Posts

Posted on

Choosing hospice care for seniors

By SeniorsMatter Staff

At a certain point, the emphasis shifts from keeping terminally ill seniors alive to keeping them as comfortable as possible. Saying goodbye to our loved ones can seem unbearable. But the silver lining is that your senior doesn’t have to suffer unnecessarily. Instead of continuing painful and tiresome treatments until their last moments, a senior’s care plan can change to focus on quality of life. Hospice services are often the best senior care option when a serious illness becomes terminal. A hospice provider will focus on compassionate, dignified end-of-life care.

If you’d like to learn more about options for hospice care in your area, our Resource Hub can help you easily track down senior care services in your neighborhood. This free online resource contains detailed listings of local hospice services, allowing you to assess and choose the best options for your senior.

In this article, we’ll explore everything you need to know about hospice care. This type of care is a common choice for those facing a terminal illness, and the National Hospice and Palliative Care Organization reports that more than 50% of Medicare recipients were enrolled with a hospice provider at the time of their death.

In 2014, the Huffington Post reported that the hospice industry in the United States had quadrupled in size since the turn of the century—to the point where 65% of all Americans spend the last stage of their life in hospice services. But how do you know if this type of care is right for your senior?

Hospice care: allowing your senior to die with comfort and dignity

What is hospice care?

The goal of hospice care is not to cure your senior or extend their lifespan. Instead, hospice care professionals strive to make the last few months of your senior’s life as peaceful and as comfortable as possible by addressing pain and other problematic symptoms in the best way possible.

The end result is a dignified death that allows seniors to spend more time creating valuable memories with family members instead of preoccupying themselves with futile medical care.

Hospice care is only for seniors with terminal diagnoses. If there’s still a reasonable hope for a full recovery, hospice services are not recommended. Some seniors take it upon themselves to choose a hospice care plan when faced with months of grueling surgeries, chemotherapy and overnight hospital stays. They’re perfectly within their rights to refuse medical treatment as long as they are of sound body and mind.

If your senior has become incapacitated for whatever reason (either physically or mentally), family caregivers may choose a hospice care provider on their behalf.

Hospice care involves a number of services, including:

  • Medical social services
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Caregiver support
  • Grief support
  • Medical equipment
  • Physician services
  • Pain medication
  • Nursing services
  • Counseling
  • Spiritual support
  • Emotional support

When should my senior start hospice care?

If you start hospice care too early, your senior may miss opportunities for potentially lifesaving treatment. On the other hand, starting hospice care too late can reduce the positive impacts this type of care can have on quality of life.

According to a report released by the National Hospice and Palliative Care Organization (NHPCO) in 2019, the average time Medicare patients spent in hospice during 2018 was about 90 days. However, about 28% of beneficiaries spent seven days or less in hospice care—which the NHPCO considers far too short to be beneficial. 

Generally, hospice care is provided when a senior has less than six months to live.

Is hospice care the same thing as palliative care?

Both hospice care and palliative care are types of “end-of-life” care options for seniors. However, they’re not the same. Palliative care is provided while a senior continues to receive medical care for a terminal condition, while hospice care essentially abandons any potential cure or treatment and focuses entirely on comfort.

Why would my senior need hospice care?

In order for a senior to be eligible for hospice care, they must have received a terminal diagnosis. Seniors may benefit from a hospice care plan if they feel like they can no longer face further painful and uncomfortable medical procedures. Many seniors accept the reality of their situation and choose to die on their own terms instead of fighting for a highly unlikely recovery.

What are some signs my senior should seek hospice care?

There are a number of signs that could suggest it’s time to consider hospice care:

  • Treatment is no longer having any effect.
  • Your senior no longer wishes to receive aggressive intervention.
  • The side effects of their medical treatments are becoming difficult to manage.
  • They seem confused or drained by constant medical treatments.
  • They are losing the ability to communicate effectively.
  • They are losing their appetite.
  • They spend much of their time sedated or sleeping.
  • Medical professionals indicate that continued treatments will provide no benefit.
  • Your senior expresses a desire to die on their own terms.

Questions to ask yourself as you consider hospice care

  • Is my senior suffering from a life-limiting disease or illness?
  • Is my senior suffering serious signs of decline?
  • Shouldn’t my senior die on their own terms?

What services does hospice care provide?

