5 Contemplations For Dementia Care Partners

Sooner or later, during one's mindful journey, one becomes faced with a wall. One has a choice then. To keep bumping one's head against the inevitable, or to stop and contemplate the very nature of the wall itself. The wall is about the impermanence of life, and our need to face that truth. Many times, whenever grief wells up inside, as it did earlier today, I call upon the 5 Remembrances:

I am of the nature to grow old.

I cannot escape growing old.

I am of the nature to have ill health.

I cannot escape having ill health.

I am of the nature to die.

There is no way to escape death.

All that is dear to me and everyone I love are of the nature to change.

There is no way to escape being separated from them. 

I inherit the nature of my actions in body, speech and mind.

My actions are the ground on which I stand.

Strangely enough, I find great comfort in telling myself those lines. It is as if the telling is paving the way for acceptance of what is to come, or what has already happened.  During my work with those in the early stage of cognitive impairment and also with dementia caregivers, I have learned to tailor the 5 Remembrances to more specifically address the unique challenges of the dementia journey. It goes like this:

I am of the nature to grow old.

I cannot escape growing old.

I am of the nature to have ill health of body and/or mind.

I cannot escape having ill health of either body and/or mind.

I am of the nature to die.

There is no way to escape death.

All that is dear to me and everyone I love are of the nature to change.

There is no way to escape being separated from them, in either body or mind.

There is no avoiding making mistakes.

I am doing the best I can and I hold myself with compassion.

May you contemplate those words often. And may you find comfort in them. 

Mindfulness, Memory, and Wisdom

Ayya Khema talks about this life as an ongoing adult education course. The main topic of the class is wisdom, of course. Many times, I find myself faced with a situation where mindfulness offers the possibility of choice. This way, or that one. Usually, the most immediate impulse is not the most advisable one. Underlying tendencies die hard, and always raise their heads when emotions are involved. This is particularly true for primary relationships. But if one has developed enough insight, the mind does not give way to such impulses. Instead, the memory of prior similar times with the same person or a different one, provides scenarios ripe for contemplation. 

Twenty years ago, when I did not know about the hindrances and their way of overtaking the heart, I let anger sever a precious bond, and a very sad story unfolded in the aftermath. Twenty years later, I am still feeling the effects of my decision. I also have a chance to not repeat the past, this time with a different partner. Whenever  I find myself triggered, I now have mindfulness to rest on, and the wisdom to choose not to react to the outer trigger. The urge to love has also become greater than the iron hotness of anger. Every night, I dwell in the garden of my heart, and I survey the situation. First, noticing the weeds, a resentment, some fear, greed, whatever they may be, I know better than to let them overtake the beautiful flowers which I know to be there. I give it a try. Pulling out the weeds sometimes takes for than one try. Those things have a way of digging deep, fast, and it may take days, weeks, months, before I can enjoy the peace and love again. 

The ability to remember is key to this whole process. Without memory, the mind cannot learn nor make the leap of inference from one past event to the present moment. Science tells us this about episodic memory:

Episodic or implicit memory is the memory of an event or “episode”. [...] Episodic memory can be thought of as a process with several different steps, each of which relies on a separate system of the brain. The initial step in forming this type of memory is called encoding. Encoding is necessary for the acquisition of new factual knowledge. [...] The step by which the information is accessed and brought back into consciousness is called retrieval. [...] Research and clinical experience suggest that information is not simply stored and retrieved, and that there may be an intermediate step in this process, which we call consolidation. Consolidation is the process by which recently learned information becomes more strongly represented in the brain.

This morning, feeling grateful for the gifts of mindfulness, memory, and wisdom. 

Top 5 Regrets of the Living

A dear friend died yesterday, someone I was supposed to do a project with. As always, the news of death rings the alarm for those of us still living. We may ask, am I living my life well?

For answers, let us turn to those at the end of life. These are the Top 5 Regrets of the Dying:

1. I wish I'd had the courage to live a life true to myself, not the life others expected of me.
2. I wish I hadn't worked so hard.
3. I wish I'd had the courage to express my feelings.
4. I wish I had stayed in touch with my friends.
5. I wish that I had let myself be happier.

