Workplace impact of care giving

Good quick read at ThinkAdvisor.  It won’t surprise you if you’re a caregiver. But I hope it reaches you before you get to the point at which I found myself a few years ago.

…approximately 68% of working parental and spousal caregivers said they were subject to at least one of eight different effects on their jobs because of providing care to a loved one.

There is a link to the full Government Accountability Office report, which includes this graph of the eight workplace effects,

Caregiving workplace impact GAO

Raising our son with autism piled up stress over the years, and in a job which required intense people work and difficult decisions, I began to falter.  I suffered a number of these effects,

  • Care giving situations made me come in late, leave early or miss work altogether on a regular basis.
  • “Leave of absence” and “left work entirely” merged in a catastrophic case of burnout.  The 24/7 stress of workplace and care giving demands led to poor decision making and lack of energy at work, eventually diagnosed as depression and off the charts anxiety.
  • Although I received some kind help that got us through and got me back into the workforce, the financial fallout is still with us.

My advice from hindsight is to trust your instincts.  Don’t try to “fake” or “tough” your way through when you sense you’re in trouble.

When you know that “this isn’t working,” initiate adjustments.  Talk to your employer about the situation – a change of shift, department, location or even position within the organization might be helpful.  Reduced travel time, better synchronization with family schedules and other time impacts might be available.

Begin to crunch numbers and, if you’re married, get into a substantive discussion with your spouse.  I was so ashamed of what I was feeling that I tried to “handle it” myself – working as a couple might have generated solutions that I missed.  What changes of income are needed?  If more, what can your situation tolerate in terms of more hours or travel?  If income must come down, what can be cut out of current spending to accommodate the change?  What options, if any, does your spouse have on the money front?

Don’t make major decisions in the midst of emotional upheaval and don’t make them alone.

Value and stand up for your insights when you know you’re right.  Caregivers get used to being flexible and not insisting on our way in order to roll with the needs of others.  But sometimes we need to draw lines and make decisions for the family good.  It’s too easy to back down and do what we think will keep things “calm.”  All we do is create a ticking time bomb emotionally, financially, in relationally and, if working, professionally.

Yes, follow the constant advice to “take care of yourself.”  I know, I know… I heard and ignored it too.  Eat right, get sleep, exercise and nurture your mind and spirit.  Seek God’s presence – but watch out for magical thinking.  You know, “If I pray hard enough or make enough sacrifices, God will fix this.”  God will help you to endure and will guide you, but the “fixes” will often involve uncomfortable commitments and actions.  Make the right choices, guided by the moral teaching you claim to follow, rather than making compromises that temporarily ease your stress.

It’s never been the position of this blog to lecture you from a point of expertise.  So I hope that sharing my profound failures is a useful way to reach out and help.  Please take good care of yourself – those in your care need you to be you.

A way to pray WITH differently abled people

People of faith pray for those in our care, but can experience frustration when we seek the intimacy of praying with them.  The communication barriers between us can sink even simple conversation, let alone deeper dives like prayer.

I follow a gent in the UK who tweets as Disability&Jesus ( @DisabilityJ ).  He’s an advocate for inclusion and accessibility in churches.  He also promotes and participates in a website called An Ordinary Office.  “Office” here is used in a church context, meaning the marking of different times of day with prayer.

The site provides three formats to include differently abled people in the same prayers:

  • Makaton, a picture system (in some ways similar to PECS)
  • Text for reading
  • Audio

Here’s a screen shot from the Makaton version of Morning Prayer,

Makaton Prayer

Again, the site offers this same prayer is available in text and audio to include as many as possible in worship.

Of course it is worth remembering the very intuitive aspect of prayer; a person with special needs may well appreciate and benefit from your offering of prayers in which s/he doesn’t seem to be participating.

Like everything else in care giving, prayer will require persistent experimentation.  No one method will work with all people.

But cheers for the folks who offer An Ordinary Office.  They’ve come up with an accessible means to gather people of differing abilities in common prayer.

No. Words.

32t0b5No, I don’t mean people who are non-verbal due to disability.

I’m talking about me with my jaw on the floor, gobsmacked as my Brit friends say, verklempt.

A friend sent me this news coverage of a Gary Indiana school (well, at least a teacher therein) that gave a student with autism a year-end award as BAILEY PREPARATORY ACADEMY 2018-2019 MOST ANNOYING MALE. 