Limiting pain and increasing comfort

Seniors who receive hospice care can limit pain with a number of options, and their pain can be controlled without frequent trips to the hospital. Whether your senior is aging in place or living in a nursing home, hospice care can make their days as comfortable as possible. For example, medical appliances and supplies can be brought to their residences (such as hospital beds and wheelchairs).

Certain therapeutic treatments can also provide relief to seniors, including physical and occupational therapy. Note that this therapy is not intended to “cure” your senior; it’s only intended to make their life more comfortable. Hospice care features a strong emphasis on holistic well-being, and it may include home health care, nursing services, medication and even respite care for family caregivers. These services are often available around the clock.

According to the National Hospice and Palliative Care Organization, 65% of seniors who entered hospice care experienced a drastic reduction of pain within just 48 hours.

Emotional support

Seniors can also receive emotional support from trained professionals when they choose hospice care. Confronting our mortality is never easy, and a range of mental health care experts, social workers, counselors and other skilled individuals can help seniors find peace and well-being as they approach the end of their life.

Spiritual support

Seniors who choose hospice care may find themselves seeking spiritual guidance. Religious leaders can visit your senior as part of their hospice experience, helping seniors navigate the process of death and consider the afterlife. Some religions suggest followers go through certain steps before they leave the world.

Limiting medical procedures

Another important aspect of hospice care is limiting medical care. If your senior chooses hospice care, they can stop undergoing difficult treatments, such as chemotherapy or dialysis. However, they may still continue with other types of treatments, such as medication for low blood pressure.

Questions about hospice care

What types of options are available with hospice care?

Hospice care can be divided into the following main categories:

  • Nursing home hospice care
  • In-home hospice care
  • Hospice care facilities

Nursing home hospice care is an excellent choice for seniors who need to remain in long-term care facilities, while home care can be delivered to those who are aging in place. Although your senior may also attend dedicated hospice care facilities, excessive transportation is not recommended for those with terminal illnesses. For this reason, the first two choices are most common.

Is hospice care safe?

Hospice services are an established part of the medical industry in the United States, and it’s completely safe when carried out by qualified, experienced professionals. Hospice care is often misinterpreted as “helping someone to die,” but medical treatment still continues until the moment of death.

Is hospice care available for Alzheimer’s disease and other forms of dementia?

Hospice care can be catered to the needs of seniors with Alzheimer’s or dementia. Along with the aforementioned services, dementia-specific hospice care options include:

  • Mental health care support specifically geared toward dementia
  • Feeding
  • Respite care for overwhelmed family caregivers

What questions should I ask hospice care providers?

  • What will my senior’s hospice care cost?
  • Does my senior meet the criteria for hospice care?
  • How long will my senior survive on hospice care?
  • What kind of workers/medical professionals will be assisting my senior?
  • Are counselors and social workers included in hospice care?
  • How often will nurses and other medical professionals come to help my senior?
  • How will you manage my senior’s pain?
  • What is the role of a hospice doctor?
  • What happens if my senior’s condition improves?
  • What happens if I decide to halt hospice care?

How to talk to family members about hospice care

Broaching the topic of hospice care can be uncomfortable. It’s important to approach this topic in a careful, considerate manner.

Hospice care is a topic you should also discuss with the entire family. Some family members may want your senior to continue fighting until the bitter end and may not want to accept that the battle is already lost. When you discuss this type of care, try to bring the entire family together and give each person a chance to speak.

How to approach the topic of hospice care with your senior

Seniors may not want to confront the possibility of their own mortality, and the conversation may become extremely emotional.

On the other hand, many seniors achieve a sense of calm and focus when they accept their fate, and they may be glad that you brought up the possibility of hospice services. Indeed, they may be thankful that you’re giving them the option to end life on their own terms and cease painful treatments.

Questions to help a senior consider hospice care

  • You’ve been fighting your illness for so long. Wouldn’t you like to be more comfortable now?
  • Wouldn’t you like to go out on your own terms?
  • You’ve been spending so much time in the hospital. Wouldn’t you like to spend more time with your family members before you leave us?

Paying for hospice care

How much does hospice care cost?

The cost of hospice care depends on the services and treatments your senior requires. Some seniors require only pain control and emotional support, while others might require more extensive care options like rehab, medical equipment and more. It’s worth noting that hospice care will probably be cheaper than continuing additional medical treatments that will not cure your senior.

Can I get help paying for hospice care?

