Month: March 2021

Posted on

From a prolonged pandemic, a rethink of life’s milestones?

By LEANNE ITALIE

Wedding anniversaries for Elizabeth O’Connor Cole and her husband, Michael, usually involve a dinner reservation for two at a fancy restaurant. Not this time around.

As the pandemic raged last May, the Chicago mom of four unearthed her boxed wedding gown from 19 years ago, got it zipped with help from one of her daughters and surprised her spouse.

Cole recreated their reception menu — a shrimp appetizer and beef tenderloin — and pulled out her wedding china and silver after enlisting another of her kids to DJ their first-dance song, “At Last,” for a romantic turn around the living room. And the priest who married them offered a special blessing on Zoom with friends and family joining in.

“Spontaneous and a bit chaotic,” O’Connor Cole pronounced the celebration. “Still, it was probably the most meaningful and fun anniversary we’ve had.”

As the pandemic enters its second year, there’s a pent-up longing for the recent past, especially when it comes to life’s milestones. When the crisis finally resolves, will our new ways of marking births and deaths, weddings and anniversaries have any lasting impact? Or will freshly felt sentiments born of pandemic invention be fleeting?

Some predict their pandemic celebrations have set a new course. Others still mourn the way their traditions used to be

Milestones, rituals and traditions help set the rhythm of our lives, from the annuals like birthdays and anniversaries to the one-timers like births and deaths, extending beyond those boundaries to more casual events like opening day (choose your sport), drinks out after work with colleagues and that first swim of summer.

Jennifer Talarico, a psychology professor at Lafayette College in Pennsylvania who studies memory and personal experience, says certain events shape lives differently — and have been reshaped just as differently during the pandemic. Perhaps most devastatingly impacted, she says, are death and dying, sitting at bedsides to comfort and attending funerals to mourn as the coronavirus has killed more than 2.3 million people around the world.

“That’s being felt the hardest because it’s the hardest to replace,” Talarico says. “That’s probably going to have the most lasting impact.”

Renee Fry knows the feeling well. Her grandmother, Regina Connelly, died Dec. 6 of COVID-19 at her nursing home in Hollidaysburg, Pennsylvania. She had just turned 98. There was no dropping everything to be at her bedside. There was no large church celebration of her life followed by dinner for all.

“We had to rely on video conferencing,” Fry says.

But they also did something else. She and her sister, Julie Fry, put together a “memory book” shared with far-flung family and friends. They included Regina’s favorite prayer, the Hail Mary, and asked loved ones to recite it on her behalf. They filled pages with photos through the years, from a portrait of young Regina in a fine red dress (lipstick to match, gold pendant around her neck) to more casual shots with grandchildren.

The sisters — Renee in Quincy, Massachusetts, and Julie in Port Matilda, Pennsylvania — wrote the story of how Regina met her husband on a blind date, then lost him when he died in 2010 after 64 years of marriage. They wrote of how she spent most of her teen years caring for her two brothers after their mother died suddenly when she was 13. They included rosaries with each of the 32 booklets they mailed.

Judging from the response — a second cousin called to say thank you, and a caregiver for Regina wrote a two-page letter offering thanks as well — it made an impact. “It was incredibly meaningful,” Renee says.

Such a booklet will be created when the family faces death once again. The pandemic, Fry says, has proven that distance no longer denies lasting meaning.

Daryl Van Tongeren, an associate professor of psychology at Hope College in Michigan, studies meaning in life, religion and virtues. Rituals, symbols and milestones help provide structure to our worlds, he says, demarcating the passage of time or a significant accomplishment but more importantly lending meaning to life itself.

“One of the things that these milestones and these rituals do is they connect us with other people and things that are larger than ourselves,” he says

Sometimes left behind in a swirl of celebration is the core significance of something just as important — the events themselves. Students who missed out on the walk across the stage at their graduations remain graduates. Couples forced to elope or give up their dreams of weddings for 200 for smaller affairs still have their marriages to experience

While some predict a Roaring ’20s renaissance once the crisis has ended, “there are going to be a number of people who are changed,” Van Tongeren says. “They’re going to say, `I’m going to emerge from this pandemic with a new set of values and I’m going to live my life according to new priorities.'”

Last year, Shivaune Field celebrated her 40th birthday on Jan. 11 with a group of friends at a downtown restaurant in Los Angeles, where she lives. It was just weeks before the coronavirus made its way to the U.S. This year, when she turned 41, the adjunct professor in business at Pepperdine University simply took to the beach with her pals.

“It felt much more authentic, a nicer way to connect without all the bells and whistles,” she says. “I think it’s really nice to get back to that. It reminds me of childhood.”

Fields grew up in Melbourne, Australia, where she says her parents kept birthdays rooted in family outings to the beach or bike rides followed by a treat of ice cream.

“Weekend get-togethers are now in sneakers with dogs sitting on grass and picnic rugs rather than on stools in fancy restaurants,” she says. And Field is just fine with that.

Marking time has changed during the pandemic. There’s the ticking off of months based on trips to the hair salon and the length of pandemic beards. There’s Zoom creativity and socially distanced trips outdoors. Recreating celebrations of the past for major, time-marking events has been difficult as time blurred and safety restrictions took over.

“We have all of this cultural baggage, in a good way, around those events,” Talarico says. “It’s a reinforcing cycle of events that we expect to be memorable.”

Memorable has been hard to achieve. But the rethink has been important for many, and its effects may ripple long after the virus has ebbed.

