Category Archives: Physical Health

Including Everyone: Faith Community Care for People with Challenges

Q: Do I show through my way of living that love of God includes affirming the equality of all people, treating others with dignity and respect, and seeking to recognize and address that of God in every person?
PYM Faith and Practice, 2002

Any of us, at any time, may experience a challenge that means we need adaptations to access places, activities, and community that are important to our lives. We are all in some way differently-abled. For some, needs differ only slightly or temporarily from the mainstream, others face lifelong challenges. Creating an inclusive environment supports Friends’ Testimony of Equality and enriches the spiritual community by allowing us to experience the rich and beautiful diversity of humankind. How can a faith community create an environment where everyone fits, all are welcomed warmly, and each person’s needs are considered?

When considering accessibility and community, try to avoid assumptions and always ask a person what they need. Many spiritual groups are eager to address building accessibility, and this is important. (It is difficult to attend an event where one cannot access the bathroom) However, inclusiveness requires sound communication and a welcoming attitude in addition to physical accessibility. Following are some ideas gathered from various Quaker Meeting’s reponses to a Philadelphia Yearly Meeting Care and Aging Survey conducted in 2009 and also from Grounded in God, Care and Nurture in Friends Meetings, edited by Pat McBee. In addition, you may want to contact your regional faith community office, such as your Yearly Meeting, or a local advocacy group for resources and support.

  • Nothing About Me Without Me: always ask people what they need, and how the community can be welcoming and accommodating.
  • Make sure you address a variety of barriers: architecture and communication is accessible, and that your attitude is welcoming.
  • Maintain awareness of local resources, call on them or your regional faith organization (Yearly Meeting for Friends, Area Agency on Aging, advocacy groups) for help.
  • Regularly make any resources known, i.e. financial assistance that is available (funds available through your faith group.)
  • Announce needs for rides, visits, or other support after worship, during events, through phone committee or e-mail lists.
  • Education for the community, on sensitivity and related to specific challenges
  • Maintain contact information for family members or close friends for people choose to share this information. This helps in the event of a crisis or if the group is unable to contact someone.
  • Support caregivers—Clearness Committees and spiritual care as well as practical support such as cooking, cleaning, visits, transportation
  • Provide opportunities for service to the community—a homebound person may be able to serve on the phone committee, for example, or ask homebound members to mentor new or younger attenders
  • Establish a “buddy system” for people who live alone
  • Communicate with people who are unable to attend worship or committee meetings through newsletters, phone calls, website. Web blogs, e-mail, home visits, send photographs or letters.
  • Assess why your members can’t attend. Are people truly homebound, or is it your environment shutting them out?
  • Do you need to work on the environment, communication, or attitudes so everyone is welcomed and included?

“The test of true ‘community’ is not its sighs of pity for its vulnerable citizens, but its acts of acceptance and inclusion.”
Christina Hurr, Superintendent for the Butler County Board of Mental Retardation and Developmental Disabilities, Ohio

“When we learn to be inclusive, we can be a world of shalem, or wholeness, and create a world of shalom, which is peace.”
Rabbi Ted Riter, Temple Adat Elohim, California

“A community that excludes even one of its members is no community at all.”
Dan Wilkins

“You should include everybody, that’s how you stop bullying.”
Buffo, World’s Strongest Clown

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LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Role of the Spiritual Community in Care
Spiritual Approach to Dementia Care

Sources/Further Reading:

Edited by Pat McBee, Grounded in God, Care and Nurture in Friends Meetings, Philadelphia, Quaker Press of FGC, 2002.

That All May Worship – An Interfaith Welcome to People with Disabilities, 2005, National Organization on Disability, Washington, D.C.

Erik Carter, Including People with Disabilities in Faith Communities, 2007, Paul Brookes Publishing, Baltimore, Maryland

Various Meeting’s reponses to Philadelphia Yearly Meeting Care and Aging Survey, 2009.

Quotes from Everyone Is Included

Aging with Peace

“I am learning to offer to God my days and my nights, my joy, my work, my pain and my grief…I am learning to use the time I have more wisely…And I am learning to forget at times my puritan conscience which prods me to work without ceasing, and instead, to take time for joy.”
Elizabeth Watson, 1979 PYM Faith and Practice

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Spirituality and Change

“What will this newfound present of old age and its unknown future demand of us? Where is dignity to be found in it? How shall we find ourselves the dignity we see is needed?”
Mary Morrison, Without Nightfall Upon the Spirit, Pendle Hill Pamphlet*

Moving through Loss: Illness, loss of mobility, hearing or sight, or other changes in one’s usual abilities can present spiritual and emotional challenges along with your physical concerns. One needs to validate the loss and allow grieving to occur, in order to move to a place of acceptance. We can find strength in our values and comfort in our spiritual community in facing our losses.