Given the reality of fake news (uhhh, does that make sense?) and a recent distortion of euthanasia news from the Netherlands,  I wondered if this Indiana story was true.  As far as I’ve been able to discover, it really happened.

From the story,

He [dad Rick Castejon] said that his son is nonverbal, occasionally rocks back and forth and can become easily emotional. Teachers often call with concerns about how to handle his son’s behavior, the father said. 

“They called me all the time if he didn’t want to work, would cry or would have a breakdown,” Castejon told the newspaper. “A special needs education teacher should know how to handle these things.”

You would think.  As was I by reading the story, the dad was stunned by the – uh – gesture, and just wanted to walk away from it,

Castejon said he didn’t want to create a scene and tried to leave the award on the table at the end of the lunch, but his son’s teacher reminded him to take it with him. 

There are all kinds of directions in which to run with a story like this, but I’ll just stick to the care giving focus of this blog:

Caregivers are blessed, by and large, with well meaning professionals in education, medicine and other fields.  But at the end of the day, we remain the primary caregivers and best advocates for those in our care.  Even when words fail us, and we just want to scoop them up and carry them from hurts.

And, thankfully, some hurts don’t reach them.  It’s unlikely that Mr. Castejon’s son understood the “award.”

But his dad, his caregiver, felt the hurt.  That’s some of what we do.

And it stinks.  But like anything else, it can be sacred work,

Don’t repay evil for evil. Don’t retaliate with insults when people insult you. Instead, pay them back with a blessing. That is what God has called you to do, and he will grant you his blessing.   (1 Peter 3:9)

Do not be overcome by evil, but overcome evil with good.  (Romans 12:21)

woulda shoulda coulda

I’m coming off a very sweet weekend in which Melissa and I marked 29 years of marriage (the large part of it as caregivers) and many kind people graced my retirement from church leadership.

It is one of those forks in the road where I guess I’m supposed to type memoir-like thoughts.  But I’m not.  The fork is not confusing and I don’t need to linger; I know where I’m heading next, at least in the short term.

I’ll be working at a local hospital in a specific kind of work, sterilizing medical implements.  It won’t be the kind of people-work that rides on one’s back all the way home and then sprawls all over one’s family and personal life.

I’m glad for it.  I applied for some other, more lucrative public service positions, but those didn’t come through – and in short hindsight I think that’s a blessing.  I couldn’t have given the emotional quality of work they needed.

The decades of family care giving simultaneous with the emotional demands of church leadership took a toll.  There were various highs and lows, but I’m not going back over them with a lot of “woulda shoulda coulda” self-absorption.  They were what they were.  I lifted a lot of people up and I let a lot of people down.  Such is human life.

20190528_080723Looking at myself honestly in the here and now, I can say that I have a good number of emotional punctures.  Not enough to incapacitate me or require major repair, but enough to know I need to keep things as simple as I can.  I’m like a garden hose with some nicks – sure, it’s not perfect, but it’s not time to throw it away.  It gets most of the water where it needs to flow.  A spot of duct tape and all’s well.

Care giving takes a toll.  I say that without shame.  It’s diminished me in some ways.

And I know it’s improved and enriched me as well.

If you are a caregiver in the trenches, you’re not crazy and, most of all, not a bad person (more than any other ) when you feel your nicks and leaks.   Care giving is costly.  As is anything ultimately worthwhile,

…through many tribulations we must enter the kingdom of God.  (Acts 14:22)

The weekend’s getting long

Holidays are seldom restful for caregivers.  Supports like schools and community centers are closed, the ones in our care can be upset by disrupted routines, and our instinctive savoring of “time off” crashes into extra hours of greater demand.

The need to pace ourselves and embrace our reality is acute.  Family care giving is not contained between punches of a workplace clock and seldom gives the satisfaction of “done.”

Memorial Day provides a long weekend.

The long Memorial Day weekend honors those who died in combat.  As one hears at funerals, they rest from their labors.

The long weekend indulges the living who have the freedom to travel, party or just be couch potatoes for a bit.

For family caregivers, it’s just long.

If you have a care giving family on your block, they might not be able to come to the park or even the party in the next yard.

But you might knock on the door just the same to drop off a plate of barbecued goodness and with your kindness make the weekend a little less long on their end.

