6 Life Lessons From Ones With Dementia

I spent Thanksgiving Day in the dementia care community where I work. Throughout the day, I got reminders about what matters in life, and what doesn't. Take a guess, then read on . . . 

Mind

Few of us pause to appreciate the beauty of our human mind. Not until we are brought face to face with the reality of a mind stripped of some of its essential functions, do we become grateful for what we have 'up there'. The ability to comprehend and make sense of things, to speak and be understood, to make decisions, to have sound judgment, to move, to have emotions, to control them, to remember what just happened, to orient ourselves visually and spatially . . . So many things we owe to the healthy mind! Every day, I marvel at my mind's ability to function so well. And I also ready myself for the eventuality of it failing some day. Not getting attached, even to the mind itself, that which makes mindfulness possible.

Body

The body that once felt eternal, has a way of betraying the very old and the ones with dementia. One by one, systems start failing. Vision, hearing are usually first. Then the legs give way, and a series of assistive devices take over. The cane, then the walker, then the wheelchair, then the reclining chair when even sitting becomes too hard . . . Pretty soon, it is the arms and hands’ turn to go limp. Bodily functions follow, that can no longer be controlled. And close to the end, even swallowing becomes a challenge. Then heart, and breath. The body, just like the mind is a wonderfully engineered machinery programmed from the start for obsolescence. While it works, we tend to treat it with nonchalance. Seeing what happens eventually serves as a powerful reminder to appreciate this body while it is still working, and to also not cling to it too much. It cannot be trusted, just like the mind.

Success

Lawyer, judge, inventor, entrepreneur, surgeon, artist, psychologist, writer . . . they made a mark in society, and had the good fortune of having success, lots of it. Now, there is hardly a trace left of their previous life, apart from fading pictures of past glorious moments, and here and there respectful references to ‘Doctor this', 'Doctor that’. Time and the inability to hang on to memories have a way of erasing what once seemed so important. The world moves on, and the young take over. Seeing this process can help us not fall into the trappings of success, and conversely, failure. No need to get too excited one way or the other. 

Money

It does not matter how much money we make or have. Eventually, we all end up without the ability to enjoy or miss those things we used to cling to. This is not to say we should not plan for the future and make sure we have a comfortable home. It just means we will eventually have to let go of all our ‘things’. Those material possessions are not what matters in the end. Very few of the people I spend time with, talk about what they used to own . . . And the ones who do, all do let go in the later stages of their illness. My mother was one of those people. 

Relationships

Nothing’s for sure, including those close relationships we take for granted. Loved ones upon whom we may have counted for comfort in our old days, those people may die on us, or have a change of heart. The old man who believes that his daughter has died is not far from the truth. His daughter is still very much alive, but she has not visited or called him in years . . . And the woman who thought her husband would be there for her, is now a widow wondering where her beloved has gone. Relationships with those we love and who love us are to be treasured. And we need to expand our circle of love to not just our family and friends, but also anyone with whom we can have a meaningful connection, even if for only a moment. 

Self

This thing we call ‘I’ is not worth getting so preoccupied with. If we live long enough, that too will be chipped away, until we no longer have a sense of identity. The glue that kept our story going will have dried up, and now there will only be a vague sense of existence, and remnants from past habits, that’s all. Yet, most of us spend so much of our lives thinking, acting based on this concept of ‘I’, ‘Me’, and ‘You’. We worry so much about what happened to 'I' in the past, and what is going to happen to it in the future. Our carefully constructed identity is indeed just a story with a beginning, middle and end. For many of us that story will end way before our final years, and in its place will be a void waiting to be filled with new meaning, new ways of occupying ourselves, right there, right now.

What life lesson(s) if any have you learned from being around persons with dementia?

5 Forgotten Mindfulness Practices With the Body

The body scan as currently taught, is not a part of the traditional teachings. Yet, it has now become the practice of choice for mindfulness of the body. This has gotten me curious. In this post, I would like to review the various mindfulness of the body practices as explained in Mindfulness Immersed in the Body. Here they are, along with my commentaries:

1. First is awareness of breath, body sensations, and tensions in the body:

[He] sits down folding his legs crosswise, holding his body erect and setting mindfulness to the fore. Always mindful, he breathes in; mindful he breathes out. "Breathing in long, he discerns, 'I am breathing in long'; or breathing out long, he discerns, 'I am breathing out long.' Or breathing in short, he discerns, 'I am breathing in short'; or breathing out short, he discerns, 'I am breathing out short.' He trains himself, 'I will breathe in sensitive to the entire body.' He trains himself, 'I will breathe out sensitive to the entire body.' He trains himself, 'I will breathe in calming bodily fabrication.' He trains himself, 'I will breathe out calming bodily fabrication.' 

