The Caregiver's Companion

Preface
In the fall of 2003, the Pastoral Care Committee of Calvary Episcopal Church, Pittsburgh, PA, sponsored a series of colloquia with nationally recognized experts in the challenges that attend family members who give care to those who are aging, infirm, or dying.

While the response to these colloquia was enthusiastic, many participants commented on the need for spiritual sustenance in their long journeys of care giving. Being a member of a parish like Calvary is a vital part of that support.

At the same time, members of the Pastoral Care Committee thought that providing a compendium of collects, psalms, and meditations which deals with care giving would also be helpful to members of the parish who are confronting "thirty-six hour days" every day of their lives.

Biomedical research teaches us that caregivers must also care for themselves, if they are to be available to others. Failure to do so leads to clinical depression and other adverse health consequences.

We hope that this collection of readings will enrich the time that caregivers take for themselves daily, to strengthen themselves for the work that God has called them to do.

We welcome your comments on this compendium and hope that you will contribute to it from your own favorite meditations. The Pastoral Care Committee would like for this to be a work in progress, to which all members of the Parish may contribute as a way of helping others. Please contact the Reverend Leslie Reimer, Associate for Pastoral Care, with your suggestions.

We remember the words of Mother Theresa: "We cannot do great things on this earth. We can only do small things with great love." Compassion helps us all to develop our sense of gratitudewine for the desert, and bread for the journey.

The Pastoral Care Committee
Calvary Episcopal Church
January, 2005
Second edition


GIVING CARE IS SACRED

Living fully includes caring for yourself and giving care to others.
Keeping both in balance will make your journey through life rich and rewarding.
Giving care is sacred.
Recognize that your actions are prayer in motion.
Value the gifts of caregiving.
It's an opportunity to grow in tolerance, patience, compassion, and understanding of the limitless power of love.
Let your wise and gentle inner voice guide you in your caregiving.
There is no perfect way to care. Perfection isn't the goal. Love is.

Julie Kuebelbeck and Victoria O'Connor. Caregiver Therapy. Abbey Press, St. Meinrad IN #20164


A COLLECT FOR THE AGED

Look with mercy, O God our Father, on all whose increasing years bring them weakness, distress, or isolation.
Provide for them homes of dignity and peace; give them understanding helpers, and the willingness to accept help;
And, as their strength diminishes, increase their faith and their assurance of your love.
This we ask in the name of Jesus Christ our Lord. Amen.
Book of Common Prayer (1979), page 830


COMPLINE

Keep watch, dear Lord, with those who work, or watch, or weep this night, and give your angels charge over those who sleep.
Tend the sick, Lord Christ;
Give rest to the weary;
Bless the dying;
Soothe the suffering;
Pity the afflicted;
Shield the joyous;
And all for your love's sake. Amen.


O God, your unfailing providence sustains the world we live in and the life we live:
Watch over those, both night and day, who work while others sleep.
Grant that we may never forget that our common life depends upon each other's toil;
Through Jesus Christ our Lord. Amen.
Book of Common Prayer, page 134

"O God, whose mercies cannot be numbered"
Collect at the burial of an adult, page 493

God does not cheapen himself or us by offering us easy answers to the anguished "why?" that we who are human cannot help but ask. The mystery of life and death and suffering remains a mystery in all human generations, and it is no less a mystery for us. We don't get a quick fix from our faith.
But we do encounter a God who sits patiently beside us in grief-silently, usually, like an orthodox Jew sitting shivah with his bereaved friend, offering no words to explain away a mystery that is beyond words. God sits with us in our sorrow. In the days and weeks after a loss, as we sit together in the silence, something new begins to creep into our consciousness. The faith that has sustained our whole lives will begin to knit our sorrow over this death together with what we believe about the life to come. Faith and experience will knit together like a broken bone knits together as time passes. We begin to see for ourselves what is already a reality for those who have gone on ahead of us, something the tears of early bereavement make it hard for us to see at first. They begin to appear in our vision of heaven, taking their place in the communion of the saints. We begin to feel their presence, not just their absence. Once again, the resurrection faith to which we cling gently bathes our hearts, and our hearts are healed.
Bishop Edmond Lee Browning, A Year of Days (January 7), Ballantine Publishing Group, 1997, New York.


