The couple asked if they might attend my morning lecture before our interview in the afternoon. Of course I agreed and it enabled me to garner some distinct observations and impressions of the couple that I could explore later. What was most striking to me were the differences in their physical appearance. Nori, a 45-year-old Rehabilitation physician, was permanently disabled due to treatment of a cancerous condition of one hip. Consequently, he has been confined to a wheelchair for some 15 years.

Despite a more recent and very troubling diagnosis and treatment of a brain tumor in 2010, Nori looked strong and robust with full cheeks; dressed immaculately in his suit and tie; and very attentive during my lecture. His 46 years old wife Hiroko presented a stark contrast. Although not disabled in her walking ability, she appeared more “disabled” in her physical appearance than her wheelchair bound husband. Although Japanese women often have more soft and small features than other ethnic groups, Hiroko was frightenly thin, pencil thin, with eyes that appeared vacant. She sat so still during my lecture, looking straight-ahead and very intent.

What was evident with this couple is what I have experienced with numerous couples and families, that the person with the illness diagnosis is often not the person suffering the most. It certainly appeared that it was Hiroko who was experiencing the most anguish.

As the therapeutic conversation unfolded, I learned more details about this couple’s illness narrative. I inquired about the impact of illness on their lives and relationship, especially their marriage. I also explored some of their illness beliefs about their current situation.

This couple had been married eight years at the time of Nori’s frightening diagnosis of a brain tumor in 2010. Hiroko claimed it was like a “nightmare” for her. This metaphor captured well her past and current torment and suffering about her husband’s condition. She reported that she worries about his condition 70% of the time and is anxious if it “will come back”. Her excessive anxiety and worry has resulted in loss of appetite, sleep and even needing to live with her in-laws for a time to be taken care of when Nori was hospitalized for his condition. She also contains her worry and does not share her concerns even with her own parents. Hiroko does all the worrying for this couple as Nori surprisingly claimed he did not think about his condition at all as he was “busy enjoying his work”.

The impact of the illness upon their marriage revealed that Hiroko has now taken on much more responsibility overseeing finances and completing their taxes. She also made a very touching comment that since they did not have children, Nori’s illness gave her an opportunity to “protect someone”! However, the protection of her husband had sadly evolved to erasing her own needs and aspirations.

As I normally do at the end of an interview, I offered this couple some commendations and recommendations. I offered Hiroko my conceptualization that she had a problem of loving her husband so much that she had made herself ill.

But first I commended Hiroko for the love, caregiving, and devotion to her husband. However, I suggested that it would be helpful in the future if she could find a way to love and care for her husband in a more “healthy” way. She then asked me how to deal with her feelings of worry and anxiety. I was pleased with Hiroko’s question as now she would be even more open to my recommendations.

Since Hiroko had been erasing herself as a woman and wife in the world, I encouraged activities that would focus on her and her current health problem. One recommendation I made was that she learn meditation as I explained it is often very helpful to persons suffering with anxiety. I also suggested she might seek out a cognitive behavioral therapist as another method of learning ways of gaining more control over the influence of anxiety in her life.

Since her husband Nori gains much support, love, and attention from his wife, I believed that shifting their couple dynamic from being less unidirectional (Hiroko to Nori) to more interactional, would enrich the marriage and enable Nori to show more of his love for his wife. His love shone through when he asked, “what can I do for my wife?” I asked him if he would be willing to take the leadership to inject more “fun” back into their marriage. I had learned that their only outings together were to attend conferences where Nori would speak about his condition and of course he would again be the focus of attention. They both appeared delighted with this suggestion and Nori said he would be willing to take the “leadership for fun”.

Of course it would have been easy to pathologize this couple (or any couple for that matter) but I prefer to be a strengths detective and uncover the competencies, strengths, and resources within couples and families and offer them back as commendations. The therapeutic intervention of “commendations” has the ability to invite family healing due to a new way for the couple to view their relationship with one another and their relationship with illness.

