Monday, January 28, 2008

Recovery from Depression and Stress

As I recover from depression and grief, I continue to seek solace in nature. After giving up my career, my Ottawa home and garden, familiar colleagues, my old city life, and my parents, I take it slowly. Walking heals me. Today it was glorious out walking in the dusk. I kept an eye out for the wolf that appeared last week when Brian was speaking on the phone to Caitlin, my daughter, while I was out at work. He was gazing out the window while he talked and stopped mid-sentence, awed by the sight as it hustled by. I think it was looking for our turkey vultures that visit our feeders--it was the cycle of life. You could see its footprint in the snow as it trekked across the lake. The colours, the shades and shadows, as well as the creatures that continue to survive in the minus double-digit temperatures always stirred me.
This morning, the blue jays were puffed up for warmth. I had filled the feeders last night--I knew it would be a cold night, ten degrees below zero or even less, and they would be hungry. I counted five jays negotiating for a spot at the feeder. The squirrels, in that endless hide-and-seek game, had wee faces covered in snow as they doggy-dug trying to first bury and then find sunflower seeds or peanuts. They were a hungry lot today, and I may give them all a second sympathy feed. The rest of us were on diets, but we don’t have to live outdoors. I was glad for no yard duty anymore. Supervising inadequately dressed teens, hell-bent on jockeying for yard position, was no fun. I spend longer outdoors now, but it is my choice and I can move around, take photos, and explore nature.
I am so glad to be on the upturn emotionally. I still find it hard being in large groups. The winter was passing, and spring would come, just as it had for the previous fifty years of my life! I endeavour to get out every day to walk or do other outdoor activities. The Vitamin D is necessary for us old folks. I have been off meds for long enough to know that I don’t need them right now, but I know that my doctor is there if I need him, and he is happy with my progress. Quitting antidepressants too quickly or suddenly can result in setbacks.
I had worked hard at doing my M.A. coursework: research to help me navigate through the past few years of depression and stress. I feel that I have made many gains. There have been days when I felt sad and tired, and re-experienced some of the warning signs of depression (sadness, anger, fatigue, inability to make a decision, and insomnia), but they are less frequent. When I recognize the warning signs, I make sure I work out more, get outside in the sun, take time for me, do something for myself, and it passes. What a relief.

In the spring, Caitlin and Jean-Luc brought our granddaughter for a visit. She was thriving in the joy and love of a wonderful home. We visit lots with Jesse, who lives the closest, in Toronto. I regularly communicate with Terry, too, and he visits from time to time. All have been grieving the loss of their grandparents. We often speak of the fond memories that we hold dear: trips to the cottage and trips to town; tons of photos and slides are on hand.

Thursday, January 10, 2008

Conclusions

Whether our seniors require eldercare in the home or in long-term care, there are many issues that create barriers to success. If we keep our seniors at home, they are happier, and often healthier, but more at risk psychologically, socially, physically, and emotionally. Caregivers themselves run the risk of burnout, with its attendant physical and psychological effects. Some profit and non-profit agencies provide respite or day-away programs for senior care. This alleviates the burden of providing the quality of care that our seniors deserve. In many cases, however, if outside agencies are accessed to recruit home care, we run the risk of hiring people who are untrained and unlicensed in caring for those with complex morbidities, exacerbated by complications of complex prescriptions, physiotherapies, emotional complications of dementia, or other biopsychosocial issues.

The difficulty with parenting has been that many parents have passed through a laissez-faire phase in which the child was allowed to flourish and thrive. I remember in Grade 7 we were to self-select learning activities, with little direct guidance from the classroom teacher. I learned very little in that class and became frustrated. This philosophy of parenting had to be changed; many books were published to teach us how to say no to our children. Rabbi Shmuley Boteach offers a show called Shalom in the Home. He is re-educating parents in how to be fair and firm. He is teaching parents to give unconditional love with the right hand and discipline with the left. Both are necessary.

In my experiences with family and friends, I have heard endless stories of adult children who are unable to say no to frail and ailing parents. It is a reversal. Adult children have to lie and deny in an attempt to protect themselves from their parents’ wrath.

Frail adults refuse the help of outside agencies, whether or not money is an issue. It is the less frail spouse who suffers. One fifty-year-old daughter, whose mother had survived breast cancer in her seventies, is trying to persuade her father to allow people to come in to help them. When he falls, the mother cannot pick him up. The mother is now fighting high blood pressure with the stress of caring for this ill man. Tough love is a concept that must be applied to adults as well as children. In this situation, it should not be up to one spouse to refuse care if family members determine that there is a need.

One family, whose father lived in the family farmhouse as he had as a boy, promised their father that his stay in the long-term care home would only last a month. They are now using more excuses to keep him in. He doesn’t like his roommate, who turns up the TV too loud, and is fighting to keep his old life. Frail and ailing adults deny that they are unable to stay in their homes; they experience falls and break limbs, which land them in an LTC home. As seniors, we must make adult choices or we will not be treated as adults.

Our favourite librarian, Mari, who kindly delivered books to my mother, told me that she tried to persuade my mother to get some help with ADL. She offered to put my parents on the Meals on Wheels program, which my father and my husband delivered. Mom would not buy into any of this. Only old, sick people needed home support!