice on the Path of Mahamudra by Ringu Tulku.

The Kagyu lineage lists Gampopa as the foremost student of Tibet’s most famous yogi, Milarepa, who had been a student of Marpa the Translator. Before he met Milarepa, Gampopa trained as monk in the Kadampa tradition, with its emphasis on the Mahayana qualities of bodhichitta, emptiness, and compassion. Gampopa brought together the Mahayana teachings of the Kadampas with the Vajrayana teachings of Mahamudra and the Six Yogas. The way he joined these teachings has shaped the study and practice of the Kagyu lineage to this day.

Ringu Tulku, born in Eastern Tibet in 1952, has acquired a friendly and effective  manner to communicate  these deep teachings to Westerners over the past seventeen years as a professor of Tibetan studies at Naropa University in Boulder, Colorado and at various meditation centers in Europe, across the USA and in India.

The eighteen short “community talks” are profound dharma teachings. Ringu Tulku anticipates some of the questions that will naturally arise in the Western mind and weaves into the chapters the root text, stories, along with anecdotes from his experiences as a teacher.

The result is a rich guide for Mahamudra meditation practice and the Vajrayana view and practice; an excellent addition to the library of someone with an established meditation practice, and a heartening experience for a lifelong learner who wants to explore unadulterated Buddhist text.

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You can listen to our interview and discussion about bringing wellness tools to caregivers on the eCareDiary blog talk radio

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An enlightened approach to Alzheimer Care

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In 1970 Joan Dye Gussow began teaching the course, Nutritional Ecology at Columbia Teachers College. It was a course she designed as she was a doctoral student, and newly appointed chair of the Nutrition Department. This course proved to be the beginning of an inquiry that “connected the dots” between the American diet, food advertising, how people spend their food dollars, agricultural systems, the landscape, and the inescapable and glorious interconnected web of life.

She is a seminal voice in support of sustainable agriculture and has influenced and inspired the legions that now strive for a sustainable food system. Locavores, Slow Foodies, dumpster divers, CSA members and more, lean on her scholarship, her insights, her passion, and her example.

Growing, Older was written after the swift death of her husband, the artist Alan Gussow. His passing happened shortly after they downsized their suburban home, to move to a river town on the Hudson River. They moved into a house they chose for the immediate view of the river and sky, and land to have a garden so they could grow their own food.

Her previous book, This Organic Life, was the first volume that chronicled putting her philosophy into action. In Growing, Older Joan shares honest reflections about the loss of her husband, juxtaposed with the work involved with maintaining the house and the garden that is repeatedly flooded by the Hudson River.

She is candid. And, she is lucky. She concludes the book acknowledging that she got what she wanted from life, and that she earned it from hard and rewarding work. Though deeply pragmatic, the book is also speckled with charm and grace.

In the chapter Bees, she quotes a conversation she had with a local beekeeper about  Colony Collapse Disorder – the dramatic  emergency brought about by the tragic disappearance  of bees; “But do you know what’s really killing the bees?…..They’re dying of unrequited love. They love what they do for us. We just don’t love them back enough.”

Her response, “What a theme for the whole planet!”is especially poignant as we strive to figure out what ARE sustainable values, and how do our feelings and attitudes about growing older, aging, and caring for older people  figure into that inquiry.

Again, thank you, Joan.

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This is a lovely book, Lastingness, The Art of Old Age by Nicholas Delbanco. The author shares his  lifelong and  deep appreciation of  artists and their work. He also shares  personal reflections, memories and  philosophical musings  about meaning, creativity and productivity. He lovingly takes us through a selected gallery of artists who shared “… some common denominator, some stubborn refusal to retire or let well enough alone.”

The title may sound resonate of the term coined by satirist Stephen Colbert’s, “truthiness”, alluding to strong opinions based on strong hunches or gut feelings. But Truthiness feels  dangerous, and Lastingness is warm, and  invokes the comfort of mindful and honest reflection.

There aren’t any answers or grand conclusions here. The author speculates about the  insights brain science might reveal  about the resilience of a creative mind rather than reference the science that IS now available; and he avoids the digital  briar patch and the implications that now artwork never dies and can  live forever in digital form. Instead,  Lastingness invites the reader to take some time and reflect, appreciate, and bring a heightened value  to the short amount of time we have to muse,  to create, and to appreciate how art can move the human soul, motivate the heart, and challenge the mind.

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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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