In a brief follow-up phone call the next day by one of my colleagues, Nori reported being pleased and satisfied with the interview while Hiroko reported that she was “uplifted”!

Perhaps the more specific lesson learned from this couple is that erasing oneself to love another, even a loved one who is ill, is perhaps not love at all, but rather a prescription to make oneself ill. Simultaneously loving oneself AND loving one’s partner in a marriage enables both to grow, mature, and thrive. I am hopeful that Hiroko and Nori will experience a more mature and healthy love as they continue on their illness journey. It was a privilege to have met them.

Clinical Practice Models utilized during this therapeutic conversation included the: Calgary Family Assessment and Intervention Models www.familynursingresources.com);
Illness Beliefs Model www.illnessbeliefsmodel.com) and
Trinity Model www.spiritualitysufferingandillness.com)

Click here to read the chapter.

No question that Steve had the drum major instinct.   Martin Luther King said:  “We all have the drum major instinct.  We all want to be important, to surpass others, to achieve distinction, to lead the parade.  And the great issue of life is to harness the drum major instinct.  It is a good instinct if you don’t distort it and pervert it.”

Perhaps we do not all agree with King that this is a universal human quality but in the genius of one Steve Jobs it was ever evident.   Steve Jobs certainly knew how to harness the drum major instinct.

I am writing this blog on my MacBook Air while lecturing in Madeira, Portugal.   I will finish and send it off into cyberspace to friends/ colleagues in many countries within a matter of seconds.   This is just one of the many products produced by Apple under the iconic leadership of Steve Jobs.

Way back in 1984, I purchased my very first Apple product, which was called the Macintosh 128.   I don’t remember if I even knew who Steve Jobs was but I vividly remember the excitement I felt as drove to pick up my very first computer.    In that model, all the developers signed their names inside the computer.   If only I would have had the foresight to keep that model as I am convinced it would now be a collector’s item.

I have been a loyal and devoted Apple fan ever since and have progressed through various models from the Mac 128, to the 512, to iMac, MacBook Plus, and others.   And then of course I expanded to the iTouch, the iPhone, iMovie, iChat, and wanting to learn iEverything!

While lecturing in Shanghai, China in February, 2011, I needed a small problem resolved with my MacBook Air so I ventured out to the Shanghai Apple store.   It was an imposing structure on a very busy street corner with the Apple logo in full view.  The building is two stories tall with a glass 40 foot circular staircase from the first to second floor.   As in North America, the store was packed with eager testers and consumers.    The visit to the store was like a going home to a familiar, favorite place.   Yes, there was the Genius Bar; the many products in full display for all to try, and all those young, smart employees eager to provide assistance.  Everyone in the store was beaming with enthusiasm and energy!

When I told the young man at the Genius Bar that I was not able to access a couple of blogs that I follow, he asked me if I lived in China.    I was taken back by his question but soon had it explained that if I lived in China, he could give me a code that would enable me to use the “underground system” of accessing items on the internet that their Government does not allow the general population to obtain.  I am guessing that Steve Jobs would be pleased to know that these young people will not allow suspicious, controlling regimes to block their curiosity to surf whatever their wish on the internet.   The Drum major instinct has found it’s way to China too.

Also while lecturing in Shanghai, I met a young woman who had changed her career from being a hospital nurse to a nursing editor with a publishing company.   I asked her how this change had come to be.   She told me that she listened to a talk by Steve Jobs (she pronounced Steve Joooobs) and inquired if I knew of him.   I admitted that yes I had heard of him.  She told me that he was the CEO of Apple and she listened to a talk by Jobs and he said that you should “follow your heart” to the work that will engage your passion.     After hearing his talk, she went to her Supervisor at the hospital the very next day and resigned as a hospital nurse.    She had a yearning for writing and publishing and approached her current company and to her great surprise, they hired her on the spot.

