Not only is today the Friday of Labor Day Weekend, it’s the last day of an insanely challenging month. I had hoped on sneaking out of work early and possibly jumping on Parkway South, but my afternoon (and, subsequently, most of my evening) was spent otherwise: for about an hour before I clocked out, I spoke at length to one of my favorite residents regarding our hemorrhoids. Yes, our hemorrhoids. Hear me out…

This particular nonna is going through a difficult transition as she moves [reluctantly] from our assisted living into long term care. She’s the new kid on the block and just as she’s getting to know the staff, they’ve still got to get to know her. She tearfully explained that she’s been in excruciating pain and that her unfamiliar caregivers just don’t get it; there’s no way they understand how much it hurts. She’s probably right – they likely have no clue, and truthfully, neither do I. I do know, however, how powerful and important empathy can be.

The concept of empathy is generally implied to mean that an environment is created in which a person feels understood and accepted, due in part to the demonstration of kindness and warmth. It involves support, sharing, and acceptance, in turn helping others to feel understood and not alone. It fosters universality, or the idea that one’s problems are not unacceptable or entirely unique to them. Empathy squashes labels and depresses stigmas.

Stigmatization of things like dementia (and obvi hemorrhoids) can foster judgment. Even worse, it can impact attitude and, as a result, care. My now great friend and I still laugh about our early days together at my first assisted living job. We had a particularly worrisome nonna who would constantly fret over things like her bowel movements and the corns on her feet. To comfort her, I’d share my own experiences and assure her we were in this together and that we’d both feel better soon. Barely knowing one another at that point, Kaitlyn turned to me and said, “Do you even know what corns are? Do you actually have them?!” I admittedly did not, but pretending I did led to instant relief for our frequent visitor.

Interpersonal relationships are important because our own self-concept is defined by others and what info we get about ourselves from those connections. Simply put, the way we view ourselves is based in part on how we believe other people perceive us. Having a sore on your rectum is not only painful, it’s embarrassing! My nonna wasn’t seeking physical assistance from me tonight, but she did need some emotional validation and support. She was eager to know she was not alone and that her pain was understood.

Put yourself in your loved one’s shoes and treat them accordingly. Disregard the stigmas and lose the labels. Tell a *therapeutic fib* or two if fitting, even if you feel embarrassed. Dementia, like my AL, is a judgment free zone; all conditions (both real and imagined) accepted.

“Where you are a success or failure in life has little to do with your circumstances; it has much more to do with your choices.”

– Nico Qubein

I recently came across the above quote in a book by one of my favorite authors, John C. Maxwell. The chapter is on growth and change, and though the reference is pretty straightforward, it resonated with me on a deeper level. As I continue to learn and grow myself, I’m astounded by how much power is held in the choices we make. I’m even more surprised by the extent to which we carry their consequences with us over time.

At the risk of sounding like a broken record, it’s worth reiterating that my loves teach me an insane amount every single day. Some lessons are intentional and others inferred. Some exciting, others sad. When it comes to our choices, I’m realizing that it’s not only the obvious ones that stay with us; things like a healthy diet and regular exercise are important and can certainly shape our future, but the others – the emotional, social, psychological decisions – are just as significant.

Nico’s remark is incredibly wise. I recently had to sit down with one of my neediest residents. Despite tireless efforts to make her happy, she is constantly cranky and drafts lists of complaints. In my eight months at our community, I’ve seen her smile once (and it was at Rosie). It’s easy to assume when interacting with people like this particular nonna that they’re just miserable; they’re unhappy and there’s nothing that can be done about it. I’m realizing that though this assertion is partially true and that I can’t control her feelings, she has the ability to change them. I explained to her that while her living arrangements are less than ideal (no one wants to move to assisted living – I don’t take it personal), she has the choice when she wakes up every morning to make the best out of her day and her current situation or to wallow in self pity.

It’s not always easy on the other side of the curtain, either. We had a mandatory team meeting a month or so ago in the midst of what is best described as a corporate systems nightmare. Much of the stress and responsibility was falling on us as leaders, but the outcomes were beyond our control. It was killing our morale and draining our spirits. At our SOS lunch, we made an important, game changing pact: we’re in this for the long haul (and for our residents), and since we refuse to throw in the towel, we’ve got to adjust our mindsets. We can’t control the chaos, but how it affects us is in our own hands. What a shift there has been since.

