TO THE RIVER

To the river I come by a thrice-known way

through a shadowy oaken stand,

as each autumn pastel turns a shade of gray

and each limb an enfolding hand.

 

Borne in body and mind and the soul, all three

on this leaf-layered, loamy road

are the burdens of lost tranquility

and the depth of thanksgiving owed.

 

A mysterious melding of land and limbs

with the river’s lamenting flow

brings a chanting of praise in ancient hymns

on a tune that I seem to know.

 

Now the body, the mind, and the soul, all sing

in a chorus of wind in trees;

and renewal in each of the three will bring

a most grateful life to its knees.

The Cahaba River at Living River Camp and Conference Center near West Blocton, AL

The Cahaba River at Living River Camp and Conference Center near West Blocton, AL

Saving Face: Preserving the Person in Alzheimer’s disease

The most clearly-recognizable human part.  That screen through which we project to the world.  The canvas of flesh onto which colors of heart and mind are displayed.  A malleable mask which portrays the full range and depth of human feeling.  That flag unfurled which bears our identity to those who seek to see and know.

The face.

Such importance was given the face in human neurologic development that large portions of the brain are functionally involved in facial recognition and interpretation.  The mere image of a familiar face upon the retina awakens extensive networks of neural pathways stretching from occipital to frontal lobes, deep portions of the temporal lobes, thalamus and brainstem.  Emotions are aroused, sensory memories awakened, self is distinguished from “other,” constraints of time and space are lifted, and we suddenly find ourselves in places we have been before.  Time travelers in the capsules of our minds, we pass through clouds of childhood excitement, mists of mature relationships, aromas of mealtime gatherings; we absorb the fading phrases of conversation, stir once-shared affections, and grieve losses…all because our minds perceive a face.  A face that speaks passionately without a uttering a sound.

Faces change with age, but are still recognizable.  Though furrows and age spots camouflage, light behind the eyes still casts patterns seen before.  Something innate tells us we will always know those faces known well, no matter how life may make them over.

But what do we do when the face no longer speaks, when the mask becomes detached, when no amount of effort can discern patterns from the “eye beams,” patterns that mean what they have always meant to us?

Many of us who have personally encountered Alzheimer’s disease have asked such questions.  We have stared into the face once-known, now silenced by a muting hand.  We have trained all senses to perceive familiarity’s faintest trace, to glimpse some fleeting flame of the one we knew (in the way we knew them before).  Rejoicing in each momentary return, we resolve to try even harder tomorrow.  We can bring back more of them if we strive hard enough.

But the harsh reality is that we can’t do what we long to do, no matter how much effort we extend.  The person with Alzheimer’s disease can’t be brought back in the same way we have been accustomed to knowing them.  That face, now lacking the spark which kindled torchlight in the caverns of our mind, cannot through efforts of our own be ignited again with a familiar luminescence in which we have been used to basking.  So we adjust our expectations and make peace with reality so that some unnecessary suffering may be avoided.

Does this mean the light behind the eyes has gone out?

Emphatically, no!

At this juncture it becomes critical for us to broaden our concept of “face.”  Face, still being that most familiar of human parts, that fleshy flagship first encountered when we seek to know another, must become for us “façade,” connoting a more superficial significance.  Recognizing façade as a mask over what lies beneath, a “persona” as in classic theatre, we must peer beneath this covering to the true “face” of the one we have known, and still know.  “Face,” considered thusly, becomes a cognitive construct, an abstraction created by our minds.  Then there can be a disconnect between the face that projects to our retinas when we look upon a person with Alzheimer’s disease and the “face” our mind creates when we think of this one.  When we visualize this familiar face internally, we stimulate those neural circuits afore-to alluded, producing the collective experiences through which we know this person.  And this happens despite the new façade, created by Alzheimer’s disease and laid upon the true face of the one we know and love.

In truth, we help this person “save face” through making a gesture in our minds by which we intend to preserve their dignity and honor.

But how do we translate our cognitive constructs in such a way as to make this person aware we are trying to build them up?  How do we promote their dignity and life quality through such intangible actions as the creation/preservation of a mental image?