I wonder how many others have been inspired by Steve Jobs words and not just the beautifully produced Apple products.    But I believe you have to be a drum major first before that kind of weight and credence will be given to your words.

The biographer of his book, Walter Isaacson, stated that Steve Jobs wanted his biography written because he wanted “his children to know him”.   Sad statement from a man who was known worldwide and by my new, young colleague in Shanghai but he did not feel known by his children.   What triggered his desire for more frequent production of Apple products that were produced at a high personal cost?

Since his passing, we have learned that in addition to the drum major instinct, it was life-threatening illness that drove his passion for innovation and distinction.   When he learned that his life would be shortened, despite the best and leading-edge treatment, he let his instincts bear down even deeper to create more phenomenal products.

As he proudly announced each new product in more rapid succession, we witnessed his body becoming thinner and thinner even though camouflaged beneath his “uniform” of black turtlenecks and jeans.   What we did not know was that as his illness progressed so did his desire to work longer, work harder, and produce more.

Martin Luther King invoked the drum major instinct was okay if we are guided by being first in love, moral excellence, and generosity.   There are many kinds of drum majors and Steve Jobs was certainly a genius in advancing technology that has enabled new ways to show love, new ways of relating to one another,.   How many babies have been born and grandparents enjoy a picture in another city or country within minutes of the birth via iPhone and iPhoto?

Thank you Steve for following your drum major instinct and for the countless hours of enjoyment I have had with your products.   We hope that your children will come to understand, if they don’t already, (and forgive If need be) that it was life-threatening illness that drove you to step up the pace of your own personal parade as a drum major and offer the world your incredible brilliance!

What area of your life would you like to be more of a drum major and “be first in love, moral excellence, and generosity”  but without the personal cost when harnessed by a life-threatening illness?

When the first images of the disasters were shown on our Canadian TV networks, I found myself tearful.   But now it has been three weeks since the triple disaster struck Japan.  Now tears are not enough.   My heart has been heavy but what can I do to help heal Japan?   What can we all do together?

All the major North American TV networks have shifted focus from talking to survivors to talking to scientists.   Is this because talking about radiation levels is more dramatic and newsworthy than to report the suffering of those who have survived but are dying inside?  What is the meaning and purpose of the lives of survivors when they have lost everything?

What do we do after we dry our tears?   The day after March 11, 2011 disaster in Japan, I had the enjoyment of dining with my colleague Dr Regina Bousso and her daughter Karina from Brazil.   I asked them if they would be willing to eat at a Japanese restaurant as a small way of honoring our Japanese friends/colleagues.   At the restaurant we were delighted to learn that all the families of the restaurant staff living in Japan were all accounted for and safe.  We expressed our sadness of what had happened in Japan and they expressed their gratefulness that we had come to the restaurant.

I have had a very fond and frequent connection with Japan ever since my first visit in 1993.   I was invited to Chiba University to give a keynote address and I was awestruck with the food, the culture, the décor but mostly by the respectfulness, politeness, and kindness which was demonstrated to me by my new colleagues.  Since that time I’ve returned almost every year because of lovely invitations to lecture/speak in many cities and towns from Kobe to Osaka, Yamaguchi to Hiroshima, Nagasaki to Kagoshima, Karume-City to Okayama, and incredible Tokyo.  I love Japanese food, culture, décor, and most of all, my relationships with friends/colleagues.   Therefore, my desire to offer help and healing to Japan and my Japanese colleagues/friends has been constantly with me these last weeks.

Since the disasters, I have been in frequent contact with friends/colleagues in Japan offering support, strength, and love from a distance.  Plus, I’ve made the traditional financial donation to assist with the disaster relief.   I have also committed to attending our 10^th International Family Nursing Conference in Kyoto, Japan in June, 2011 as another small way of providing support and courage in this time of great suffering.    But how can this possibly be enough?