Choices, when made consistently, become habits. Positive, healthy habits breed success. According to her son, the nonna referenced above has been unhappy her entire life, and that’s been her decision. It’s difficult to break bad habits at 90, but I’m thankfully finding it easier than expected at 30. Start right now. If your circumstances are unwavering, make the conscious decision to choose positivity. Oh, and if you insist on making lists, please write down what you’re thankful for.

I’m not the type of girl who’s easily embarrassed. Earlier this month, while exploring Ireland with my best friend, there was a makeup incident that resulted in a stained shirt and impromptu shopping trip. I offered to trade; her white crop top was super cute and, in my opinion, the bronzer was barely noticeable. She was mortified. Weeks later, we’re still laughing about our Logan’s detour and her refusal to be out in public with that shirt, even if I was the one wearing it and not her. As silly as it sounds, it got me thinking.

The lessons my loves teach me are uncountable. Some are intentional and others by example. Dementia is known to lower inhibitions, leaving those with the disease more carefree. Dr. David Hilfiker, who is living with mild cognitive impairment, confirms:

“With this disease, much of my fear of humiliating myself has shriveled. When I do something outrageous, I apologize. Most people understand that I’m doing the best I can and that these kinds of things are just going to happen in Alzheimer’s. I’m still embarrassed, I suppose, but I no longer feel humiliated; this illness has given me the great gift of acceptance.”

Similarly, Cary Henderson writes:

“Somehow I learned to cope with it. First of all, you know you’re going to screw up a good many times, so just don’t let it bother you. There’ll be another time to screw up, and there might be a few times when things go right.”

Unfortunately, this attitude doesn’t always translate to caregivers. A diagnosis alone can be enough to spark embarrassment. In the 2012 World Alzheimer’s Report, researchers noted that one in four families hid their diagnosis from others, much unlike those with loved ones fighting cancer. Symptoms, I’ve found, are even more shameful; it’s incredible how many articles there are with tips on how to avoid embarrassing situations (i.e., “entertain friends at home”) and diffuse them. One caregiver suggested passing out cards that read, “My loved one has Alzheimer’s – Please excuse their behavior.”

Humiliation is exhausting. Yesterday afternoon, I had a long talk with a nonno whose wife has dementia. Despite both living in my community, he insists on helping, and it is evident he’s burning out. I was both saddened and confused to hear him say that he can’t bear to see her pick out mismatched outfits or order food she would have otherwise scoffed at. Why? Perhaps her decisions now are not those she would have made when she was well, but why do they embarrass him? His wife is happy.. She is safe, well cared for, and content. Her choices may not align with his, but they’re her own and she should make them. As Dr. Taylor (also living with the disease) confirms, it’s even good for her:

“I appreciate and sometimes immerse myself in the process rather than only or mostly on the outcome. I like doing things. I like and appreciate the doing. Doing is how I know I am alive, and how I appreciate being alive.”

As caregivers, it’s essential to accept that most elements of this disease beyond our control. Stepping into our loved one’s world means not only going with the flow, but also embracing change and ditching shame. Embarrassment is useless at any age and in any country (including Ireland).

It’s no secret that senior citizens can be preoccupied with money. They worry not only about what they have, but where it’s kept, who can access it, and how it’ll be distributed once they’ve passed. Those fears can heighten tenfold with dementia.

I never really got it; money is of course important, but I couldn’t relate to the fixation (…or so I thought). Recently, while volunteering in the Philippines, I caught a fraudulent charge from Sprint on my credit card. When I saw the $816, I lost it. I was on a paid-off trip with a $30k credit limit, money in the bank, and Chase promising me I wasn’t responsible for the charge, but I was beside myself. Long story short, I trolled Sprint’s Facebook page like a crazy ex girlfriend and they paid me back in full. I eventually got over it, but to say it was an eye opener would be an understatement.

