Hope and the Triage Moment

triageMany of us learned the meaning of the word “triage” because we watched M*A*S*H. Every week, the doctors and nurses on our favorite TV show worked through the triage episode. Some patients could wait a while. Others were taken immediately to surgery while several unfortunates received last rites from Father Mulcahy.

The working definition of “triage” means “to assign the degree of urgency to a wounded or ill patient.” Even in today’s healthcare environment, triage nurses and doctors determine the priority of working with a patient, especially during crises.

Recently, I heard a phrase which caused me to stop and ponder its impact: Triage your worry bucket.

Most of us deal with one situation or another. Many of my friends are caring for an elderly parent or two while supporting a kid or two in college. Scores of people I know struggle with medical issues while others are trying to pay off debt and/or college loans.

All it takes is five minutes watching the news on any channel to know we are in serious trouble.

But what can we do about it? Triage the worry bucket.

Decide which issue is most urgent and deal with it first. Put everything else in the waiting room until you’re ready to bring it front and center. By that time, those secondary issues may have dissipated or won’t seem that important.

Most of the national and international issues are out of my control. I cannot do anything about them other than to educate myself so I’ll know how to vote in 2020.

My mother’s Alzheimer’s journey does not warrant any fresh worry. It is what it is. I’ve already worked through most of the grief. Only time will determine how it ends.

My son is an adult, and he makes his own choices. I’ve done my best to raise him, but I cannot control anything he does. So far, he’s being wise. No worries.

Health issues or crisis events can be troubling, depending on what happens. But I cannot worry today about what may or may not become a struggle during the next decade. I’ll triage that worry bucket when the time comes.

So what is on the priority list for my triage bucket? Recently, digestive issues. So I’m working with a doctor, taking my meds and trying to set boundaries around my food choices. Unfortunately, chocolate is NOT on the list.

A possible car purchase is on the horizon. No emergency, thankfully. Just trying to be conscious of the best deal and find something that will last for a while.

The problem escalates when our worry buckets overflow. We cannot make effective decisions when we’re overwhelmed.

But if we purposefully triage the worries and only allow the most urgent struggles to rise to the top, we can deal with whatever life hands us.

I often tell my Coaching clients to take “One microstep at a time.” The same holds true for the crises that pepper our lives.

So triage your worry bucket and live in the hope that one day, all your worries will cease.

©2019 RJ Thesman – All Rights Reserved

A life of faith helps defeat the overwhelming worry bucket. Check out Uploading Faith: What It Means to Believe.

Hope Struggles with a Birthday

Exfoliates quoteAll day I thought about her, my mother who lives within the shadows of Alzheimer’s Disease. Celebrating her 88th birthday without me and without any knowledge that she had survived another year.

By mid-afternoon, I couldn’t stand it anymore, so I called assisted living and asked if they could bring Mom to the desk for a phone call.

“It will be just a minute,” the nurse said. “She had such a good day.”

“Really? You helped her celebrate?”

“We partied for all the February birthdays, and your mother had such a good time with our Hawaiian theme. She wore a grass skirt.”

“What?” My mother, the dignified woman with perfect posture, who always carried herself with self-respect. Dressed in a grass skirt?

The nurse continued, “Our activities director decided on the theme. Everyone wore a lei and we had a pretend luau with island music. It was such a great idea.”

I know about activities directors and the impact of their work. Roxie, in the Reverend G books, helps each resident find some type of interest that will increase their sense of significance.

These directors walk a fine line. How do you approach these seasoned seniors who deserve honor even while they have mentally become children? How do you celebrate birthdays for the generation that survived World War 2 and the depression, then rebuilt America and sent their kids to college for the education they always wanted but couldn’t afford?

Now they fidget away their days, shuffling with a variety of walkers, forgetting their names and the children they birthed, aware only of the dinner bell when they file obediently into the dining room and eat silently, then retire to their rooms to turn up the volume on the TV and hope sleep will come soon.

“We had pineapple upside down cake,” the nurse said.

“My mother likes pecan pie. I’ve never seen her eating pineapple anything.” I could not erase the vision of my mother in a grass skirt – this woman who raised me with a no-nonsense approach and a duty-bound responsibility to always do my best and use my gifts to the utmost for God’s glory.

“Oh, here she is!” cried the nurse.

“Hello?” answered a shaky voice.