Despite these triple disasters, Japanese culture remains one of order and calm.  One of the most heart–wrenching images of quiet resilience was watching a very long line of stoic Japanese citizens queuing up to each receive one apple.   ONE APPLE!! There was no looting for this apple, no yelling at the authorities in charge that the line wasn’t moving fast enough or that some should be entitled to more than one apple.

Each person was quietly and calmly accepting the one apple and bowing to the volunteer who passed it to them.  Even in the midst of horrible suffering, the code of civility, respect, patience, and decency in Japanese culture has not been broken.

Of course it is going to take a very long time for Japan to recover from the terrible disasters.   The stories of suffering and strength of the survivors and the relief workers needs to be witnessed, listened to and documented.   The spiritual suffering of the loss of meaning and purpose in the lives of the survivors needs to be given a voice as they search what is worth living for.

For those of us living in other countries at great distances from Japan, perhaps the best way we can help is by being willing to learn from the example of the Japanese of how suffering can be endured in dignified and respectful ways.   Perhaps acknowledging in our own lives the suffering lessons from Japan will help them on their healing journeys because their suffering will have not gone unnoticed or been in vain.

Perhaps each one of us who observes these dramatic displays of patience , respect, and strength can make a commitment in our own lives to complain less; show kindness more; to patiently wait our turn in life; and to offer a hand to those who are suffering in our midst when tears are not enough.

What ideas do you have for how to help Japan heal from a distance?  What have you learned from the example of Japanese survivors that you will implement in your own life?

As Bryan Adams song offers:  Heaven knows that tears are not enough; We can make it work, for God’s sake lend a hand.

To more adequately honor the monk who took the initiative to start the Center for cancer patients and families, I would like you to know his name.  His name is Pra Ajarn Paponpat Jiradhammo and he is respectfully known as ‘Luang Ta’ by the villagers.   My Thai colleague/friend Dr Somporn is also sending him a copy of the blog and I can only hope that I have represented his comments well.

I’ve also included a couple of photos of this monk on the previous blog.  One photo shows some of the patients/family members, with their herbal preparations on their laps, meeting with the monk for his blessing on the herbal preparation.  The other photo is the meeting we had with Pra Ajarn Paponpat Jiradhammo at the end of our visit.

To view the previous blog with the photos, just click on the following:   http://www.lorrainewright.com/blog/2011/02/21/the-most-powerful-kind-of-healing-not-desiring-a-cure/

I am delighted that so many of you have found my reflection about the fascinating phenomena that letting go of the desire for a cure tends to invite healing as a useful one for yourselves.

International travel and lecturing affords me many meaningful and serendipity experiences.  One such experience occurred recently in Thailand. Three Thai colleagues/friends and a Canadian friend and I visited Wat (temple) Kumpramong.

In addition to the Temple, the area also consists of a Center which functions like a large palliative/hospice care center but with some stark differences from North American cancer care.  The Center and Wat are located on a large expanse of land that is very beautiful, peaceful and a far distance from any other towns Punnanakorn district in the province of Sakonnakor, Thailand.

The Center can accommodate 50 patients and their families who are experiencing cancer.  No distinction is made between rich and poor.   All are welcome and there is no cost.  The Temple and Center operate on the generous donations from others.   However, family members must stay and provide the care to their loved one.  A physician volunteers once or twice a week for medical assessments.  Other volunteers also assist at the temple for care and support.

The Center is led by a monk, Pra Ajarn Paponpat Jiradhammo,  who himself has experienced cancer.    At the time that he fell ill with cancer, he was a practicing engineer.  But life after cancer found him researching various healing methods that led him to develop an herbal drink with eleven different ingredients.   And this led to his new vocation as a full time monk.  He is respectfully called ‘Luang Ta’ by the villagers.

The herbal drink developed by the monk is one of the important interventions at the Center.    However, in witnessing this intervention, I was struck by how many other interventions were embedded in this one ritual and at the center as a whole.

