“Compassion begins at home, and it is not how much we do but how much love we put in that action. Do not think that love has to be extraordinary. What we need is to love without getting tired.” Mother Theresa
Every week my sister drives one and a half hours to visit her meditation teacher who now lives in a long-term care facility. One and a half hours that my sister, Sue, does not begrudge because as Sue remarks to me, she is my meditation teacher, mentor, friend, spiritual guide and second mother.
Whenever Sue visits, she leaves with gifts – words of wisdom, inspirational quotes, encouragement and love.
Sue explains that her friend is coming to terms with the last stage of her life – her failing health and the losses that surround this stage. But she tells Sue that the loss of independence is the deepest cut because it can lead to the loss of self.
My sister’s meditation teacher has no dementia. Now 86 years young, her body no longer obeys her commands; her aging body has begun to betray her, not her mind. She needs support in many facets of her life now, including a wheel-chair and bed lift – all physical. Spiritually, she is still intact.
In spite of feeling frustration that her voice is not heard, and her suggestions for improvement within the facility are ignored, Sue’s friend is optimistic that she can facilitate change. Once a city councillor, yoga teacher, and meditation teacher (who trained other yoga teachers and meditation teachers), she is a woman of substance – a woman at the young age of 86 (her words, not mine) who feels that she can still contribute and make a worthy difference to other residents’ lives. So she continues to push her ideas for change. Her suggestions are mostly simple ones, but significant to those who live in the facility. One of the changes she thinks would make a difference is a slight tweaking of the mechanical lift that transfers a patient from a bed to a wheelchair or vice versa (and is used to transfer a resident from chair to bathtub). Apparently when Sue’s friend is transferred from the bed, the position of her body becomes quite uncomfortable and causes some pain. When her friend tells the staff about this problem, she is ignored because there is nothing we can do about it and well, it doesn’t seem to bother anyone else.
Now you and I know that these kinds of answers are patronizing at best and shouldn’t be tolerated. But think about this: You are at the last stage of your life, you own an imperfect body that is not working, and you are totally dependent on the staff for all your basic needs to be met. If the staff do not hear you, what then? Her daughters are now talking to management about the issue, but that is what irks Sue’s friend the most: I should be seen and heard, not my daughters. I live here. Not them. She’s astute enough to recognize that she is experiencing a loss that many of us are not even cognizant of – the loss of not being seen and heard – the loss of self.
Our society and our culture worships at the altar of youth and beauty – we have no time for people who are aging and past their prime (whatever that is). Oh sure, if someone is past retirement and yet still working, owns their own business, is a creative force in the art or literary world (think musicians that are older and still performing to sell-out crowds) – those lucky individuals are still worthy and deemed valuable to society. But once someone goes to a long-term care facility (or a retirement home), the perceptions of value begin to change.
So when Sue asked her friend what would she change in the facility if she had the power to alter her circumstances, her teacher simply replied: I would only hire staff on the basis of compassion and loving kindness.
Sue asked her if she would make any other changes…perhaps the size of the room, the beds, the daily routine, the food, the activities?
Her friend shook her head. No, Sue. Just loving kindness and compassion. Loving acts and deeds of kindness are transformative because it is in the care and consideration that is shown that makes the true difference. She expanded further: Unless we have compassion, our encounters only fulfill the basic needs; as humans we need more.
The two of them spent their visit imagining a dream home for residents. They laughed aloud at how wonderful the homes would become: daily schedules would cater to the residents (not the efficiency of the system) – staff members would be allowed to spend long periods of time just talking and sitting with their residents, instead of a tight schedule that does not allow for companionship (facilities rely on family and volunteers for that); staff members would sense when a resident needed a good cry, a massage, a hug, or a good cuddle. Oh, the dream! The dream!
When Sue told me this story, I stared at her and said that according to the mission statements of most long-term care facilities (what can I say, Googling is a hobby), they are already resident-centered or resident-focused. The intent is clear. But what about the delivery?
In long-term care residences, you will find most of the staff members who are caring individuals. In the residence where my mother lived (and where I now volunteer) nearly all of the staff are kind and compassionate. Yes, some personal support workers are not as nice as others; but on the whole, many are loving, beautiful human beings. Unfortunately, the ratio of carers to residents is usually too high and carers or staff are run ragged. That hurry-up energy begins to wear on the carer (I know because I lived it) and breaks down their resolve to be kind. Once frustration or burn-out occurs, a hardening of the heart begins to affect the carer. And we begin (as carers and staff) to only see and feel our own frustrations which blinds us to others.
When we do not understand what someone is experiencing or what they are going through, we do not understand their suffering. If we do not understand a person’s pain, we cannot experience and feel compassion for them. Yes, we can empathize; but compassion can only arise in us when we feel for them or we see them and we are moved to alleviate their suffering. Compassion moves us to want to make a difference.
“True compassion, is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring.” Martin Luther King, Jr.
I once walked into a resident’s room and I found the resident and the personal support worker sitting on the bed, the personal support worker’s arms wrapped around the resident. She was rocking her back and forth, whispering words of comfort to her. I was moved to tears and slowly, silently retreated from the room. I stood in the hallway and honoured the moment. I, myself, have experienced those kinds of moments with my own mother when she was upset and I learned valuable lessons when those moments occurred. When my mother was brave enough to show me her vulnerability (she wept in my arms), my heart broke open – and we connected so strongly that it is difficult to even describe it. I can only write…Grace surrounded us and comforted us both.
It is the spark of recognition that we see our self in another human being that connects us, the recognition that we are all One. I think it is this spark (this Divine spark) that moves us to action.
And it is this spark that needs to be in every encounter for our compassion to arise. When a staff member takes a resident to the bathroom, does she hurry and make the resident feel that she doesn’t matter. Does she understand that the resident does not want to need help? When we ask a resident a question, and their dementia does not allow for a quick answer – do we answer for them, instead of pausing? Worse, do we ignore them? Or, when a resident is hurting, and we are on a tight schedule, do we completely miss all her signs of distress? Palliative nurses are trained in recognizing a patient’s signs of discomfort and pain. Is the person grimacing? Is her brow furrowed? Is she behaving differently? Has she lost an ability or skill and is now compensating for that loss? Palliative staff are trained to see! They understand that any change in behaviour may reflect pain. And more importantly, that pain can be seen – it’s reflected on their face.
“It matters not what you look at But what you see.” Henry David Thoreau
When we begin to really see someone, we begin to notice their suffering. And this awareness allows for an opening or a softening of our hearts.
My sister’s meditation teacher is right: Loving kindness and compassion is the answer. At the very least, it’s the beginning.