Ministration to the Sick: A Collect for Doctors and Nurses

Sanctify, O Lord, those whom you have called to the study and practice of the arts of healing, and to the prevention of disease and pain.
Strengthen them by your life-giving spirit, that by their ministries the health of the community may be promoted and your creation glorified; through Jesus Christ our Lord, Amen.
Book of Common Prayer, 460


For the Sanctification of Illness
Sanctify, O Lord, the sickness of your servant, that the sense of his weakness may add strength to his faith and seriousness to his repentance;
And grant that he may live with you in everlasting life; through Jesus Christ, our Lord, Amen.
Book of Common Prayer, page 460


Psalm 121: Levavi Oculos

I lift up my eyes to the hills; From where is my help to come?
My help comes from the Lord, The maker of heaven and earth.
He will not let your foot be moves, And He who watches over you will not fall asleep.
Behold, He who keeps watch over Israel Shall neither slumber nor sleep;
The Lord himself watches over you; The Lord is your shade at your right hand,
So that the sun shall not strike you by day, Nor the moon by night.
The Lord shall preserve you from all evil; It is He who shall keep you safe.
The Lord shall watch over your going out and your coming in, From this time forth for evermore.
Book of Common Prayer, page 779


Prayers for Use by a Sick Person

In the morning
This is another day, O Lord. I know not what it will bring forth, but make me ready, O Lord, for whatever it may be.
If I am to stand, help me to stand bravely.
If I am to sit still, help me to sit quietly.
If I am to lie low, help me to do it patiently.
If I am to do nothing, help me to do it gallantly.
Make these words more than words, and give me the spirit of Jesus. Amen.

For Sleep

O heavenly Father, you give your children sleep for the refreshing of soul and body;
Grant me this gift, I pray; keep me in that perfect peace which you have promised to those whose minds are fixed on you;
And give me such a sense of your presence, that in the hours of silence I may enjoy the blessed assurance of your love;
Through Jesus Christ our savior, Amen.
Book of Common Prayer, page 461


A Powerful Message for Caregivers and Care Receivers

Arthur Steven Levine asks the question, "If you had an hour to live and could make only one phone call, who would you call, what would you say, and why are you waiting?"
Who knows what we are waiting for?.Whatever the reasons, most of us simply wait too long.
Later today my father and I are driving out to visit my grandmother's grave site. She died about two years ago. Before she passed away, it became obvious how important it was to her to let her family know how much she loved us all. It was a good reminder that there is no good reason to wait. Now is the time to let people know how much you care.
Ideally, you can tell someone in person or over the telephone. I wonder how many people have been on the receiving end of a call where the caller says, "I just called to tell you how much I love you!" You may be surprised that almost nothing in the world means so much to a person. How would you like to receive the same message?
You may find that as you get used to it, letting people know how much you love them will become a regular part of your life.
It probably won't shock you to know that, as it does, you'll probably begin receiving more love as a result.

Richard Carlson, Don't Sweat the Small Stuff, New York, Hyperion, 1997, pp 99-100


Finding Comfort
All I am doing is to ask people to face the facts-to understand the questions which Christianity claims to answer. And they are very terrifying facts. I wish it was possible to say something more agreeable. But I must say what I think true.
Of course, I quite agree that the Christian religion is, in the long run, a thing of unspeakable comfort.
But it does not begin in comfort; it begins in the dismay I have been prescribing, and it is no use at all trying to go on to that comfort without first going through that dismay.
In religion, as in war and everything else, comfort is the one thing you cannot get by looking for it.
If you look for truth, you may find comfort in the end; if you look for comfort you will get neither comfort nor truth-only soft soap and wishful thinking to begin with and, in the end, despair.
C.S. Lewis, from Mere Christianity. In A Year with C.S. Lewis: Daily Readings from His Classic Works. San Francisco, Harper Collins.


For Those Who Fear Losing Hope
Loving God, inspire by your Holy Spirit those who are afraid of losing hope, especially N. for whom we now pray. Give her/him a fresh vision of your love, that she/he may find again what she/he fears she/he has lost. Grant her/him your powerful deliverance; through the One who makes all things new, Jesus Christ our Redeemer. Amen.

In Times of Personal Distress
Lord Christ, you came into the world as one of us, and suffered as we do. As we go through the trials of life, help us to realize that you are with us at all times and in all things; that we have no secrets from you; and that your loving grace enfolds us for eternity. In the security of your embrace we pray. Amen.

For Serenity
Merciful Jesus, you are my guide, the joy of my heart, the author of my hope, and the object of my love. I come seeking refreshment and peace. Show me your mercy, relieve my fears and anxieties, and grant me a quiet mind and an expectant heart, that by the assurance of your presence I may learn to abide in you, who is my Lord and my God. Amen.
or this
Jesus, let your mighty calmness lift me above my fears and frustrations. By your deep patience, give me tranquility and stillness of soul in you. Make me in this, and in all, more and more like you. Amen.
A Prayer of Thanksgiving for Caregivers
Merciful God, I thank you that since I have no strength to care for myself, you serve me through the hands and hearts of others. Bless these people that they may continue to serve you and please you all their days. Amen.