Once a week, the monk offers prayers and an inspirational talk of Buddhist beliefs wherein he also offers hope and humor.  Following his talk, each patient (or a family member if the patient is too ill) brings their package of herbal mixture developed by the monk and kneels respectfully in front of him. Prayers and a blessing for the herbal preparation is then offered by the monk.  The monk also mentions the name of each patient during this ritual.

Afterward, each family takes the herbal preparation and immerses it in boiling water.  Once stirred and boiled sufficiently, this drink is administered to the patient several times a day.  This ritual is repeated each week.

Subsequent to this ritual, we had the privilege of meeting three families who had been admitted during the past 24 hours.  I was curious what they were hoping for during their stay at the Center.   All responded unanimously that they desired a “cure”.

Later as we walked about the grounds, we spontaneously encountered other patients and families who had been at the center much longer than a day; some for two weeks, others even two months.   Quite different responses were offered by these patients/families about their experience at the center.   Amazingly, no one mentioned the desire to be “cured” but rather how they liked the peacefulness of the center, living with other families and helping one another.

One of our Thai colleagues, Dr Somporn, was able to arrange for a discussion with the monk at the end of our visit.  During this discussion, I asked this very devoted and dedicated monk if the goal of the center was for “curing” or “healing”?   He offered that patients/families come to the center hoping to be cured but leave with healing; peace of mind and letting go of the desire for a cure. Indeed some are cured but the most precious outcome seems to be healing rather than curing.  The monk was also quick to offer that the herbal drink was but one aspect of the healing process at the center.

Leaving the Center, I was profoundly touched by what I had witnessed and experienced.   This Center combined many interventions that created a beautiful context for healing and softening suffering.  Specifically some of the interventions offered were:  family support for an ill loved one and for other families; families forming a community of mutual assistance; spiritual wisdom from the head monk; prayers; addressing individual patient’s by name in prayer; and the ritual of praying over the herbal preparation; patients/families boiling the herbal preparation together.   This truly was a Center for cancer patients and their families that addressed the biopsychosocial-spiritual needs.

It struck me that this spiritual leader also functioned as a very wise, self-trained, health care professional.  He was insightful and knew that when patients and families altered their belief and desire for a cure that their suffering softened and healing began.   One is left to wonder if  healing became even more precious and cherished than curing as startling as that may be?   Is not the ultimate goal of all heath care professionals, especially nurses, to create a context of caring where healing may emerge whether or not a cure happens? I believe so.

What reflection do you have for your own life and practice about healing vs curing?

My New Question:  When is a family a “family”?

 I was surprised that there were more family members present than just the ill child;s parents’ Rafael and Valeria and their five year old handsome son Gustov. Rafel’s sister, brother, and aunt accompanied the young couple exemplifying Brazilian culture and devotion to family.  All of the adult members of this family who attended the meeting were only in their 20’s.

 The couple’s daughter had spent most of her short 18 months of life in hospital with a serious but undiagnosed illness with metabolic and respiratory consequences.   As I listened to this heart-wrenching narrative, I learned that the parents had suffered greatly because of their daughter’s long hospitalization.   In the relating of this illness story, triggered by my therapeutic questions, I now understood where their greatest suffering lie.

Specifically, they all held a common belief that this little Carol had not experienced being a family despite steadfast and committed visits by family members.  They offered their belief that  this child could only truly “experience being a family” if she was at home.  They suffered great anguish that their family was not complete as long as their daughter lived a hospital life rather than at home.  They realized that if their ill child came home, it would require great sacrifices on their part but the goal of “being a family” superseded any concerns or worries about being caregivers.

 Witnessing their great anguish and suffering around their belief that a family is not a family if one member lives in the hospital invited me to offer the recommendation that it is “time to bring your daughter home”.  The family members’ reaction to my advice was to weep in relief.   I believe the family wept because their deepest suffering had been acknowledged based on their belief that they were not a “family” if one person lived in the hospital.  Of course the family realized that this idea of bringing their daughter home would have to be proposed to the health professionals in charge of their daughter’s care plus a plan for how they could care for her at home.

