Every Note Played

I am a commuter these footloose and fancy free days.  Yes, that’s sarcasm.  Care giving rides with me all the time.  It knows when I’ve been sleeping, it knows when I’m awake, it knows that I’m trending badly and never good enough… Whee!  Everybody sing!

Still, the time in the car lets me enjoy reading, by which I mean listening to audio books.

Every Note PlayedI just finished Every Note Played by Lisa Genova.

This simultaneously brutal and beautiful novel is primarily a call to compassion for those suffering with ALS, commonly called Lou Gehrig’s Disease.

It’s also an honest and sympathetic portrayal of care giving.

The story follows world renowned concert pianist Richard as the disease takes control of his life.

At the same time, it gives voice to his decidedly estranged ex-wife Karina.  As the disease progresses, it falls to her to become his primary care giver.

The fictional Karina will become an immediate confidant to any real life care giver who reads or hears the story.  Like most of us, care giving falls in on her.  Her life is taken over by ALS, too.

The author brings out the full range of care giving emotion.  There are all of the bitter, ugly feelings and daydreams.  There are also the splendid discoveries and inner healings that would never come without the demand to take care of another in ways above and beyond “normal.”  There’s painful honesty about playing the victim and blaming others or an out-of-our-control illness for life choices we did have and failed to make – or made poorly.

The story also brings in the perspectives and significance of others called upon to care for Richard; there’s Bill, a home therapist who found his calling by caring for a partner with AIDS; Grace, Richard’s and Karina’s collegiate daughter who must slog through the fallout of their divorce to reconnect with her father; and an array of medical and therapeutic specialists whom the author imbues with distinct personalities and gifts that they bring to bear as Richard’s need escalates.

Genova does noble work in articulating, through Richard, the point of view of the person receiving care.  There’s the flood of gratitude for what seem like minor gestures, and the cold indifference or flaming hostility to big ticket technology that can add convenience but deepen feelings of imprisonment and humiliation.  There’s the need for power to make some choices, from the right music to play to life and death decisions about treatment options.

By exploring Richard the caree and Karina the primary care giver with depth and honesty, the story makes their struggle to be at peace credible, dramatic and moving.  If your tear ducts still work, they will find opportunity to represent as this story unfolds.

My minor quibble with the book derives from its core strength.  It is a detailed explanation of ALS in story form, but the quest to get in all the info about the disease sometimes overflows the narrative and comes out like a lecture.  A chapter that mentions a palliative drug cocktail lists the specific medications at least three times by name.  There’s an infrequent but noticeable tendency to wander away from expressing the disease through what Richard is experiencing, thinking and feeling to sentences that seem disembodied and didactic.  The info is worthwhile, to be sure, but sometimes intrudes on the connection with the characters that is the heart of the book.

But taken as a whole it is an excellent novel.  It is a story in which the heroes are the villains and vice versa.  Richard and Karina are each, as Charles Lamb said of Coleridge, An Archangel a little damaged.  Although their story is driven by ALS, their struggle will ring true for family caregivers in any setting.

Who cares for prisoners’ carees?

A friend who visits prisoners shared this piece that crosses into both of our areas of concern.

state penitentiary

A view of the South Dakota State Penitentiary, Sioux Falls

Care giving tends to be accepted rather than sought out.  It lands on many of us more like a meteor than like Santa sliding gently down the chimney with gifts.

Spouses, grandparents, foster families and others care for the dependents of people in prison.  They accept difficulties that none of us would choose:

FINANCIAL IMPACT OF INCARCERATION ON CAREGIVERS

Financial problems are extremely common for caregivers. Consider these key factors:

  • Family income averaged over the years a father is incarcerated is 22 percent lower than family income was prior to the father’s incarceration. (Western and Petit)

  • Seventy percent of children’s caretakers are over the age of 50. About 55 percent of children live with a caregiver who doesn’t have a spouse. And 19 percent live in households with four or more children living there as well. (Hairston)

  • Caregivers may have to make the decision to leave their jobs in order to take better care of the children. Those caregivers who are no longer working often exhaust their retirement savings in order to pay for the children’s needs. (La Vigne)

  • Forty-one percent of children in kinship care live with families with incomes less than 100 percent of the federal poverty level. (Hairston)

Prison Fellowship and others have creative programs aimed at supporting the care givers outside of the walls.

Care givers are easily overlooked as it is.  The shaming and marginalization of those with a loved one in prison can only add to invisibility.

Missing Cushion

Our 28th wedding anniversary comes up toward the end of this month.

We’re coming up on half a year since our 24 year old son with autism, a presence for all but four of our married years, moved to his group home.