 

“To The Other Mother”

Greet Rufus, chosen in the Lord; also his mother, who has been a mother to me as well.  (Romans 16:13)

Joey 21 McNally

Mother’s Day is here  – let’s show some love for all the moms!  I want to honor Melissa, not only for giving birth to our two sons, but for the long term momming that went into raising a son with special needs to adulthood.  (re: the picture – no, he doesn’t drink.  It was just a milestone to celebrate his 21st birthday in a place that required him to reach 21.  Strictly a burger run).

I know from years of church experience that piling on the Mother’s Day sentiment can have unintended consequences.  Women who are not birth moms, or who can’t be, or who lost a child, or who are estranged from their kids might perceive a “second class female” label being slapped on them when church services set aside the Gospel and function more like a Hallmark holiday.

I don’t think that means we should eliminate Mothers Day but we should be aware of its limits.  Giving birth is not the only value to a woman’s existence and, frankly, there’s more to being a mom than giving birth and having a baby shower. We need to watch out for romanticizing and minimizing what should be serious, sacrificial and lifelong effort.  (Motherhood in this fullest sense is quite Christ-like).

The full expression of motherhood involves care giving.  I’ve watched Melissa’s role continually evolve as our boys age.  She’s always their care giver, even as they grow in adult independence.  She continues to be a source of “home” for them, even across distance.

I quoted Saint Paul at the top of these thoughts.  In an easy-to-skip ending to one of his letters, where he’s writing a lot of “Say ‘Hi’ to so-and-so” pleasantries, he mentions a fellow Christian named Rufus and then asks his readers to greet Rufus’ unnamed mother, who, Paul writes, has been a mother to me as well. 

What form this took we don’t know.  We know that Paul’s ministry kept him on the road; perhaps Rufus’ mom gave the Apostle a sense of home base and family when he visited Rome.  Paul mentions ailments in some of his letters; perhaps Rufus’ mom gave him respite and comfort.  And Paul’s life was full of hardships and hostile confrontations; perhaps the mothering he received from this unnamed woman was in simple hospitality, human warmth and affirming words when they crossed paths.  In a world that beat Paul physically and emotionally, this lady’s glad hug and smiling “Welcome back, stranger!” would have been the medicine of motherly love (I remember the days when our kids seemed to get better from bugs by just sitting on Melissa’s lap for a bit.)

In her book Teaching Diamonds in the Tough, Cleo Lampos includes a chapter entitled To The Other Mother.  She lauds those who step in to give care in ways that make them mothers to the world’s needy children of all ages,

DiamondsIn our family, my Aunt Lois served as our unofficial foster care system.  At one time or another, Aunt Lois took care of most of my cousins for varying lengths of time and for differing reasons.  Her frame house in mid-Iowa became a refuge for my sister and me for over a year as my mother battled with an alcoholic husband in another state.  Aunt Lois provided stability and protection at a time when my sister and I displayed emotional signs from abuse.  She infused us with hope because we had lost ours.  Aunt Lois became “our other mother.” 

To women like… Aunt Lois, a lot of adults owe debts of gratitude that can never be paid.  The “other mother” saved our lives.

So I take this Mother’s Day on the calendar to give thanks for all of the mothers on the job out there; those like Melissa who gave birth and continue to nurture those lives decades later,  and to all the “other mothers” who give care and bring forth new life when others have the blues…

 

 

Two deaths, one love

Jean Vanier died on May 7th.  He was a gentle presence who moved people to significant action and life changes.  I was privileged to hear him speak about twenty years ago in Southern California.

Vanier founded L’Arche and Faith and Light,  now more than 1,500 communities in which “people with and without intellectual disabilities” live more as families than as professional caregivers and patients.  As Vanier said of L’Arche,

Genuine healing happens here, not in miraculous cures, but through mutual respect, care, and love. Paradoxically, vulnerability becomes a source of strength and wholeness, a place of reconciliation and communion with others.

He translated family-style care giving into “institutions,”  encouraging vulnerable amateurs to practice companionship and respect rather than technique.  His approach has been replicated in communities around the world, and to needs beyond intellectual disabilities.

Today…

Bill… I went to the conference center at the community agency that is the home for our son with autism.  They were holding a memorial service for Bill, one of the four other men with whom our son shares a group home.  Bill died late last month.