The good news is you can get help paying for hospice care from a number of potential sources:

  • Medicare: Medicare can provide funding for hospice care under certain circumstances. Medicare’s hospice benefit applies if your doctor certifies your senior has a life expectancy of six months or less. Once your hospice benefit begins, Medicare will not cover anything intended to cure the terminal illness but will cover all hospice care costs.
  • Medicaid: The Medicaid hospice benefit provides nursing, physician services, counseling and more to those with a terminal diagnosis. Coverage includes home care, short-term inpatient care, respite care, equipment and more. Patients must file their election statement with a chosen hospice provider to be eligible.
  • Veterans Benefits: Veterans Benefits provides VA Palliative Care for enrolled veterans. Coverage includes the cost of a health care team, which not only includes medical professionals but also mental health workers and chaplains.
  • Private insurance: In some cases, private insurance plans will cover hospice care. However, it really depends on your specific plan, and you’ll need to read the fine print to be sure.

How can I find hospice care near me?

If you’ve been searching for hospice care near you, it’s easier than ever to locate qualified, reputable care options. Refer to our Resource Hub for detailed listings of hospice care providers in your neighborhood. It’s as easy as visiting this free online resource, browsing your options, and choosing the best hospice care provider nearby.

Complete Article ↪HERE↩!

Posted on

Simulation in medical school helps prepare doctors to care for dying patients

by University of Sussex

Simulated experience of caring for a dying patient and their family can improve the confidence and preparedness of medical students to provide such care, according to a new study by Brighton and Sussex Medical School (BSMS) published in BMJ Supportive & Palliative Care.

Immediately after the simulations were completed, student confidence almost doubled (98% increase) in relation to communicating with dying patients and their family. Confidence in patient management increased by two-thirds (66.2%), and increased by almost one half (48.4%) for multidisciplinary working. These increases in confidence were sustained when measured again six months later.

Qualitative measurements of preparedness demonstrated that students welcomed greater exposure to hands-on teaching on the care of dying patients, and felt better prepared to provide this care following the simulated experience.

Lead author Dr. Geoff Wells, Honorary Clinical Lecturer at BSMS and ST6 Registrar in Palliative Medicine at University Hospitals Sussex NHS Trust, says that “Foundation Year 1 trainees, straight out of , can feel anxious, poorly prepared and unconfident in providing care for dying patients.”

“Our study showed that after a series of simulation sessions reported a marked increase in , which was maintained six months later.”

Year 4 students at BSMS took part in eight half-day simulation sessions, which used a hi-fidelity mannikin (with pulse, breathing sounds and chest movements) to represent an unconscious, dying patient and an actor to play a family member. A range of scenarios were played out, including some in which the patient died.

Dr. Wells added that they “use simulation to teach many areas of medicine, particularly in managing acute emergencies, and this is known to be an effective teaching tool. As with an , with a dying patient you also have a to provide appropriate and competent clinical care, with a single opportunity to get it right—so there are parallels between the two situations.”

“Ultimately, we believe developing simulation in palliative care teaching could reduce distress among , with the patient dying comfortably, and with any previously unmet needs having been addressed.”

Following the success of this study, these simulations are now being incorporated into the BSMS undergraduate curriculum so that all students will have the opportunity to learn from simulated care of the dying scenarios. This will also provide many opportunities for further study with much larger participant numbers.

Complete Article ↪HERE↩!

Posted on

Finding A Reason to Stay Alive Past Age 75

At 90, a grieving widower read an essay from medical ethicist Dr. Ezekiel Emanuel and realized he’s grateful for all his years, even in the face of sadness

I understood my life would have purpose only if I touched others with acts of kindness and brought love to every encounter with my family and close friend

By Robert W. Goldfarb

Dr. Ezekiel Emanuel, an oncologist, medical ethicist and adviser on health care to President Obama, decided he wanted to die when he became 75 years old. He announced his intention in an essay in The Atlantic Monthly when he was 57. Emanuel saw only decline after 75, when the heights to which he had ascended would pitch downward.

As a father, he would have already celebrated the college graduations and career choices of his children, their marriages and the birth and growing independence of his grandchildren. It would be time, he felt, to abdicate the role of patriarch, stepping aside so his children could climb their own mountains.

When Muriel died suddenly and unexpectedly, grief mounted my back and drove me into despair’s black waters.

