The Cost of Efficiency

My Grandfather, whom I never met, was a doctor. A real old-fashioned one who treated whole families, like you’d see in a black-and-white movie.

His name was Isidore Brill, but people called him “Doc”. Yes, he made house calls; even delivered babies, before they had specialists to do that. In his hometown of Champaign, Illinois, he was well known. And if you couldn’t afford to pay him, well, that was all right, you paid him when you could.

Doc Brill served in the war, and afterwards worked so hard, he had a heart attack and died in his 40s. He left my Grandma, Rosa Lee Brill, to raise their 3 daughters (the middle one is my mom). After he died, there was so much unpaid debt, as the question of insurance or how the patient was going to pay for his services was never asked. Some of the debt was collected…much of it was just “written off”…which is what Doc would have wanted.

Unfortunately for all of us, doctors like Doc Brill are a part of the history books.

Brill Wedding
“Doc” and Rosa Lee Brill, wedding picture

I’m just old enough to remember a time when a doctor’s office consisted of one or two doctors, a nurse (maybe), and someone to answer the phone. In fact even my doctor’s office here in Gainesville used to be that way. But they’ve long since closed down, and my doctor left to join a massive conglomerate with about 50 doctors and specialists, and a staff of 100s. The focus there is on efficient delivery of standardized medical services, and they do that quite well. But good luck to you if you ever don’t pay your bill on time, or have some kind of medical crisis that might require some extra compassion on their side (unless compassion is a covered service they can bill for).

I’m not here to gripe about them today, though. They have their purpose.

By today’s standards, if you had to use to use two terms to describe the way Doc Brill ran his practice, they would probably be: “Bad Business” and “Inefficient”. Well…maybe my Grandfather, who never knew me, would be proud, because you could probably accuse Friends Across the Ages of having the same faults.

You see, efficiency makes good business sense. But there are some problems with it. You probably notice it when you call tech support and are swiftly routed to the correct department, where you reach operator #4957 (in India). Now there’s some magnificent efficiency for you there. By the way, how’d that last tech support call work out for you?

So don’t dismiss inefficiency too quickly. There are two flavors of it. Sure, there’s the kind that is just lazy and slow, for no good reason. But there’s the other kind, that realizes that every person that comes your way deserves to be treated like a human being, even if it slows you down a bit.

“Every good cause is worth some inefficiency.” — Paul Samuelson, Nobel Prize winning economist

That kind is inefficiency is willing to give someone a chance, whom the odds are stacked against. We’ve been fortunate to take some Special Needs volunteers over the years. I remember one of them, “Joanne”, telling us she had tried to volunteer all over town, and had been turned away everywhere else. I’m glad we were inefficient enough to take the time to work with her. The experience was time consuming, but transformative for Joanne, us, and the nursing home residents she visited.

I invite you to take this message to heart on your next nursing home visit. The nursing home is a great place to practice some wonderful inefficiency. Walk a little more slowly down the halls. When you walk slow, your body language projects that you are less busy. Maybe a nursing home resident will strike up a conversation with you, and you’ll make a new friend. Talk slower, linger a little bit longer after the first “uncomfortable silence”. Forget about whatever agenda you had for that visit.

Here’s a scenario (taken from actual events): maybe you run into a resident who has a craving for cheesy puffs. (Who among you reading this has not experienced the urgent, desperate craving for cheesy puffs from time to time?) It would certainly be inefficient, but you just drop everything and walk to the Quicky Mart down the street and buy them a bag. And when you return, and see the look on that resident’s face when they take their first bite, and you see their fingertips covered in all-natural bright-orange fluorescent cheese, you’ll know that was some delicious inefficiency right there!

[The law offices of Dewey, Cheatem, and Howe has urged me at this point to inform you to please ask a nurse before buying food, including the aforementioned cheesy puffs, for any nursing home resident.]

The truth is, we haven’t run Friends Across the Ages efficiently, and I’m proud of it. We used to get calls all the time from people who needed services in their home. Elders who desperately needed help with daily tasks around the house. Rarely were we able to get directly involved, but what we did offer was a listening ear, a voice of genuine compassion on the other end of the line. They weren’t getting that anywhere else they called.

My friend Arupa Freeman runs an outreach to people who are homeless. She used to call it the “Home Van”. She wrote this about her experience one Friday:

“We had a young mother and a five-year-old who came to us on one rainy Friday. They had an apartment as of Monday morning, but no shelter for the weekend. We got them into a motel. There will always be a need for small, non-bureaucratic missions like the Home Van, who are in a position to address situations like that.”

Yes! What would happen if all the “inefficient” grassroots charities closed down, who would fill that gap?

I know I’ve jumped around a lot here, but the point I’m trying to make is this:

Inefficiency isn’t necessarily something you strive for, it just kind of happens. It happens naturally when you accept the premise that every person that comes your way deserves to be treated like a human being, and they deserve your undivided attention, even if just for a few moments.

“…for through it, some have unknowingly entertained angels”.

Efficiency gets things done. Without it, our economy would suffer and we wouldn’t be able to enjoy the standard of living to which we’ve grown accustomed. But it is important, among all the buzz and efficient milling about, to embrace some healthy inefficiency from time to time.

We can practice this at the nursing home, and apply it at home with our children as well.

I don’t always follow my own advice so well in this department. I’m going to try to slow down. I hope Doc Brill would approve!