20180516_074005Someone described empty nest couples (sorry for the mixed metaphor ahead) as two people finding that “the cushion is gone.”  Two people with a relationship… what? invested in?  distracted by? absorbed with? filtered through? children wake up and find this empty space between them and start trying to scoot together across it.  Or refill it.  Or whatever else people do with empty spaces.

Deferred desires long stuffed under the cushion become visible.  Missed time with friends and extended family, skipped travels, unmade personal touches to home and yard, shrugged off study and career opportunities and piles of other hoped-for endeavors are there, but harder to pick up now that the restrictions of age, time and overworked finances have fallen into that space with them.

Old grievances come into the space.  The demands of the special need were exhausting but they buffered deeper discussions and discoveries that the couple should have shared.  Now these flop in with all of their emotional distortions and disputed memories and toxic colorization of today.

There’s pleasant stuff, too. A gentle pace of life was buried under the cushion and can be restored.  Daydreams can be shared over coffee or cocktails. Decisions can be talked out at length.  There isn’t a frayed and fragile cushion sitting there demanding urgent care.  Life doesn’t have to be lived as a constant emergency response.

The two shall become one flesh says God through Moses, Jesus and the Apostles.  With the cushion gone, the two can dare to shimmy across the couch, risk a hug, chance some words from their hearts, and get on with it again.

Transitional objects (or, should Power Rangers really “Go, go”?)

So our son with autism has a new bed coming today.

It is a change made at his request.  He managed to verbalize the desire for a new bed in his old room for visits to our house.

We’ve been buying new blankets to replace frayed old familiars.  But here’s where autism and the need for predictability comes in.  Not only are some of these old items like old friends, they have the ability to make change (e.g. a new bed) more agreeable.

20180504_094038The issue at hand is an old Power Rangers blanket.  It is fraying and, while not presently bleeding out fibrous filler, it will soon be in that dryer-clogging-expensive-appliance-wrecking place.

We want to throw it away.  We want to make the new bed a new bed, dang it.

But this is where a person-centered approach is important.  We need to make such a decision Joey’s.  We need to ask Do you want the Power Ranger blanket on your bed or is it all done?  

If he wants it, we honor that.  If it starts to come apart, then we three have the conversation explaining how it is broken and has to go.

We don’t do stuff only to and for Joey, we do it with him.

Strong mind, weak back

When advocating for our son’s placement in a group home, one of our arguments was our increasing age and the upcoming physical challenges of ’round the clock care for an adult with autism.

Now that he’s placed, our incredible wisdom is validated.

This week, Tim was diagnosed with something called “frozen shoulder.”  As the Mayo Clinic reveals,

Certain factors may increase your risk of developing frozen shoulder… People 40 and older… (Note: Tim’s about half past 40).

Even with Joey in a good group home, our age impinges on what we can do for him.  We just bought the new bed he needs, and Melissa’s call to the mattress place went something like,

My husband can come pick it up, but he’s got a shoulder thing.  Can someone there help him get the mattress on top of the van?  And can you tie it down for him?

Which is to say,

Paper Trail

Melissa is reclaiming a room of the house to turn into a man cave for Tim.  Well, more of a study really since Tim lost his man card ages ago.

Anyway, this is an empty nest dividend, a chance to use space that was ignored or allowed to be thrashed during the long years of care giving.  To friggin’ enjoy parts of our house in non-care-giving ways.

20180421_180524Today we cleared out two broken down file cabinets.  They will be hauled away but oh what they held.

Well, frankly, most of it was trash.  Sure, important trash that will need to be shredded.  But stuff no longer needed.

Years of mortgage and refi paperwork from trying to strike deals to make ends meet without upending our son’s life.

All kinds of medical insurance stuff as the pursuit of more income, better coverage or simply more time to meet care giving demands worked itself out in an array of job changes and second jobs.

And of course tons of educational and social service type stuff that life with autism generates.  IEP “invitations” and outcomes that seemed like the be-all-and-end-all of life at the time.  Report cards.  Respite care accounting forms.  Our son’s participation in a University of California search for autism causes in the environment (no, they didn’t find one).  All of those pull-off-the-ends-and-lift-the-sticky Social Security Administration forms.

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Not even the tip of this iceberg.

There were a few important things to retain, but by and large the paper trail of our care giving life is heading to the garage in reinforced bags to be handed over to a shredding service.

Then there were some sentimental rescues.  Pictures of Joey, class photos from various schools, notes from teachers and others who helped Joey and our whole family over the years.