As a physician, concern that declining dexterity, reading of medical advances but not leading them, being a patient rather than treating patients and taking medication he previously prescribed, only hardened his resolve. He would die up there on the mountain, not laced to a catheter in a nursing home down in the valley. Emanuel is now 65, and nothing he’s written since that I’ve read indicates he’s changed his mind.

Finding A Way to Live

Shortly after my wife died in the early days of the pandemic, a friend sent me Emanuel’s essay. I had already lived 15 years beyond my own 75th birthday and was thankful I hadn’t read the article in the first agonizing months of my loss. For Emanuel, 76 years would have been one too many to live. Would his words have tempted me to think a day without Muriel was one too many to endure?

When Muriel died suddenly and unexpectedly, grief mounted my back and drove me into despair’s black waters. Had I already read Emanuel’s essay, I might have stroked deeper, hoping to drown. But I hadn’t read it and imagined the arms of my children thrashing the dark water, hoping to grasp my hand and pull me to the surface. My death, so soon after their mother’s, would have devastated the family Muriel and I had built. I would have to find a way to live even if I wanted to die.

Since I was 22, just off a troop ship from Korea, I turned to Muriel in moments of uncertainty. I was now 90 and doubted I had the resources and will to go on without her. Emanuel — a physician and medical adviser to a president — saw no point in living beyond age 75. What reason did I have to leave my empty bed to go to other empty places? If there were reasons to live, I would have to reach deep within myself to find them.

The few reasons I did find seemed to have no purpose, certainly nothing important enough to live for. Yes, I speak every day with my children and each weekend with my grandchildren. But the emptiness within me left me with little to give them. I understood that if I found no reason to go on, the despair I felt could kill me. That would take time when every clock seemed stopped at midnight. But, unexpectedly, time’s slow crawl proved to be a blessing: it gave me hours to think of nothing but what made life worth living.

Gradually, in those midnight hours, flickers of light began piercing the darkness. A friend called and said “I don’t like the sound of your voice. I’m coming over. Meet me outside and let’s talk.” It was the first of the acts of kindness that carried with them a hint that I could heal.

A Buddhist friend urged me to talk with Muriel. “She’s not gone,” he said. “She’s in your being. Talk with her!” I was about to shrug off his advice but was in such pain I would try anything.

Understanding Life’s Purpose in My Nineties

Just thinking of Muriel began to fill the empty places within me. I called out to her, hoping she would hear my voice and that I would hear hers. Her first words sounded so like her. She told me it wasn’t what I lost that mattered. What mattered was what we had for all those years. Her words, as they always had, brought with them the gradual return of my courage.

I am certain I have found reason to press deeper into my nineties.

Now, three years since I lost Muriel, I realize what kept me from drowning in those dark waters. I was startled to find how unimportant many of my relationships and activities had been. If I were shaken awake in the middle of the night and asked what kept me alive, I could think of only two reasons. It was being surrounded by the love of my family and by acts of kindness from friends, sometimes from strangers. It was these that gave me the strength to go on, not dinners with people I barely knew.

I understood my life would have purpose only if I touched others with acts of kindness and brought love to every encounter with my family and close friends.

I need no reminder that I’m one of the “old-old.” The slightest graze leaves an angry welt; a scratch I barely feel bleeds through multiple band-aids.

But I am certain I have found reason to press deeper into my nineties. My children and grandchildren will have to climb their own mountains, but I believe they’ve seen that mountains can be climbed even when bearing the heaviest of burdens.

Perhaps that’s reason enough to be grateful I’ve remained alive in the years Dr. Emanuel has chosen to forego.

Complete Article ↪HERE↩!

Posted on

An end-of-life doula’s advice on how to make the most of your time on earth

Life is short. Here’s how to cherish every day of it.

By Rachel Friedman

“I want a party in the woods with an all-night campfire. I’ll be off to the side in a sleeping bag, nice and cozy. There will be s’mores and cocktails. My friends can come and go, saying goodbye however they want, or just sitting quietly with me and holding my hand. Nobody should touch my feet, though. I hate having my feet touched. A playlist of my favorite songs should be on repeat. I’d like to die as the fire burns out at dawn. Lights out and lights out, you know?”

I’m on Zoom and a chaplain from Iowa is describing her ideal final hours of life. We’re training to become end-of-life doulas, and this morning’s assignment is to help each other talk through a final hours ritual. It’s one of many exercises designed to confront us with our own mortality, so we can leave our own feelings about death at the door before we step across someone else’s threshold to help with theirs.