“For those wanting to reminisce years later about important events that happened during the pandemic, there will likely be nostalgia mixed with more than a tinge of trauma,” says Wilfred van Gorp, a past president of the American Academy of Clinical Neuropsychology.

“It may remind us of the loneliness and isolation brought about by the pandemic, our fear of catching the virus, fear of dying, fear of losing loved ones and loss of any we knew who may have died from COVID-19,” he says. “And,” he adds, “recollections of what we didn’t have, what we missed, and the experiences we couldn’t share together.”

Complete Article ↪HERE↩!

Posted on

Growing My Faith in the Face of Death

I spent a lifetime counseling others before my diagnosis. Will I be able to take my own advice?

By Timothy Keller

I have spent a good part of my life talking with people about the role of faith in the face of imminent death. Since I became an ordained Presbyterian minister in 1975, I have sat at countless bedsides, and occasionally even watched someone take their final breath. I recently wrote a small book, On Death, relating a lot of what I say to people in such times. But when, a little more than a month after that book was published, I was diagnosed with pancreatic cancer, I was still caught unprepared.

On the way home from a conference of Asian Christians in Kuala Lumpur in February 2020, I developed an intestinal infection. A scan at the hospital showed what looked like enlarged lymph nodes in my abdomen: No cause for concern, but come back in three months just to check. My book was published. And then, while all of us in New York City were trying to protect ourselves from COVID-19, I learned that I already had an agent of death growing inside me.

I spent a few harrowing minutes looking online at the dire survival statistics for pancreatic cancer, and caught a glimpse of On Death on a table nearby. I didn’t dare open it to read what I’d written.

My wife, Kathy, and I spent much time in tears and disbelief. We were both turning 70, but felt strong, clear-minded, and capable of nearly all the things we have done for the past 50 years. “I thought we’d feel a lot older when we got to this age,” Kathy said. We had plenty of plans and lots of comforts, especially our children and grandchildren. We expected some illness to come and take us when we felt really old. But not now, not yet. This couldn’t be; what was God doing to us? The Bible, and especially the Psalms, gave voice to our feelings: “Why, O Lord, do you stand far off?” “Wake up, O Lord. Why are you sleeping?” “How long, O Lord? Will you forget me forever?”

A significant number of believers in God find their faith shaken or destroyed when they learn that they will die at a time and in a way that seems unfair to them. Before my diagnosis, I had seen this in people of many faiths. One woman with cancer told me years ago, “I’m not a believer anymore—that doesn’t work for me. I can’t believe in a personal God who would do something like this to me.” Cancer killed her God.

What would happen to me? I felt like a surgeon who was suddenly on the operating table. Would I be able to take my own advice?

One of the first things I learned was that religious faith does not automatically provide solace in times of crisis. A belief in God and an afterlife does not become spontaneously comforting and existentially strengthening. Despite my rational, conscious acknowledgment that I would die someday, the shattering reality of a fatal diagnosis provoked a remarkably strong psychological denial of mortality. Instead of acting on Dylan Thomas’s advice to “rage, rage against the dying of the light,” I found myself thinking, What? No! I can’t die. That happens to others, but not to me. When I said these outrageous words out loud, I realized that this delusion had been the actual operating principle of my heart.

The cultural anthropologist Ernest Becker argued that the denial of death dominates our culture, but even if he was right that modern life has heightened this denial, it has always been with us. As the 16th-century Protestant theologian John Calvin wrote, “We undertake all things as if we were establishing immortality for ourselves on earth. If we see a dead body, we may philosophize briefly about the fleeting nature of life, but the moment we turn away from the sight the thought of our own perpetuity remains fixed in our minds.” Death is an abstraction to us, something technically true but unimaginable as a personal reality.

For the same reason, our beliefs about God and an afterlife, if we have them, are often abstractions as well. If we don’t accept the reality of death, we don’t need these beliefs to be anything other than mental assents. A feigned battle in a play or a movie requires only stage props. But as death, the last enemy, became real to my heart, I realized that my beliefs would have to become just as real to my heart, or I wouldn’t be able to get through the day. Theoretical ideas about God’s love and the future resurrection had to become life-gripping truths, or be discarded as useless.

I’ve watched many others partake of this denial of death and then struggle when their convictions evaporate, and not just among the religious. I spent time as a pastor with sick and dying people whose religious faith was nominal or nonexistent. Many had a set of beliefs about the universe, even if they went largely unacknowledged—that the material world came into being on its own and that there is no supernatural world we go to after death. Death, in this view, is simply nonexistence, and therefore, as the writer Julian Barnes has argued, nothing to be frightened of. These ideas are items of faith that can’t be proved, and people use them as Barnes does, to stave off fear of death. But I’ve found that nonreligious people who think such secular beliefs will be comforting often find that they crumple when confronted by the real thing.

So when the certainty of your mortality and death finally breaks through, is there a way to face it without debilitating fear? Is there a way to spend the time you have left growing into greater grace, love, and wisdom? I believe there is, but it requires both intellectual and emotional engagement: head work and heart work.

I use the terms head and heart to mean reasoning and feeling, adapting to the modern view that these two things are independent faculties. The Hebrew scriptures, however, see the heart as the seat of the mind, will, and emotions. Proverbs says, “As he thinketh in his heart, so is he.” In other words, rational conviction and experience might change my mind, but the shift would not be complete until it took root in my heart. And so I set out to reexamine my convictions and to strengthen my faith, so that it might prove more than a match for death.