Doc Brill

Al Lesesne and the Fire Tea

I encourage our volunteers to get outside their comfort zone, because that’s where real growth can take place. I know for me, visiting the nursing home for the first time (18 years ago) was one of the biggest steps outside my comfort zone I ever took, and it changed my life forever.

Getting out of your comfort zone can also be a big thrill. That’s why people climb mountains and skydive.

Al Lesesne

So what about our friends at the nursing home? Are they “too old” to get out of their comfort zone? Let me tell you a story from many years back, about a resident named Al Lesesne (that’s one of the only pictures I have of him). Al was a funny guy who used to tell great fishing stories. He told me the secret to catching fish was to feed the worms some onions overnight. I’ve never tried it; maybe you fishermen out there can give it a shot and report the results back to me.

I always got the impression Al was a little wild in his younger days, perhaps a daredevil. I was sitting there one day with Al and a volunteer whose name was Priel Schmalbach. I remember Priel well, though I lost track of him years ago. Maybe he’ll google his name some day and will read this story. Priel had showed up for volunteering that day with a hot thermos in hand. We inquired what was in it, and he told us that he had made some sort of “Fire Tea” that he was taking to a friend’s house. I don’t remember exactly what was in it but he said it was tea with Tabasco sauce, crushed hot peppers, and all kinds of other things you would NOT want to drink.

Then Al surprised me: “I’m not afraid — Pour me a cup”, he said. I laughed it off and said something like, “Al, you’re too old for that”. But then something got me thinking, why not? Is it going to kill him? Why can’t an old man have some fun?

We almost didn’t even ask Al’s nurse, because we were afraid she would say no. But I finally decided we better ask first, lest I have to explain to all our volunteers why I got banned from the nursing home. So Priel and I went to the nurse and explained what it was Al was about to drink. The nurse gave us a puzzled look (as in, why would anybody drink that?), but eventually she said, “Al is free to make his own decisions about that.”

Fire Tea

Al dared me to try a cup too. Not one to turn down a dare, I agreed. So, the moment of truth. I admit, I was nervous. We filled up 2 cups, and gave a 1….2….3…CHUG! It was like swallowing hot lava. I opened my mouth and expected to see fire shoot out. Priel laughed. I glanced over at Al. His eyes were closed and sweat poured down his cheeks.

And yet, I looked deeper and saw something else on Al’s face. A look I can only describe as…pure joy…freedom…nirvana. We both felt like we could conquer the world that day, because we were brave enough to try the Fire Tea.

Reflecting on this…how rare it is for nursing home residents to get to experience these kinds of emotions! I remember another resident, Anna, at Park Meadows, who used to sit in the hall and “boywatch” (as she called it) whenever the EMTs or firefighters came in the building. Her volunteer, Kathy, told me, “Anna would wave at them as they passed by. One time, one of the EMTs smiled and gave her a wink in return, and Anna nearly melted.”

Someone who wrote the laws on what care we have to provide for our abandoned elders, decided that they need food, clothing, medication, and shelter. And they certainly DO need those things, and I’m grateful they are provided to them. And in practice, it’s difficult to write laws that provide anything more than this.

But that is not LIVING, in and of itself. If you ask around about the real essence of “living”, these are some responses you’re more likely to get:

Living is…

  • Being free
  • Getting out of your comfort zone
  • Breaking the rules
  • Giving something
  • Getting the Final Jeopardy question right
  • Laughing so hard your side hurts and you beg your friend to stop making that face at you
  • Comforting someone
  • Screaming out “AAAAAAAAAAHHHHHHHH!!!!” because you ate your ice cream so fast you got brain freeze
  • Riding the mechanical bull for 8 seconds at a country bar
  • Watching a scary R-rated movie
  • Building something out of blocks, then knocking it down
  • Eating a hot pepper
  • Listening to an orchestra play
  • Singing karaoke with friends who cheer you on even though you’re the worst singer on earth!
  • Running to the beach just in time to catch that sunset

We often think nursing home residents are too old to have any fun. The list above wasn’t just made at random — many of those are things I actually HAVE done with a nursing home resident! Yes, including going to a country bar and riding the mechanical bull. (Clarification: he didn’t ride the mechanical bull, but I did, and he got to watch and laugh as I was thrown off.)

We are fortunate that our friends at the nursing home have the basics of life provided for them. Keep your eyes open for opportunities to provide them with a little something more.

Cat Brain Freeze
Believe it or not, YouTube has lots of videos of cats getting brain freeze

Caught vs Taught

The Whole World is Watching

“Children learn more from what is CAUGHT than what is TAUGHT”, or so they say. Teach your children constantly with your actions, not words. I’ve kept that in mind as I’ve raised my kids, on the lookout for opportunities as they arise. Surprisingly, I’ve gotten more out of it than the kids. I don’t honk and yell at people while I’m driving, because I don’t want my kids to learn road rage from me. I might go just a little more out of my way to help that homeless person, or stop to offer assistance to a driver with a broken-down car. I should have been doing things more often before I had kids, but the children have been the catalyst to get wheels in motion.

I remember one such moment a few years back. Peter was about 5 years old and he and I were in the car together, driving to his next activity, whatever it might have been. It was a cloudless, hot summer day and as we passed Highway 441 I saw “Bill” waiting at the bus stop, in the scorching heat. Bill is a 50-something man with autism, who used to work as a janitor at my former employer’s office. He acts much like a child, but with a good support network manages to live on his own.