As I often experience, it is having suffering acknowledged and understood that has the potential to offer great relief to families regardless if their desired changes can be met.

 I have made efforts to define a family in our book Beliefs and Illness:  A Model for Healing (2009).  Janice Bell and I defined family as a “group of individuals who are bound by strong emotional ties, a sense of belonging, and a passion for being involved in one another’s lives”  (p. 46).  This definition can certainly apply to  this young and impressive family.

Maureen Leahey and I have also offered a definition from the family’s perspective in our book Nurses and Families:  A Guide to Family Assessment and Intervention” 5^th edition (2009). Specifically, we offered the idea that the “family is who they say they are” which was evident by who chose to come to the family meeting.   But these definitions did not capture the family’s feeling or experience of being a family.

But can you “touch” a family?

But despite all my well intentioned efforts to define a family, develop models to assist families, one of my most fascinating realiazations is that you cannot actually “touch” a family.  The best we can do is talk to individuals who think of themselves as being part of a family.   Family is such an interesting notion that has been created and evolved in sacred texts, academic books, novels, television sitcoms, movies, and now in the social media with stories and pictures of one’s family on Facebook and You Tube.

Of course each person’s own beliefs about their experience of family contribute to the discourse.  The concept of family is socially constructed and our beliefs about what constitutes a family are deeply entrenched and often out of our awareness.  But everyone has an idea of when they feel like family and others extend their experience of family by saying “they have become just like family” or reducing this experience to “I don’t have a family”.  It is in the experience of feeling and being a family, that one can actually “touch” a family?

I now routinely ask the question “when do you experience being or feel like a family” in my clinical practice and the answers are incredibly far-ranging and enlightening.   I thank this lovely Brazilian family for teaching me and continuing to add to my understanding about families even after 35 years of direct clinical practice.   This new learning of course influenced the interventions that I offered the Brazilian family.

Maureen Leahey and I have co-produced an educational DVD entitled:  Interviewing an Individual to Gain a Family Perspective”as another effort to expand the notion of family experience with chronic illness even if only able to meet with an individual.

 You might find it enlightening to ask your own family “when do you experience being a family?”   Would you also be willing to experiment asking families especially when one family member is hospitalized, “when do you experience being a  family”?

The new Leonardo entered my life far away from my home here in Canada but in Sao Paulo, Brazil.  While lecturing at the University of Sao Paulo and the Federal University of Sao Paulo in September, 2010, I had the privilege of meeting with a Brazilian family to discuss and learn about their experience with serious illness.

This family consisted of the mother, age 53, who was diagnosed with lymphosarcoma; Father, age 47, and their two children, Fabiana, age 24, and Leonardo, age 20.  The mother sat in a wheelchair during the interview appearing very thin and wearing a scarf to cover her head that was left bald as a result of chemotherapy treatments.  The mother and father were married 20 years but now separated for 5 years.  Surprisingly, although they were separated, they were still very “married” as evidenced by their descriptions of their relationship as being “closer”, more “friendship” and “caring”.

After our initial greetings to one another, I asked the family a variety of assessment and interventive questions to ascertain how they were experiencing this hard journey with a serious illness.   For example, I explored the roles in the family by asking who was caring for their mother at home.  To my amazement, Fabiana answered that it was Leonardo, her brother.  I told Leonardo that in Canada, I had never met a young 20 year old son who cares for his ill mother.

Leonardo’s name was offered again when I asked the question “Who in the family is suffering the most?” The son affirmed other family members’ perspective that he was the one with the most anguish in this experience of his Mother’s illness. Fabiana offered the explanation that Leonardo was suffering the most because he is the “keychain” to his mother. Leonardo and his father did not disagree.   I have found it to be a very common experience that the family member suffering the most is usually NOT the one with the illness diagnosis.