“The secret of finding joy after sorrow, or through sorrow, lies,…in the way we meet sorrow itself…accept sorrow as a friend, if possible. If not, as a companion…Together we can create beauty from the ashes and find ourselves in the process.”
Elizabeth Gray Vining, 1952, PYM Faith and Practice

Letting go of what was: Though we most often associate bereavement with death of a loved one, it is important to acknowledge that grieving occurs with other losses or changes that occur in our lives—a changed relationship, lost job, physical challenges, or illness. Understanding the bereavement process and moving through grief allows you to move to a place of acceptance, which will help you to make the most of your life under changed circumstances. For more information on the grief process, see the “suggested resources” below.

Understanding What Is: When you are ready, knowing more about your illness or challenges may help you learn to live with your changed circumstances. Find out what you want to know about your physical condition, or enlist a friend to help you.

Consider Possibilities: You may find yourself with a long list of “can’t.” It helps to think in terms of adaptation, rather than giving up. Are there ways you can adapt your home to accommodate your needs? Are there support groups in your area or online where you can learn more, and find others who share similar experiences? A friend who loved to cook and eat at restaurants had to give up many beloved foods because of her illness. Her doctor handed her a list of what she couldn’t eat. With a pared down list of ingredients, she researched recipes made with things that she could eat, and had fun creating some of her own dishes.

“I see this time as our opportunity to explore and experiment with this law of spiritual change in our own lives, beginning with little ways, infinitesimal ways, which will lead us to the larger, broader ones…There are infinite possibilities for us…”
Gene Knudsen Hoffman, 1982 quoted in Practicing Peace, edited by Catherine Whitmire

Actively Envision the Future:

  • What are your core values, and what do you need to live in a way that is consistent with those values?
  • Who are the people that can help you, and what do you need from them? Don’t be afraid to be specific. Many of us want to help, and don’t know how.
  • What will you need to do differently than you used to, and how can you make the adaptations necessary to live your potential?

Creating an accessible worship environment for those facing physical challenges, such as hearing, vision, or mobility is an opportunity for creativity and broadening in your community. Let people know what you need to participate —sound systems for the hearing impaired, a wheelchair ramp, a certain place to sit. Sharing your story helps others grow in their understanding, and will help alleviate their fears as they see you facing your challenges.

Download this article in pamphlet form

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Continuity and Coping
Conversations About Driving
Downsizing and Spiritual Practice
Generativity and Aging
Spirituality and Aging

Other Articles/Links:

Coping with Serious Illness: Letting Change into Your Life, by Marcia Breitenbach

Sources/Further Reading:

John Yungblut, On Hallowing One’s Diminishments, Pendle Hill Pamphlet 292, Pendle Hill, Wallingford, PA.

Mary C. Morrison, Gift of Days, Pendle Hill Pamphlet 364, Pendle Hill, Wallingford, PA.

* Mary Morrison, Without Nightfall Upon the Spirit, Pendle Hill Pamphlet, Pendle Hill, Wallingford, PA.

Interdependence

“Our life is love, and peace, and tenderness; and bearing one with another, and forgiving one another, and not laying accusations one against another; but praying for one another, and helping one another up with a tender hand.”
Isaac Penington, 1667, Quoted in PYM Faith and Practice, 2002

In Mother Teresa In My Own Words, she tells of bringing rice to a family of eight children who had not eaten for days. The mother accepted the rice, and then divided it in half and went out the door. When she returned later, she explained to Mother Teresa that the people next door had just as many children, and they, too, were hungry. Mother Teresa did not bring her more food that day to make up for what she had shared, but instead waited until the next day. She recognized this mother’s need, despite her own poverty, to give to others, and wanted her to enjoy that happiness.