Sensing a “teaching moment”, I pulled over to offer Bill a ride. I gently reminded Bill who I was, and he accepted the ride, cautiously entering the car. Bill lived on the other side of town so the ride took 15 minutes. (If you’re not from Gainesville, it takes 15 minutes to get anywhere in this town. I know it defies the laws of physics, but no matter where you are going, it will take exactly 15 minutes to get there. Ask anyone.)

For the duration of the car ride, Bill looked downward, never making eye contact, and repeated himself on an endless loop about how scared he had been that the bus was never going to pick him up, and he would be left there all night. This was absurd of course, because Bill rides that bus almost every day, and it comes quite regularly. But this is one manifestation of Bill’s autism.

Anyway, after we finally dropped Bill off, I figured it was a good chance to enlighten Peter about how some people are different than us, and all that important stuff. Well, Peter turned the lesson right around on me. I was unable to convince Peter that Bill was “different” in any way. Not making eye contact is the norm for kids Peter’s age. And, Peter totally understood how scary being stranded at the bus stop all night would be! To him, Bill was perfectly normal. I realized quickly how in tune my “radar” is – how quick I am to label people as “weird”. For better or for worse, with time, Peter will probably build up his ability to label people as well.

It’s the same thing at the nursing home. Kids don’t seem to notice anything unusual about the residents there. Maybe just a little bit – I mean, you can’t help but notice they are all in wheelchairs. But mostly, kids seem to find nursing home residents exotic, and approach them with curiosity. My daughter Annie adores this 93 year old lady named Doris, and clings to her whenever the chaos at the nursing home gets too much.

Thinking back to my own childhood, I have memories of my Great-Grandmother – we called her “Mimi” – and her sisters. Mimi lived to be 101 and several of her sisters lived into their 90s. They were all so friendly and loving, and I vividly remember how beautifully wrinkled Mimi’s face was – I thought she was the most beautiful person on earth. I can picture her so clearly even now, and the way I felt about her looks. That’s not the same reaction we have as adults to someone that looks like that – we’d probably think “I wonder if she has Alzheimers”.

“Truly I tell you…unless you become like these little children…” said the wise man. I think I understand that a little more now.

Aunt Shirley

A Visit with Dee

A college friend of ours, Dani Clark, wrote this reflection about her experiences visiting a nursing home. We asked her if we could reprint it here.

I had to laugh out loud when I read about the smuggled “cafeteria booty”. As I write this I have here on my desk (compliments of Parklands) two packs of cheesy crackers, some oreos, and two of those restaurant-style jelly packets with the peel-back foil lid (one grape, one mixed fruit). I almost always accept gifts from nursing home residents, because they don’t often get to experience the joy of giving. — Steve

———————————————

A Visit With Dee, by Dani Clark

Dani ClarkIt’s another Sunday afternoon at the nursing home.

My friend Dee is waiting for me at the entrance, bouncing her birdlike frame from foot to foot, impatient for the cigarettes I promised to bring. Newport 100s, as always.

I got you a present, she says, handing me a trash bag as I slip her the contraband cigarettes. Inside is cafeteria booty: two sodas, a Nutrigrain bar and a plastic fruit cup. Her wizened, nearly toothless face looks at me with expectation. Will you use it? I hope you can use it.

This is our routine.

Yes, yes, I will use it. Thank you so much.

We sit outside while she smokes. The weather is fair and snow water drips from bushes nearby. She’s happy, she tells me, that her youngest child surprised her with a visit the other day.

Michael is 40 now, a janitor in a Virginia Beach motel. He was 12 when his father died and things fell apart. When Dee became addicted to Valium and lost the house. When she lost him, and his four siblings. When she took to the streets and then they lost her—for 20 years.

Maybe I can finally get my own place by Easter, Dee says, sucking in smoke. Michael can visit and I can cook for him. We can do what we used to do in the old days: take a trip to McDonald’s and go to the mall.

This dream is Dee’s obsession, and I’ve heard it a million times. I never know what to say. It’s clear she can’t take care of herself physically. She’s lucky to be in the nursing home.

But something else is on her mind today. Yesterday, someone died.

Dee didn’t know her too well. But the death, when she reports it, prompts a serious look, and a confiding, low voice. Dani, is there such a thing as a shot to make you live longer? Her eyes search mine, reminding me of a child. I tell her there are many medicines for many different types of diseases, but there’s no magic shot.

DeeHer chin drops and carries her head down with it. Dee is 69 years old. Someone told her there was a shot.

We all have to die, she says, nodding now, and resigned. But what happens then, Dani? Is it real that we go to heaven? I don’t want to die here.
My answer is wanting and incomplete, exactly how I feel. But Dee seems so relieved of it, of the clichés I repeat, harkening things the nuns told us in grade school. My hands feel so empty, my heart so poor.

The cigarette is a stub. It’s time to go inside.



Before leaving I make the rounds of the dining room and run into William. He wants to talk. I haven’t known him that long, but there’s a connection between us, a spark of recognition shining from the eyes.

Who this elderly black man was or what he did before he was confined to an electric wheel chair is still a mystery to me. But I do know that he is lucid and wise, and that he thinks deeply about things—rare attributes, in the nursing home.

He’s worried about the residents, he says, they all seem so down because of the death. He plans to purposefully lose a game of chess with Maurice, just to make Maurice feel better. He knows everyone thinks about death, especially in the nursing home, especially when you get older, he says, but he doesn’t worry about it anymore.

Oh no?

No. If you pay attention, if you pay deep attention, William says, you will realize something. Heaven is right here too. It always has been and always will be. Heaven is happening now.