Paul Brand, an orthopedic surgeon, spent the first part of his medical career in India and the last part of his career in the U.S. “In the United States … I encountered a society that seeks to avoid pain at all costs,” he wrote in his recent memoir. “Patients lived at a greater comfort level than any I had previously treated, but they seemed far less equipped to handle suffering and far more traumatized by it.”

Why is it that people in prosperous, modern societies seem to struggle so much with the existence of evil, suffering, and death? In his book A Secular Age, the philosopher Charles Taylor wrote that while humans have always struggled with the ways and justice of God, until quite recently no one had concluded that suffering made the existence of God implausible. For millennia, people held a strong belief in their own inadequacy or sinfulness, and did not hold the modern assumption that we all deserve a comfortable life. Moreover, Taylor has argued, we have become so confident in our powers of logic that if we cannot imagine any good reason that suffering exists, we assume there can’t be one.

But if there is a God great enough to merit your anger over the suffering you witness or endure, then there is a God great enough to have reasons for allowing it that you can’t detect. It is not logical to believe in an infinite God and still be convinced that you can tally the sums of good and evil as he does, or to grow angry that he doesn’t always see things your way. Taylor’s point is that people say their suffering makes faith in God impossible—but it is in fact their overconfidence in themselves and their abilities that sets them up for anger, fear, and confusion.

When I got my cancer diagnosis, I had to look not only at my professed beliefs, which align with historical Protestant orthodoxy, but also at my actual understanding of God. Had it been shaped by my culture? Had I been slipping unconsciously into the supposition that God lived for me rather than I for him, that life should go well for me, that I knew better than God does how things should go? The answer was yes—to some degree. I found that to embrace God’s greatness, to say “Thy will be done,” was painful at first and then, perhaps counterintuitively, profoundly liberating. To assume that God is as small and finite as we are may feel freeing—but it offers no remedy for anger.

Another area of head work for me had to do with Jesus’s resurrection. Ironically, I had already begun working on a book about Easter. Before cancer, the resurrection had been a mostly theoretical issue for me—but not now. I’m familiar with the common charge that any belief in an afterlife is mere wish fulfillment without grounding in fact—and that belief in Jesus is in the same category as faith in the Flying Spaghetti Monster. But over the past 20 years, I’ve been drawn to the work of the British biblical scholar N. T. Wright, who mounts a historical case for Jesus’s bodily resurrection.

I returned to his material now, with greater skepticism than I had previously applied. I didn’t want to be taken in. But as I reread his arguments, they seemed even more formidable and fair to me than they had in the past. They gave me a place to get my footing. Still, I needed more than mental assent to believe in the resurrection.

The heart work came in as I struggled to bridge the gap between an abstract belief and one that touches the imagination. As the early American philosopher Jonathan Edwards argued, it is one thing to believe with certainty that honey is sweet, perhaps through the universal testimony of trusted people, but it is another to actually taste the sweetness of honey. The sense of the honey’s sweetness on the tongue brings a fuller knowledge of honey than any rational deduction. In the same way, it is one thing to believe in a God who has attributes such as love, power, and wisdom; it is another to sense the reality of that God in your heart. The Bible is filled with sensory language. We are not only to believe that God is good but also to “taste” his goodness, the psalmist tells us; not just to believe that God is glorious and powerful but also to “see” it with “the eyes of the heart,” it says in Ephesians.

On December 6, 1273, Thomas Aquinas stopped writing his monumental Summa Theologiae. When asked why by his friend Reginald, he replied that he had had a beatific experience of God that made all his theology “seem like straw” by comparison. That was no repudiation of his theology, but Thomas had seen the difference between the map of God and God himself, and a very great difference it was. While I cannot claim that any of my experiences of God in the past several months have been “beatific,” they have been deeper and sweeter than I have known before.

My path to this has involved three disciplines.

The first was to immerse myself in the Psalms to be sure that I wasn’t encountering a God I had made up myself. Any God I make up will be less troubling and offensive, to be sure, but then how can such a God contradict me when my heart says that there’s no hope, or that I’m worthless? The Psalms show me a God maddening in his complexity, but this difficult deity comes across as a real being, not one any human would have conjured. Through the Psalms, I grew in confidence that I was before “him with whom we have to do.”

The second discipline was something that earlier writers like Edwards called spiritual “soliloquy.” You see it in Psalms 42 and 103, where the psalmist says, “Why are you cast down, O my soul?” and “Bless the Lord, O my soul. And forget not all his benefits.” The authors are addressing neither God nor their readers but their own souls, their selves. They are not so much listening to their hearts as talking to them. They are interrogating them and reminding them about God. They are taking truths about God and pressing them down deep into their hearts until they catch fire there.

I had to look hard at my deepest trusts, my strongest loves and fears, and bring them into contact with God. Sometimes—not always, or even usually—this leads, as the poet George Herbert wrote, to “a kind of tune … softness, and peace, and joy, and love, and bliss, exalted manna … heaven in the ordinary.” But even though most days’ hour of Bible reading, meditation, soliloquy, and prayer doesn’t yield this kind of music, the reality of God and his promises grew on me. My imagination became more able to visualize the resurrection and rest my heart in it.

Most particularly for me as a Christian, Jesus’s costly love, death, and resurrection had become not just something I believed and filed away, but a hope that sustained me all day. I pray this prayer daily. Occasionally it electrifies, but ultimately it always calms:

And as I lay down in sleep and rose this morning only by your grace, keep me in the joyful, lively remembrance that whatever happens, I will someday know my final rising, because Jesus Christ lay down in death for me, and rose for my justification.