The seats of the ample conference hall were filled.

The current staff and residents, including our son Joey, were all there.

Other employees of the agency were there.

Other recipients of agency services came.

Former employees who knew Bill, including the Pastor who led the service, were there.

When given an opportunity to share memories of Bill, there was no lack of speakers, prepared and impromptu.

A message that echoed through the memories recalled the values that Jean Vanier carried in his work and that many caregivers who’ve never heard of him carry in theirs:

We’re not staff and clients, we are more like family.

There was a slide show of Bill’s life and a display of his favorite things.  The whole event reflected “person centered care,” valuing Bill not only as part of the community, but as an enrichment of it.

Bill’s warmth – manifested notably in a thunderous Hi! and sweeping wave of his hand to group home visitors  – was a gift to our family as we went through the emotional time of transitioning our son into his new house.  We trusted the staff and liked the house’s set up, but to experience immediate warmth like Bill’s was an extra that softened the big change in our family’s life.

Bill’s loved ones donated his belongings to the home to use as needed, and Joey inherited a recliner chair that he’d coveted and attempted more than once to occupy.  We will still think of it as “Bill’s chair.”

Jean Vanier, known around the world, and Bill, loved locally, merge into one.  Both reflect a community of love – relationships entered into vulnerably – as the model for care giving.

I came away from Bill’s service red eyed but uplifted.  The community is diminished, temporarily, yet lives in love.

Whatever their gifts, or their limitations, people are all bound together in a common humanity. Everyone is of unique and sacred value and everyone has the same dignity and the same rights.  (Jean Vanier)

…we are to grow up in every way into him who is the head, into Christ, from whom the whole body, joined and held together by every joint with which it is equipped, when each part is working properly, makes the body grow so that it builds itself up in love. (Ephesians 4:15-16)

Hi!  (Bill Wilde)

 

Puppy Dog Tales

Yesterday was the long anticipated Sunday night battle on Game of Thrones introduction of our son with autism, Joey, and our new puppy, Henry.

It was, well, autistic?

Henry wiggled up all full of canine cuteness and joy and Joey didn’t make eye contact.

“Joey, this is Henry” we squealed with caregiver cuteness and joy.

“No” came the J-man’s “I’m not interested” reply.

Henry Peter Griffin pose

Reminds me of Peter Griffin after a fall on Family Guy.

Henry sulked.  His 8 puny weeks of life have been non stop adoration by the cosmos.  When we apologized for posting so many puppy pictures on social media, several people replied “There’s no such thing as too many puppy pictures.”

So Henry had his first moment of existential rejection, courtesy of autism.

887210_A140107_004A

 

 

 

It’s not that Joey doesn’t care.  His affect was aloof when it came to Lily, our dear departed Black Lab.    But when we she spent a night with the vet Joey wore a distressed face and kept saying “Lily’s not here.”

Henry just experienced one of the stinky things about care giving.  You put your emotions out and you don’t get the responses you want.  We’ve been relatively blessed, as Joey has been emotionally connected (albeit expressed in some roundabout ways); many families of people with autism would kill to get even some roundabout engagement.

Lily last picture

In her day, Lily wasn’t put off by Joey’s autism.  She would hover protectively after he suffered seizures.  And in my very last picture of her  – wouldn’t you know it – she’s sharing sunshine with Joey by last year’s freshly cut Christmas tree.

 

As for Sophia the cat?  fuggedaboutit

 

Be a voice while waiting for a voice

APRIL IS AUTISM AWARENESS MONTH

A mother with considerable language skill shares about coming to terms with her daughter’s autism:  

As a speaker of English, Italian, French and Russian, the fact that my daughter did not have speech was a constant source of despair…Yes, I still find myself hoping that one day my daughter will speak to me and tell me all about what it’s like be autistic, but for now, I can wait.

The mom makes use of her local newspaper to share insight into autism and the needs of family caregivers.  Being a voice for those in our care and for caregivers can spread not only awareness but opportunities for support and compassion:

Without a support group, I had no guidance on how to deal with issues created by my daughter’s condition in public, so I did the best I could to be honest and take responsibility.

When a stranger would scold my daughter or shout at her for behaving inappropriately in public, I would say, “I’m sorry. My daughter has autism. We meant no offense.”