A Prayer of Comfort in God
God, you are my help and comfort; you shelter and surround me in love so tender that I may know your presence with me, now and always. Amen.

In Desolation
O God, why have you abandoned me? Though you have hidden your face from me, still from this dread and empty place, I cry to you, who have promised me that underneath are your everlasting arms. Amen.

For Caregivers and Others in Support of the Sick
Lover of souls, we bless your Holy Name for all who are called to mediate your grace to those who are sick or infirm. Sustain them by your Holy Spirit, that they may bring your loving-kindness to those in pain, fear, and confusion; that in bearing one another's burdens they may follow the example of our Savior Jesus Christ. Amen.
or this
Compassionate God, support and strengthen all those who reach out in love, concern, and prayer for the sick and distressed. In their acts of compassion, may they know that they are your instruments. In their concerns and fears may they know your peace. In their prayer may they know your steadfast love. May they not grow weary or faint-hearted, for your mercy's sake. Amen.

For Companions to Those Who Are Chronically Ill
O God, surround N. [and N.] with your compassion as she/he/they live[s] with N. in sickness. Help N. [and N.] to accept the limits of what she/he/they can do, that feelings of helplessness and frustration [and anger] may be transformed into serene acceptance and joyful hope in you. Let her/him/them remember the grief and love of Jesus over the afflictions of his friends, knowing that God too weeps. Bring her/him/them gladness and strengthened love in her/his/their service; through Christ our companion. Amen.
from Enriching Our Worship 2


Twenty-two years later, the words of my friend Wolf (Wolfram Swoboda) still inspire me. I know I adopted these words into my personal philosophy and they helped me get through my own encounter with the prospect of death when I had my open heart surgery in 1997. But, I was glad to have Wolf's exact words which were read at the scattering of his ashes:
I cannot choose to live, because I cannot choose not to die as the only question about death is "when?" not "whether." But I can choose to think about life rather than death while I am alive, thereby choosing not life, but to the conscious of living, and thus not just live but experience the life and its living.
And the knowledge of having that particular choice is the same as making it. For to truly know Is the same as to act. Wolfram Swoboda (1943-1982) To have learned from each leaf in autumn that its fall is also its last and first free dance And so to fall not with desperation, but with grace. Wolfram Swoboda (1943-1982) I remember the last time I saw him, I was trying to think about what I could say to him as a way of a good-bye before I left his room. As I leaned over his bed that day at UPMC, he looked up at me and said, "I love you, too." I realized I had never said those words to my friend, but yet he knew. I didn't know Wolf very long, but as you can tell, he was one of those people I have never forgotten. I don't remember what I did for Wolf, but I sure remember what he did for me. Caregiving is also a gift to the caregiver. from Judie Compher


Bibliography

Richard Carlson. Don't Sweat the Small Stuff. New York, Hyperion, 1997.
Julie Kuebelbeck and Victoria O'Connor; illustrated by R. W. Alley. Caregiver Therapy. Published by One Caring Place, Abbey Press, St. Meinrad, Indiana 47577, 1995
C.S. Lewis. A Year with C. S. Lewis: Daily Readings from His Classic Works. HarperCollins, San Francisco, 2003
Linus Mundy; illustrated by R. W. Alley. Elf-Help for Overcoming Depression. Published by One Caring Place, Abbey Press, St. Meinrad, Indiana 47577, 1998.

Websites on depression that may be helpful, especially for older people and their caregivers

Depression - American Geriatrics Society
www.americangeriatrics.org/education/forum/depression.shtml
Q&A format, with answers from experts, targeted to family and friends of depressed elders.
Depression: Don't Let the Blues Hang Around National Institute on Aging
www.niapublications.org/engagepages/depression.asp
Written in simple language and in a large print format, this classic from the Age Page series provides a symptom list, treatment information, and links to major organizations.

Don't Accept the Blues: Depression in the Elderly Is Treatable National Institutes of Health
www.nih.gov/news/WordonHealth/jun2000/story01.htm
From the NIH Word on Health series, here is a journalistic account of a patient case with information on symptoms and treatment.

Sleep and Aging National Sleep Foundation
www.sleepfoundation.org/sleeptionary/index.php?id=7
Sleep problems, a troubling aspect of aging, are often linked with depression as explained here.

Suicide Among the Elderly National Strategy for Suicide Prevention
www.mentalhealth.org/suicideprevention/elderly.asp
The hidden epidemic of suicide among senior citizens is exposed in this fact sheet.

William and Rose Styron Families for Depression Awareness
www.familyaware.org/familyprofiles/styrons.asp
The story of author William Styron's personal history of depression, together with his wife's perspective as his caregiver, provides an excellent resource for understanding the human side of late-life depression, in a Q&A format.