Everflowing

Helplessness

This week during a nursing home clinical practice, a student was faced with a day of complete helplessness.

The first client was in severe pain when we went into the room, and in pain when we left the room.

The second client was very open for touch for the first 10 minutes and then transitioned into a second personality; becoming paranoid, confused, and agitated at everything around her. The client was left agitated and confused.

In both situations; however, the clients experienced moments of pleasure and obvious intimate contact.

In the first client’s room the client was completely engaged for 45 minutes, holding the student’s hand periodically, and gazing into her eyes. The client animated pain quietly through facial expression, and expressed verbal gratitude for the company and the touch.

What greater gift can we take to the bedside than the gift of sharing the pain and witnessing the suffering of another human being.

However, as a witness for a client who is experiencing pain and/or whose disease is progressing, I am confronted with the loss of control by my client and myself. There is no longer a separation in the helplessness. Living in a culture that teaches us to value ourselves according to what we can fix, change or correct, turns feelings of helplessness into embarrassment, low self-esteem, shame, and/or guilt.

The first few years of this work when I felt unable to help a client, it was hard for me to sleep. I was depressed and anxious. The sense of failure and guilt struck deep. These were difficult feelings to have. They were overwhelming.

Through allowing my feelings to be present, and through sharing them with people involved in the same work, I realize that the feeling of overwhelm comes from my fear of failure — my fear of being helpless.

I don’t know if I’ll ever lose this fear, but knowing how it is triggered, and the rhythm in which it rises in me, allows me to integrate it into my consciousness. The fear of helplessness has become familiar to me. I don’t have to be overwhelmed by it.

This process of integration expands my heart and deepens my awareness of compassion. Having compassion for myself, I may now receive my client more fully.

I look forward to your sharing and questions.
Blessings,

Irene Smith

www.everflowing.org

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 Last week a woman named Beth called me to schedule an appointment on the referral of her hospice nurse. I asked if we could explore her situation over the phone first, to see if we were a good match.

 Beth is 84 years old with a 20-year history of Parkinson’s Disease.

She said she had low back pain and that’s why she wanted a massage.She was also experiencing right side weakness, frequent falls, and a large open wound on her right leg that wouldn’t heal.

She also explained that she had two brain surgeries 1 year ago. A brain stimulator had been placed in her head with the second surgery.

 With encouragement Beth explained that the wires to the stimulator ran from her chest up the right side of her neck and the back of her head.

 I asked her if she had experienced massage before, and she said yes. A month prior to our conversation a massage therapist had come over with a table and given her a deep tissue massage.

 I paused and explained that I offered very gentle work for someone with the many sensitive conditions she had explained to me. She did not adjust her request. Beth wanted more deep tissue massage.

 She asked if I could refer someone else. I told her I would check and call her back the next evening.

 After much consideration I called her to let her know that, with my experience, I could not refer her to someone for anything except very gentle massage.

 Beth was seemingly despondent when she asked me to hold on for a moment.

 She returned to the phone and said, “My sister just reminded me that I was in a great deal of pain after the last massage and fell several times. She suggests that I try some gentle work.”

Beth’s tiny room in the assisted living community was beautifully decorated.

 After assessing the amount of space around the bed, and deciding on positioning strategies I helped Beth into her bed, and on to her side.

 As I gently touched Beth’s back I was astonished at the sensitivity of her muscle tissue and tendons. Her body was like touching water and the slightest touch seemed to cause her internal structures to roll back and forth as well as in and out.

After a while I had Beth turn onto her back to work with her legs, feet and head. Using any pressure at all, on her right side, initiated a nerve response that caused her body to jump. I worked gently, slowly, and with caution. Beth slept deeply throughout the session.

 I called Beth the next day and left a message. I called a second time several days later. Beth explained that she had been in the hospital. Her doctors had discovered the brain stimulator was causing too much stimulation. It had to be adjusted.

She also explained that she had deeply relaxed during our session and would call me again.

 Recognizing one’s scope of practice; owning the responsibility to gather information, and knowing when to say no, is the professional integrity that must be honored during the growth of this field of massage.

I look forward to your input on this  important issue.

Blessings

Irene Smith www.everflowing.org

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 Sunday August 22,2004 I came out of my shower, went into my bedroom ,layed on top of the bed to relax and looked out to the tops of the trees from my 3rd floor attic apartment.

I sat in utter amazement and wondered what it meant. After about two minutes it flew away.

 I immediately got my animal spirits book and looked up hawk. A Native American omen of healing, rebirth, and a sign that I should be alert to what is coming ahead. The eagle is the messenger to God who takes our prayers to Heaven. I knew I was being given a very important message but I wasn’t clear what it was.

 I emailed a good friend in Arizona and related the event.

I look forward to your stories of vision and spirit.

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One day my hospice client, Edna, asked me to just get into the bed and hold her. Edna had bone cancer and was in a great deal of pain.