As this spiritual reality grows, what are the effects on how I live? One of the most difficult results to explain is what happened to my joys and fears. Since my diagnosis, Kathy and I have come to see that the more we tried to make a heaven out of this world—the more we grounded our comfort and security in it—the less we were able to enjoy it.

Kathy finds deep consolation and rest in the familiar, comforting places where we vacation. Some of them are shacks with bare light bulbs on wires, but they are her Sehnsucht locations—the spaces for which she longs. My pseudo-salvations are professional goals and accomplishments—another book, a new ministry project, another milestone at the church. For these reasons we found that when we got to the end of a vacation at the beach, our responses were both opposite and yet strangely the same.

Kathy would begin to mourn the need to depart almost as soon as she arrived, which made it impossible for her to fully enjoy herself. She would fantasize about handcuffing herself to the porch railing and refusing to budge. I, however, would always chafe and be eager to get back to work. I spent much of the time at the beach brainstorming and writing out plans. Neither of us learned to savor the moment, and so we never came home refreshed.  

A short, green Jedi Master’s words applied to me perfectly: “All his life has he looked away to the future, the horizon. Never his mind on where he was.” Kathy and I should have known better. We did know better. When we turn good things into ultimate things, when we make them our greatest consolations and loves, they will necessarily disappoint us bitterly. “Thou hast made us for thyself,” Augustine said in his most famous sentence, “and our hearts are restless until they find their rest in Thee.” The 18th-century hymn writer John Newton depicted God as saying to the human soul, “These inward trials I employ from pride and self to set thee free, and break thy schemes of earthly joy that thou would find thine all in me.”

To our surprise and encouragement, Kathy and I have discovered that the less we attempt to make this world into a heaven, the more we are able to enjoy it.

No longer are we burdening it with demands impossible for it to fulfill. We have found that the simplest things—from sun on the water and flowers in the vase to our own embraces, sex, and conversation—bring more joy than ever. This has taken us by surprise.

This change was not an overnight revolution. As God’s reality dawns more on my heart, slowly and painfully and through many tears, the simplest pleasures of this world have become sources of daily happiness. It is only as I have become, for lack of a better term, more heavenly minded that I can see the material world for the astonishingly good divine gift that it is.

I can sincerely say, without any sentimentality or exaggeration, that I’ve never been happier in my life, that I’ve never had more days filled with comfort. But it is equally true that I’ve never had so many days of grief. One of our dearest friends lost her husband to cancer six years ago. Even now, she says, she might seem fine, and then out of nowhere some reminder or thought will sideswipe her and cripple her with sorrow.

Yes. But I have come to be grateful for those sideswipes, because they remind me to reorient myself to the convictions of my head and the processes of my heart. When I take time to remember how to deal with my fears and savor my joys, the consolations are stronger and sweeter than ever.

Complete Article ↪HERE↩!

Posted on

Grieving Through Laughter

Sarah Weaver has combined tragedy and comedy in her webcomics as a way to cope with the death of her older sister

Sarah Weaver in Polson, Montana on Oct. 17, 2020

By Ashley Nerbovig

Monotony was kindling for Sarah Weaver’s burning grief.

After the June 2010 death of her older sister, Melissa Weaver, in a plane crash in Northwest Montana, Sarah would fumble over familiar questions such as, “How many siblings do you have?”

The tragedy shook Sarah’s entire worldview. For years she plodded along. She moved to Washington D.C. and took a job creating retirement policy at the U.S. Department of Treasury. Her boss would tell her the work she did made a meaningful difference. But Sarah didn’t see it. In 2016, she wondered whether she’d chosen where she was, or if she’d just ended up there.

In two years, Sarah traveled to 45 countries on six continents. When her travels ended, she returned to Polson, settling near where Melissa lived before she died. And now, 10 years after the plane crash, Sarah is using her webcomic, “Adventures with Vrah” to write about death, depression and diarrhea.

The combination of tragedy and comedy was appealing.

“It’s what has helped me cope and move through my own grief,” Sarah, 32, said. “I think it might help other people, or hope that it will help other people.”

Sarah was living in London at the time and staying with her aunt and uncle. She was about a week into an internship when she opened a Facebook message that read “Sarah, I’m so sorry to hear about your sister. Let me know if I can do anything.”

Sarah Weaver’s webcomic “Adventures with Vrah.”

The cryptic message left her scared and confused. The surreal feeling stayed with her as she got ahold of her parents. They were already in Polson with Sarah’s other two siblings, Emily and Joe, trying to get more information about the whereabouts of Melissa’s plane.

On June 27, 2010, Brian Williams and newly licensed pilot, Sonny Kless, picked up Melissa and her friend Erika Hoefer for a sightseeing trip over Glacier National Park. A woman reported seeing the plane, but no one reported seeing it crash. Officials believe the plane lost lift over a box canyon near the National Bison Range, roughly 100 miles south of the West Glacier entrance to the park, and dropped out of the sky.

A flight plan wasn’t filed before the four left, which made it difficult for rescue teams to know where to look. Sarah remembers hoping Melissa would be found alive. But their mother, Kathy Weaver, said she knew the moment she heard the plane went missing that Melissa was dead, even if a very small part of her thought that if Melissa did survive the crash, she would do anything to come home. She’d walk on two broken legs, Kathy said.

After three days of searching, the crash site was found. The plane had caught fire. Melissa, Hoefer, Williams and Kless all died in the crash.