Too fragile. Not the strong tone I remembered from my visit at Christmas. “Hi, Mom. It’s me, and Caleb is here, too.” I was certain the name of her grandson would trigger a memory.

“Hello?”

“Happy birthday, Mom.”

“Thank you. Hello?”

I ground my teeth and prayed for wisdom. “Did you have a party today?”

“No, I don’t think so.”

She was probably refusing to remember being dressed up like a perky five year-old and forced to wear a stupid grass skirt. I could do nothing to help her. I wanted to scream, but tried a different thought. “Did you have a piece of cake?”

“No, I don’t think so.”

My mother, who used to call me with hour-long conversations, asking about my writing and my work, interested in everything her grandson accomplished – now responding only in mono-syllabic words, phrases she somehow chose from the fog of a plaque-infested brain.

Surely, she would talk to her grandson. “Here’s Caleb.” I handed him the phone.

“Hi, Grandma. Happy birthday.”

“Thank you. Hello?”

“Grandma, it’s me, Caleb. How are you?”

“Hello? What?”

He looked at me, helpless. “Talk louder,” I whispered. “Maybe she can’t hear you.”

“Grandma, we love you.”

“Hello?”

Finally, I took the phone again. “Mom, we’ll see you soon. We just wanted to tell you happy birthday and we love you.”

“Thank you. Hello.” I wondered if all the hello’s really meant good-bye.

Then she was gone, and I imagined her shuffling back to her room, not caring that she is now 88, unaware of 2016, a presidential election coming soon and spring flowers eager to burst through the crust of winter soil.

For a minute, I felt the guilt of being the long-distance caregiver assuaged. We tried to help her celebrate the day, tried to let her know we love her and miss her, wished we could be there.

But it wasn’t enough. The echoes of her voice followed me up the stairs as I hurried to my bedroom to cry.

I hate Alzheimer’s.

©2016 RJ Thesman – Author of the Reverend G books http://amzn.to/1rXlCyhwedding - rj, ct, mom

How to Find a Legacy Within Alzheimer’s

Because October is my birthday month, my thoughts often center around the woman who birthed and raised me. Although Dad was a prominent faith figure in my growing up years, it was Mom who pushed me out of the birth canal and then pushed me to become who I am.Arlene Renken - nurse

She was a fighter and an extrovert, unlike the rest of us who liked to disappear within our private worlds to write, listen to music or find our energy in the beautiful solitude of the Oklahoma landscape.

Odd that I speak of Mom in the past tense, even though her brave heart still beats as she stares at the wall opposite her chair. That’s what Alzheimer’s does to a family. We say goodbye, one stage at a time, one regression after another so that when death finally releases our loved one – much of the grieving has already been done. “The Long Goodbye” is aptly titled.

Mom grew up poor, walked to high school (yes, miles away, even in the snow and rain) and wore the same two dresses until her Sunday dress became too worn for church. It was then relegated for school wear as her mother sewed a better one for the Sabbath or one of the cousins passed down a Sunday outfit that wasn’t yet worn out.

As part of her legacy, Mom was determined none of her children would ever be ashamed of their clothes or feel embarrassed because they didn’t fit in. So she learned how to sew, spread out the material on the farmhouse floor, cut, pinned and put together whatever clothes we needed to look like we had some cash in the bank.

Then she made certain that each of us understood the importance of a quality education so that we would never feel the sting of poverty. We grew up with a solid work ethic, attended college, saved our pennies and never bought anything we didn’t really need.


It was a simpler time – a beautiful segment of history, without traffic snarls, school shootings or adultery in every family tree. I miss it every day.


Mom was willing to live in an old farmhouse and fix it up gradually, learning how to wallpaper and restore old pieces of furniture. Much of our house looked like the early-attic variety, but none of us minded. It was a safe place to grow up although cold in the winter and hot in the summer. But who minded when the kitchen smelled like fresh-baked bread, the fields sprouted a golden harvest that supported us all year and the animals taught us about life and death.

As a registered nurse, Mom followed the habits of “old school” nursing. Always dressed in white, her uniform and hat starched and gleaming, her white shoes and hose the perfect accessory. In those days, no jewelry was allowed except a simple wedding band.

But Mom, always a bit of a radical, wore a cross necklace under her slip. “To remind me I’m working as a Christian,” she said. “To keep me focused on what matters when I have to clean someone’s bottom or tell a family their child just died.”

