Dad was a simple, common-sense man born and raised in the country. He was always resourceful at learning and adapting. That's why there was a sadness and longing in him and us as we watched his life skills erode. I believe that he still possessed a lot of knowledge, but he was trapped by the illness and no longer able to act upon that knowledge and awareness. Consider some of his abilities that slowly ebbed away in his last 5 years:
- He spent over 30 years learning about high voltage transmission line construction; the last few years of his working career, he supervised projects all over the state. But he could no longer speak about it, even though he enjoyed his work and had a personal fondness for his former co-workers.
- He was an excellent farmer and gardener. His veggies were the best, but the ability to garden left him.
- He loved to hunt and fish, but lost all interest in outdoor hobbies.
- He could compete with many southern women in the kitchen. His fried fish and hushpuppies, bbq and brunswick stew, roast and taters, fried pork chops or smothered streak and rice & gravy, potato salad (yum yummm!), fried okra, stewed squash, pancakes and sausage, and of course, his signature lacy cornbread, were all the best. His dishes were the feature of many family reunions for about 20 years or so. But that all left too. Dad could no longer do something as basic as take 2 pieces of bread from a bag and tie it back up.
- He studied the art of syrup-making, learned the craft from another older man, perfected the technique to produce a syrup that hundreds of people would eventually taste and enjoy. He grew and harvested his own sugar cane, and made his own syrup on the farm for many years, but he lost the ability to act on that knowledge, and lost interest in the taste of the product he had loved all his life.
- He was an exceptional house manager and money manager, yet his ability to handle finances, pay bills, maintain order and cleanliness around his home was gone too.
- His ability to read and write diminished over time, but he still enjoyed perusing the pages and pictures of newspapers and magazines. That activity filled a lot of hours, and had a calming, contentment-inducing effect on him.
It's difficult to watch a man "unlearn" his life, but these were just skills. Life skills or talents don't make the man. The Lord makes the man. Our value comes from Him. So, while Dad's skills ebbed, he was never robbed of his personhood or worth, and he was always our dad. He never became a lesser person. He could never be a burden or expendable. He was a man with the touch of the divine, and worthy of our best, loving service.
Wednesday, January 31, 2018
Tuesday, January 30, 2018
Parenting My Dad
For the first two years, Dad and I were more like roommates. He was highly functional in many skill areas, mobile, had great stamina for walking, and just needed minor helps and assists from day-to-day. Years 3 and 4 were the period when he lost much of his ability to perform basic tasks, and I assumed a greater role and responsibility for his livelihood. While his decline was slow and obviously happening for a long time, it was only in the last year that I realized I had become his parent. And he was my boy! :)
He was childlike in so many ways. He learned to trust me, to depend on me, to love me in this new role, to respect me, and to take my advice to the extent he could do so. I helped him get up and dressed in the morning. I prepared his morning coffee. I helped him shave. I served the meals (mostly take-out, but my sister brought many meals for us in the evening to enjoy). I gave him his vitamins and meds to take. I bathed him. I washed the clothes. I took him shopping with me. I managed the house. I paid the bills. I cleaned our messes. I talked to him. I prayed with him. I got us ready for Sunday worship at the Chapel. I tucked him in at night. I told him I loved him and kissed him on the cheek. And just like a little kid, he always liked that. He would kiss me back and say "I love you too". I think he was reassured when I tucked him in at night, and that I was up and ready to greet him when he woke up the next morning.
Instead of subtracting from our relationship, his dementia added to it. He never ceased to be my dad, and nothing that we had together was taken from us, but we added a new relationship of trust, dependence, and faith, all of the elements found in a parent/child relationship, except I became the dad and he became the son. It was beautiful.
He was childlike in so many ways. He learned to trust me, to depend on me, to love me in this new role, to respect me, and to take my advice to the extent he could do so. I helped him get up and dressed in the morning. I prepared his morning coffee. I helped him shave. I served the meals (mostly take-out, but my sister brought many meals for us in the evening to enjoy). I gave him his vitamins and meds to take. I bathed him. I washed the clothes. I took him shopping with me. I managed the house. I paid the bills. I cleaned our messes. I talked to him. I prayed with him. I got us ready for Sunday worship at the Chapel. I tucked him in at night. I told him I loved him and kissed him on the cheek. And just like a little kid, he always liked that. He would kiss me back and say "I love you too". I think he was reassured when I tucked him in at night, and that I was up and ready to greet him when he woke up the next morning.
Instead of subtracting from our relationship, his dementia added to it. He never ceased to be my dad, and nothing that we had together was taken from us, but we added a new relationship of trust, dependence, and faith, all of the elements found in a parent/child relationship, except I became the dad and he became the son. It was beautiful.