We do this through strengthening our relationship with them; through entering into their world of experience as totally as we can; through validating them there, and through bearing to them the banner of their true “face” in the mirror of ourselves.  Only this image in the mirror they recognize as their own.

We must hold their hand ever more tightly as they appear to grow more distant from us in their existence.

Persons afflicted with Alzheimer’s disease, having developed some of their mature pre-disease identity through vocational accomplishment and cognitive-empowered sociocultural advancement, now must seek self-preservation in relationship with others…others who care, who remember, and who have their best interests at heart.  In short, they must now find identity through relationship.

It is within this relationship that what I will call “translational life enrichment” must occur.  Because we know them, because they have left an indelible imprint on our minds, because we still see clearly internally who they are to us, because we can train our eyes to peer past the unspeaking façade of Alzheimer’s and follow the inner warmth we have felt before and know to be present inside, we must bring about the translation of our mental constructs into actions which build up the personhood of those with Alzheimer’s disease.  We who are professional caregivers must do this even for those we don’t know but to whom we are providing assistance.  First, we must care enough to learn their life stories.  Then we must validate the good, essential and true of what we learn, so that the end result is the promotion of dignity and quality of life.  Even those who have known us only briefly can find an element of their identity through relationship with us, provided the experience is a positive one for them.

We have to construct their “face” within our consciousness through exerting the effort to know them as completely as we can, then show that face back to them, in all its complexity and depth, so that they may recognize it as their own.

In no way do I mean we should be nostalgic in our appreciation of them.  Though we must focus a portion of our affections on the person we discover or know them to have been before the illness began, it is essential that we validate the person they are in the present.  We have to learn to love and appreciate what they are in their now.  Otherwise our efforts to up build will have the unintended consequence of abasing who they are now through validating only who they were in the past.  I believe most people with Alzheimer’s disease are aware, at least partially and intermittently, of their losses.  Remember, they cannot return, and we cannot make them do so.

We must determine to partner with them in their present reality, to appreciate what they are there, and to identify and preserve enough of their core and historical identity in which to dip a brush and paint their colors across the canvas of current life.

It falls on us, then, to discover, appreciate, and display for their edification the very characteristics that make them who they are in the present time.  We must help them preserve personhood.  We must help them save face.

Because they can no longer speak in “native” language, and because our new cognitive constructs of “face” depend to a certain degree upon our understanding of who they have been and who we know them to be at present, we have the obligation to find a language through which to understand, as truly and deeply as possible, their essence.  Alzheimer’s disease affects linguistic expression, thereby laying a communication blockade. But, to which we have alluded already, the person with Alzheimer’s still has much to say.  I assert that the heart of the individual, rich in elemental composition, lies minimally affected by the disease.  The fundamental energies of the core seek channels for expression; collaterals, to invoke a cardiovascular analogy.  And when these enduring self-elements are liberated, the person’s “face” becomes enlivened; if not literally, then within our own mental constructs. We caregivers, through whom those with Alzheimer’s may discover more and more of their identity as the disease advances, are obliged to help them find their most natural expressive avenues. By doing so, we imbue the banner of their “face” with its most characteristic and recognizable hues.

As an essential element of compassionate, person-centered care, the expressive arts represent an effective means of self-expression in those with Alzheimer’s disease.  By these I refer to art, music, poetry and other literature, dance and drama therapies.  These expressive arts therapies, often combined with reminiscence, have numerous benefits including improved communication, the fostering of relationships, elevation of mood and sense of wellbeing, reducing agitation and adverse behaviors, and respite for caregivers.  Overall, they promote dignity and improve quality of life.  They are but one of many means by which to foster personhood.

