Gems of Insight in the Dementia Ward

I was walking down a hallway in the long term health care unit at Cedar Village Retirement Community a few weeks ago, when I came across a woman sitting in her wheelchair in the middle of the hallway with tears in her eyes. Our eyes met. I smiled and asked if she wanted some company. She said “Yes,” so I knelt down on the floor next to her and took her hand. She told me that her son had come to visit her that morning, as he does every morning on his way home from working a night shift. This morning seeing her had made him cry. She couldn’t get the image of her strong son crying out of her head. It made her feel guilty and helpless, and she asked me if maybe it would be better if she asked her son not to visit her anymore. I took her hand and asked, “Do you enjoy your son’s visits?” She nodded and smiled, “Very much so. But I don’t want to hurt him by making him see me this way.” Then I asked her how taking care of him as a child had made her feel. She grinned and began telling me all about his many accomplishments over the years and about how much she loved making him chicken soup when he was sick or kissing his scraped knees “better.” She trailed off after a moment and then looked me in the eye and said, “I guess it’s his turn to take care of me now, isn’t it? I didn’t like to see him teased by the other boys at school or sick to his stomach with the flu, but I loved being the one he turned to.” I just nodded, with tears in my eyes.

At Cedar Village, instead of ranking stages of dementia numerically, we describe the residents and their conditions using the names of gems—a sapphire is on one end of the spectrum and is used to describe a person with very little memory loss, and a pearl on the other end of the spectrum describes a person in the final stage of dementia. In this system, each person is a gem and deserves to be treated as such. Each gem has a different quality and color, and each gem has its own beauty and something distinctive to offer. This system at Cedar Village helps remind each of us that as a gem has many facets, so too do we. And each of us makes the world more beautiful simply by being present in it.

So often, we relegate the old and infirm to the land of death and dying, long before they are actually dead. The residents I see every week complain that they used to feel left behind, under-appreciated and forgotten by the outside world. Now, at Cedar Village, they live somewhere which prides itself on being, as emphasized in their mission statement, a place “where life begins.” Each and every staff member, from the janitor to the CEO and everyone in between, must complete at least two levels of dementia care training and all of them are taught to meet residents where they are on any given day.

The residents, both those who live in the dementia ward and those who do not, are actively teaching me how to become a rabbi. They, more than anyone, are my professors. Sometimes, the women share stories of what it was like being a professional woman before it was considered an acceptable option, or the men remind me of how difficult it is, once earned, to lose your power and self-sufficiency. All of them have taught me what it was like growing up Jewish in Ohio at a time when Jewish doctors couldn’t get residencies at non-Jewish hospitals and there was a Jewish quota at most major universities. I have come to see both HUC and Cincinnati through the eyes of people who truly love and know this city.

I run alternative prayer/spirituality groups with residents all over Cedar Village and tailor these meetings to meet the abilities of the group I am working with. We have made prayer flowers out of tissue paper, choosing each color to represent a blessing that we had in our lives. We made a book of miracles, as well as experimented with new ways to recite the Sh’ma (holding hands, looking in the eyes of another, and sharing our innermost needs). The residents force me to try new things and create moments of connection outside of my comfort zone. They tell me when things work, and fall asleep or complain when they don’t! But most of all, they meet me wherever I am willing to take them, constantly surprising me with their openness and craving for something new, something different, and most of all, something meaningful.

The residents have taught me the value of being of use. They constantly remind me of how, even when living so close to one another, we humans have a tendency to isolate ourselves—not to tell others what is really going on with us or what we really need. We don’t want to be a bother. And yet, nine times out of ten, when I ask residents if they feel fulfilled, the ones who say yes are the ones who feel needed—the ones who volunteer at the store or visit sick residents or those in hospice. The ones who struggle the most are the ones who feel as if no one needs them. And the funny thing is that despite the fact that my job at Cedar village is to help them, I’ve discovered that they are also helping me in very meaningful ways.

Another thing the residents have taught me is how important human touch is. There is a woman I visit every week who has been on hospice care for over a year. She lives on the dementia ward, and spends ninety-nine percent of her time alone and in bed. When I see her she is usually pretty up-beat, and enjoys having her hands held. She has a habit of kissing my hands and saying “Thank you God,” which is incredibly endearing. When I came back to Cedar Village after being in Africa for a month, my first fear was that she might have died. To be completely honest, it surprised me how much the possibility of her dying while I was gone upset me. I was surprised at how much I cared. We hold hands for about fifteen minutes each week, but, generally speaking, the vast majority of that time is spent in silence or with me singing a wordless tune. Sometimes she rambles incoherently, but most of the time she just lies there holding my hand. I’ve always enjoyed our time together, but I hadn’t realized how much it meant to me. I give her some small amount of comfort by being with her and she, in turn, comforts me. With no words at all, she has taught me the power of human touch and of community. This little old lady who can barely speak, curled up in her bed with perfectly painted nails, is actively teaching me how to become a rabbi. She has made my life richer simply by letting me hold her hand.

I keep coming back to this question: What makes a life meaningful? My time with the residents at Cedar Village has taught me that the moments of honesty and connection, of true seeing and hearing, matter the most. The residents see me and hear me. There is a reason why the Sh’ma is often called the watchword of our faith. “Hear o Israel, Adonai our God, Adonai is One.” Before we can enrich one another’s lives, we must first be willing to stop and to hear, to listen and attend to those around us.

Iah Pillsbury is a third year rabbinic student and a TJF Fellow. You might also enjoy this piece by the CEO/President of  Cedar Village.

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