Monday, January 29, 2018
Shepherding My Dad
I have been in pastoral ministry/roles for over 20 years, and while I did not have a traditional pastoral assignment in an organized church setting over the last 4 years, I continued in the role and calling of a shepherd. The size of our flock was just 2....dad and me! We did life together. We ate together. We shopped together. We went to the doctor together. We worshiped together. We prayed together. We read the Bible together. We practiced many of the "one another"s of the New Testament. You know them....love one another, pray for one another, teach one another, rejoice with one another, weep with one another, encourage one another, and so forth.
While I cared for dad's physical well-being, I also stood watch over his spiritual well-being too as a shepherd. And we experienced the Lord together in so many ways and learned much about Him. And in our flock of two, I assure you that this was never a one-way service. I received alot from Dad too. He loved me, showed it often, and never withheld it from me. He trusted me. He confided in me, when he was able, with words, gestures, facial expressions, and of course, those beautiful blue eyes. He never stopped teaching me. He enjoyed being with me. He was always capable of emotions, joy and sadness. He encouraged me more times than I can ever count.
I loved our "church" and admit that I miss it very much.
While I cared for dad's physical well-being, I also stood watch over his spiritual well-being too as a shepherd. And we experienced the Lord together in so many ways and learned much about Him. And in our flock of two, I assure you that this was never a one-way service. I received alot from Dad too. He loved me, showed it often, and never withheld it from me. He trusted me. He confided in me, when he was able, with words, gestures, facial expressions, and of course, those beautiful blue eyes. He never stopped teaching me. He enjoyed being with me. He was always capable of emotions, joy and sadness. He encouraged me more times than I can ever count.
I loved our "church" and admit that I miss it very much.
Saturday, January 27, 2018
Friday, January 26, 2018
Caregivers: A Population At Risk
I am blessed with overall good health and still some youthful vigor. OK OK don't laugh too hard, y'all! But I came to understand the physical and mental decline that can occur in long-term caregivers. The toll is significant. Why? Some modest research on the issue reveals that caregivers are prone to depression, stress, frustration, exasperation, coping by using destructive diversions/vices, isolation, ignoring our own healthcare (both preventive and corrective), inactive/sedentary lifestyles, increased risk of heart disease, diminished immune responses, lower levels of self-care, rest, and respite, and increased mortality by almost 60%. "Wow!" is right!
I know some of these pressures. I felt them. I experienced the weakening of my body and physical health, the decline of mental sharpness, social isolation, and had to fight against the feelings of loneliness, anger, and resentment. As a Christian, the spiritual struggle to be true to my first love, the Lord, was intense because I experienced the decline in spiritual disciplines (Word, prayer, community) that promote vitality and joy. While ultimately victorious in His grace, I lost some skirmishes along the way.
Awareness and knowledge of these issues will be key in the future. There will be a surge in caregiving requirements as the Baby Boomers reach long-term care conditions. Clearly, there hasn't been enough planning (family, financial, or emotional) for this. Healthcare resources will be stretched to limits. Tough choices will have to be made. There are not enough long-term care facility options to meet the needs, and competition for space and the best care will drive the cost out of reach for most of us. We will face the reality of long-term, in-home care for our elderly parents, or yield to man's worst impulses and just neglect them.
Sadly, that latter condition will be a concern as the sanctity of life continues to erode in our culture. I'll write more about that in the future.
I know some of these pressures. I felt them. I experienced the weakening of my body and physical health, the decline of mental sharpness, social isolation, and had to fight against the feelings of loneliness, anger, and resentment. As a Christian, the spiritual struggle to be true to my first love, the Lord, was intense because I experienced the decline in spiritual disciplines (Word, prayer, community) that promote vitality and joy. While ultimately victorious in His grace, I lost some skirmishes along the way.
Awareness and knowledge of these issues will be key in the future. There will be a surge in caregiving requirements as the Baby Boomers reach long-term care conditions. Clearly, there hasn't been enough planning (family, financial, or emotional) for this. Healthcare resources will be stretched to limits. Tough choices will have to be made. There are not enough long-term care facility options to meet the needs, and competition for space and the best care will drive the cost out of reach for most of us. We will face the reality of long-term, in-home care for our elderly parents, or yield to man's worst impulses and just neglect them.
Sadly, that latter condition will be a concern as the sanctity of life continues to erode in our culture. I'll write more about that in the future.
Thursday, January 25, 2018
A Burden? Or A Privilege?
I empathize with and greatly admire solo caregivers who have little or no help. I know there are many such people, but since I haven't walked in their shoes, I don't know how they do it. Never getting a break. Never being allowed to let their guard down and just rest for a while. Never having the flexibility to treat themselves to something that could refresh their mind or body. I could not have succeeded without having the support of my sister and brother who were also committed partners in dad's care and life at home.