Through further questioning, Leonardo revealed that he accepted his role willingly to care for his mother.  And in the caring for his mother, he even discovered a new interest in “gastronomy” (cooking) that he wishes to pursue when his mother is well enough for him to obtain further training.  The family was optimistic about the mother’s prognosis because of her positive response to chemotherapy treatments.

At the end of our meeting, I offered the family some commendations.  Specifically, I offered them the idea that I believed that the caring and devotion they showed to their mother and wife has also contributed to her healing, in addition to the chemotherapy treatments.  They all agreed.

But I gave special attention to Leonardo by telling him that I will always remember him and that he was much more handsome and was doing something much more worthwhile than Leonardo the actor.  He smiled profusely as did all family members.   Yes, THIS Leonardo is my new favorite one because he gives willingly so much of his young life and love to his mother during this very trying time.  It was indeed an honor to have met Leonardo and his family.

I am also very grateful to my colleague/friend, Dr Margareth Angelo of the University of Sao Paulo, who patiently and caringly provided translation between the family and me for this interview.

Ideas for how to ask questions that can invite healing are provided by Dr Maureen Leahey and me in a DVD entitled How to Use Questions in Family Interviewing.

But the most curious developmental aspect of becoming a senior was the realization that I am now a Senior Daughter of a Senior Father (88 years).

Over the past couple of weeks, I experienced being a Senior caring for a Senior while my Senior Father and his Senior 84 year old wife (of eight years) were guests in my home.  I was keen and willing to care for them and transport them to their various medical/dental appointments.  I believed that I could easily implement some of the skills that I often use in my clinical practice when working with the elderly and their families.  But alas, for the most part, these skills escaped me.

In my recent ‘at home experience’ of elder care, the huge difference was that I was caring for my Senior Father, not a client.  I have a lifetime of history, patterns of interaction that are quite entrenched; mingled with strong affection for my Father.  The other qualities that I wanted to express during my Father’s stay included kindness, patience, and thoughtfulness. I wish I could say that I demonstrated these qualities everyday but I cannot.  Some days these qualities came easily, other days not so much.

I also found myself wanting to have a break from caring for my Father but guilt held me back. Did my Father also want a break from me sometimes?  I blamed the close living quarters, tiredness, or was it just that two senior generations living together, even for a short time, are just not a “fit” in our Canadian culture. Is this what the need for respite feels like, for both a Senior Daughter and Senior Father?

Some days I relished having my Father in my home to benefit from his wisdom and experience. I took advantage of this opportunity by asking for his advice on various matters in my life but then would quickly fall into the trap of being too directive and instructive about his diabetic diet, his exercise, even his life.

No wonder my instructions were met by a wall of  humor or defensiveness to deflect my intrusions into his life. Where was my real respect for his wisdom?  Is this how Senior Daughters express their concern and love for the lack of a perceived healthy lifestyle of their Senior Parent(s). How quickly I forgot their many years of life experience and decision making that brought them to this moment.

These few weeks of living with my Senior Father and his wife was but a drop of time in all of our lives but many life lessons were learned. The main lesson for me was that the elderly like my Father and his wife who continue to live on their own with minimal assistance, need encouragement, admiration, respect and a cheering club for how they continue to manage their lives.

So I am left believing that I am under skilled (but willing to learn) as a young Senior Daughter but well skilled as a Health Professional to assist other seniors caring for seniors!   I hope there will be a more of a professional/personal balance soon.

Perhaps it would also have helped if I had reviewed the recent educational DVD that Maureen Leahey and I just produced entitled:  Tips and Microskills for Interviewing Families of the Elderly. In this DVD Maureen interviews a brother and sister in their early 70’s regarding the care they provide to their 99 years old mother.