My heart leaps. I know what he is saying is true. And I grab a pen so I don’t forget it.

Dim the Lights

Serenity Prayer

In nearly 18 years of hanging around the nursing home, Allison and I have had a few opportunities to practice that first line of the serenity prayer: “God, grant me the serenity to accept the things I cannot change”.

But ugh, how difficult sometimes!

I told you a few months ago about the day my nursing home friend Dan disappeared, and nobody would even tell me if he was dead or alive.

I’ve also told you about the time I got scolded like a little child by the administrator, for locking up my bicycle to the fence. I had been asking them for 10 YEARS to put in a bike rack! (They still don’t have one). I’m steaming just writing about that day!

I continue to ponder how I could better handle these kinds of situations at the nursing home WITHOUT anger, and accept the things I cannot change. Because the lessons we learn at the nursing home always spill over into our personal lives (in a good way).

Our Bicycles
Allison and I arriving at the nursing home on our bicycles

We celebrated MLK’s birthday last month. He’s been gone for nearly 50 years, but we still take time to remember his life, take a day off from school or work, and listen to snippets of the “I have a dream” speech on the nightly news.

Of course there’s really nothing new under the sun, and most of what MLK taught was originally taught by another wise man nearly 2000 years earlier. It was the way MLK practiced what he preached that really separated him from most of us.

There’s one other story of his that you don’t see on TV that often, even though he repeated several times in his preaching career. It’s called the “Dim the Lights” story, and it’s the one that is the most challenging to me. Here’s one telling of it from a sermon he gave in November of 1957:

My brother and I were driving one evening to Chattanooga, Tennessee, from Atlanta. He was driving the car. And for some reason the drivers were very discourteous that night. They didn’t dim their lights; hardly any driver that passed by dimmed his lights. And I remember very vividly, my brother A. D. looked over and in a tone of anger said: “I know what I’m going to do. The next car that comes along here and refuses to dim the lights, I’m going to fail to dim mine and pour them on in all of their power!” And I looked at him right quick and said: “Oh no, don’t do that! Be too much light on this highway, and it will end up in mutual destruction for all. Somebody got to have some sense on this highway.”

That’s really the whole problem, isn’t it? Whether it comes to neighbor vs neighbor, or brother vs brother, or country vs country — nobody wants to be the first to dim to lights.

I got a very poignant taste of this just the other day. This story actually begins about 10 years ago. I was involved in a business transaction the turned sour due to a few petty details. One day I was on the phone with the other party and we really got off track, and all of a sudden I realized he was SCREAMING at me. I had never been on a call like this and I was kind of like a deer in headlights. He proceeded to yell all kinds of insults for at least 10 minutes, while I barely got in a word. Then he hung up on me, and we’ve never spoken again.

Monkey Phone
(Actual guy I was talking to, only madder)

That really ate me up for a long time. Once I gathered my thoughts, I kept thinking I was going to call him back some day, and yell at him for while, just to get my revenge, but I never had the guts to do it.

The story doesn’t end there. As some of your know, I run the chess club at my son’s school. For a couple years I’d recognized the last name of one of the kids in the chess club, and then one day, it hit me. AHA! That’s his DAUGHTER! (She was an infant when this original incident occurred.) Then I said to myself, “FINALLY, I’ll get my REVENGE! I’LL BAN HIS DAUGHTER from the chess club! HE’LL BE CAREFUL WHO HE MESSES WITH NEXT TIME!!!”

Let me be very clear with everyone reading this. This was not a joke. I didn’t laugh afterwards. For a brief moment, I was dead serious, until fortunately, the absurdity of what I was about to do became clear.

This revealed two things to me. First of all, it revealed what a ridiculous person I am, that I was actually considering this. But it also made it clear to me how strong that power is, the power of wanting revenge, which is rooted in pridefulness. In an instant, it transformed me from a normally calm, gentle person, into an angry lunatic, willing to take out a 10-year old grudge on an innocent 10-year old kid.

I see this kind of high-speed-mood-swing behavior all the time when I’m riding in the car with someone. You can be sitting there with a mild-mannered person, having a conversation about, I don’t know, what you’re getting your kids for Christmas. Another car turns right on red in front of them and instantly both hands spring into action. One goes to the horn for a 10 second HONNNNNNNK, and the other one goes out the window, with the middle finger raised. We’ve just got to get our revenge! I think that’s really what it comes down to. It’s not that they made you tap your brakes, or that you’ll get home a full 2 seconds later. It’s as if by cutting us off they “defeated” us in some way, and we don’t like to be bested by anyone.

Angry Driver
What do you mean Starbucks was out of my Latte Macchiato?!?

It’s so easy to talk about world peace and complain about “those savages” fighting amongst themselves in the Middle East, and “can’t we all just get along?” Aah, but when it comes to our own personal life, we realize how tough it really is to love our enemies. I can’t imagine there’s anything tougher to do. Heck, I’m not even close to the goal of LOVING them yet — I’m just trying not to HATE them. There’s good reason to do this though, because “Hate destroys the hater as well as the hated” (MLK). The key is being able to realize when anger and pride are getting the best of us, and snapping out of it, before we do something we’ll regret.

But ugh, how difficult sometimes!

Remembering Hansford W. Farris

A Visit from Bill
Bill stops by our house for a visit

Christmas is a time when many of us get together with family and celebrate. However, around this time of year we also experience some sadness, as we think about past Christmas’s with family and friends who are no longer with us. Today I am missing my good friend Bill Farris, who died last December.