End-of-life (EOL) doulas are at the opposite end of the life cycle spectrum from birth doulas. They provide non-clinical care (emotional, logistical, and physical) and help with planning; engage with life reviews and legacy work; and provide support for family and friends so caretakers can bring their best, rested selves to support their dying loved one.

I knew training to become a doula would change my relationship to death, but I didn’t anticipate how it would transform my day-to-day life. Like others, my smartphone use skyrocketed during the isolation of the pandemic. Even after those panic-inducing first months in NYC, I still found myself using my phone as a constant distraction — lurking on Instagram, clicking every New York Times alert, obsessively refreshing my email like it was a Vegas slot machine.

I didn’t become an end-of-life doula to fix my fragmented focus. I did it because Covid-19 made death suddenly feel very real and very present. But I found that a deep dive into death work profoundly clarified my priorities, and has helped me spend time in ways more aligned with those priorities thanks to the soul-shaking understanding that our time here is truly limited.

Here are three components of EOL doula training that have been useful in my never-ending quest to live a more present and focused life in this Age of Endless Distractions. Think of it as a looking-back-from-your-imagined-deathbed approach to living — which sounds morbid in theory but is empowering and enriching in reality.

Imagine you have three months to live

I’m not going to lie to you: This exercise isn’t going to feel great! Please do it only if you feel equipped to engage with feelings of grief and loss. I recommend having someone you trust read it to you, someone who also has the emotional bandwidth and who is not currently grieving. You’ll need a pen and paper. Choose a time when you’re not going to feel rushed and are in a comfortable space. Take some deep breaths. Settle in. Here we go.

Write down your five most-prized possessions, your five favorite activities, your top five values, and the five people you love the most.

Close your eyes. Imagine you’re at a doctor’s office. You’ve just been given a terminal diagnosis and told you have approximately three months to live. Sit with that news. Breathe. Open your eyes. Cross any four items off your list.

Close your eyes. You’re back home with your spouse or friends or children or pet. You have to find a way to tell those you love: “I’m dying.” Breathe. Open your eyes. Cross another four items off your list.

Close your eyes. You’ve started feeling the effects of your illness. You can’t get around as easily. Your sleep is restless. You’re nauseated from the medications you’re taking. Breathe. Open your eyes. Cross four more items off your list.

Close your eyes. You’re mostly confined to your bed now. Your loved ones have gathered because they know they will soon have to say goodbye. They drift in and out of your bedroom, or wherever you have chosen to spend your final days, holding your hand, perhaps playing music you like or reading aloud your favorite book. Breathe. Open your eyes. Cross four more items off your list.

Close your eyes. You’re in bed, eyes closed, unable to move much or to speak at all. You sense that you’re going to die soon, and you wonder what will happen when you go. What are you thinking about in these final moments? Breathe. Open your eyes. Cross the remaining four items off your list.

Whew. You did it. Make sure to give yourself as much time as you need to regroup before you reenter the “real world.” Sit still. Focus on your breath. Drink lots of water.

When I did a version of this exercise, I was amazed at how real loss and grief felt as I crossed items off my list. (There is nothing quite like imagining your kid’s life without you to bring on The Sobs.) I don’t want to overstate the impact of imagining loss versus actually experiencing it, nor minimize our individual, multi-faceted responses to real grief, but research has shown that stressful life events can change us, and that includes clarifying our values and priorities. Maybe you, like me, tapped into some of that clarity during this exercise.

A few days after I tried this exercise, I rewrote my Top 20 list on a notecard. I keep that notecard by my laptop and look at it often. It has been an unexpectedly powerful reminder of what and who I love, of who I am and want to be. Each day I think about how to fit in as much as I can from this list, even if I only have a few free minutes to myself. It has become the framework that informs my daily to-dos and balance of urgent/important tasks.

Practice deep, active listening

A good deal of EOL doula work is listening work. The deep, active listening doulas are trained for involves holding back our own stories, comments, and feelings. Doulas don’t tell a dying person what to do. They don’t try to fix the situation. They ask open-ended questions and understand that how people move through the dying process is up to them. This kind of listening requires empathy and restraint. It insists on being free from distractions, external (cellphone notifications, I’m looking at you) and internal (like that voice inside your head that wants to judge or give advice).