My loves are billed monthly to live in our community and the rates are basically all-inclusive. They don’t need as much as a dollar on them, yet the money struggle is real. They’re constantly panicked about it in some capacity, whether they’re convinced it’s been stolen, determined to change their Will, or simply needing to know what’s left. I learned very quickly that assuring them they don’t need cash is useless, just as Chase’s words to me fell on deaf ears in January. Actually, I learned that any degree of rationalizing is impractical. Here’s what I do instead:

• If a nonna is convinced money has been stolen, I “review the tapes.” We have cameras everywhere and I’m calling a detective. Whoever took it will be terminated and maybe even jailed, but not before that money is returned. It will never happen again. Did she need me to loan her some in the meantime? What is she up to today; did she have shopping plans? I’ve made the mistake of swearing that the cash didn’t exist in the first place, that it had not been taken. Not only was I not helpful – I became the culprit.
• If a nonno is convinced and angry that his kids are spending his hard-earned money, I’m “going to call and give them a piece of my mind.” The audacity! It’s not theirs to spend! How many kids does he have again? Is everybody local?
• If a nonna wants it just in case and feels better knowing that it’s there, I grab it from the safe. I “keep everyone’s money locked up in my office.” I even hold IDs! For those who need more reassurance than my words can offer, I have backup: Amazon sells double-sided play money that has been an absolute lifesaver, as has my iPhone camera for fake ID photos. What a pretty picture, by the way! I look so silly in mine.

I’ve heard countless opinions on this matter. Some say not to reassure them, not to lie. Everyone is different and no advice is one-size-fits all. The recurring theme is that I validate their feelings, and I follow up with redirection. Kudos to my CC company for doing just that as they talked me off the ledge. As for Sprint: thanks for the lesson, but I still hate your guts.

It may be the psych major in me, but I’ve always found it interesting to think about the things that stick with you from childhood. I have a distinct memory of a conversation with my mom about birthdays: she was indifferent about them then, but she’d admittedly had a really hard time with turning 30. Parting with her 20s made her sad – depressed, even. An impressionable kid, I held on to that. I’ve dreaded the big 3-0 to the extent that I booked a trip alone (at least initially) as to not have to acknowledge it. The only party on the agenda was a pity party, and there’s obviously only room for one on that guest list.

Ma perché?! The more I think about it, my apprehension is not only silly but irrational. I’ve dreaded 30 not because of its consequences (which, by the way, are nonexistent – you don’t even need a new license) but because that’s what I inadvertently learned you’re supposed to do. So much so, in fact, that I f’ing ran from it.

Working in the senior care field these past few years has been nothing short of incredible. It’s insanely difficult at times, heart-wrenchingly sad at others, but always, always fulfilling. If there’s one thing my loves have taught me, it’s to embrace every single day. Our body is like a vessel; it simply transports us through life. Yes, it grows old – there’s no denying that (we put it through a lot!) but that’s the only thing that really changes. The “growing up” we talk about? The part when we’re supposed to suddenly feel like responsible, accomplished, brave, composed adults? That’s the myth. Nobel Prize winning novelist Doris Lessing said, “The great secret that old people share is that you really haven’t changed in 70 or 80 years. Your body changes, but you don’t change at all.” The famous “age is just a number” adage is corny but so, so true.

My loves have taught me (both outright and indirectly) that doing anything short of all you’ve ever dreamt is ludicrous. To wait for better timing or less responsibilities is dumb. To take risks when you feel more courageous is an oxymoron; courage, after all, is not an absence of fear but rather doing what you’re afraid to do. Things will work out as they should – they always have:

“You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, ‘I lived through this horror. I can take the next thing that comes along.’ You must do the thing you think you cannot do.”
– Eleanor Roosevelt

The point is, who we are inside is not what changes, not at our core. Only our bodies do (speaking of, when does the good stuff happen..? Like no more pimples, for instance?!?). We’ll never feel like we’ve learned it all or that we have it completely together, or that we’re ready for whatever it is we’re scared of. The emotional constraints of growing old are self-imposed and the limits we set for ourselves the real tragedy, not our actual age (even if it’s the dreaded 3-0).