Bill was not a nursing home resident — he lived independently and was sharp as a tack until his death at 95 years old. I always felt a little awkward talking about Friends Across the Ages around him, because I wanted to follow it up with “But just so you know, Allison and I really really like you, not just because you’re old!” Guess I’m neurotic about stuff like that. I didn’t want him to think we just hung out with him as a charitable work, but I could never find an appropriate way to express that to him. Hopefully he knew.

Allison and I both wrote reflections about Bill shortly after he died. We never posted them anywhere, but it seemed like an appropriate time to do that now. Since they were remarkably similar anyway, I’ve combined the two into one reflection below.

Meeting Dr. Farris

We met Hansford W. “Bill” Farris five years ago, when we bought our current house from him and his wife Vera, as they downsized and moved to The Village. 3-year-old Peter charmed him and Vera so much that they decided to accept our offer on the house, even though there was another better offer at the time. A few months later, Annie was born on October 7, 2009. Bill’s birthday was October 7, 1919. They shared a birthday, exactly 90 years apart, so we called them “birthday buddies”.

Vera died a few months later, unfortunately. Bill’s love for her never did, and he spoke about her often; he called her his “little miracle”. We had the great privilege of becoming good friends with Bill over the past 5 years. He was a true gentleman and a scholar in every sense of those words. Incredibly kind, courteous, intelligent, compassionate, astute, and witty. He was one of those people who inspire us to say, “I want to be just like him when I grow up.”

Call me Bill

For a year or two we always called him “Dr. Farris”. Then one day he sat Steve down and said, “Steve, I need to have a talk with you. If we’re going to be friends, you going to need to call me Bill!”. And he was right, it did make a difference. Steve felt more comfortable just calling him up out of the blue and saying, “Hey Bill, how ya doin’?” He even wanted the kids to call him Bill – we compromised at “Dr. Bill”. (By the way, you might have speculated that his middle name is “William”, but it’s not — we’ll leave that story for another time).

Bill was a retired professor of electrical engineering, but he never really retired from teaching in the broader sense. From time to time he would make an unscheduled stop by our house, to drop off a math problem or two for Steve. Steve learned more about the Fibonacci Sequence, the Golden Ratio, and Euler’s Formula, than he ever learned in college. Bill taught us how in 1969 “We went to the moon on a slide rule”, and how the invention of the Magnetron (used in radar) turned the tide in World War II, and forever changed engineering education. And it wasn’t just like reading about it in a textbook, he lived this stuff! Steve doesn’t see engineering as just a job any more, and is proud to identify himself as an engineer because of Bill.

Steve would occasionally ride his bike over to Bill’s new apartment at The Village. Sometimes we would watch his old videos – he had a great series of videos, produced in the 1970s, that featured a youthful Bill Farris discussing the role of the Engineer in society. There was one episode about how a junkyard separates old cars into various elements for recycling, and Peter enjoyed this one.

The “100th Birthday Party”

We always had Bill over for a birthday lunch, except for his 95th, when we came to him, since he had stopped driving. (We called that lunch the “100th birthday party”, since he and Annie were a combined 100 years old). After each lunch, a homemade thank you card from Bill would swiftly arrive in the mail a day or two later. He had an impressive command of the English language (unusual for an engineer). He was so careful in his use of language, and so skilled at finding just the right word to express every nuance of what he meant to convey, whether in writing or in speaking. Allison wasn’t surprised to find out they shared a favorite book: Caring for Words in a Culture of Lies by Marilyn Chandler McEntyre.

Bill died peacefully at his apartment, just two months after the “100th birthday party”. His health and mobility had been deteriorating, much to his frustration. One afternoon he decided it was his time. He took a shower, laid down in bed, and closed his eyes. After his death, his daughter Diane found among Bill’s possessions a birthday card for Peter. Peter’s birthday was not until December 22nd, but Bill had made a card for him ahead of time.

We feel so fortunate, SO blessed, to have known Hansford W. Farris. One thing Allison and I are certain of: it was not by chance this wonderful gentleman and scholar came into our lives. Bill, we will never forget you, and each time we celebrate Annie’s birthday, we will remember to celebrate yours as well. We will take care of your house, and will try to share with our children some of the lessons we learned from you. As sad as we are to lose you, it cheers us to think that you are back together with your beloved Vera, just in time for Christmas. We love you, Bill.

Birthday Party
The “100th Birthday Party”

Where’s My Friend Dan?

Milk Carton

Thursday, October 1st, 2015. I’m angry. I probably shouldn’t write angry.

I’ve lost my friend Dan. I don’t know where he is. I don’t even have a picture of Dan, or I’d put him on a milk carton.

I first met Dan over 10 years ago, when he used to drive his giant 1970s car (more like a boat) over to the nursing home to visit his wife Nellie. He used to visit her daily, and would always stop to chat with me in the halls, and we became good friends.

Nellie passed away, and I didn’t see Dan for many years after that, until at 91 years old, HE had to move into the same nursing home himself. He and I would spend some time together each week. It was like old times again.

That is until yesterday, when I went to the nursing home, and Dan was gone. His room cleaned out. Maybe he moved home. Maybe he passed away. Maybe he went to Hospice. I don’t know, and nobody would dare tell me.

The reason I don’t know the whereabouts of Dan, is because of an oppressive bit of legislation known as HIPAA laws. HIPAA has tormented me for 15 years now.

