On a recent morning just before sunrise, I sat on my deck overlooking the Nottely River. Lately I’ve developed a routine. I work for a few hours early in the morning, then around sunrise I go outside with my second cup of coffee and read a chapter of whatever book I’m working through. That morning I never opened the book.
The sun was coming up over the river, its rays glistening against the water as it cascaded over rocks, creating thousands of little diamond-like reflections. A cool breeze rustled the trees lining the banks. Cardinals came and went from the bird feeder above my head. Three Merganser ducks landed, then two more. Pink clouds appeared and slowly disappeared as the sun climbed higher. It was about 68 degrees, the humidity had broken, and there was no mist hanging over the river.
There was an enormous amount going on, yet it was remarkably peaceful.
My attention wasn’t riveted to anything in particular, but it also wasn’t wandering. There wasn’t so little happening that my thoughts turned inward or so much that I had to concentrate. Most importantly, nothing asked anything of me. I didn’t have to decide, remember, or respond. I could close my eyes and open them a minute later without feeling that I had missed something. I could simply wait for the next ripple of water, flight of a bird, or rustling of leaves. Indeed, I was overcome by a feeling of wanting to share this wonderful calm.
Later I began wondering what exactly made that morning so calming. Years ago I had a thought experiment. Imagine sitting in a chair four feet from a completely blank white wall. How long before your attention turns inward and you begin thinking, planning or worrying? Now put the same chair in front of an old brick wall. You begin noticing variations in the bricks, mortar joints, colors, shadows, and imperfections. The wall isn’t exactly entertaining, but it gives your attention somewhere to go.
The Nottely seemed to occupy a wonderful place between too little stimulation and too much. Maybe calm isn’t the absence of stimulation. Maybe calm comes from stimulation without demand: enough complexity to occupy the mind, enough predictability to be comfortable and enough variation to remain interesting, but nothing requiring a decision or response.
That thought became more important when I considered my life as a full-time caregiver.
My wife, Gail, has dementia, and anxiety and unsettled feelings are sometimes part of our household. Yet Gail has already discovered her own version of my river. There are certain television programs she particularly enjoys, especially familiar crime programs that are in rerun mode. Their structure is predictable. About every ten minutes, music plays where a commercial used to be, the narrator then summarizes what has happened up to that point. Gail can watch, close her eyes, or doze for a while. When she wakes up, she hasn’t necessarily lost the story because somebody brings her back into it.
The program doesn’t punish her for having stopped paying attention. She can leave and come back. Music works much the same way. It can be complex while remaining repetitive and familiar. Rhythm returns, melodies recur and we begin anticipating what comes next. We can listen closely, let our thoughts wander or fall asleep. The music simply carries on.
Then I wondered whether this principle should apply not only to the environment we create for someone with dementia, but also to us.
We can become the demanding part of their environment without intending to. “What do you want for lunch?” or, even more simply, “Do you want lunch?” or “How is your day today?” These sound like ordinary conversation, but for someone having difficulty retrieving information, organizing thoughts or making decisions, every question can require work.
At a restaurant, instead of handing Gail the menu and asking what she wants, I can tell her what I’m considering. “I’m thinking about the hamburger. The chicken sandwich looks good too, and they have that soup you liked.” I’ve given her something to work with. She can choose one, look at the menu herself or say nothing at all.
Instead of asking how her day was, I can tell her about mine. I might tell her something funny Tucker did or about the ducks that landed on the river. She might laugh, tell me something about her day or simply listen. I’ve invited her into the conversation without requiring her to participate.
That is a subtle change in companionship. Most of us learned conversation as an exchange: I talk, you talk; I ask, you answer. With dementia, ordinary conversation can unintentionally become a series of little tests. Perhaps we can share rather than quiz and invite rather than require.
That brings me back to the Nottely.
The river was never still that morning. Water tumbled over rocks, sunlight sparkled across the rapids, leaves moved, birds flew and clouds appeared and disappeared. Yet none of it required anything from me. The river didn’t ask whether I remembered what it looked like yesterday. It simply gave me something worth noticing.
Maybe when someone we care for is anxious or unsettled, we shouldn’t always ask how we can make their world quieter. Perhaps sometimes the better question is how we can make their world interesting without asking anything of them.
Be the calm in the room. Be something they can engage with when they want to and simply enjoy when they don’t.
Be the river.
Gregg
Get a letter like this every Tuesday.
