Caregiving is a job of the heart that answers the needs of all of us

[caption id="attachment_20138" align="alignleft" width="241"] Caregiver[/caption]

Carol Forsloff----Maria Shriver has been in the media many times recently, underlining the needs of Alzheimer's patients,  offering this group as an example of those individuals who need caregiving.   Virtually all of us require emotional or physical assistance at some time in our lives, and as the population ages those needs will only increase experts remind us.

US News and World Report's Tom Sightings writes that as baby boomers age,  most worry about their future security and what limitations they may have in retaining quality of life.  They wonder what options exist for aging in place. Caregiving is something many of us will require,  or do,  in some form.  It is a service of the heart that can make a positive difference for those who need safety and support at critical life junctures.

Those with disabilities resulting from age, accident or disease are the ones most often needing care-giving. And it is a process of support that begins first with an assessment of a patient's needs and ends when an individual is able to be self-sufficient or some other resolution is made to provide needed assistance.  Caregiver help can therefore be short or long term.

The intial assessment for caregiving includes observation and documentation of the details about an individual specific to personal care needs. It also includes a review of the environment, the home, and the support systems. After the assessment is done, services are targeted specifically for that person's special concerns.

The one who offers caregiver help is one who offers not just physical and emotional support for a patient but is a listener who assists in finding the approach most suitable for the individual needing care.  This often means following a plan that is written either by the one rendering care or a life care planning nurse or counselor. It is that listening, observing, and taking the time to learn about each person's unique set of circumstances that allows services to be appropriate.

Many times family members find they have neither the time nor the skills to render the help a loved one may need. That's when a professional caregiver can be called. Those who render these services have the training and expertise to follow a life care plan, family directives or doctor's orders for the range of services can be broad enough to include everything from household help to bedside care.

For those with mental health issues, caregiving can be stressful. In fact it can be so stressful that it can cause breakdowns in the family, both individually and collectively. It is then professional caregiver help is of particular value for the family and the patient as well. That's because the caregiver does not have the emotional involvement of a family member or some friend whose personal concerns can be heightened during crises. The caregiver is trained to know what to do and when to do it, so some of the burden of decisions and hands-on service can be lifted, allowing respite for those who can become so overworked and stressed during the care of the patient to be unable to function optimally in the care of the patient.

More than five million Americans now live with Alzheimer's disease,  a disease that is the one most feared by the elderly. Statistics indicate one in three people over age 80 will suffer from this disease. Dementia robs the person of memory and ability to do some of the simple, everyday tasks. During the early stages of the disease, it is possible for many individuals to be cared for in the home. Care-givers can either supplement family help or be the front-line assistance in observing function and helping determine when to take the next step, which might mean sending the family having to move a loved one to a specialized residence designed for the care of those in the advanced stages of Alzheimer's disease.

Maria Shriver, daughter of Sergeant Shriver and his wife Eunice Kennedy, saw her father's decline, as he suffered from Alzheimer's disease. Despite the money in the family and all the resources, Shriver said the emotional cost was almost intolerable. She said, “In the beginning, I know I definitely felt overwhelmed on more days than not. And I have the financial resources to hire people to help and to get the best doctors. I kept thinking, if I'm struggling here, and I have the financial resources and a flexible job, I can only imagine what everyone else does.”

That emotional toll can cast a heavy shadow on the family and on relationships. The caregiver brings the compassion, knowledge and support that allows the family members to carry on  normal activities without always having to worry about what might happen next and how they will be able to handle the multiple demands required by those in declining health.

The nurse at the bedside in the final moments of life is that final symbol of caregiving, representing the point of light that exists in work that comes from the heart. Sometimes it is the caregiver, nurse, nurse's aid or companion, who holds the hand of a dying person and listens, watches and serves compassionately.  And science tells us that caregiving helps transitioning not just from one stage of our physical life to another stage,  but in that transition at death to alleviate the fear folks, especially single women,  often have about dying alone.

Caregiving is a vocation of the highest calling; and when we need help ourselves, it's nice to know there are those who can offer it with knowledge  and compassion. Caregiving is that job of the heart that answers the needs of all of us at some time in our lives.

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Carol Forsloff, a trained and experienced journalist, worked as a counselor, and managed a counseling company over 20 years.  Her specialty in the years before retirement was life care planning, which involved the direct interface with caregivers.  She says that first-hand relationship with caregiver and patient inspired admiration for the profession of caregiving, as she, like her friend Ann Blair, a hospice nurse, defines it as a vocation of the heart.