As the person at a party who makes approximately 30 seconds of obligatory small talk before diving into deeply personal conversations with strangers, I assumed I was custom-built for this part of being a doula. But it can be difficult to stick to open-ended questions, to sit comfortably in silence, or to resist giving well-meaning but unsolicited advice.

So, I’ve been practicing. A lot. This kind of listening has altered what I can only think to call the texture of my time. It has made me more present, empathetic, and curious in conversations and relationships.

The next time you’re having a conversation with someone who is sharing important information or struggling in some way, you might try it. Ask open-ended questions. “How are you feeling about X?” “Do you want to talk more about Y?” Give their answers space and silence to settle.

Reflect back what you think you’ve heard. Be open to being wrong about what you think you’ve heard. Be supportive, but don’t try to fix the situation with advice or talk them out of what they are feeling. Avoid platitudes like “give it time” or “it wasn’t meant to be.” Even “I know how you feel,” well-intentioned though it is, often misses the mark because we mostly don’t know exactly how someone else feels or entirely understand their specific situation.

Of course, not all our conversations require this therapist-like level of restraint, but challenge yourself to consider that plenty of them could benefit from a touch more deep listening.

Legacy projects in the here and now

Doulas often help with legacy projects: autobiographies, letters to loved ones, art projects, and more. These projects memorialize a person’s passions and creativity, values and contributions, and — spoiler alert! — you don’t have to wait until you or someone you love is dying to work on one.

Complete Article ↪HERE↩!

Posted on

One Good Thing

— A food memoir about love, grief, and lockdown

The Year of Miracles by Ella Risbridger.

In The Year of Miracles, Ella Risbridger cooks through the end of the world.

By Constance Grady

British journalist Ella Risbridger’s new food memoir The Year of Miracles was not, she informs us in her first sentence, “meant to be” a book about grief. It was meant to be a cheerful little book about hosting dinner parties, a happy follow-up to Risbridger’s 2019 hit Midnight Chicken, about how she cooked as a way of dealing with her depression. “But what can you do?” Risbridger goes on. Grief “gets into everything.”

Part of the charm of Midnight Chicken was the way Risbridger conjured her lovely life onto the page: a life of quirky, cozy, bookish love with her partner the Tall Man (real name John Underwood) in their Tiny Flat. It was marred only by the tragedy tucked away on the back page in the acknowledgments: In the time between Risbridger handing in her manuscript and Midnight Chicken coming out, Underwood had died of a rare form of lymphoma at age 29. (Risbridger gives Underwood, along with the rest of her friends, a pseudonym in The Year of Miracles. Here, he becomes Jim.)

The Year of Miracles is Risbridger’s account of how she cooked her way through the ensuing grief. And because it is, ominously, set in 2020, she is grieving not just the loss of her partner, but also the loss of a whole way of pre-pandemic life.

“This is supposed to be the year when the world, my world, starts again;” Risbridger writes as she first hears news of the pandemic. “This is not the year the world is supposed to end, because my world has already ended.”

The world does not quite end, and Risbridger keeps cooking through it. She cooks Leftovers Pie for her new housemate, because she loves her; Crisis Cardamom Coffee Banana Bread, because everyone made banana bread at the start of lockdown; Turkish Eggs, because Jim would have hated them and he’s no longer there to object.

It’s this last question, of what to do now that Jim is no longer here to make his objections known, that leads Risbridger to some of her most affecting passages. She spent years of her life as Jim’s caretaker, guiding him through chemotherapy and all its accompanying horrors, rendered “subservient, essentially, in a way no other adult relationship demands.” Now that Jim is no longer there, she has space to think through her own preferences, and to deal with the guilt and the horror surrounding that space.

With her housemate, she invents “the Self-Esteem Finger: you hold up one finger, to indicate a desire that has no reference or recourse to anyone else, and you say ‘self-esteem!’” She stops making roast dinners, which Jim loved and she hated, and she indulges in meals with very little meat, such as the Turkish eggs in garlic yogurt.

A watercolor illustration shows a black-and-white cat walking below an outdoor metal staircase covered in flowerpots. In the background, a blooming cherry tree and a weeping willow stand against a blue sky while a yellow bird flies overhead. In the bottom right corner is printed the word “April.”
A chapter header from The Year of Miracles.