No need to wait for the end to become wise. Looking back on my life, I have my own list of regrets, mistakes made along the way that I wish to not repeat. Here it is:

1. I wish I had spent less time in fear
2. I wish I had spent less time in anger
3. I wish I had been more wise in some of my choices
4. I wish I had discovered mindfulness earlier
5. I wish I had understood loving kindness earlier

What is your list?

The First Day of Your Life

Ayya Khema asks us to contemplate:

"Think about today as the first day of your life. How do you want to live the remainder of your life? What changes do you need to make?"

I have been pondering that question.

The past is past and cannot be undone. At best, I can learn from it. I can view today as a chance to start anew, with mindfulness and acquired wisdom as my best allies. 

The more I age, the more life feels precious. Each day, each hour, each minute, each moment, a new gift that is not to be wasted with wrong action, wrong speech, wrong thoughts. There are long run decisions to be taken, and micro ones to be made every day. 

Doing the right thing requires seeing clearly within ourselves. Mindfulness can help shed some light, but it is not always enough. We need to stop, and probe deeply within. Armed with paper and pen, we can sit and reflect back on unhelpful patterns. Do we feel un-ease? Where does it come from? Can it be helped with changes within, or do we need to take action outside? What is in our control, and what is not?

We need to ask the big questions:

Which company do I want to keep?

Pema Chodron talks about the difficult ones as our teachers. Similarly, Ruth Denison often talks about her difficult relationship with her husband and how being his wife was a part of her spiritual path. Ayya Khema urges us to be careful and not haste to place the blame outside of ourselves. We are not perfect, and we need to first look inward before attributing our unhappiness to someone else's actions. I keep their advice in mind. I also remember the Buddha's admonition to only have noble friends. The Buddha is very clear on that matter:

Admirable friendship, admirable companionship, admirable camaraderie is actually the whole of the holy life. 

We are to keep company with those who encourage us on the spiritual path, in whichever form that may takes.

Next is, which work do I want to devote myself to?

I have the good fortune of having found work that incorporates mindfulness practice, service, and creativity while at the same time allowing me to make a living. Of course, the danger exists of perverting the purity of the initial intention. Wanting more money, more prestige, more self-gratification. Looking around, I am reminded that  outer claims to 'mindfulness' and to serving a higher cause, are no guarantee. Always, going back within to check. What are my motives? Am I being honest? Has greed arisen?

Last, the most important question.

If practice is the most important thing, am I making enough room for it? And if not, why?

I had planned to go on a two-week retreat this coming week. I ended up canceling. It did not seem wise to leave in the midst of so many important work projects. I promised myself that I would reschedule and retreat in September instead. I rationalized that practice can take place anywhere. I could sit longer every day, redouble my effort to bring mindfulness in my daily activities. I could listen to more dharma talks. I could attend mini-retreats here and there. Being a lay person is not easy on practice. Distractions and good reasons abound, that take one away from inner freedom.

Three questions worth asking ourselves. How would you answer them?

Being Sick

Being sick, as I have been for the last few days, forces upon oneself the reality of the body. A cold, is all it takes to drive home the wisdom of the second remembrance:

I am of the nature to have ill health.

I cannot escape having ill health.

Head cluttered with fever, chest shaken with a relentless cough, limbs burdened with soreness, there is no room left for extra-thoughts. The mind can only attend to the present moment, the unpleasantness of sick body. Of course, the temptation is great to want to jump to aversion, 'I hate this', and its cousin, craving for the return to a healthy state, 'I want to be well'.

Being sick, one gets to practice mindfulness of vedana, using the bridge from the second remembrance to get one step closer to equanimity and acceptance of the inherently displeasing nature of this life.

Being sick, is a dress rehearsal for what it must be like at the time of final parting:

I am of the nature to die.

There is no way to escape death. 

Lots of one's fears about death are born out of times when the body is well enough to leave the mind free to make up stories about one's dying. Just a cold is enough to make one realize what happens when the body breaks down. The illness takes over, and the unpleasantness is such that one becomes disenchanted with life. Letting go starts feeling sweet.