Four years ago, our family made a commitment to help Dad live well at home for as long as possible. While I moved in to live with Dad, all three of us were committed to his care. In my first 2 years with him, we were more like roommates, and we did really well together. When our step-mother passed away in 2014, Dad was sad, but he seemed relieved to know that he would not have to live alone. Dad was highly functional, only needing modest helps and reminders from time to time. Respite breaks were not a big issue then, so staying and caring for dad 6-8 weeks between breaks was not difficult. I took some time away usually when my sister, a teacher, had school breaks. I was blessed the following year when my sister decided to retire, so that added more flexibility to our care for dad, especially considering that his needs and oversight were gradually increasing. I eventually settled into a monthly routine of taking one week off to refresh. While our brother continues in his working career, he was willing to come over and "dadsit" in the evening or on the weekend to give us a break when we needed. This partnership worked well for us.
We were blessed with love and respect for Dad, and love and respect for one another. Was dad-care and dad-sitting hard? Yes. Did we often feel clueless? Yes. Did we often feel stretched and pressured? Yes. Did we eventually wonder whether we could fulfill Dad's wish and stay home until he went Home? Yes. Was Dad a burden? NO!
We were privileged to honor our dad, to care for him, to give him as much opportunity to live happily and freely as his health allowed. Daddy gave far more than he received! The Lord gave us far more than we gave. We increased in love and blessings every day, so the assessment of these last four years is clear. It was a privilege and gift from God to be able to care for our dad and walk him to the finish line. If any family is blessed, then we are surely that family.
Four years ago, our family made a commitment to help Dad live well at home for as long as possible. While I moved in to live with Dad, all three of us were committed to his care. In my first 2 years with him, we were more like roommates, and we did really well together. When our step-mother passed away in 2014, Dad was sad, but he seemed relieved to know that he would not have to live alone. Dad was highly functional, only needing modest helps and reminders from time to time. Respite breaks were not a big issue then, so staying and caring for dad 6-8 weeks between breaks was not difficult. I took some time away usually when my sister, a teacher, had school breaks. I was blessed the following year when my sister decided to retire, so that added more flexibility to our care for dad, especially considering that his needs and oversight were gradually increasing. I eventually settled into a monthly routine of taking one week off to refresh. While our brother continues in his working career, he was willing to come over and "dadsit" in the evening or on the weekend to give us a break when we needed. This partnership worked well for us.
We were blessed with love and respect for Dad, and love and respect for one another. Was dad-care and dad-sitting hard? Yes. Did we often feel clueless? Yes. Did we often feel stretched and pressured? Yes. Did we eventually wonder whether we could fulfill Dad's wish and stay home until he went Home? Yes. Was Dad a burden? NO!
We were privileged to honor our dad, to care for him, to give him as much opportunity to live happily and freely as his health allowed. Daddy gave far more than he received! The Lord gave us far more than we gave. We increased in love and blessings every day, so the assessment of these last four years is clear. It was a privilege and gift from God to be able to care for our dad and walk him to the finish line. If any family is blessed, then we are surely that family.
Wednesday, January 24, 2018
A Caregiver's Contentment
I first experienced peace with God through the gospel of Christ when I was a college student. That peace resulting from God's gift of salvation can never be taken away from me. Through Christ's atoning sacrifice, the Father receives the repentant sinner calling upon Him in faith. God declares the sinner righteous in Christ. God adopts the sinner as His own child. God ends all hostility between Himself and the new believer. Christ's blood produces more than an armistice or a cessation of hostility. The spiritual war between that individual and God is over, forever. Amen!
The peace of God is the experience of joy and satisfaction in the Lord. That peace is real and experiential, although disobedience to the Lord's will can introduce conflict in the experience of it. Having peace with God and the peace of God produces great contentment, as happened in me. From the world's perspective, I'm a tragic, helpless victim, and I should be screaming out for recognition of my victimhood.
How does the world, the flesh, and the devil attack? Here's another example during the caregiving years: "Greg, you have no job, no income, no flexibility, no wife, no kids, no goals beyond the day." The enemy then gives voice to a nameless "Christian" who comes along and questions: "Greg, at your age, how can you justify not doing anything with your life? or not having a job?" Whew.....that's when you have to hold your tongue, shake the dust off your feet, move along, and wait upon the Lord to set the record straight on the Day of His choosing.
"Not that I am speaking of being in need, for I have learned in whatever situation I am to be content." Phil 4:11
Contentment with the Lord's care, His will, His judgments, His timing frees us from chasing the empty things of this world, success, assets, money, fame, reputation, respectability, the admiration and accolades, and especially the approval of those who don't know the Lord.
The peace of God is the experience of joy and satisfaction in the Lord. That peace is real and experiential, although disobedience to the Lord's will can introduce conflict in the experience of it. Having peace with God and the peace of God produces great contentment, as happened in me. From the world's perspective, I'm a tragic, helpless victim, and I should be screaming out for recognition of my victimhood.
How does the world, the flesh, and the devil attack? Here's another example during the caregiving years: "Greg, you have no job, no income, no flexibility, no wife, no kids, no goals beyond the day." The enemy then gives voice to a nameless "Christian" who comes along and questions: "Greg, at your age, how can you justify not doing anything with your life? or not having a job?" Whew.....that's when you have to hold your tongue, shake the dust off your feet, move along, and wait upon the Lord to set the record straight on the Day of His choosing.