Maureen and I offer our ideas on the DVD about how to engage with family members of the elderly, obtain a brief relevant history and assess one of the most common experiences of seniors caring for seniors, that is, caregiver burden and the impact on personal and family life.  Maureen does a lovely job of responding to their suggestions about their mother’s care.  You can view a sample streaming video of this DVD by just clicking on this link.

Are your skills in balance between caring for your elderly parents (if you have that privilege) and caring for the families of the elderly in your professional practice?

Flight Plans for our Personal Lives

I found the constant correcting by a pilot toward the stated flight plan to be a useful metaphor for correcting and improving ourselves in our personal and professional lives.   For some of us, we are overly zealous about trying live the perfect “flight plan”.  These individuals tend to be obsessive, highly disciplined, but often find it difficult to have fun in the pursuit of their destination.   The “flight plan” or journey is not enjoyed because of the complete focus on the destination or goal.

At the other end of the pendulum are individuals who drift far away from their life’s “flight plan” and their ultimate destination, sometimes by their own choices, sometimes not.  For example, these individuals may experience serious illness, relationship issues, and/or addictions.

For the majority of us, we try to correct the flight plan a few degrees at a time to improve ourselves, our relationships, health, and/or work to reach our destination or goals.

Perhaps perfection need not be our ultimate goal but to know what the corrections need to be that will bring us closer to perfection and the desired “flight plan” for our lives.   In our personal lives, they are as many flight plans as there are individuals.   Discovering what kind of individual we are and/or want to be is a unique search for everyone.  Once we are clear about the “flight plan”, then it is a series of corrections and how to avoid the mistakes that will take us away from our flight plan and our various destinations.

Flight Plans Caring for Families

For those of us that are health professionals involved in the caring of families experiencing illness, we also know that the “flight plan” of working with families will need constant correcting and avoiding of errors.   There is much written by various health professionals about the kind of relationships and skills that will soften suffering but little about what errors to avoid in our relationships and how to correct those errors.

A few years ago, I presented at a conference in Iceland some preliminary findings about therapuetic errors and failures. The room was packed with fellow health professionals.    I was curious why so many had attended and so I asked the question: “Why did you decide to attend my presentation?”.  Several participants made the same comment:  “I know what I am supposed to be accomplishing when meeting with families with illness but I have never heard anyone present about mistakes and how we can correct them.   We all are making mistakes that we wish we could avoid”.

These preliminary findings were from research conducted with Janice Bell and our research assistants.  We observed retrospectively on videotape our clinical work with families who expressed dissatisfaction with our efforts to assist them. We discovered that the following errors had occurred with these dissatisfied families: failing to create a context for change; taking sides with family member over another; and/or giving advice prematurely.   By identifying these errors, we have been able to substantially correct our “flight plan” with families and are more sensitive to avoiding these mistakes.

Identifying common errors is the beginning of awareness to change our behavior as clinicians. Further improvement in our relational practice and clinical skills can occur through the demonstration of how to correct our mistakes when interviewing families.

To that end Maureen Leahey and I just produced a brand new 2010 DVD entitled:   Common Errors in Family Interviewing:  How to Avoid and Correct. You can view a sample streaming video of this DVD by just clicking on this link.   Specific interviewing skills are demonstrated that show how to work collaboratively with all family members in the room without taking sides and how to create a context for change once these mistakes have been made. Both physical and mental health issues are explored.

The skills to avoid mistakes and errors can also be read in more depth in the chapter in our book Nurses and Families:  A Guide to Family Assessment and Intervention (2009) 5th Edition.

To correct errors in our personal lives, even small corrections can make for substantial changes to move closer to the preferred “flight plan” of our lives.

The same is true in our clinical work with families.   Small corrections can move us closer to a preferred “flight plan” working with families that will offer more hope and healing to individuals and families who find themselves suffering an undesired and unplanned “flight plan” for their lives.

How close are you to your preferred flight plan for life and caring for families?

What small corrections would make for substantial changes towards your destination?