Let me tell you a little about HIPAA. First of all, HIPAA is more than just about privacy. It stands for the Health Insurance Portability and Accountability Act of 1996. If you want to learn all about it, you’re going to need a law degree and the stamina to read 1000s of pages of legal stuff.

Honestly, I can’t claim to know a lot about HIPAA, because I’m not a lawyer. In fact some HIPAA experts out there might read this and tell me I don’t know what the heck I’m talking about. So take this account for what it is, my personal experience with one small aspect of HIPAA. What I’m going to focus on here is the application of HIPAA to privacy, especially as it affects non-family caregivers.

I know, it’s not good to be anti-privacy. I’d do just as well being anti-baby or anti-puppy than being anti-privacy. But hear me out.

One of the typical implications of HIPAA privacy is this: health care workers cannot share health information about a patient, except with family members, or those people specifically cleared by family members. From day one, employees are warned of the grave consequences (termination) of violating HIPAA. The end result is that health care workers are extremely tight-lipped and fearful around non-family caregivers. Know any non-family caregivers? ME! (And every other Friends Across the Ages volunteer!)

So nursing homes put the fear of God into their employees about privacy. When I ask a question about a resident, my request is often scoffed at. I suppose I can’t blame the employees personally – if they answer me, it might cost them their job.

I believe that nursing homes, at least at the corporate level, actually like this aspect of HIPAA. In general, HIPAA is a thorn in their side, but this is one silver lining. The reality of the situation is, the fewer people asking questions, the better. It just means fewer people to please, fewer people who might find out something that shouldn’t be known. People asking questions are burdensome, at least strictly from a business standpoint. And perhaps, who is to blame them for feeling this way? One nursing home administrator told me there are 17 lawyers in town who do nothing but sue nursing homes, all day, every day. That’s over 2 lawyers PER nursing home!

But here’s the problem. Some people don’t have any family. Or, they only have distant family – a cousin or niece, an elderly sister who lives in another state, etc. We meet many such residents in the nursing home, for precisely that reason – they have no family to care for them! In today’s society, non-family caregivers are becoming more and more important. Our elderly are counting on friends and neighbors to care for them. My wife always says, “Friends become our chosen family”.

HIPAA is inhibiting my ability to care for my friends. They are running a marketing campaign to hype the joys of HIPAA. They have posters up that say “HIPAA: Protecting patient’s privacy!” with a picture of Hipaa the lovable Hippo on it. I kid you not! At this moment I’m in no position to take down this behemoth called HIPAA. But I’m at least going to use the small power of my blog to educate my readers: don’t believe the hype.

Hippo 1Hippo 2

If I were in the hospital and they asked me if I wanted privacy, I’d reply, “Heck no! If anybody calls, tell them I’m sick as a dog! In fact, tell them to get their butt over here and come visit me!” I suspect many of you would feel the same way. I think most of us really aren’t that concerned about having the utmost level of privacy, unless perhaps in the rare case when we have a particularly embarrassing medical condition.

My suggestion is that we take a survey, and ask everyone. “If you were in a hospital or nursing home, would you mind if the nurses told your friends some basic information about your medical condition? If you died, or got transferred to another facility, would you mind if the nurses told your friends where you went?” I think most people would NOT mind, and therefore I think that the presumption should be that most people don’t want this kind of “privacy”, and as a patient you have to specifically “opt-in” if you want it.

I’m not asking to block anyone’s right to privacy. I’m simply asking, can I opt-out? Can I waive my right? Shouldn’t patients be asked if they’d like extreme privacy or not? I’m exposing HIPAA privacy for what it is: a road block to friends, neighbors, and other caregivers (our “chosen family”) who want to minister to us in our time of need. And a convenient tool to save health care institutions from having to deal with questions from meddling little nuisances, like me.

Knock Knock

One of these days, perhaps in a future lifetime, I’m going to go to Washington and take on HIPAA. For now, they’ll continue to bludgeon me with it, when I have the audacity to ask “Where’s my friend Dan?”

UPDATE, OCTOBER 4TH: I FOUND DAN! He is back at the nursing home now. Turns out he had to go to the V.A. Hospital for a few days. I got his niece’s phone number today too, so I won’t lose him again. Life is good!

Lunchroom Drama at Calusa Elementary!

Lunchlady
Our Lunchlady (Artist’s Rendition)



Do you know, I can vividly remember the first time I was ever treated like an adult?

The story starts in sixth grade at Calusa Elementary. This was back in the days (geez I’m old) when sixth graders were still in elementary school – you went to “Junior High” after that. Anyway, we had a crisis in the lunchroom. The oppressive lunch lady didn’t like how loud it generally was, and would constantly turn out the lights on us. When the lights were out, you had to be absolutely quiet. I’d say we ate about half our lunches in the dark.

As a duly elected member of the student council, I decided to do something about this. I met with the lunch lady and arrangements were made for a chart to go up on the wall. Every lunchtime, if we kept our voices at a reasonable volume, we would get a sticker on the chart. I know that sounds incredibly nerdy, but I was strictly a businessman: every time we filled up a row on the chart, the lunch lady had to give us free ice cream.



Milton
Milton knows how to play his radio at a reasonable volume


The chart was a huge success and everybody won. The lunch lady got a quieter lunchroom, we didn’t have to eat in the dark as often, and we got free ice cream (complete with miniature wooden spoon) to boot.