"Not that I am speaking of being in need, for I have learned in whatever situation I am to be content." Phil 4:11
Contentment with the Lord's care, His will, His judgments, His timing frees us from chasing the empty things of this world, success, assets, money, fame, reputation, respectability, the admiration and accolades, and especially the approval of those who don't know the Lord.
Tuesday, January 23, 2018
Grief Is Good, Even Divine
I often think about the Lord's compassion upon the crowds, struggling without a shepherd to lead them. Or weeping over Jerusalem having thrown away her King, His servants the prophets, His Word, and preparing to kill her promised Messiah. Or weeping at the tomb of His friend Lazarus, even though He knew the end from the beginning and the marvelous resurrection He would perform.
Grief is divine and good. We are given the opportunity to remember the Lord's kindness and mercy and blessings. Grief leads us to thank Him, to put love into action, and to forgive others, or ourselves, regardless of whether the wrongs are actual or imaginary. Grief activates the body of Christ. "Rejoice with those who rejoice, weep with those who weep." Romans 12:15
We are given the opportunity to comfort those who are distressed with the same comforts that the Comforter (the Holy Spirit) has gifted us. My family experienced every grief, and still do, but we also experienced the consolation of the Lord and the comforting empathy of His people.
Grief is good, even necessary. Don't deprive yourself of it, but don't remain in it indefinitely either.
Grief is divine and good. We are given the opportunity to remember the Lord's kindness and mercy and blessings. Grief leads us to thank Him, to put love into action, and to forgive others, or ourselves, regardless of whether the wrongs are actual or imaginary. Grief activates the body of Christ. "Rejoice with those who rejoice, weep with those who weep." Romans 12:15
We are given the opportunity to comfort those who are distressed with the same comforts that the Comforter (the Holy Spirit) has gifted us. My family experienced every grief, and still do, but we also experienced the consolation of the Lord and the comforting empathy of His people.
Grief is good, even necessary. Don't deprive yourself of it, but don't remain in it indefinitely either.
Monday, January 22, 2018
My Immediate Thoughts Since Dad's Homegoing
He was my dad, but in the last year, I began to realize how much he had become my child and I was his parent. His dependence, life needs, trusting nature, and child-like qualities were present for 2 or 3 years, but my understanding of this dual-role interrelationship did not become clear until last year. So, when the Lord visited our house to welcome Dad home, I knew that my dad and my child left at the same time. The spiritual and emotional senses are doubly stirred as a result.
I am taking time to heal, re-engage with the Lord's Word in a more intentional way, and to write down this journey. I will not be entertaining requests to pastor, preach, or teach beyond my current commitment to "story" the gospels twice monthly with the Chapel ministry. As a caregiver, my Scripture study became much more devotional in nature. It's difficult to have a richer Word/prayer life when you're just catching a few moments here or there. No regrets whatsoever. There is a season for everything, and a new season has arrived for me. But I'm well aware that I'm not spiritually fit to rightly divide the Word, so I will take this time to experience the Lord, listen to Him, and prepare for this next season of life in Christ.
In every important way, I'm alright. In some lesser ways, I'm not, but I will be, and I'm closer to being the man the Lord would have me to be than I was 4 years ago. No regrets, my friends. That is liberating indeed!
I am taking time to heal, re-engage with the Lord's Word in a more intentional way, and to write down this journey. I will not be entertaining requests to pastor, preach, or teach beyond my current commitment to "story" the gospels twice monthly with the Chapel ministry. As a caregiver, my Scripture study became much more devotional in nature. It's difficult to have a richer Word/prayer life when you're just catching a few moments here or there. No regrets whatsoever. There is a season for everything, and a new season has arrived for me. But I'm well aware that I'm not spiritually fit to rightly divide the Word, so I will take this time to experience the Lord, listen to Him, and prepare for this next season of life in Christ.
In every important way, I'm alright. In some lesser ways, I'm not, but I will be, and I'm closer to being the man the Lord would have me to be than I was 4 years ago. No regrets, my friends. That is liberating indeed!
My Message To Family & Friends Graveside
When we gathered in the cemetery on January 11, 2018 to conclude Dad's memorial service, I shared this simple message:
"The cemetery is the most difficult place a family will meet. Our eyes deceive us. Our feelings swing to extremes. Our hearts sink. Even though we know it is not possible to bury someone who is not present, we tremble. The pain is a reminder to our minds and consciences that we were not created for this, neither a casket nor a grave. We were designed by God for life with Him and the enjoyment of Him.
But sin ruined it all, originally in the first man Adam and now in all of us. We groan. The trees groan. The ground groans. Nature groans. BUT GOD offers us redemption, freedom from sin's grip and penalty. He gave His Son to take our judgment, to spill His blood and wash our sins away. He lives today to welcome you, and 'whoever calls upon the name of the Lord, will be saved.'