You can successfully cook from these recipes, more or less. The rice bowl with Vietnamese flavors Risbridger has dubbed Coconut Pow comes out bright and sharp and sweet, although its many parts make it fiddly to put together unless, like Risbridger, you are already in the habit of keeping quick-pickled radishes and salted mango in your fridge. When I followed her recipe for cardamom buns, I found that she’d left out a few details about how to construct them, so that I couldn’t seal them properly and the spiced butter filling leaked out of the buns as they baked. They were still absurdly delicious.

But the recipes here are more indicative of Risbridger’s personality than anything else. They are organized chronologically, with 12 chapters, one for each month of the year, and they are optimized specifically for the way she runs her personal kitchen. As such, she is always specifying the exact color and flakiness of the kind of sea salt you should use, but when a recipe calls for just plain table salt she tells you to pinch your flaky sea salt into dust, because she can never remember to keep plain table salt in stock.

>What you’re really reading for here is Risbridger’s sprightly, evocative prose, which is never more compelling than when she’s describing the sheer joy of her food. Roasted eggplants are “blistered and blackened and chewy and delectable;” fresh dukkah is “a beautiful sunset orange” that makes every salad “a riot;” soy-marinated eggs are “sticky” with “golden, liquid yolks.” Periodically, she peppers her instructions with bossy repetitions (“I do know your life, and you don’t need more flour”) and shameless confessions (“I have a weakness for adding leftover sour cream and chive dip, but I understand this is horrible”).

Bouncing up against Risbridger’s prose are Elisa Cunningham’s whimsical watercolor illustrations, which range in elaborateness from two-page-spread tableaux of the neighbor’s cat in Risbridger’s fire escape garden to half a lemon rolling around the bottom margin of a recipe for parsnip purée. They are sweetly messy sketches, matching the sweetly messy energy of this home cook’s recipe book.

And that, in the end, is what you read The Year of Miracles for: the sweetness and the mess. Cardamom buns that fall apart in the oven but are still buttery and rich with sugar and spices. An account of a life laced with grief that wasn’t supposed to be there, and a world that ends over and over and over again and manages to keep its beauty and its charm regardless.

It’s what makes this cookbook-cum-memoir feel exuberant, unstoppable, and triumphantly on the side of love and life in the face of death and loss and grief.

Complete Article ↪HERE↩!

Posted on

A grievers mini library filled with solace

By

On Aug. 11, I will stand beside a book box stocked with 50-plus books for bereaved children, teens and adults and cut the ribbon to launch the first ever “Grievers Library.” This mini library, sited on a parking strip in front of a Seattle senior center, is the culmination of a concept that has taken 20 months to fulfill.

With the support of 90-plus volunteers and donors, we are giving away free books, love and compassion. Four more book boxes are planned to open in Seattle later this year.

It is both a small thing — just a wooden box of free books — and a big thing — a biblio-lifeline to grieving folks who want to understand why they can barely breathe, eat or sleep; who seek answers to troubling questions like, “Why has the most important person in my life died?” or, “Where has my person gone?” or, “Will I live through this?”

I know. When my 23-year-old son died by suicide in 2020, I was left with 100 questions and no answers. I was shattered, and I wanted an antidote to my anguish and despair. In those early months, I found books about grief written by grievers and grief experts alike provided a modicum of comfort. They said: I was not crazy; I was not alone; and that, over time, I would somehow survive.

Nonetheless, finding good grief books was just plain confusing. Our local library system listed 1,604 books under the subject of “grief.” The first was a thriller, the second a murder mystery … (Well, I guess it’s not surprising — Dewey gave “grief” short shrift — it’s #158 in his decimal system.)

Cognitively disabled with “grief brain,” I gave up and bought used books online and waited two weeks for them to arrive in my mailbox.

Over time, I discovered that public libraries don’t carry the majority of grief books because they are either self-published, too old or have low circulation. Conversely, they don’t buy near enough copies of the latest grief “bestsellers” to meet demand. So why not create mini libraries stocked with free grief books and place them around the city so everyone has 24/7 access?

A University of Washington library student joined our team and led collection development. Unlike Dewey, we parsed “grief” into 50 different categories and created color-coded tags for easy selection by overwhelmed grievers staring at 50 book titles.

Surprisingly, our biggest challenge was not buying, sorting and cataloging hundreds of grief books, nor building and painting five handsome book boxes. It was finding a facility that would let us install a grievers library on the parking strip in front of its building. After we received rejections from churches, libraries, businesses and local nonprofits, we proposed siting our book boxes in front of five Seattle community centers. To our dismay, the progressive, compassionate civic leaders at Seattle Parks, Department of Transportation and City Hall responded in concert, “We don’t think it’s appropriate for them to be installed in parks or in front of community centers.”

