nonni

Kiss Me Like You Mean It

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Full disclosure: I am not a PDA kind of girl. The above title is actually a direct (and frequently used) quote from a college boyfriend who was contrarily very into public displays of affection. He was super huggy and kissy regardless of where we were or who was around, and the fact that I wasn’t drove him nuts; a quick peck to appease him was clearly insufficient, hence the “kiss me like you mean it.” Don’t get me wrong, behind closed doors is a completely different story – I am beyond affectionate, playful, and even huggy-kissy. There are only two instances in which you’ll witness that side of me in public, however: with dogs (surprise, surprise 😉 ) and with my loves.

I am a huge advocate for touch. Numerous studies have proven that it’s not only essential for our development, it is also necessary for us to grow, learn, and literally survive and thrive. From infancy, touch is used to both communicate and to heal; a loving caress releases oxytocin and instantaneously boosts one’s mood, strengthens the immune system, and reduces stress. It’s not one-sided, either: there is evidence that the person doing the touching gets just as much benefit as he or she being touched. Incorporating even the simplest pats with other forms of communication increases connectedness, improves attitudes, and calms nerves. We are biologically wired to the need to connect with others on a basic physical level, and it’s something we don’t grow out of.

I’m not alone in being anti-PDA; we are a seriously touch-phobic society. The resultant touch deprivation in the elderly is alarming, especially for those who are frail or demented. Such deficiency leads to feelings of isolation, anxiety, poor trust in caregivers, a greater decrease in sensory awareness, and insecurity – the last thing they f’ing need. As if dementia didn’t leave one feeling frightened and alone enough, our lack of intimacy just kicks a nonna while she’s down, as to deny it is to deprive her of one of life’s greatest joys and deepest comforts.

It’s not just our nonnos we’re depriving, either: a study from the 1960s looked at café conversations all over the world. In France, friends touched each other 110 times per hour. Puerto Ricans beat them by 70 – a whopping 180 touches were recorded in the span of 60 minutes. In the US? Twice. In “bursts of enthusiasm,” we touched each other twice. 😐

Touch is the universal language of compassion. When words are no longer understood, there is no better substitute than a gentle hug or holding hands. In old age especially, the need for physical affection is more powerful than ever, for it is one of the only sensuous experience that remains. It is one of the few persisting methods of communicating with a nonna of limited cognitive function, and its effects are both physically and emotionally favorable. In a study that examined the impact of touch on appetite in picky elderly eaters, all participants had a significant increase in caloric intake when given a gentle touch and spoken to during mealtime. Additionally, a study on dementia patients proved that touch is calming; all residents who received hand massages presented significantly less agitated than those who did not.

Sources of proof are endless; there is no question that affection is insanely beneficial to seniors (and to the rest of us!). How we choose to implement it in our daily practice is subjective. In my own experiences, I have found that while being huggy-kissy with boys makes my eyes roll, doing so with my loves is invaluable. I greet nearly every resident with a kiss.. I don’t care if they’ve got half their lunch on their lap or if they’ve had a cold for days, I’m wrapping my arms around them and kissing their cheeks (don’t worry Dad, I wash my hands). If a nonno’s in a wheelchair, I crouch beside him and rest my hand on his knee. I’ll walk arm-in-arm with nonnas and cozy up on the edge of their recliner when we rest. I’ll sit right on that hospital bed, my fingers locked with theirs, regardless of cognizance or how tightly they grasp back. If there are tears (God, I hate when there are tears), I softly wipe them dry. I kiss them like I mean it, and honestly, the impact is immeasurable.

Conversational in Italian, Fluent in Pavarotti

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     Since I recently left the kennel ( </3 ), I’ve decided to update my resume to be sure it’s reflective of where I’m at now. I have a “Skills” section at the bottom where I mention that I’m “Conversational in Italian,” and I’m impatiently waiting for the day that I can confidently change it to “Fluent.” I probably have a solid 10 years before I’m close, so Conversational is staying for now. I am, however, tempted to include “Fluent in Pavarotti” below my subpar Italian skills, and I have my loves and this trip to thank for that.

     According to Paula Spencer Scott:

“The arts have an amazing power to reach people with dementia. When rational language begins to erode, symbolic emotional communication remains. That is what art is, symbolic emotional communication – sharing a vision of the world through gestures, words, sounds, images. Shared communication of any kind can bring people suffering from loneliness and isolation into community.”