Look across the cemetery, see the hundreds perhaps thousands of monuments. If the Lord delays His return, we cannot escape this day. Our mortality is 100%. This place is where hope ends for everyone. Now that sounds harsh, but let me explain. For those who do not know the Lord Jesus, He is the last person you want to meet on the other side of the grave. Let's be honest! If you offend Him every moment of every day and then add to the offense by rejecting, dismissing, or ignoring THE WAY of salvation He alone gives, then you should expect that He will really be offended when you meet Him in the next world.
But if you know and trust the Lord, hope ends too, as does faith. Why? Because you don't need hope or faith when you see Him as He is. And how is He? Lofty, exalted, worthy, enjoyable, and pleasurable in every aspect of His glory. Faith and hope reach their end too, but the love of Christ will still endure even after every star in the sky has dissolved to nothing.
The Lord is enough. His grace is sufficient. His love is unending. His joy cannot be overcome by any hardship of this world. I will always be satisfied in the care of this amazing Lord, who cannot fail and does not fear, Amen?"
"The cemetery is the most difficult place a family will meet. Our eyes deceive us. Our feelings swing to extremes. Our hearts sink. Even though we know it is not possible to bury someone who is not present, we tremble. The pain is a reminder to our minds and consciences that we were not created for this, neither a casket nor a grave. We were designed by God for life with Him and the enjoyment of Him.
But sin ruined it all, originally in the first man Adam and now in all of us. We groan. The trees groan. The ground groans. Nature groans. BUT GOD offers us redemption, freedom from sin's grip and penalty. He gave His Son to take our judgment, to spill His blood and wash our sins away. He lives today to welcome you, and 'whoever calls upon the name of the Lord, will be saved.'
Look across the cemetery, see the hundreds perhaps thousands of monuments. If the Lord delays His return, we cannot escape this day. Our mortality is 100%. This place is where hope ends for everyone. Now that sounds harsh, but let me explain. For those who do not know the Lord Jesus, He is the last person you want to meet on the other side of the grave. Let's be honest! If you offend Him every moment of every day and then add to the offense by rejecting, dismissing, or ignoring THE WAY of salvation He alone gives, then you should expect that He will really be offended when you meet Him in the next world.
But if you know and trust the Lord, hope ends too, as does faith. Why? Because you don't need hope or faith when you see Him as He is. And how is He? Lofty, exalted, worthy, enjoyable, and pleasurable in every aspect of His glory. Faith and hope reach their end too, but the love of Christ will still endure even after every star in the sky has dissolved to nothing.
The Lord is enough. His grace is sufficient. His love is unending. His joy cannot be overcome by any hardship of this world. I will always be satisfied in the care of this amazing Lord, who cannot fail and does not fear, Amen?"
The Inevitable Attack Of The Enemy
Our adversary, the devil, must be resisted constantly. How? By our daily, moment-by-moment submission to the Lord. His attacks were frequent during these years. I will probably describe some of those episodes when I write further, but here is one of those attacks during the week after Dad went home.
The enemy came along with the temptation that goes something like this: "You let him die, didn't you? You didn't do enough. You didn't try. You just let him go. Did you really care? or was it all a ruse?"
This is a good time to recall James 4:7: "Submit yourselves therefore to God. Resist the devil, and he will flee from you." In Christian circles, the second and third phrases of that verse are often quoted, but scarcely is the first phrase (a command) mentioned, which is the key to fending away the enemy. It is submission to the Lord's will that enables spiritual defenses against the schemes of the devil. Boasts of super spirituality and pompous "rebuke the devil in Jesus' name" claims actually enable his schemes. Whereas, humble and quiet submission to Christ's lordship takes all the weight off of us, and places that weight upon our heavenly Advocate and great High Priest, who will vindicate His name and all of His kids in His time.
The enemy came along with the temptation that goes something like this: "You let him die, didn't you? You didn't do enough. You didn't try. You just let him go. Did you really care? or was it all a ruse?"
This is a good time to recall James 4:7: "Submit yourselves therefore to God. Resist the devil, and he will flee from you." In Christian circles, the second and third phrases of that verse are often quoted, but scarcely is the first phrase (a command) mentioned, which is the key to fending away the enemy. It is submission to the Lord's will that enables spiritual defenses against the schemes of the devil. Boasts of super spirituality and pompous "rebuke the devil in Jesus' name" claims actually enable his schemes. Whereas, humble and quiet submission to Christ's lordship takes all the weight off of us, and places that weight upon our heavenly Advocate and great High Priest, who will vindicate His name and all of His kids in His time.