When we are helping someone who is confined by physical, emotional or cognitive challenges, it is easy to overlook the basic human need to be useful to others. We are so conscious of being helpful that we reject offers of help from the one being cared for, saying “It’s ok, we can do that for you,” or “You don’t need to worry about that.” It may be easier or seem safer to do a task for someone than to allow the time or adaptation needed for that person to do for themselves. Nevertheless, we all need to give, and to feel useful and needed. Our good intentions in protecting someone from stress or absolving them of responsibility may result in that person feeling diminished.

As a new caregiver, I quickly discovered the challenge of following this philosophy of care. Usually I worked daytime hours facilitating programs, but I was required to work in direct care one weekend a month. Weekends in the nursing home were usually short staffed, and we were required to assist anywhere from 8-10 people from bed and through morning routines of using the bathroom, brushing teeth, shaving, bathing, and dressing. Ideally, we were to have this finished within one and one half hours so we could then assist those who needed help eating breakfast. This was much more difficult for me than the challenges of my usual job.

During the day, it could be hard to balance the responsibilities of facilitating a program with the personal care needs of residents. Groups would be interrupted to meet a resident’s more urgent need, such as to use the bathroom. Truthfully, I enjoyed these moments of respite and one on one conversation, and I worked hard to help in a way that was discreet and did not add to the embarrassment of the person in need. This often meant relying on the residents in the group to keep things going for themselves, and I learned to return quietly to enjoy the sense of empowerment the group acquired in my absence. However, morning routines on weekends did not afford the luxury of this approach.

I found it impossible to help people through the morning routine in the allotted time while preserving their self-sufficiency. There simply was not enough time in the schedule to allow adaptations necessitated by cognitive, physical or emotional differences. During the day, process was priority over product in our programs and we made adjustments. However, sacrificing a care task such as brushing teeth or shaving was not an option, so those I cared for and I were always late for breakfast.

One morning, I was trying to help a woman with late stage dementia get dressed. Only half dressed, she decided to quit. She simply sat quietly down. She would not allow me to help her any further. No cuing, no amount of choices, no cheerful invitation “Can I help you with…” would convince her to continue. She had only one shoe on and removed her shirt. If I left her this way, she would likely walk into the hall and I was concerned about her dignity and safety. I stuck my head in the hallway; sometimes a switch in caregivers would help in such a situation. There was no one in sight. I made her bed, busied myself with other tasks and tried again. I held up her shirt; let the open sleeve brush her arms for physical cuing. “Can I help you get this other shoe on? That must be uncomfortable,” got a smile and nothing more. She held fast her arms and kept her unshod foot firmly on the ground. I was aware that I was holding up care of other residents and frustrating my co-workers. The approach to care that I had been taught seemed impossible in this reality, and overwhelmed, I started to cry.

I looked up from my place on the floor by her feet and said, “I need your help.” Her expression changed from apathy to genuine concern. This woman had little ability left to process language, but she was listening to me at another level. I told her I needed to go to the dining room to help another person who could not feed himself; would she please go with me? She seemed to sense that she was needed and the momentum shifted—she quickly responded to my cues and finished dressing.

Later, I felt guilty. I wondered if expressing my need so emotionally was unprofessional. I should have been caring for her; it was unfair of me to unload this burden of my work. Nevertheless, I realized that what happened in our exchange was an allowance of genuine giving. Who gave what to whom? Despite her resistance to getting dressed, her presence was peaceful and serene. Her serenity gave way to allowing me to express myself sincerely—there was nothing artificial in my breakdown into frustration. I gave her my need, something she had not experienced in a while, and she gave me the allowance to care for her. The exchange was reciprocal. I really did need her help.

I never became efficient at the morning routine. This is the reality of staffing for many organizations, and unless that can be addressed, there will always be a tendency for care to be rushed. In those circumstances, it is very hard for a caregiver to meet the level of dignity that is possible when people are encouraged and enabled to care for themselves. I did learn some valuable lessons about independence and interdependence.

Someone might enjoy a shave, having their nails done or getting a haircut as these are things we are accustomed to allowing others to do for us. Rarely have I met someone who felt genuinely accepting of help with the full range of personal care, especially such intimate care as cleaning up after using the bathroom. Gentle, validating kindness helps and empowerment to do what one is able is crucial. Yet, does any approach take away the underlying shame of being unable to do for oneself in a society that fiercely promotes self-sufficiency and independence?

Our lives intertwine like tree roots beneath the ground, together holding the soil and feeding our individual selves. Under the skin of our separate existence is a skeleton that holds us in place. Without the roots, the ground below us crumbles away. Without the skeleton, we are perhaps able to live but unable to get anywhere.