Those we boxed for various destinations – some for a shinier new file cabinet to come, of course – but others for a scrapbook for Joey.  He delights in looking at pictures of past friends, teachers, neighbors and classmates.  Will be a joy to bring a collection to grace his new home.

20180421_180647.jpgAnd you can bet that some paper will just live here with us, in wallets and purses, in drawers where we can bump into a memory in the course of daily routines, maybe in albums for us.

I mean, who else will  reminisce and smile and maybe shed a sweet tear over a picture of Joey turning his back on the camera… and on Santa?

I’m a little teapot…

Melissa and I just bought  this whistling teapot:

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Her social media comment says it all.

The autistic kid moves, the tea kettle whistles after 22 years

We’ve chronicled some of the sensory issues that bedeviled Joey and through him the whole family.  We had to banish whistling teapots from our home for 22 years because the sound distressed him to the point of meltdown.

Hey, it wasn’t all bad.  I mean, I had plenty of opportunities to avoid cleaning the house because the sound of a vacuum put him over the edge.

But the little blue teapot is another sign of our lives being liberated from the concessions, adaptations and drudgeries of care giving.

Hang in there, wherever you are on the care giving journey.  I’ve been slogging through the Biblical Prophet Ezekiel.  The first 39 chapters are a gloomy tale of people living in exile, familiar life erased.

Then one day life starts to come back together.

Death and that other stuff

So yesterday I did my taxes.  Well, I compiled all the stuff so a tax pro could do tax pro voodoo with it.

Screenshot 2018-02-09 03.54.10

Screen grab from my personal Facebook page.

Tax time gives me mixed feelings.

Yes, it’s a pain with our over-complicated system, built for those with the means to manipulate and a money vacuum stuck in the pockets of working people.  So I grumble.

But because all kinds of people all over the place pay taxes, there are various programs that make life gentler for our son with autism, and that ease our burdens as caregivers.  So I give thanks.

But more than all of this is the fact that I had to download and print a number of documents.  THIS is where I felt the impact of decades as a caregiver.

See, our son likes to grab pieces of paper, crumble them up and wave them in moments of self-stimulation.  As a result we used to keep all of our bills and documents secure, and we never, ever, ever left paper in the exposed printer feed tray.

So yesterday, after printing the 1095 and the mortgage interest thingy and such, I took all the paper out of the feed tray and hid it in a file cabinet.  Even though our son doesn’t live here anymore.  

Care giving.  A gift that keeps giving.  With all the certainty of death and… and… what was I talking about?

Cue the Music

One of our autistic son’s pleasures is music.

He’s done well in music therapy, even showing some potential on drums.

He’s eclectic in his tastes.  He likes Disney movies for their music; he enjoys soundtracks by Rodgers and Hammerstein; and now and then he gets hooked on a popular song and tracks it down on YouTube to play over and over.

Now that he’s in his own residence, reminders of his likes and quirks sneak up on me as pleasures rather than form a constant din.  That happened quickly.  We’ve been less than a month with him living elsewhere.

This frosty morning, too early, I hopped in the car to go to work and punched on the car radio.  This was playing:

I don’t know why our son took a liking to this song years ago, but it’s one he circles around to every few months.

I started laughing and got a bit misty eyed on the short drive to work.  The song had me thinking fond thoughts and offering little prayers for our son.

We have him over once a week.  It’s not a long distance relationship.  But tender thoughts move in quickly to drive out the anxious energy that care giving required and sustained over decades.

I’m liking this aspect of the change.

One week at HIS house

Our son just accomplished his first week in a staffed group home.

He’s here at home our place (yes, we’re trying to call the new house HIS home) to spend the night.  This afternoon and evening will include a haircut by his fave stylist and a pizza party with her family.

The week was a case of “no news is good news” since not hearing from the staff meant no problems.

20171208_135432When I went to pick him up at HIS HOUSE (I must keep practicing this) he was comfortable in HIS greenish recliner ($50 at a used hotel furniture place).  I simply told him that we were going to mom-and-dad’s house for a haircut and pizza with his stylist and her kids.

He came along just fine – although he was a bit confused by my car sitting in HIS driveway.  He turned toward the garage to look for the house van.  He’s already into all of the routines of HIS NEW HOUSE.

Once at our place, he got in a hug from mom.  He was a bit miffed that the Christmas tree is down, but that didn’t last long.

Now he’s taking a short nap in his old bed (with a cushy new blanket he got for Christmas.  Friends provided a second cushy new blanket for HIS house and it even goes with HIS drapes.

This is going well.

Of course there’s the trite line from the old Westerns, It’s quiet.  TOO quiet.