Saturday, January 20, 2018
Dad's Last 7 Days
New Year's Day 2018 began like most other days. Dad rose from bed after 8 A.M. I helped him dress. He drank two small half-cups of coffee and ate a Little Debbie's snack. That was his usual routine. But the difference on this day is that he soon fell asleep on the sofa. Dad would occasionally sneak a nap from time to time, but never as much as eventually happened on this day. He ate well at lunch and then sat back down to nap. Mid-afternoon, he and I went for a drive, returned about an hour or so later, and he sat down to nap. My sister brought his favorite fast-food (Wendy's chicken nuggets) for dinner, he ate them heartily as he always did, but when he finished, he sat down to nap. By 7:30 P.M., Dad was very lethargic and difficult to maneuver to bed, but I succeeded. He was up-and-down a couple of times, and having difficulty toileting, and about 4:30 A.M. Tuesday morning, I was able to tuck him in bed to get some more rest until daybreak. I had no idea how different that morning would be from the previous 1000 mornings.
Dad was asleep (mostly unconscious) all day Tuesday and the following night. His nurse checked him and he wasn't sick with any obvious condition. No fever, vomiting, flu, breathing difficulty, pneumonia, heart rate, pulse, or blood pressure irregularities. The nurse bathed him, and we agreed to let dad rest in bed. On Wednesday, January 3, we were more hopeful. The nurse checked dad, bathed him, dressed him, and dad was ready to walk. We helped him into the living room, and he sat in a reclined seat for several hours during the afternoon. That was a snow day, and dad glanced outside the window to notice, but did not enjoy the sight of it as he had done in the past. He sipped water, juice, ginger ale, and soup broth. He was very weak. We put him to bed about 6 or 7 PM, and he slept well again that night. On Thursday, the nurse checked him, bathed him, but dad was much weaker and could not walk. We wheeled him into the living room to sit up a while, but dad slept more during the afternoon. He sipped less water and broth than the previous day, and by the end of the day, I knew when we laid him in bed that he would not get up again. He didn't want to sit up. He didn't want food or drink. He wanted to sleep, and so he did. Friday. Saturday. Sunday. And Monday until 8:40 P.M. when the Lord visited our house.
Dad slept right into the next world. He was never sick, no fever, never had breathing distress, and no indications of pain. His passing is one of the most beautiful scenes I have ever witnessed. As a former pastor, I have witnessed the passing for several family members and friends, but not one as sweet or easy as dad's. Dad had maintained a steady, but rapid breathing rate for about 2 days, but when I went into his room at 8:30 P.M., I noticed a slight change in the pace, nothing too noticeable but distinctly different. I walked into the living room and told my sister and brother, "we need to pay attention to dad; I think he will leave us tonight." I had no idea it would be 10 minutes later! His passing was remarkably fast.
As his breathing faded, the three of us were at his side, talking to him, touching him, kissing him, telling him that we loved him, and letting him know he was OK and we would be OK. As he was passing, he slightly opened his right eye. His eyes had been closed for most of his last 3 days. I am thankful that dad could hear us, feel our touch, and see that we were present with him to say our goodbyes. As he was taking his final breaths, the three of us laid hands on him, prayed, and thanked the Lord for him and our family. He is a gift from God that we will always cherish.
Dad was asleep (mostly unconscious) all day Tuesday and the following night. His nurse checked him and he wasn't sick with any obvious condition. No fever, vomiting, flu, breathing difficulty, pneumonia, heart rate, pulse, or blood pressure irregularities. The nurse bathed him, and we agreed to let dad rest in bed. On Wednesday, January 3, we were more hopeful. The nurse checked dad, bathed him, dressed him, and dad was ready to walk. We helped him into the living room, and he sat in a reclined seat for several hours during the afternoon. That was a snow day, and dad glanced outside the window to notice, but did not enjoy the sight of it as he had done in the past. He sipped water, juice, ginger ale, and soup broth. He was very weak. We put him to bed about 6 or 7 PM, and he slept well again that night. On Thursday, the nurse checked him, bathed him, but dad was much weaker and could not walk. We wheeled him into the living room to sit up a while, but dad slept more during the afternoon. He sipped less water and broth than the previous day, and by the end of the day, I knew when we laid him in bed that he would not get up again. He didn't want to sit up. He didn't want food or drink. He wanted to sleep, and so he did. Friday. Saturday. Sunday. And Monday until 8:40 P.M. when the Lord visited our house.
Dad slept right into the next world. He was never sick, no fever, never had breathing distress, and no indications of pain. His passing is one of the most beautiful scenes I have ever witnessed. As a former pastor, I have witnessed the passing for several family members and friends, but not one as sweet or easy as dad's. Dad had maintained a steady, but rapid breathing rate for about 2 days, but when I went into his room at 8:30 P.M., I noticed a slight change in the pace, nothing too noticeable but distinctly different. I walked into the living room and told my sister and brother, "we need to pay attention to dad; I think he will leave us tonight." I had no idea it would be 10 minutes later! His passing was remarkably fast.