“For years I’d hope that they were wrong,” Sarah said. “I’d think, ‘Everything was burned, so how do they even know it was the right plane?’”

Melissa, who was the oldest of the four Weaver siblings, was 23 when she died. Sarah, 21 at the time and 18 months younger than Melissa, was thrust unprepared into the oldest sibling leadership role. Emily Weaver, who was 19, had finished her first year of college. Joe, 17, was still in high school and living in Billings with their parents, Kathy and Dan Weaver.

Sarah Weaver with her sister Melissa.

For Sarah, a large part of working through the Melissa’s death was scribbling down her thoughts and doodling. It started as a way to keep memories of Melissa fresh, a way to help her siblings remember Melissa, who was four years older than Emily and six years older than Joe. Sarah wasn’t an artist. She’d studied finance at UM. But, after she showed one of the comics she’d made to a friend, he encouraged her to share it online. She launched her comic site in 2016, and since then her style has continued to evolve. One of the inspirations for her series was Allie Brosh, the creator of “Hyperbole and Half” and a fellow University of Montana graduate.

Years before Melissa died, Sarah watched a movie about a wife who called her husband’s cellphone and listened to his voicemail while crying in bed. It was one of the saddest things she’d ever seen, she said.

“So when Melissa died, I remember thinking back to that scene and being like, ‘I’m in the sad movie,’” Sarah said.

Sarah would still call Melissa and send her Facebook messages until one day when she called, a man answered. Melissa’s cellphone number had been reassigned to a stranger. It was devastating, but Sarah didn’t want to stop calling her sister, so she kept calling Jeff. She pretended they were lifelong friends. Jeff usually hung up on her.

One day, she got a text from Jeff’s son, telling her she was freaking out his dad and to please stop calling. She did, but she still hopes that Jeff will realize one day why she called so often and they’ll become friends. She never explained why she had “his” number. She never told him about Melissa. The comic she made about the experience with Jeff is one of her family’s favorites.

“It was just easier to play a character, a game — it was too sad,” Sarah said. “What if he did care why I was calling him?”

As Sarah’s perspective on Melissa’s death evolved, so did the webcomic. It stopped being about who Sarah was without Melissa and became about Sarah.

After spending two years abroad, Sarah returned to live in Polson. She set up a Patreon for her webcomic and thinks about turning it into a book one day. In moments of uncertainty, she wonders if it’s wrong to link her career path to her sister’s death, but ultimately she hopes her art could help people.

Sarah Weaver’s webcomic “Adventures with Vrah.”

Emily understands Sarah’s doubts but believes in her mission.

“The fact of the matter is, it happened, and we have to make as much good of it as we can,” Emily said.

Melissa’s death set off a chain of events, including unexpectedly positive developments. For one, Emily transferred from Carroll College to the University of Montana to live with Sarah after Melissa’s death and met her husband there. But the family members were isolated from one another in their grief, Emily said, and it took awhile for them to repair themselves. Every year that passes, it gets better.

The family got together this year on the 10th anniversary of the plane crash. For the first time, it felt like it wasn’t just about being sad about Melissa’s death, Emily said.

“It feels like everyone’s gotten through some of their grief,” Emily said, “and that let us come back together as a family.”

The siblings’ father, Dan, said his grief over Melissa’s death is like a heavy coat he has to wear year round. It unnerved him at first that Sarah was going to write about it. Over time, though, he’s gotten more enjoyment from Sarah’s comic. He learns things about the kids that he’d never known.

The public nature of the comic has been beneficial to Sarah. Beyond people writing to say how her comic helped them, having it as her full-time job forces her to be frank with people about her life. The process of writing and explaining it to people, sometimes in different languages, made it easier to answer the questions that stumped her after Melissa died.

Before she and her husband took their two-year trip all over the globe, they’d gone on a shorter trip to Indonesia. There, a woman asked Sarah what she did for work. When Sarah showed the woman a translation of her comic’s themes, the woman pointed to the word “depression” and said, “Yes, I know this.”

“It helps me,” Sarah said. “It’s powerful when someone can say, ‘I know, maybe, a piece of your pain.”

Complete Article ↪HERE↩!

Posted on

Death Doulas Give Time To Those Running Out Of It

By

Chris Bruton said his dad got sick in 2017 and just never got better.

“He had fatigue and we didn’t know what it was,” he said.

By January 2018, they had an answer.

“He actually had stage four kidney cancer,” Bruton said. “He was basically given about two to four months to live.”

When Bruton was a kid, his dad travelled a lot, so he didn’t get to know his dad that well. But after Bruton’s mom died, his dad moved from North Carolina to live with Bruton in Colorado. Bruton was in his 40s, his dad was in his 70s.

A year later, his dad got sick. Once they got the diagnosis, a woman Bruton was seeing suggested a death doula.

“And of course, I’d never heard of it. It sounded a little bit, a little bit hocus pocus-y to me,” he said. “I thought, well, I don’t think my dad would be up for anything like that.”

But then his dad started to close himself off and isolate, so Bruton agreed to meet with Cindy Kaufman, an end-of-life doula who works out of Denver. And Bruton introduced her to his dad.

He remembers chatting before Kaufman asked his dad how he was doing – how he was really doing. In an uncomfortable silence, Bruton and his aunt left to give them space.

“And as I walked out, I heard sobbing from my father that I had never heard before,” he said. “This well of stress and fear, anxiety, sadness, it all just came out.”