Strength of character. Rock solid faith. Those qualities are hard to imagine in the woman who now rocks back and forth and accuses strangers of stealing her digital clock.

Yet it was those very qualities that taught me how to work well even when no one is watching, how to pray my guts out, how to deal with life when it hurts by working hard and moving forward, how to fight against traditions that are based only on men’s interpretations rather than the powerful voice of God.

Even now, as I have journeyed through a faith crisis and wondered how to find a church that will accept my calling – I know Mom would understand. If I could just communicate with her, she would get that steely gleam in her eye and tell me to “Stop whining. Just get busy and do it.”

She was probably one of the first parents who envisioned the concept of giving your children roots and wings. She taught us well, then let us go and cheered us whether we succeeded or learned hard life lessons through failure.

Never demonstrative with her love, if anyone attacked her kids – they would face the wrath of a woman who knew how to struggle through the worst of life’s catastrophes and conquer them through sheer determination and grit.

No one dare beat up her kids, either emotionally or physically. She would stand tall in her 5’8” frame and declare, “One more word, and I’ll jerk a knot in you.”

So I am proud of the legacy Mom has shared with me, a strength of character that dares to question the establishment yet humbly accepts God’s will.

Even in the shadows of Alzheimer’s, I see Mom’s resolve to finish her course well, to find contentment in the every dayness of Bingo, planned meals and assigned seats during movie night.

The strong woman who raised me still exists somewhere deep within, even though the outer shell gains fragility, age spots and graying hairs.

The legacy continues. Thanks, Mom.

©2015 RJ Thesman – Author of the Reverend G Books http://www.crossrivermedia.com/portfolio/1624/gallery/fiction/

An Ethical Alzheimer’s Question

The question came up again last week when a caregiver faced the ultimate decision. “Should we put our mother through a surgery, knowing that it may save her life, but at the age of 88, it will only prolong her journey into Alzheimer’s. What should we do?”

The decision, of course, will ultimately rest with that family and the medical professionals, but it is a quandary that many of us face as our parents age without the ability to express what they want for their own bodies.

Doctors are trained to preserve life, to “do no harm.” And they are skilled in the various ways to test for disease, treat the symptoms and perform surgeries that prolong life.

But at some point, don’t we have to ask the hard questions? Is Alzheimer’s any type of quality life? Would our loved ones want to go through the pain of surgery, the rehab after surgery and still face an even longer period of time living within the shadows of Alzheimer’s?

My family faced this decision a year ago with Mom’s pacemaker surgery. Yes, her heart needed stimulation because she was passing out, bumping her head and experiencingAlz awareness all sorts of physical problems. Doctors determined she needed a pacemaker, and the decision was made quickly by those who care daily for Mom.

It was supposed to be an easy surgery, in and out in a couple of days. But complications set in, Mom’s mental status quickly deteriorated from confusion to dementia, and the end result was four days in the hospital with a transfer to nursing home care.

Would it not have caused less harm to let Mom’s brave heart just wear itself out and wing her to eternity where there is no pain, no surgeries and no Alzheimer’s?

As I stayed night with Mom in the hospital, she experienced a rare moment of lucid thought and communication. She asked, “What did they do to me?”

I explained about the pacemaker and the complications of a collapsed lung, the possibility of pneumonia. “Your heart needed to be fixed, Mom,” I said, glad for this moment between us but wishing we could be talking about something besides her difficult prognosis.

She raised up in bed, setting off monitors that blinked and brought nurses running. “If they would have asked me,” Mom declared, “I would have said ‘No.’”

When I arrived back in Kansas, the first thing I did was to instruct my son that absolutely no life-saving measures should be performed on me. “If I get Alzheimer’s like Grandma, and if I’m not able to take care of myself, the best way you can love me is to let me go.”

Then I wrote it down in my last wishes’ papers and finalized everything. Do no harm. Let me go.

In the third book of the Life at Cove Creek Series, Reverend G, Jacob and Chris will also face this decision. Writing about this serious topic in a fictional story was easy because I had lived through it with my mom. I knew what Reverend G would choose because I knew my own choice and what I felt was the sanest and kindest way to go.

When it comes to that decision, a life of further Alzheimer’s versus stepping into eternity – for me there is no debate. But each family has to make that choice.

What do you think? I’d be interested to know where you stand on this subject.

©2014 RJ Thesman – “Intermission for Reverend G” – http://amzn.to/1l4oGoo                                                            Finding Hope When Life Unravels