As his breathing faded, the three of us were at his side, talking to him, touching him, kissing him, telling him that we loved him, and letting him know he was OK and we would be OK. As he was passing, he slightly opened his right eye. His eyes had been closed for most of his last 3 days. I am thankful that dad could hear us, feel our touch, and see that we were present with him to say our goodbyes. As he was taking his final breaths, the three of us laid hands on him, prayed, and thanked the Lord for him and our family. He is a gift from God that we will always cherish.
Friday, January 19, 2018
General Overview: Onset, Diagnosis, Progression, Need For Help, & Life Skills Decline
Bobby Riner's "mild cognitive impairment" was first documented by Dr. Steven Hill October 3, 2011, at age 80. In 2012, Dr. Hill further noted "mild memory loss and forgetfulness". And on February 20, 2013, Dr. Hill noted "mild cognitive impairment but likely progressing to senile dementia." The physician prescribed donepezil (generic Arecept) at that time. Dad began seeing neurologist Dr. Martina Vendrame in October 2014. She prescribed Exelon patches, later swapping to generic Exelon capsules, twice daily, and also added a prescription of Namenda in 2015. Fortunately, the side effects were minimal to non-existent, but for dad, the benefits of the medicines seemed minimal too.
Dad's wife Peggy was terminally ill and moved into nursing care and later hospice care in February 2014. At that point, I (son Greg) relocated to Vidalia from Atlanta, moved into dad's home to assist with his care. From that time forward, Dad never spent a day or night alone. When needing respite, I often received assistance and relief from my sister Marcia and brother Jonah, but at all times, our dad had oversight and assistance to live successfully. We encouraged our dad to quit driving in the summer of 2014, and he did not renew his driver's license when it expired. We drove him wherever he needed to go. Dad had no history of chronic health problems, which enabled his longevity to live at home with family assistance. In the early days, his functionality was higher with only reminders or minor help required, but the gradual progression of the dementia resulted in decreased functionality on his part and greater assistance by our family.
Dad was generally able to walk without assistance and feed himself when a meal was prepared and served to him until the last week of his life, but he required much more help with all other tasks, bathing, changing clothes, shaving, taking medications and vitamins appropriately, toileting, staying hydrated, etc. His former skills of house management, cooking/cleaning, money management and bill pay, gardening, farming, and outdoor work completely eroded. At the end of his journey, he had no competent ability in any of these areas. His ability to read declined, but he often enjoyed scanning newspaper headlines and magazine photos. His ability to write, or sign his name, diminished by the fall of 2016. His ability to print his name diminished by the fall of 2017.
For the period from 2014 to the Spring 2017, dad took daily walks on land owned by his family. He showed excellent stamina for much of this time. That routine ended when he became less timely and predictable to return home, and strayed about three times from the walking paths, once unintentionally onto a neighbor's property and another time, walking the streets of an adjacent neighborhood. Dad's hearing was very poor and had been for over a decade, possibly contributing to the dementia onset and progression. His ability to speak declined significantly. For much of 2017, he could only say "yes", "no", "OK", "alright", short phrases, or sometimes just gibberish. He struggled to speak what was on his mind, often communicating with gestures. When he was sick, he was unable to say what is wrong with him.
During 2016, dad lost the ability to call any of his children by their first names, and by the end of 2016, dad could no longer say his own first name or state his birthdate. In 2016, he began to lose the ability to consistently swallow pills and tablets. We continued to try all of them regularly, because it was an opportunity to increase his water intake, which became more important than the meds or vitamins. In April 2017, I noted the appearance of blood in his urine. he was taken to the emergency room where he was diagnosed with a renal stone lodged in his ureter, reviving his dormant history of kidney stone troubles. He underwent a successful crush procedure by his urologist at the local hospital and recovered quickly. The effect of the anesthesia on his memory and function was noticeable and lasted for a few weeks.
Fortunately, most evenings he rested well, often sleeping 10-12 hours, even though the process of going to bed became more difficult in the last 6 months. He began to have mobility issues, unsteadiness, and inability to cooperate with daily personal activities during the weeks leading up to Thanksgiving 2017. He had a severe flare-up of a years-old hernia on Dec 18, 2017, requiring a trip to the hospital ER. He had two more hernia pain attacks over the next 10 days. After consulting with a surgeon and his primary care doctor, we agreed that he was not a candidate for surgery unless an emergency intervention was needed. His doctor recommended we meet with a hospice agency to consider home health care.
We began hospice care the last week of December 2017. He was under hospice care for only 2 weeks at home. The first week, Dad responded really well to his male nurse. He allowed the medical check-ups and was completely cooperative with the nurse bathing and dressing him. I cannot describe the relief I felt that week to have some in-home professional assistance, considering I had been thinking for about 2 months that we were reaching a point where a greater level of professional care and help would be needed to continue at home. During the second week, Dad went to sleep for about a week, and slept on into the next world. I'll describe those days in my next post.