My father, Lester Potts, became an acclaimed watercolor artist in the throes of Alzheimer’s disease at a time when he was rapidly losing verbal abilities. Those who view his art marvel at a depth and richness present even in his late-stage creations.  His abstract depictions of home and family even at this late stage convince me that he was indeed “still there,” and was vibrantly attempting to make his story known to the world.  In the supportive person-centered milieu provided by the dementia daycare he was attending, Lester was handed the tools to bypass expressive roadblocks laid by Alzheimer’s disease.  Someone cared enough to try and create, in their mind’s eye, Lester’s “face.”  They laid down the essential elements of his story, gathered by peering past the façade into the center of the person…a person worthy of attention, of validation, and of meaningful and supportive relationships.  And based on what they were to know of him in his here and now, they deemed him a worthy soul with a brimming heart.  And they provided him a means of communication, a release for inner creative content.  This promoted dignity, improved quality of life, and helped to shore up his sense of self (which was becoming increasingly relational, as previously discussed).  And, low and behold, the unpredictable happened. The face shrouded in dementia’s veil quickened through new-found creativity, and brought light and color and hue and home to those all around who took the time to look…to see the authentic “face.” Lester was once again made his own standard-bearer, his own banner-carrier.  And the image lavished out was the very content of his heart and soul.

To what greater goal could we as caregivers possibly aspire than to love enough to seek the truest colors of another, no matter how deeply buried in the rags of affliction, raise them high for the wounded to see and know as their own, and pass them back to the very one defending their identity against the onslaught of Alzheimer’s disease?  I know of none.

I am reminded of the powerful photograph of the hoisting of the flag over Iwo Jima by those soldiers in World War II, tattered by the conquest, but fortified through what they knew their America to be.  We caregivers, the walking wounded, can do the same for persons fighting the battle for their minds against Alzheimer’s disease.  And just as every American whose eye perceived that poignant image symbolically clamored up to lend a hand, so the ones with Alzheimer’s disease, drawn by their own raised banner of personhood-preserved, find courage to be themselves again.

Helping them find the courage to be themselves again.  Enabling them to speak passionately without having to utter a sound. Making a gesture in our minds by which we intend to preserve their dignity and honor. Helping them find their identity through our relationship with them.  Learning to love them in their “now.”  Affirming that personhood still exists, even in the presence of Alzheimer’s disease.

Bearing the banner.  Saving face.

And, with wounded hand clutching wounded hand, we lift each other’s banners to the skies.

RESURRECTION

At the knitting edge
where wrinkled hands wring and knead
life’s endless unfoldings,
you and I and everyone
come as skeins to be unwound
and worked deftly into the pattern
of another dawning day story
that is the fabric of this
infinite and intimate resurrection
enwrapping us all.

INCARNATION

In a silent room
where even broken spirit weeping
burns its torrid day and lies vacant,
dry, spent of any flow, coldly dying
down a stiff wood grained gray
as the heart of all good
spills away its blood pools
of groping fingers underneath
the shutting door of night;
in the rip-stained, stripped-through
stillness of this time
something starts to sing.

TODAY

Today I met a man whose arm was drawn.

He couldn’t reach and take my hand.

His other arm was gone.

 

Today a daughter told me of her pain.

She couldn’t run or swim or climb,

from static in her brain.

 

Today I heard the sad cries of a son.

His father has forgotten him,

and nothing can be done.

 

Today each one of these has shared a gift,

an open door through which to go;

a burden there to lift.

 

The truth is this: my arm is missing, too.

My other one is stiff and bent.

God made me reach for you.

 

I’ve also had to stay inside all day.

My brain has static of its own.

You brought me out to play.

 

You’re grieving with a voice not all your own.

Love never will forget your name.

Love never cries alone.

THE CROSSCUT SAW

One of Dad’s (Lester E. Potts, Jr.) earliest memories was of pulling a crosscut saw with his father.  “He wore me out on that old saw,” he used to say, speaking of his dad. 

Lester’s last painting, created in late-stage Alzheimer’s disease, was of a saw.  Bereft of language at the time of its creation, when asked if the image depicted a saw, Lester simply cried.

Those of us who knew him look upon the saw as a self portrait of sorts, an image of steely tenacity, albeit with handles worn off from a life of selfless giving.

Lester Potts Jr The Saw

The last painting of Alzheimer’s artist Lester E. Potts, Jr.

Those who love him,

who call him Bubba, Papa, Les;

who knew the richness of his white oak heart

before life’s rings were laid

can tell that this last picture is a saw,

and they know why.

 

He spoke of it to me

whenever two were needed for a task,

and tales of pushing, pulling,

giving, taking teamwork between man and boy

goaded little hands to help.