The story ends with me graduating and moving on, but not before leaving a brand new chart in place for next year. We lived right across the street from the school, and I stopped in for a visit at some point the following year. I found, much to my chagrin, my chart was gone, and the vicious cycle of chaos and darkness had yet again erupted.

This honesty made 7th grade Steve really angry, and one of my former teachers talked it over with me. Here’s the point of this whole story: Something about this conversation with my former teacher was so different than any other conversation I had had with an adult up to that point. She honestly lamented with me why no one had been willing to spend the ounce of effort it would have taken to keep the program going. She even apologized for not taking it on herself. I can’t quite capture what was different about this conversation. It was the intangibles. She pulled up a chair and sat down with me. Not on the other side of a desk, but right next to me. And she looked relaxed, not like a teacher lecturing a student, but like two friends having coffee at Starbucks (which didn’t exist in 1986 — you bought Folger’s Crystals and made your own damn coffee at home — but stay with me!)

Reflecting on this today, I realized how critical it is that we capture some of this peer-to-peer conversational style in our nursing home visits. But it has to be genuine; from the heart. Do you know that salesman, that’s trying really really hard to convince you that he’s your best friend, but you’re just not buying it? Yes, you know that feeling. That’s not what we’re aiming for.

I’m really struggling to capture in words what it’s all about. It has to do with body language, vocal cues such as intonation, speech patterns, maybe more. (I’ve noticed that members of my family can usually tell when I am talking to them, without me saying their name. Just by the way I speak to them.) Likewise, I just know when I’m being treated like an adult, and when I’m being talked down to or patronized. Even from a young age, we are very attune to this. So are the elderly – perhaps even more so after 80 or 90 years of tuning up their senses.

If you honestly feel like you are a just a caregiver to our nursing home friends, or a provider of some kind of charitable service to them, or an adult talking to a child, they’ll pick up on it. They get plenty of that already, from their family members, some of whom think they are just old and crazy. Some staff members haven’t been educated in the importance of this, so they are guilty of the same thing. They might address the residents as “Mr. Smith” or “Mrs. Jones”, but their vocal cues give away that they believe they are talking to a child.

So, how do you accomplish this zen conversation I’ve been describing? I think the best advice I could give you would be the same advice your mom gave you when you went on your first date. Remember how terrified you were, and your mom said “Relax! Just be yourself!”.

Occasionally, the peer-to-peer style of communication doesn’t feel right. I’ve told you before about the man named Warren Bowshot that Allison and I used to visit. He was an accomplished Musician, Engineer, Veteran, World traveler. His friends called him “Buck”, but he was always Mr. Bowshot to us; we never felt comfortable calling him anything else. We addressed him with maybe an ounce of friendship and a pound of respect. But there have only been a few examples like this – in my general experience, nursing home residents respond best to being treated as peers.



Mr. Bowshot
Mr. Bowshot with one of the model ships he built.


I invite you today to scan your brain’s hard drive and think back to a time you were unexpectedly treated like a peer, and how that made you feel. If you can somehow capture some of those verbal and non-verbal cues and apply them at the nursing home, it will make your nursing home visits that much more transformative.

Dear Pepper Steak, you were delicious!

Pepper steak with noodles

One of my mom’s best stories tells of a time when she was in Grad School at the University of Florida. She lived in an apartment with two roommates who had nothing in common. One of them had made some pepper steak with noodles and left it in the refrigerator, intending to eat it the next day. But by the next day, all the pieces of pepper steak had vanished, and nothing was left but the noodles. The roommate left the following note on the fridge: I HOPE THE BASTARD THAT ATE MY PEPPER STEAK ENJOYED IT! (By the way, there’s a whole website dedicated to passive-aggressive refrigerator notes.) Later that day, a reply was found attached to that same note: DEAR PEPPER STEAK, YOU WERE DELICIOUS! SIGNED, THE BASTARD.

Funny, but not exactly an apology. Most of us apologize only slightly better than this. We say, “Look, I’m sorry… but you really need to lighten up, it wasn’t that big of a deal.” Or, “Hey I’m sorry if you got offended, but you kind of deserved it.” (Ever heard those ones before? Did you feel any better afterwards? Probably not.)

I think nursing home residents rarely, if ever, get any real apologies. The staff throw out a hasty “Sorry, but I was busy” when they forget to bring a meal tray, or forget to help someone into bed. As a volunteer, I’m not much better. I don’t show up when I say I’m going to, or I forget to bring something from the store that I promised I would pick up. I see a resident flagging me down and I say, “I’ll be right back”, but then I forget and never come back.

I think the reason I don’t apologize much for these things is that, deep down, I feel like I’m providing a service to the nursing home residents. I’m taking time out of my busy day to visit them, right? If I don’t do a perfect job, they should just get over it, right? Deep down, I feel like I don’t owe anybody at the nursing home anything, so why apologize?

I’m trying to be more mindful of this, and offer real apologies to nursing home residents when one is deserved. I read an interesting article about apologizing in Enterpreneur magazine of all places. Did you know there are 3 (sometimes 4) steps in a real apology? I sure didn’t. They are:

  1. Admission of guilt (this is especially important if the other party isn’t even aware of what you did).
  2. Explanation of your actions (you can defend yourself a little here)
  3. Expression of remorse
  4. Reparations (optional, in some cases the apology itself is enough).

To apply this to our pepper steak incident:

  1. Sandy, I was the one who ate your pepper steak.
  2. I knew it wasn’t mine. But I was hungry Thursday night, and it looked so good. I couldn’t stop myself.
  3. I’m really sorry I did that. I promise to be more respectful of your possessions in the future.
  4. Could I make it up to you by cooking you a new pepper steak this weekend, and we could have dinner together?