Kaufman came by one or two times a week, and then drove down for the end. It only took about two months. Bruton said she even helped his dad’s dog through it.

“After my dad had passed, she said, ‘Hey, let’s get Matty up here on the bed and so she can see your dad.’ And I think that even helped the dog find closure and understand what was going on,” he said.

Even though he’d never heard of a death doula before, Bruton is now a convert.

“I had no idea how much work there was to do to help someone who’s going through the dying process until I saw what Cindy did. And yeah, changed our lives,” he said. “Changed our lives and changed my dad’s life at the very end of it.”

Death doulas are also called death midwives or end-of-life doulas, but whatever you call them, their numbers have blossomed in the last decade. There’s a few in every state, but Colorado is a hotspot in the Mountain West. Beyond being a doula, Cindy Kaufman leads the Colorado End-of-Life Collaborative.

“End-of-life doulas fill what we believe is a gap,” she said.

That gap is the space between hospices, which provide necessary medical care, and what she does – help someone with the actual process of dying.

Since the hospice industry started in the ’70s and ’80s, Kaufman said, it’s become more of a business with certain hours and staff caring for multiple clients. While they started as non-profits, the majority of hospices are now for-profit institutions.

“We don’t carry those kinds of case-loads, we work for (ourselves),” she said, comparing death doulas with hospice staff. “We don’t fall under insurance, we’re private pay.”

Kaufman said death doulas can bring ritual back into dying, and make it easier to say goodbye.

They can help plan legacy projects, say late-night prayers, figure out what kind of burial or cremation someone wants. For some, they just sit with people, right up to the end.

And death doulas are incredibly diverse, not only in what they offer but with their backgrounds. There’s no licensing requirement or mandatory training. Kaufman said some people use their own culture to inform how they practice as death doulas, and they don’t want more regulations.

“They want to be honored for the fact that they were trained within their own family and community to do what they do,” she said.

Still, several training centers have cropped up in recent years. Some are in places like Australia and the UK. And there’s one in New Jersey called the International End Of Life Doula Association, or INELDA.

Henry Fersko-Weiss is a death doula who created INELDA six years ago.

He said it’s good to take other cultures into consideration, but the profession needs standardization if they want to be reimbursed by Medicare or Medicaid. He said that could also improve quality of care – and help the fledgling profession evolve and gain trust.

“Anybody could call themself a doula without knowing anything, without having any training,” he said. “And I think that can do a disservice to the development of this field.”

Nancy L. Compton is an INELDA trainer based in Boise, Idaho. She’s also a certified hospice nurse assistant, palliative nurse assistant and death doula.

She’s proud death doulas can work outside normal constraints.

“Not everybody is born nor dies Monday through Friday, 8 to 5,” Compton said.

But she’s also proud of what her intimate knowledge of the dying process does for families.

“That’s where I am different and that’s where I pioneered this, especially in the Boise Valley,” she said.

Compton said a hospice paid her to practice there, and that’s unusual for a death doula. Medicare sanctions death doulas, but won’t reimburse for their care – yet. That would require a lot more standardization.

Deb Rawlings, at least, is fascinated by the diversity in this budding industry.

“It was amazing to find that there were so many differences in what the death doulas say that they do and what they offer,” she said.

Rawlings teaches palliative care at Flinders University in Australia. She’s one of the few people who’ve researched the occupation.

She found that many death doulas are former hospice workers or nurses. Some volunteer, others charge. Some help with a spiritual journey, others help with more physical tasks.

But even though they’re so different, death doulas have generally described their role to Rawlings like this: “We’ve got time. So I’ve got time to come in and sit with you. I might sit with the person who’s dying and let their family go and have a break. I might help and do the washing.”

In other words, they give time to those who are running out of it.

Complete Article ↪HERE↩!

Posted on

Grieving Is Hard.

Grieving During A Pandemic Is Even Harder.

Without rituals, or a communal gathering, the the loss of a loved one can be felt even more keenly

by Julia Paskin

I recently lost someone who, in a lot of ways, was like a second mother. She didn’t die from COVID-19 but pandemic regulations still stand. It’s not safe to have a memorial for her.

Grief is never easy. I’m having trouble processing her loss for a few reasons but a big one is that Mama Sue was a mother to a whole lot of people, and being unable to gather with all of them in her honor has me feeling kind of stuck in my grief.

Dr. Katherine Shear says rituals surrounding death are an important part of the health process. “Without those rituals we struggle a lot more with coming to terms with the loss, which is of course what we have to do,” said Shear. Ultimately healing requires us to “regroup and find our way forward.”

PROLONGED GRIEF

Shear teaches psychiatry at Columbia University and specializes in prolonged grief, something she’s seeing a lot more of these days. Grief is considered prolonged when the feelings disrupt everyday life beyond what’s considered a healthy degree and amount of time. Symptoms of prolonged grief, also known as complicated grief can include extreme sorrow, isolation, and an inability to feel joy long after suffering a loss.

For many, it’s not only about missing out on the ritual and sense of community. It’s also about not being with someone when they die. Shear says separation from loved ones during the dying process can also make healing more difficult.

“Those things contribute to the processing of the reality of the death,” said Shear. “That’s a part of what we have to do – accept the reality. And then we have to find a way to restore our capacity to feel well-being.”

ENORMOUS NUMBERS

Demographer Emily Smith-Greenaway teaches sociology and spatial sciences at USC and has quantified the impact of COVID-19 fatalities on its survivors. She says “each death results in about nine Americans grieving the death of a close relative.”