I didn’t know how people would react, and I was surprised by the response I got. Often the person would say, “I’m sorry. I didn’t know.”

But sometimes they would say, “I have three grandchildren with autism,” or “My niece and nephew have autism,”or “My best friend’s son has severe ADHA and is on the spectrum.”

On at least one occasion, a complete stranger came up to me afterwards,, and told me about a member of their family with a disability.

There are a lot of us out there, and if you follow the news on autism, there are more of us every day.

Often we would take a few minutes to talk about the difficulties involved with rearing a child with a disability and the stress, not just about behavior, but also of not knowing where they will be developmentally in 10 years, or 20 years, or after you’re gone.

I learned that I wasn’t alone.

Recently, a group of us in Yankton formed our own “Mothers of Disabled Children” support group. It’s small, and we’ve only met a couple of times, but I already look forward to hearing about what’s going on with the other moms and their kids — without judgement.

It is a great example of communication with the community, both in the happenstance encounters she describes and in the intentional formation of groups and use of local information sources.

 

Rules of Engagement

APRIL IS AUTISM AWARENESS MONTH.

Yeah, this post’s title is a military term.  Rules of engagement tell you when you’re allowed to shoot back.

Sometimes care giving feels like combat, albeit in non-lethal form.

One particular battle is the effort to engage people with autism in collaborative behavior.  I was going to say meaningful behavior but that assumes that people with autism are absorbed in meaningless behavior on their own, which is not true.  Their behavior has great meaning to them, even if we can’t always crack the code and understand it.  And who knows, maybe they perceive our antics as meaningless.

OK, back to collaborative.

Our 25 year old son with autism, Joey, lives in a warm and supportive group home here in town.  Our custom is to pick him up on Sunday afternoons for dinner and an overnight with us.

We try to engage him in play, household activities or just chit chat.  None of these have ever been among his favorite things.  And as we shared a few weeks ago, his priority right now is to negotiate and nag about an unavailable form of entertainment he used to enjoy on his own.

So there’s some creative combat as we try to get him to say or do anything besides chanting “VCR will be here soon.”

Music usually engages him, but he’s figured out that playing tunes on our computers or phones is our effort to stifle the VCR negotiation.  So he either covers his ears and stomps away, whines “No MUSIC” or, wonder of wonders, forms a sentence to say, “I want quiet, please.”  Which is collaborative communication, except it leaves us all staring at one another non-collaboratively.

So I ran and got some picture books from our years of accumulated kids’ books.  We got a few smiles out of him with our funny character voices,  but he would not sit on the couch with us to look at them, let alone read with us.

So Melissa continued to try an engage him in talk or music while I huffed away to empty the dishwasher (does he think I’m engaged in meaningful behavior when I do that?  Do I?)

Then a little light bulb fizzed on over my head.  I said, “Hey Joe, come in here with dad.”

He glowered at me.

“Come on and help dad,” I chirped.  “This will be FUN!”

He uncurled from the couch and stood looking at me.  I indicated the silverware drawer.

20190331_213344“Help dad put these away.”

I handed him a butter knife.  Lo and behold, he put it in the slot with the other knives.

“Good job with the knives,” I oversold the moment.  Then I gave him a salad fork.

He put it in with the other smaller forks.  That was impressive, as he could have just mixed it up with the larger dinner forks.

I commenced praising him and called out my delight to Melissa.  I was going to move on to spoons, but he made an annoyed face, sounded off with his go-to word, “NOOOO,” and returned to the couch.

We counted the night a success.  Caring for people with autism requires rejoicing in small victories, connections that might seem trivial in what we perceive as normal life.

We’re still refusing to chase after another VCR.  But we are adopting a puppy.  And we’re provisionally excited, because Joey made eye contact and whispered “Yes” when we told him about it and Melissa showed him pictures like this one:

20190330_130429

This little guy is named Henry.  We hope he will help us with some fun engagement with Joey.  That is, once Henry’s done eating Melissa’s glasses.

So, what forms of engagement reach the one(s) in your care?  Always open to new tactics.  What works with one person with autism doesn’t necessarily reach the next one.

Very often, the most loving care is to keep showing up, trying again or trying something new.

And sometimes just showing up and letting them be.

Are you a family caregiver or know someone who is?  Consider getting or gifting our little book for this Autism Awareness Month.