I sat by the bedside and froze.I told her I couldn’t do that. She asked me again, “Just hold me.” She said, “I’m in so much pain.” I told her again I couldn’t do that.

Feelings of discomfort, shame and guilt flooded over me and I was relieved when the session was over.

 That evening I called the care manager and talked to her about my experience.

 For the next couple of weeks I felt uncomfortable seeing Edna. I was however, deeply exploring my feelings surrounding her request.

Right before Edna died I had worked with my feelings of fear to the degree that I was able to meet her need.

 I got into the bed, positioned her head on a pillow in my lap and stroked her hair, her face and her shoulders until she fell asleep.

 How wonderful it felt to let go of how I thought professional was suppose to look and answer a call of the heart.

Confronting my fear of intimacy as a professional has been an ongoing challenge in this field. Being an intimate professional is not easy.

I look forward to your discussion of this topic. Please share your stories.

Blessings

Irene Smith

www.everflowing.org \

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I am asked over and over again what defines Everflowing teachings? What sets Everflowing apart from other touch modalities?

Everflowing gives practitioners permission to feel the intimacy between human beings touching. Involvement with texture, temperature, movement, and yes, also feeling the emotion beneath this experience is the Everflowing approach.

As an Everflowing practitioner I sit by the bedside of someone who might be in a wet diaper, in physical pain, feeling separated from and devalued by the whole world. What message, through my touch, is going to validate the beauty and perfection of this being, remind this being of his or her connection to a greater whole, and nurture me in a way that I can continue to show up, if not the core hope in the message of tactile bonding; the emotional connection.

 For me the bonding process in touching is where the emotion of touch is centered. Permission to bond in the moment, to become involved without attaching to the touch having any conditions or any future, is what I call involvement without attachment.

This approach allows the practitioner to experience the nurturing and healing in the tactile relationship.

 Last weekend after a practice session, a student commented, “you are teaching from a place that we are asked not to go into as a professional.” This student then shared that he felt confused at first, but became more comfortable as he realized, he had permission to care.” This feels natural to me,”he continued.

 I was profoundly moved by this student’s ability to witness his process.

 Everflowing classes are small, four students maximum, therefore personal sharing, close supervision and feedback are incorporated to create a safe environment for experiencing this type of approach.

 Involvement without attachment, gives me permission as a professional to be whole. This approach validates all my feelings, and gives me the freedom to establish clear boundaries through the experience of choice. This is my Everflowing gift.

I look forward to your comments. Blessings Irene Smith
www.everflowing.org

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Stark concrete yards, wire fences, guard towers, iron bars and the sounds of gates locking behind you could describe any correctional facility in the USA. The California Correctional Medical Facility State Penitentiary for Men in Vacaville California however, is no ordinary prison. This prison houses 30 angels behind bars.

When the demonstration was over, the Native American inmate who had volunteered to let me demonstrate on him said, “Everything you said someone would feel, I felt. All the benefits you said people will receive, I received.” He expressed his gratitude for my being there. Then he told me of a ceremony he had recently held in the yard for a fellow native American who had died and showed me the plaque that had been created in the inmates honor.What a blessing to speak to a group who clearly understand the need to explore compassion as a path for a peaceful existence. How glorious to see human beings so willing to touch the heart fully, serve so passionately and forgive so deeply, and how nurturing to receive abundant gratitude for skills taught.

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It seemed as usual, walking down the long corridor in the inpatient hospice unit on Sunday.

We were witnessing twenty-two beds with curtains in between to allow visual privacy to residents in various stages of their dying process. Curtains were drawn to allow complete privacy for some; others, with curtains open, were watching TV or listening to music with head sets, and some were lying across their beds in obvious discomfort. There were residents being vocal with their personal needs, and residents needing their quiet space.

After 15 years of coming to this unit, although I never know what will appear, it all seemed to be somewhat familiar.

I knew however, that for the two Everflowing interns with me, it was not familiar. I was giving an orientation for our clinical practice and this was our first walk through the unit. I sensed the impact of this long corridor.

We were passing through the men’s area when at the other end of the unit, in the women’s area, there was a slight Asian woman coming our way with a nursing assistant. We kept walking. She kept walking towards us. As the woman approached I noticed her expression change from curiosity to acceptance.

Then, when we were only a couple of feet away from each other,the woman stretched out her arms  to me. Her face was open and inviting. I stopped walking. Our eyes met in soft recognition of our humanness, and I responded with outstretched arms as well.

With obvious respect, she took one of my arms in her hands, stroked down the arm slowly, and looking into my eyes, took my hand and gently stroked the side of her face. . ” Thank you,” I said. “Thank you,” ‘she replied. .

Reaching out, she then silently offered to hold one of the interns hands for a moment, and thank you’s were expressed.

Approaching the second intern, the woman stood on her tip-toes and stroked the interns shoulder and across his chest. She was beaming with care and tenderness.

After all thank you’s were expressed this angel of the hospice continued her journey to the kitchen.