Currently, the awareness of breath practice is most often split from the awareness of sensations in the body as taught in the body scan. Also, many teachers stay clear from any active involvement with areas of tightness in the body. We are told to mostly notice the 'bodily fabrication', and not do anything about it. Here, according to the traditional teachings, the meditator is to use the breath to 'calm' bodily fabrications. I find this more aligned with my experience of the body. Sitting, paying attention to the breath, the attention gets drawn to some discomfort, or pain in a part of the body. I do not fight the distraction, but instead choose to be with it, giving it space to be within each in breath, and letting it dissolve as it may with each out breath. A reminder that mindfulness practice is very much an active practice. It is much more than just sitting . . . 

2. Second is mindfulness of physical activities:

When walking, [he] discerns, 'I am walking.' When standing, he discerns, 'I am standing.' When sitting, he discerns, 'I am sitting.' When lying down, he discerns, 'I am lying down.' Or however his body is disposed, that is how he discerns it. [...] When going forward & returning, he makes himself fully alert; when looking toward & looking away... when bending & extending his limbs... when carrying his [belongings]... when eating, drinking, chewing, & savoring... when urinating & defecating... when walking, standing, sitting, falling asleep, waking up, talking, & remaining silent, he makes himself fully alert. 

We are so conditioned to think of mindfulness practice as mostly sitting, or walking. We forget that opportunities for practice are with us at all times. Sitting now at my desk, I can become aware of fingers tapping the keys. Mindfulness is a 24/7 practice, minus the time we spend sleeping.

3. Third is awareness of the repulsiveness of the body:

[He] reflects on this very body from the soles of the feet on up, from the crown of the head on down, surrounded by skin and full of various kinds of unclean things: 'In this body there are head hairs, body hairs, nails, teeth, skin, flesh, tendons, bones, bone marrow, kidneys, heart, liver, pleura, spleen, lungs, large intestines, small intestines, gorge, feces, bile, phlegm, pus, blood, sweat, fat, tears, skin-oil, saliva, mucus, fluid in the joints, urine.' 

To which I will add the practice of witnessing the results of aging on the body, ours, and that of others. Working with sick, old, and dying folks, I get a chance to see what awaits most of us in the end, if we live long enough. The stench of human feces and urine, all mixed in, in the middle of the night  . . . Youthful beauty, disintegrated, and giving way to an ugly bag of bones. Faces, contorted from pain everywhere in the joints, the organs . . . Minds, gone and struggling to make sense of each moment. We all try so hard to disguise the repulsive nature of our body and the fact that we are walking, defecating machines. 

4. Fourth is awareness of the 4 elements in the body:

[He] contemplates this very body — however it stands, however it is disposed — in terms of properties: 'In this body there is the earth property, the liquid property, the fire property, & the wind property.' 

Standing, I feel the solidity of my feet against the ground beneath. Once mind steps aside, there is only earth element. Taking a shower, I sense the water running down my body, and within, inside the mouth, the viscosity of saliva. Outside, inside, same fluidity. Sick with a fever, I feel fire within. Out and about, the sun warms the outside of my skin. Spinning at the gym, I feel the air from the fan, caressing my face. Meanwhile, the breath comes and goes, inside the nostrils, the chest, the belly. Air all around. The body, our body is not separate from the environment, but instead a different configuration of the four elements. 

5. Fifth is contemplation on the fate of the human body:

As if he were to see a corpse cast away in a charnel ground — one day, two days, three days dead — bloated, livid, & festering, he applies it to this very body, 'This body, too: Such is its nature, such is its future, such its unavoidable fate'...

Yes. Today's charnel grounds are to be found in hospices and nursing homes. Tending the dying, we get to see what happens to the body after death. We may want to beautify corpses, and make them look as if life had not left. That is missing out on the opportunity to contemplate the profound truth of impermanence as it relates to the body. 

Which of these five practices do you feel most inclined to take on?