     She goes on to specify that “lyrics can stay in the brain even after language skills are lost; music can be a real source of joy.” How nuts, right?! We’ve all of course experienced this to some degree – an old favorite pops up on shuffle and we’re able to excitedly recite every word. Songs often evoke memories, too. I always make playlists for my trips so that when I’m home, I can be reminded of that vacation and how it made me feel.

If it hasn’t been apparent already, I truly value and appreciate what Dr. Taylor writes in his essays (being that he is battling Alzheimer’s himself):

“Singing something, anything, from children’s songs to hymns, from the Hallelujah Chorus from Handel’s Messiah (I can still recall the first note for tenors) to any and all Beatles songs, helps me feel that I am feeling okay and, in fact, good.”

     It’s no secret that music is an incredible therapeutic tool. My only dilemma initially was that I am not, in fact, a ninety-something year old nonna; I didn’t grow up here, I understand next to nothing when I hear different dialects, and the closest thing I’m familiar with to an old Italian song is “Dominick the Donkey.” While my site doesn’t offer formal music therapy, a few patients are avid (and loud) singers. I began to decipher as much of what they were belting out as I could, then searched Google for the rest of the lyrics and to find the title. The clouds parted and God presented Luciano Pavarotti, one of the most successful operatic tenors of all time. Thankfully for me, he’s covered almost every top hit amongst my audience.

Our day to day has changed. While not a music therapist, I am a self-proclaimed Pavarotti cover artist and enthusiast. My laptop speakers blare songs with all their might, and   w e   g o   n u t s; we f’ing scream those lyrics, thanks in part to the advice of Dr. Taylor:

“It is best to sing out loud and loudly. Thinking about singing is like thinking about sex. It is much, much more satisfying if done with all of your body instead of just between your ears. It is much, much more satisfying if others can and do join in.”

     What has this incorporation of music done besides wake our neighbors? It’s allowed us to let loose, have fun, and simply enjoy each other. A loud singer is a lot less aggravating to others if they themselves have joined in too. It has also, and most importantly, facilitated communication and elevated mood. There are nonnas who I actually believed to be unable to speak that have since blossomed into some of the most caring, outgoing, and affectionate patients that I have the pleasure of loving every day. One in particular hadn’t smiled or spoken once in the weeks that I’d known her; I had ignorantly assumed her to be either shy or too far cognitively impaired to converse. She is one of my most passionate (and vocal!) back-up singers today, and she does not stop hugging, kissing, or smiling.

I cannot forget my nonnos, some of whom can often be particularly cranky (am I the only person who adores cranky old men?!). One of my favorites enjoys sharing stories about his hometown (my Roma ❤ ) but becomes more forgetful and likely disinterested when in an unfavorable mood. Though not a singer himself, after our concerts he is without fail more cheerful and able to recall that which he had difficulty remembering only hours before. It is truly remarkable what music can do. Grazie Pavarotti ❤

*note: our fav https://www.youtube.com/watch?v=UNmT7UswM7E

Can I Still be the “Kennel Girl” ?! Please

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HW for life <3

      I know I nonchalantly mention in my “About Me” that I quit my job to come here like it was an easy, almost impulsive decision, but I totally played it down to sound like a baller. It was honestly one of the hardest things I’ve ever done and I cried like a baby. Just this weekend, I woke myself up in the middle of the night because I was dreaming of the kennel and crying so hard that I actually began sobbing IRL. Poor me, leaving my job where I’d get peed on regularly to move to Italy, right?!

      There’s so much more to it than that, though. I worked at Hal Wheeler’s for seven years; I grew there. Within that time, I graduated college, went out (and broke up) with my first real boyfriend, attended grad school, watched my parents separate and divorce, moved three times, struggled with figuring out what I wanted to do with my life…I became more of who I am today, and much of my identity was shaped around and influenced by my years there. Hal’s wasn’t just my job, but part of who I was – I snuck my phone number to worried customers and chatted with them late-night so that they’d feel better about leaving their pups (sorry Mike! My boss hated this!!), I took pictures and videos to assure that they were safe, and I kissed and cuddled with them as if they were my Maxi ❤ so that everyone felt more at ease. I was the “kennel girl,” and I cared so deeply about those dogs and their parents.

      Though it’s more than a quarter of my life, seven years is nothing compared to the time my patients have spent investing in and growing from their roles, professional and otherwise. I can’t imagine how much more of a baby I’d be had I hit the ten-year mark, let alone something like forty. I honestly feel sad when I think about my replacement and how now if I leave Max to go away she’ll be sending me pictures and talking me down from the ledge that is my irrational nervousness. I cannot begin to fathom, then, the emotions that must be sparked in the face of role confusion (and often reversal) after so many years of perfecting one’s identity.