Values-based education seen as critical for sound child development and learning

Desiree Rowling--How do we raise children to be responsible caring, sharing adults?  There are organizations set up these days to help educate children specifically in humanitarian values, and these organizations tell us that children and parents are actually increasing their activity in service groups and in working together harmoniously.

Kim Simon in Voices of Compassionate Education writes of her experience when asking herself, and responding to others about the question she poses: “What can we do to help young men respect women, recognize consent, and have healthy sexual relationships? Teach them kindness to others—and the courage to go against the crowd.”

Kindness she believes is the essential quality in life.  And that means not being involved in activities that are harmful or unkind to others.  She also says it is important to teach boys to be brave, to go against the crowd when that crowd applauds or seeks to do bad things.

Other groups are focused also on values-centered education.    Values-based schools promote an ethical vocabulary and behavior as part of good educational practice.  It encourages adults to participate in their child’s education and to reflect values in their own lives.   School that do this receive the Quality Mark as Values-based Schools.
Values-based Education  is said to be successful as it nurtures a sense of the self and supports good academic standards.  The Catholic Church has maintained for many generations the importance of a spiritual development within the context of learning.  The Church maintains good values can stay with young people often throughout life.

Many faith-based groups have their own schools, but there are organizations that do not teach sectarian views on values, but instead universally appealing and important ideas related to the community as a whole and a spirit-filled life.    Julie Rubenstein, an active member of the  Baha’i Faith, maintains these programs reach out to entire communities where she lives in Washington County in the greater Portland area that extends to the Northwest sections to Hillsboro and Beaverton, Oregon.  Many children attend values-based classes during the summer where they learn how to work together on projects related to service.  “These are very successful, and many, if not most of those who attend these programs are not Baha’is themselves.”

But it isn't just schools and faith that believe in value-centered learning.  Even dance groups have found that teaching values in dance can help people learn and live together in harmonious ways.

Values in education do not mean sectarian ones but those based on learning about one's relationship to others and the development of a spiritual life in motion.  It is that central idea of "do unto others" that remains a significant part of that value-centered curriculum.



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Desiree Rowlings is a retired educator who is presently traveling across the United States, following a long career as a teacher.  The publisher of this journal received her article, appending some of the last paragraph as an addition.  Values education is Rowlong's special interests.  She has been an educator in Catholic schools.

John Hopkins doctor underlines quality of life in treatment of braincancer.

[caption id="attachment_4309" align="alignleft" width="256" caption="Cerebral lobes of the brain"][/caption]

Carol Forsloff - This idea of living longer, but not living very well with brain cancer
worries Alfredo Quinones, M.D., so he stresses quality not just quantity
of life and a special multi-faceted approach.



Quinones, who is Director of Brain Tumor Surgery at John Hopkins University


Quinones has expertise in looking at the various aspects of brain cancer and 
"minimizing collateral damage," the euphemistic way of saying trying to
reduce the elements of the disease so that people can be as comfortable
as possible.


“Brain cancer is sort of the bastard child of cancer,”says Quinones.
“There are about 3,000 new cases a month of the very malignant cancer,
like Senator

Ted Kennedy had.” Thousands more people develop secondary brain tumors –
offshoots of cancer that originate elsewhere, say in the lungs, and
somehow find their way to the brain. “Once cancers get to the brain,
people tend to give up on these patients. But there are so many simple
things we can do,” he says, to have an immediate result on quality of
life, and possibly prolong survival. For example, simply treating
depression and controlling blood sugar levels can make a big difference.


Educating the medical community about how small things can make a big
difference in the quality of life for cancer patients is something
Quinones says is very important.  That's because cancer has so many
facets.


Today, the prognosis for someone diagnosed with an aggressive brain
tumor is devastating; the average survival is just 15 months. “Can we
make it 20 months,”says Quinones. “Then, can we make it 40 months?Ten
years?” But – and this is huge – can those be good years? “Or are those
going to be patients who have absolutely no memory, their brains
potentially fried by radiation, severely impaired. We have to find ways
to minimize the collateral damage that we do through surgery and
adjuvant treatment.” The length of survival is 
meaningless, he adds, “if you’re bedridden, you don’t recognize your loved ones, if you have no memory.”


Quinones is convinced that research on the multiple aspects of brain
cancer and looking at the quality of life as well as the length of life
in the treatment of the disease will be the key to changing how patients
are treated.


This is not rocket science,” he says, “but no one asks,especially with
brain cancer patients, how the family is doing. How are the caregivers
coping? This is honestly part of the big picture; quality of life is not independent.
We are building that infrastructure for long-term follow-up.” Quinones has been concerned for a longtime about the complications of brain cancer and that while doctors look at prolonging the life of their patients, he says it is also important to look at that quality of life that should go with it.