Based on that projection, 225,000 people in California were personally affected by the death of someone from COVID-19 in 2020 alone. “The size of the population grieving, and grieving very intimate losses, is just enormous,” said Smith-Greenaway.

Fellow USC professor Diane Blaine specializes in thanatology which is the study of death and its impact. She says there are ways to find solace in creating our own rituals to help the healing process…

“Write a letter, light a candle too, you know, I have a little altar, and to just sit and weep,” said Blaine. “We can still do those things.”

FUTURE GATHERINGS

Many are finding ways to connect with other mourners. Zoom memorial services and online religious ceremonies are being frequently held. If you’re still struggling though, Blaine recommends talking to a grief counselor or support group.

The challenge is that there are a lot of communities where mental health services are hard to access and they’re often the same communities with high COVID-19 mortality rates. An emerging idea is to train people already trusted in the community like barbers and church members to give support.

Most importantly, Blaine says to remember that grief doesn’t have a timeline.

“Even though right now there might have to be a forestalling of whatever form of grief process, it can continue and it can continue on even for years.”

Blaine says we will be able to gather in the memory of those we’ve lost again at some point. And that can be healing whenever it happens.

For what it’s worth, I think I’ll light another candle for Mama Sue tonight.

Complete Article ↪HERE↩!

Posted on

There Is No Vaccine for Grief

But there are ways to prepare to face it.

By A.C. Shilton

For months, I’ve felt like the emotional equivalent of a car with a cracked windshield. I’m still rolling through daily life, but one good knock is bound to shatter me. Although the number of coronavirus cases has been declining, the number of deaths has soared well above 500,000, and now we have the new variants to worry about. I know that if I have not yet lost a loved one, I’m one of the lucky ones — and no one’s luck lasts forever.

I love being proactive — I’m all about having a go bag with extra batteries, duct tape and granola bars ready for any emergency. But what, if anything, could I do to prepare myself for grief?

Anticipatory grief is a well-documented phenomenon in grief counseling, said Dr. Katherine Shear, the founder and director for the Center for Complicated Grief at Columbia University. But usually researchers study anticipatory grief in environments like hospices, where loss is imminent. What many of us are experiencing right now is more nebulous. Dr. Shear cautioned that spiraling into anticipatory grief for a loss that may not even happen is likely to be unhelpful.

Of course, even if you do not lose a family member or friend in the pandemic, that does not mean you will not experience grief. At its core, grief is a reaction to a change that you didn’t want or ask for, said David Kessler, a grief expert and author of many books on the subject, including his most recent, “Finding Meaning: The Sixth Stage of Grief.”

Even those who have not lost family members are experiencing some level of loss in the pandemic, he said, from the disappointment of missing in-person experiences and holiday celebrations to the losses of our jobs and even our homes.

“The problem with comparisons in grief is if you win, you lose,” Mr. Kessler said, adding, “and the world is big enough for all our griefs.”

Inoculating yourself against feelings of loss may prove harder than getting a routine vaccine. “Grief is as unique as a thumbprint. What works for one person may not work for another,” said Deanna Upchurch, the director of clinical outreach services at the Providence-based hospice HopeHealth. Still, should the worst happen, knowing what tends to help others could help you gird yourself — even just a little bit. If doing something feels better to you than doing nothing, consider this your packing list for a grief go bag.

Practice Experiencing Your Emotions.

“In our culture, we tend to think painful emotions are bad,” Dr. Shear said. “But that’s really not true. It’s true that they’re painful, but we can learn from them,” she said. Next time you feel something unpleasant, take a moment to sit with it and think about why you’re feeling the way you’re feeling.

Mr. Kessler suggests looking to the animal kingdom for inspiration on learning to live with uncomfortable emotions. After his 21-year-old son died suddenly in 2016, Mr. Kessler was watching a documentary on buffalos. The documentary noted that buffalos run straight into oncoming storms.

“Because they run into the storm, they minimize the time they are in the discomfort. We live in a society that minimizes grief. Unlike the buffalo, we try to stay a mile ahead of it, but it’s just always there, chasing behind us,” he said. Consider, instead, being willing to run into the rain.

Shower the People You Love With Love.

Maureen Keeley, a professor of interpersonal communication at Texas State University, has been studying the final conversations between family members for nearly 20 years. In that time, one theme has emerged over and over again: “We need to tell those we love that we love them,” she said.

This advice sounds so simple. And yet, when I tested it out by calling my best college friend to tell her how grateful I was for her friendship, the gears gummed up. (Instead, I asked about her new cat.) To which, Dr. Keeley gave me this advice: “Grow up.” Telling someone how much they mean to you may feel a bit awkward. Go on and reveal the mushy bits of your soul. Most people enjoy hearing how much they matter, and saying it now saves you from having regrets later.

Nurture Your Network.

“We are not meant to be islands of grief,” Mr. Kessler said. Everyone grieves differently, and even within your grief there may be periods when you wish to be alone and periods when you really need a friend. When the latter happens, having a sturdy network to lean on is so important. “We need to know our loved one’s life mattered, our loved one’s death mattered. It brings us meaning to see our pain witnessed in someone else’s eyes,” he said. Now is the time to make time for friends.

Some people need something to look forward to. Others find thinking about the future overwhelming, said Ms. Upchurch. If you’re currently planning what to serve at your post-vaccine dinner party, you’re likely in the first group. Knowing that can help you put things on your schedule that will bring you joy in a dark time. If, however, you’ve been getting through the past year of social distancing by not thinking too far into the future, you may be better served by just allowing yourself to stay in the moment, taking each day as it comes.