This is our cultural allergy to grief at work. A grievers library is not a gruesome gravestone that belongs in a cemetery; it is a medicine cabinet filled with love potions that belongs on our streets — for easy dispensing to those afflicted with heartache and despair.

Thankfully, the Greenwood Senior Center embraced our request to host a book box on the front of its property. Its people know grief and that biblio-therapy is a meaningful, positive resource to offer to our whole community. For this we are grateful. For more information: grieverslibrary.org

Complete Article ↪HERE↩!

Posted on

‘My husband’s death left me with so much regret, I don’t want you do make the same mistake’

A simple conversation could have changed so much…

Melissa Reader shares her experience of poor death planning to help others have a better experience.

By Melissa Reader

After losing her husband Mauro tragically young, Melissa Reader is personally motivated to help more Australians talk about the end stages of life. Because accepting that death is a part of life is the first step to ensuring the final stages of living are done with dignity, and surrounded by love.

It wasn’t long ago that these topics were shrouded in stigma. And while we have some way to go in making these areas of life safe topics of discussion for everyone, there’s no doubt that over the last 10 years we’ve come a long way.

So it’s still surprising that we have allowed death to remain a taboo subject. Death is as universal as life – we all die. And just like mental health, sex and identity, talking about it openly normalises the experience and helps to make it the best it can be, for everyone involved.

Avoiding the topic

It’s a known fact that ‘what we resist, persists’, so our fears around death and dying heighten and become more difficult to address as time goes on.

The lack of communication at the end of life leads to a lack of preparation; right now in Australia, only 14% of us have a plan in place for how we want to die. The last stage of life and the end of life is never going to be easy – but it can be better, and learning to talk, plan and care for each other when the time comes is key. Or we end up with a big gap between what we hope for, and what happens, which is what happened in our family.

If we had managed to have the important conversations, like how to make the most of the time ahead, we might have made different decisions.

How my family changed forever

We were a very normal, happy, busy family, with three children. Our youngest child, Orlando, was just nine months old when my husband Mauro’s diagnosis came completely out of the blue.

He was 40-years-old. Through the 15 months of his illness, we did our best to navigate life, family needs and the confronting and ever-changing demands of his cancer disease. But we avoided having honest and open end-of-life conversations as a couple, as a family, and with his medical team. We didn’t understand, or maybe we couldn’t accept, that he was terminally ill – that he was dying.

The regret never fades

I still feel so sad about the way Mauro spent the last stage of his life – in and out of the hospital, away from his family, and his home. We didn’t think about how to really make the most of those precious months together. We never accessed palliative care, which would have been so helpful, and we weren’t in any way prepared for his death.

It all flew by in a painful blur and suddenly, I was standing beside him in the ICU, reeling, and finally realising that he was about to die. Realising that we’d missed so many moments for love, connection, memory, and legacy. Realising that Mauro was going to die in a cold, clinical and unfamiliar setting – something he wouldn’t have wanted.

We were left without a husband, and a father, and I was holding many deep regrets about the way the last stage of his life played out.

How to talk about death, better

Honesty and kindness are not mutually exclusive. By having more open and candid conversations, and planning together where everyone is involved is the key to making the experience the best it can be.

Unfortunately, life doesn’t offer us a chance to re-do this scenario. My advice is this: be gentle, be brave, and try to open more conversations with family and friends about what’s most important in the last stage of our lives.

Remember, it’s your compassion, not your vocabulary that matters – there are no perfect words. Rather than getting caught up in trying to find the right things to say, my advice is to instead focus on timing and tone. If you get these things right, the words tend to find their own way. Take your time, use gentle and well-spaced questions and be prepared to revisit conversations over a few sittings.

And if you need support with where to start or how to unravel what comes of these chats, you can always reach out to the Violet Initiative. We’re a national not-for-profit that’s helped thousands of Australian families navigate this life stage.

A personal pledge

I made it my life’s calling to create a safe space where family, friends and colleagues of someone who is in the last stage of life can go for support, so they know that they aren’t alone and that help is available.

So next time you’re catching up with friends and you find yourself discussing your mental health, take a moment to think of some of the end-of-life conversations that might lie ahead, and make a pact to approach these with the same openness and honesty.

Complete Article ↪HERE↩!