“Everyone needs a philosophy of life. Mental health is based on the tension between what you are and what you think you should become. You should be striving for worthy goals. Emotional problems arise from being purposeless.” – Viktor Frankl

      Frankl’s right, and there is no expiration date on what he said. Imagine being treated as a child by your kids and supervised like an entry-level intern in your own home. Picture having your words spoken for you and a constant presence over your shoulder, for reasons foreign and unfathomable to you. Imagine!! I’m sick at the thought, and I’m only 26; the nonnas and nonnos probably laugh with each other at my so-called independence and unwavering sense of self (lovingly, of course).

      Dr. Taylor, a father and former professor, stresses in his essays:

“Actually, what I need is to feel that I am still taking care of something. Something that returns love, that gives itself away without expecting anything back…”

      David Troxel reiterates:

“People with dementia still need to feel productive – arranging flowers, sorting and organizing, folding clothes, hammering nails. When my mother was in assisted living, I’d keep rolls of wrapping paper, bows, and supplies in her room. I kept buying new things for her to help me wrap – for a friend, I’d tell her. She had so much fun, picking the paper, holding the ribbon while I tied the bow…

I’d bring my mom half a dozen dress shirts and neckties, and ask for her help. She loved matching the shirts with the best neckties. It’s empowering to feel you have a say in things.”

      I see this constantly; nonnas especially love to offer input and provide assistance. After all, they’ve run the show for far longer than I’ve attempted to, and there’s much to be learned from them and their experiences. It is because of this (and so many other reasons) that I approach each patient not with the attitude that they require my help, but that ours is a mutually beneficial relationship. I admire them outwardly and without shame, seeking guidance and offering praise for even the most trivial tasks. I look up at them when we are talking, not down, and kiss their hands when we’re not. I speak properly (Lei, not tu) and show respect. Most importantly, I embrace, encourage, and solicit their guidance and their nurturance, as it has been not only their “job” to provide them but part of who they are for so, so many years.

Learning the Language(s)

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As I’m taking notes from work today, I can’t help but sneak a picture of where I’m writing:

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I am so in love with this town (& with Italy in general)! Though I studied abroad in Rome and have been back since, I still find myself struggling with the language; when you don’t use it for a while, you definitely start to forget! Thank God for iPhone apps and Google translate :-O

Working with my loves, I’m realizing, requires me to learn and practice two languages: that of Northern Italy and of Alzheimer’s disease. The latter is more complex and multifaceted than even the most ridiculous Italian verb conjugations.

In one of many insightful essays, Dr. Taylor writes:

“If I call you “Mom” or “Dad,” I am probably not confusing you with my mom or dad; I know they are dead. I may be thinking about the feelings and behaviors I associate with mom and dad. I miss those feelings; I need them. It’s just that I so closely associate those feelings with my mom and dad that the words I use become interchangeable when I talk about them. I don’t take the time or I can’t or won’t make the distinction between the people and the feelings.”

Similarly, Dr. Robbins goes on to stress that:

“Almost always, though, what’s said in the moment does NOT reflect how the person with dementia has always thought.”

Not only are we listening to (and, in my case, translating) what’s being said, we must also attempt to decipher its true meaning. Much like learning Italian, this requires patience and practice coupled with both empathy and understanding.

My phone can help me hold a conversation, but not to interpret unspoken messages. Aside from the always-entertaining hand gestures, most of what I’ve had to learn in Italian is verbal/written. The language of Alzheimer’s, however, is often primarily unspoken.

According to Bob DeMarco, when spending time with his mom it’s important for him to “speak the local language.”

“Eventually I realized I was drowning my mother with too many words. Sometimes, all I needed to do was smile. Or put my arm around her shoulder and my head on her head. Instead of a long explanation about what we were going to do (like go to the bathroom before lunch), I’d stick out my hand and say, ‘Let’s go.’ And she’d come along willingly, even before asking, ‘Where are we going?’ To which I’d just smile and say, ‘To have fun.’”

In my experience, it’s the nonverbal that has been most powerful. It’s the smiling, hugging, kissing (often on the mouth 😐 why do Italian nonnas and nonnos LOVE to kiss on the mouth?!?!), and just being together that have sparked incredible responses and opened seemingly glued-shut doors. It’s the respect, patience, and empathy.. the looking up instead of talking down.. the face-to-face instead of over-the-shoulder.. these are what I’ve seen to brighten days and open flood gates.