Find a Natural Space.

Even if you’re generally not the outdoorsy type, a tiny slice of nature can be helpful in navigating grief, said Sonya Jakubec, a professor in the school of nursing and midwifery at Mount Royal University in Calgary, Canada. Dr. Jakubec studies the impact of natural spaces and parks on patients and caregivers. As she reported in a chapter she wrote on grieving in nature for the book “Health in the Anthropocene: Living Well on a Finite Planet,” she took palliative care patients and caregivers out for a walk near where they worked.

“Many of them had never considered the idea of going for a 20-minute walk break,” she said. After the field trips outdoors, 93 percent said they agreed or strongly agreed that natural spaces provide emotional comfort. Dr. Jakubec has seen similar results with grief groups that meet outside. “Parks and nature feel like a container that is large enough to hold our grief,” she said.

Thanks to vaccines and hospitals having more tools to treat critical patients, it’s possible that the bump we’re all bracing for will never arrive.

Still, it’s worth fortifying yourself now, because grief is an innate part of what it means to live a full and rich life as a human.

“Generally, grief is a lifelong experience that changes over time,” said Ms. Upchurch. Still, humans can be surprisingly resilient. That resilience will help you weather whatever else the pandemic has in store — cracks and all.

Complete Article ↪HERE↩!

Posted on

We all hope for a ‘good death’.

But many aged-care residents are denied proper end-of-life care

By

Death is inevitable, and in a civilised society everyone deserves a good one. It would therefore be logical to expect aged-care homes would provide superior end-of-life care. But sadly, palliative care options are often better for those living outside residential aged care than those in it.

More than a quarter of a million older Australians live in residential aged care, but few choose to be there, few consider it their “home”, and most will die there after living there for an average 2.6 years. These are vulnerable older people who have been placed in residential aged care when they can no longer be cared for at home.

The royal commission has made a forceful and sustained criticism of the quality of aged care. Its final report, released this week, and the interim report last year variously described the sector as “cruel”, “uncaring”, “harmful”, “woefully inadequate” and in need of major reform.

Quality end-of-life care, including access to specialist palliative care, is a significant part of the inadequacy highlighted by the report’s damning findings. This ranked alongside dementia, challenging behaviours and mental health as the most crucial issues facing the sector.

Longstanding problem

In truth, we have already known about the palliative care problem for years. In 2017 the Productivity Commission reported that end-of-life care in residential aged care needs to be better resourced and delivered by skilled staff, to match the quality of care available to other Australians.

This inequality and evident discrimination against aged-care residents is all the more disappointing when we consider these residents are among those Australians most likely to find themselves in need of quality end-of-life care.

The royal commission’s final report acknowledges these inadequacies and addresses them in 12 of its 148 recommendations. Among them are recommendations to:

  • enshrine the right of older people to access equitable palliative and end-of-life care
  • include palliative care as one of a range of integrated supports available to residents
  • introduce multidiscpliniary outreach services including palliative care from local hospitals
  • require specific training for all direct care staff in palliative and end-of-life care skills.

What is good palliative care?

Palliative care is provided to someone with an active, progressive, advanced disease, who has little or no prospect of cure and who is expected to die. Its primary goal is to optimise the quality of life for that person and their family.

End-of-life care is provided by palliative care services in the final few weeks of life, in which a patient with a life-limiting illness is rapidly approaching death. This also extends to bereavement care for family and loved ones.

Unlike in other sectors of Australian society, where palliative care services are growing in line with overall population ageing, palliative care services in residential aged care have been declining.

Funding restrictions in Australian aged-care homes means palliative care is typically only recommended to residents during the final few weeks or even days of their life.

Some 70% of Australians say they would prefer to die at home, surrounded by loved ones, with symptoms managed and comfort the only goal. So if residential aged care is truly a resident’s home, then extensive palliative and end-of-life care should be available, and not limited just to the very end.

Fortunately, the royal commission has heard the clarion call for attention to ensuring older Australians have as good a death as possible, as shown by the fact that a full dozen of the recommendations reflect the need for quality end-of-life care.

Moreover, the very first recommendation — which calls for a new Aged Care Act — will hopefully spur the drafting of legislation that endorses high-quality palliative care rather than maintaining the taboo around explicitly mentioning death.

Let’s talk about death

Of course, without a clear understanding of how close death is, and open conversation, planning for the final months of life cannot even begin. So providing good-quality care also means we need to get better at calculating prognosis and learn better ways to convey this information in a way that leads to being able to make a plan for comfort and support, both for the individual and their loved ones.

Advanced care planning makes a significant difference in the quality of end-of-life care by understanding and supporting individual choices through open conversation. This gives the individual the care they want, and lessens the emotional toll on family. It is simply the case that failing to plan is planning to fail.

We need to break down the discomfort around telling people they’re dying. The unpredictability of disease progression, particularly in conditions that involve frailty or dementia, makes it hard for health professionals to determine when exactly palliative care will be needed and how to talk about it with different cultural groups.

These conversations need to be held through the aged-care sector to overcome policy and regulation issues, funding shortfalls and workforce knowledge and expertise.

We need a broader vision for how we care for vulnerable Australians coming to the end of a long life. It is not just an issue for health professionals and residential care providers, but for the whole of society. Hopefully the royal commission’s recommendations will breathe life into end-of-life care into aged care in Australia.

Complete Article ↪HERE↩!