How can we weave the will for independence with the inherent need for interdependence in caring for one another? Can we shed the ingrained need for independence in our self-image?

We could work on this change as individuals, promoting an attitudinal shift to accepting care with grace. However, if independence is such a strong societal value, it seems we also need to make a shift in our interactions with one another. We should support independence of an individual to the degree possible, as this will promote their emotional well-being. What if we also supported and consciously acknowledged one another’s interdependence? By baring our own needs, can we open the door for others to accept care willingly?

Mother Teresa understood how important it was for the mother in that story to give as much as to receive food for her hungry family. In turn, what a gift it was for someone as humble and generous as Mother Teresa to allow someone else the pure joy of giving. This story does not tell us if she had mixed feelings, whether she questioned her decision not to rush back in with more food, or if she had to fight her natural impulses to allow this. It does illustrate her understanding of the value of pure, heart-felt sacrifice, the need we all have to give.

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Allowing Yourself to be Cared For: Autonomy, Interdependence and Interrelationship
Continuity and Coping
Generativity and Aging
Spirituality and Change

Sources/Further Reading:

Mother Teresa, edited by Jose Luis Gonzalez-Balado, Mother Teresa In My Own Words, New York, Gramercy Books, 1996

Ram Dass, Still Here – Embracing Changing, Aging and Dying, 2002, Riverhead Books, New York, NY.

Being Present When Friends are Ill

Q: How am I present with others in my community when they are experiencing challenges?

We are on this life journey together. Any of us, at any time may find ourselves relying on others. In fact, we truly cannot exist without one another, regardless of our strength. Yet it is usually hard for us to accept that we need help, especially when it is likely that our need for care will increase as time goes by. . Or, we may find ourselves caring for a friend or family member. We want to be supportive but may not know how, or we are afraid of being overly intrusive.

Family, friends, colleagues, and all the significant people in a person’s life are potential partners with that person on the journey through illness, disability, memory loss or other changes that may come along. Caregivers need to be supported in their needs along with the person facing new or chronic challenges. The more each of us understand and learn, the better we will be able to navigate the journey together. Though we cannot all be experts in the many areas of need that may face us in a lifetime, we can practice being present for one another in love and compassion in any circumstances. The process can be one of deepening and growing in love as each person’s needs and values are considered, and each offers their strengths and unique perspective.

“The remarkable discovery we can make is that love has not deserted us, and that it is available to us now in a new way.”
Margaret Torrie, 1975, PYM Faith and Practice 2002

James E. Miller and Susan Cutshall, in The Art of Being a Healing Presence, developed seven simple steps for people accompanying a person through illness or other care needs. This is a highly recommended book for anyone who is or may be in the role of a caregiver, as family, friend, or member of the spiritual community. Linuponivil . Below is a Quaker adaptation and summary of those steps.

Quaker ABC’s of Healing Presence*

  • Allow Opening — to your experiences, vulnerabilities, and fears. Consider your own life story and accept how this has influenced your unique spirit; extend to yourself the compassion you wish to extend to others.
  • Be Intentional — in your decision to be a healing presence. Be patient with your fallibility.
  • Clear — yourself of other obstacles and concerns. At least, for the moments you are together with the person in your care, be present, make space for calm.
  • Discover the Light— within the individual you are with, respect their innate capacity for healing. Appreciate who they are, as they are, in this moment.
  • Extend your Gifts — openly and simply. Know it is up to the other person to accept them. Offer empathy, dependability, unselfish focus, love and acceptance.
  • Freely Receive — what this person, this experience, has to offer, and be grateful.
  • Grace and Balance — know that setting realistic limits on what you can do will allow you to be a more open presence for others. Accept that you are also a person with needs.

*Adapted from James E. Miller and Susan Cutshall, “Steps to Being a Healing Presence,” The Art of Being a Healing Presence, pages 74-75,Willowgreen Publishing, Fort Wayne, Indiana, 2001.

Download this article in pamphlet form

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Role of the Spiritual Community in Care
Spiritual Approach to Dementia Care
Vigiling: Being with a Dying Person

Other articles/links:

Jame’s Miller’s book and other resources from Willowgreen Press

“Compassion strengthens your outlook, and with that courage you are more relaxed.”
Dalai Lama, Mind of Clear Light