 

Picture2

Lester E. Potts, Jr. and his father, Lester, Sr. in 1930

Strength, innate to him,

was given meaning and a name

across its blade, where as a son

he’d first sensed power and endurance

in his father’s arms.

“He wore me out on that old saw,”

was often said submissively.

Like most sons, he felt himself

a lesser man than Dad.

 

How tragic, yet how poignant

one man’s time comes down to this:

a jagged, worn and lifeless print;

aphasic, meaningless to most,

but an icon to the ones

who know his oaken core.

 

Its crooked teeth bespeak tenacity,

a stubborn will to persevere

even as life’s gnarly knots distort and mire.

With labor to be done

one mustn’t let a sappy vice

restrict the motion of one’s steel.

 

Picture1

The Potts sawmill, around 1930, with Lester E. Potts, Sr. in the front center in overalls

Imagined scent of sawdust

piling up like snow beneath metallic skies

might penetrate his fog-bound world,

low beams from the old log truck

leading to a happy place

that smells like home.

 

His hands,

now swollen and contused,

still long to lend themselves

to all who need their skill and strength.

 

Sadly, though,

there’re no handles left to hold,

just worn wood longings of a white oak heart

beneath the ringed restraints

dementia tightens fast.

 

Through murky mists

he strains expectantly to see

his father’s face, no longer there,

and feel the tug of steely arms

which first embodied might.

 

When looking on the crosscut saw

one notices a missing end.

Perhaps his eyes misjudged

and drew onto another page,

a scrap discarded

like a stubby hardwood log,

yet of itself, an artful work of hand.

 

In deepest spaces of the soul

I know this theory won’t suffice.

For amidst fragments of a broken mind,

longings of a wandering heart,

and comforts of a loving God

the undone portion takes its shape:

 

a handle clasped by nail-scarred palms,

familiar, strong, and true,

which can’t be painted, only felt

in pushing, pulling, giving, taking teamwork

between friends.

 

So the saw remains,

its image speaking for the one

whose severed sentences stack up

like stumpy syllables upon a sawdust bed.

The sum of what it says is this:

 

Picture4

Lester E. Potts, Jr., 1947

Strength,

Labor,

Trust,

Family,

Love,

Home.

BROKEN HALLELUIAH

(for Papa, inspired by Leonard Cohen’s “Halleluiah”)

 

I’ve heard you had a secret art,

an exhibition of the heart

that pleased the Lord, as He could see right through ya.’

But did you know before the spell,

the cruel curse (a living Hell)

that in your soul you’d painted, “Halleluiah?”

Halleluiah, Halleluiah…

Halleluiah, Halleluiah.

 

We saw the righteous way you stood

and showed your marbled grain of wood

to all who took a hallowed place next to ya.’

But even we who knew you well

could not imagine or foretell

that in your heart was painted, “Halleluiah.”

Halleluiah, Halleluiah…

Halleluiah, Halleluiah.

 

The devastation of your mind

and shattered mem’ries left behind

compelled the ones who cared to come rescue ya.’

Then strangely, through an opened door

an artist saw your spirit soar

and helped the hand to paint its “Halleluiah.”

Halleluiah, Halleluiah…

Halleluiah, Halleluiah.

 

Such beauty we had never known,

created by your hands alone

had power to bring dignity back to ya.’

And though we sometimes saw you smile

we knew the hurt within the trial

had made your art a broken “Halleluiah.”

Halleluiah, Halleluiah…

Halleluiah, Halleluiah.

 

And now that you have flown away

to where we’ll meet again someday

and stand in awe of One who always knew ya,’

in words and art you’ve left behind

those shattered pieces of the mind,

composing us a healing “Halleluiah.”

Halleluiah, Halleluiah…

Halleluiah, Halleluiah.

 

I did my best (it wasn’t much),

I couldn’t think, so I tried to touch.

I told the truth, I didn’t come to fool ya.’

And even though it all went wrong

I stand before the Lord of Song

with nothing on my tongue but “Halleluiah!”

Halleluiah, Halleluiah…

Halleluiah, Halleluiah.”

The Broken Jar