Now there’s a real apology! See the difference between that and, “Look, I’m sorry, but get over it, it was just a stupid pepper steak”?  Now, for the a nursing home:

  1. Hi, could I speak to Mrs. Clark? Hello, Mrs. Clark? It’s me, Steve. I know I didn’t come by to see you today, even though I said I would.
  2. I got held up at work, and then the kids were anxious for me to come home.
  3. I’m sorry I did that to you. I promise next time I’ll call beforehand to let you know, so you won’t be waiting for me.
  4. I’m not doing anything this Saturday, what if the kids and I stop by for a visit?

As is often the case of the lessons we learn at the nursing home, they transfer into our personal lives too. This I promise you: a well thought-out and sincere apology can melt a heart of stone. As the receiver, we succumb to its power; it swallows up our anger even against our own desires (because dammit, I still want to be mad at you!). It replaces that anger with compassion and forgiveness. An apology works wonders for our relationships – I have witnessed its powers first hand when I’ve been brave enough to offer one. For whatever reason, it usually stings a bit to apologize. But sometimes, if you dig deep enough and admit to yourself that what you did was wrong, it can feel really good.

Hey, I’m sorry that this reflection on apologies was so long, but it’s your own fault for reading it anyway! (Ok, guess I’ve still got some work to do…)

Remember Me

Else and Peter Pan on Halloween
Else and Peter Pan on Halloween

By Allison Blay

As I sit down to write this, I have just come from another funeral.  Steve and I go to a lot of funerals—it sort of comes with the territory of volunteering at a nursing home.  However,  this particular funeral was not for someone we met through the nursing home, but rather for a former neighbor of ours—who later did spend some time in an assisted living facility.  Her name was Else, and she was this tiny, sweet little German lady.  She and her husband George (who died a couple of years ago) lived up the street from us, and we would see them often because they were almost always out in their yard, doing some sort of gardening or another—their property was a pristine park thanks to their meticulous care of it.  Else loved children, and when I would walk up the street with my son in the stroller, she would always take off her gardening gloves, and come over to tickle his toes, tousle his curls, and say “oh, what a beautiful baby.”

There were not many people at Else’s funeral today—only her daughter and son-in-law, and a handful of neighbors.  I couldn’t help thinking that Else deserved a cathedral packed with people, so sweet and tender-hearted was she.  She lived such a full life in her 89 years.  (I am told she was even an Olympic skier!)  I felt fortunate to be one of the people there to say good-bye to her.

November is a time in my faith tradition for remembering the dead.  Steve and I have so many friends who have gone on, and each of their names brings a smile to our faces as we think of them—Miller, Annie Mae, Judy, Sally, “Skybow”, Joanne, Dorsey, Bill, Jethro, Miss Black, Lana, Mr. Bowshot, “Granny”, Ruth, and on and on and on.  Annie Mae is the one I miss the most.  I visited her for seven years, several times a week—and now it is hard to believe she has already been gone seven years this month.  As difficult as it is to lose a friend, I feel it is such a blessing to know people during this sunset part of their life, to hear their stories, and to keep them company as they walk this last part of their journey.

Annie and Jethro
Annie Mae and Allison, with Jethro and Steve

Only once have I actually been present when someone died—that was Judy, who was someone Steve and I got to know very early in our years of volunteering.  Judy was probably somewhere in her 50′s, and had end-stage colon cancer.  She was very quick-witted, and had a wonderful spirit.  One day she took us down to her room and said she wanted to give us a some things of hers: a couple of glass votive candle holders and a chipped ceramic angel.  She said she wanted us to have something to remember her by.  Not long after, her health went downhill very suddenly, and in just a matter of a couple of weeks she went from being the vibrant, spirited Judy we knew to being barely conscious…and then not conscious at all.

I remember the last week, her family was suddenly there all the time and I didn’t get a chance to see her much at all because I didn’t want to interrupt their time with her.  But one afternoon I peeked in her room and there she was, all by herself.  The nurse had told me she didn’t think it would be long now.

Her breathing was very labored.  She was visibly suffering, clearly ready to go.  What was holding her here?  I thought about how she had wanted us to remember her, and recalled reading about the needs of someone who is dying: to be remembered, and to be told it is o.k. to go.  So I took her hand and started talking to her, telling her “Judy, I promise we will remember you.  We will never forget you.  We love you.  It’s o.k. to go now.”  And I prayed that if it was time, God would take her home.  Slowly her breathing grew more spaced out.  I called for the nurse, and then went back and took her hand again, saying the same things to her.  In the minute or two it took for the nurse to get there, Judy breathed her last.  It was the only time I’ve ever seen someone die, and as it turned out, I was the only one there to witness her death.  I have never forgotten that moment, which was over a decade ago, and I don’t suppose I ever will.

Being present with those who are nearing the end of their lives can be sad, scary, painful, heart wrenching…but there is something mysteriously holy and beautiful about it too, something that is really beyond words.  I think during the time when someone dies, the veil between this life and the next flutters a little, and grace can enter in ways we do not expect.

I hope when my time comes, someone will be a friend to me—willing to hold my hand and tell me that they love me, and that they will remember me.  In the meantime, I am grateful to Judy, Else, Annie Mae, and so many others who have let Steve and I share the end of their journey with them… we will remember them always.

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