Dad's wife Peggy was terminally ill and moved into nursing care and later hospice care in February 2014. At that point, I (son Greg) relocated to Vidalia from Atlanta, moved into dad's home to assist with his care. From that time forward, Dad never spent a day or night alone. When needing respite, I often received assistance and relief from my sister Marcia and brother Jonah, but at all times, our dad had oversight and assistance to live successfully. We encouraged our dad to quit driving in the summer of 2014, and he did not renew his driver's license when it expired. We drove him wherever he needed to go. Dad had no history of chronic health problems, which enabled his longevity to live at home with family assistance. In the early days, his functionality was higher with only reminders or minor help required, but the gradual progression of the dementia resulted in decreased functionality on his part and greater assistance by our family.
Dad was generally able to walk without assistance and feed himself when a meal was prepared and served to him until the last week of his life, but he required much more help with all other tasks, bathing, changing clothes, shaving, taking medications and vitamins appropriately, toileting, staying hydrated, etc. His former skills of house management, cooking/cleaning, money management and bill pay, gardening, farming, and outdoor work completely eroded. At the end of his journey, he had no competent ability in any of these areas. His ability to read declined, but he often enjoyed scanning newspaper headlines and magazine photos. His ability to write, or sign his name, diminished by the fall of 2016. His ability to print his name diminished by the fall of 2017.
For the period from 2014 to the Spring 2017, dad took daily walks on land owned by his family. He showed excellent stamina for much of this time. That routine ended when he became less timely and predictable to return home, and strayed about three times from the walking paths, once unintentionally onto a neighbor's property and another time, walking the streets of an adjacent neighborhood. Dad's hearing was very poor and had been for over a decade, possibly contributing to the dementia onset and progression. His ability to speak declined significantly. For much of 2017, he could only say "yes", "no", "OK", "alright", short phrases, or sometimes just gibberish. He struggled to speak what was on his mind, often communicating with gestures. When he was sick, he was unable to say what is wrong with him.
During 2016, dad lost the ability to call any of his children by their first names, and by the end of 2016, dad could no longer say his own first name or state his birthdate. In 2016, he began to lose the ability to consistently swallow pills and tablets. We continued to try all of them regularly, because it was an opportunity to increase his water intake, which became more important than the meds or vitamins. In April 2017, I noted the appearance of blood in his urine. he was taken to the emergency room where he was diagnosed with a renal stone lodged in his ureter, reviving his dormant history of kidney stone troubles. He underwent a successful crush procedure by his urologist at the local hospital and recovered quickly. The effect of the anesthesia on his memory and function was noticeable and lasted for a few weeks.
Fortunately, most evenings he rested well, often sleeping 10-12 hours, even though the process of going to bed became more difficult in the last 6 months. He began to have mobility issues, unsteadiness, and inability to cooperate with daily personal activities during the weeks leading up to Thanksgiving 2017. He had a severe flare-up of a years-old hernia on Dec 18, 2017, requiring a trip to the hospital ER. He had two more hernia pain attacks over the next 10 days. After consulting with a surgeon and his primary care doctor, we agreed that he was not a candidate for surgery unless an emergency intervention was needed. His doctor recommended we meet with a hospice agency to consider home health care.
We began hospice care the last week of December 2017. He was under hospice care for only 2 weeks at home. The first week, Dad responded really well to his male nurse. He allowed the medical check-ups and was completely cooperative with the nurse bathing and dressing him. I cannot describe the relief I felt that week to have some in-home professional assistance, considering I had been thinking for about 2 months that we were reaching a point where a greater level of professional care and help would be needed to continue at home. During the second week, Dad went to sleep for about a week, and slept on into the next world. I'll describe those days in my next post.
Wednesday, January 17, 2018
Daddy's Journey Through Dementia On His Way Home
This webpage is dedicated to proclaim the Lord's worth, to praise His goodness, and to thank Him for my dad's (Bobby Riner) life and journey home. Some aspects of dad's life, at various stages, will be recalled to explain the context of the issues, but most of the discussion will focus on the last 4 years of his life (2014-2018), where as his son (Greg), shepherd, caregiver, and eventually "parent", I describe his walk into dementia until his ultimate freedom from it when he went home to the Lord on January 8, 2018. Topics will cover spiritual, emotional, and physical matters, as well as issues involving healthcare, the needs of the care-recipient, and the concerns of the caregivers. I will describe our family's unique walk with our dad, the challenges we faced, the lessons we learned, the joys and hurts we experienced, and the questions that were never answered.
I do not claim that our experience was superior, that our decisions were infallible, that our actions were flawless, nor do I deny that others may choose a differing, appropriate form of care for their loved ones, nor do I believe that anyone should feel guilty to replicate our experience. I write this to encourage other families in their journey. Filter everything presented here. Take what is helpful and use it. Ignore the rest.
If your family is going this way too, then I pray God's Spirit will comfort and cheer you in your time of need, and that you will experience the sufficiency of the enduring love of Christ.
- Greg
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