We were left standing in the center of this corridor softened with gratitude. Our orientation had been transformed . Our hearts were full and our spirits light.

A simple caring gesture of touch; a glance into the eyes of an intimate contact with no attachment; no planned intention to fix, change, heal or correct anything, had changed everything.

Thank you for your personal sharing and comments. I look forward to hearing from you.

Blessings Irene smith

www. Everflowing.org

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Choosing to visit Celine after visiting hours seemed perfect; however I knew I should call and alert nursing staff. I explained to James, Celine’s nurse, that I was on my way to the hospital to give Celine a massage. James with extraordinary compassion in his voice told me Celine had just died. I took a breath. The silence encouraged me to ask if I could come anyway. James said, yes.Lavender scented lotion was Celine’s favorite, so I packed it in my bag and called a taxi.

Celine had been my neighbor for 25 years and allowing others in her private space was not Celine’s way. Being called for touch support in the final months of her life was quite an honor.

Eight weeks later Celine became bedridden and no longer capable of caring for herself. Being there when her power of attorney called and told her that I had to call 911 was one of the hardest moments I’ve ever experienced with a client.

As I packed Celines’s bag and assisted her in getting ready for the ambulance we both knew she would never see her home of 45 years again.

When the taxi arrived at the hospital, I went to the 4th floor. James appeared with extended arms. We hugged. “What a beautiful idea” he said.

There was a feeling of deep peace in Celine’s room as she lay like an African queen on a royal voyage. James removed the iv’s from her arms, the cooling blanket at her feet, and left us.

I looked around the room. There were several stones and some pieces of wood. Wood and rocks had always comforted Celine with the spirit of the forest. I spoke to Celine of the peace I felt in the room and of the beauty I witnessed in her open unfurled face. I told her I forgave myself for calling 911, and after sensing the peace around her in that moment; I knew she forgave me as well.

The scent of lavender filled the air as I slowly and gently anointed her body for the last time. Tears washed away my guilt and my heart received the honesty and fullness of our experience.

 It seemed guided as I placed the pieces of driftwood on Celine’s heart, solar plexus, and belly and laid the perfect lightweight sand colored stone on her forehead.Soft tones began to come through my throat and a chant was revealed. “You are the texture of the wood. You are the voice of the rock people. You are the movement of the breeze blowing through your window. You are harmony converging.” I repeated this several times.

Two nurses entered. Each stayed for a while sharing tears and expressing gratitude for the ceremony.I requested that the stones and pieces of wood remain with Celine as she was transported from the 4th floor. James agreed.

As I waited for my taxi, I stood deeply humbled by the blessings in my life and by my chosen work.Putting this experience into words has been yet another blessing. Thank you. I look forward to your comments.

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A Career Opportunity

After 26 years of providing massage for dying persons I ‘m excited to see this field within the profession being recognized by mainstream massage schools. With the growth of oncology massage the end of life has finally been brought into the classroom.

The information; however, may be a short section offered within the larger oncology program. If the presentation comes from hospice staff and/or a massage volunteer with a local hospice it may prevail as inspirational yet may not be complete enough to give a practical application for the opening of heart that has been elicited for the practitioner.

The possibility of hospice massage being a career opportunity, in itself, is not the focus. Therefore if you are interested in working with dying persons you may be left wondering how you can generate funding to support your passion.

Certainly if you choose to offer your service to a low income or disenfranchised population then the mission is to seek organizational funding or other community funding sources. However, it’s important to realize that all dying persons do not fall into this category. Working with dying persons offers vast opportunities for a passionate and financially supportive career as a private contractor.

In 1989 after 6 years of volunteering massage services for hospice I was contacted by a court conservator, named Gene. A conservator is a person that handles the business affairs for individuals who can no longer perform the responsibility for themselves.

Gene, asked me to visit his client, Mary, whom after a long hospital stay, was stuck in fetal position. I saw Mary 3 times a week for 2 years before she died. Mary was the beginning of my 20 years to date in private practice with dying persons. In my private practice I am paid by several different methods.

Every Monday I see Susan, now in end stages of Alzheimer’s disease,  whom I have been seeing for 11 years.  Contracted through Susan’s conservator, I make written reports after each session, and 2 times a month I send the reports and an invoice to her conservator’s office .Invoices are paid within 5 days.

On Wednesday I visited Diane, a client with advanced Parkinson’s disease. A once a week client for 2 years, Diane has moved into an assisted living community and now has massage once every 2 weeks. At the end of the session Diane pays me directly.

On Friday I provided massage for Marjorie, an 89-year-old woman with lung disease and mild dementia who also resides in an assisted living community. I do not discuss payment with Marjorie. I invoice the bank that handles Marjorie’s trust account. Marjorie’s care coordinator arranged this method of payment.

Saturday I will be meeting a new client, Michael, who is in end stages of HIV infection, and in a skilled nursing facility. Michael is alert and will pay me onsite after our session.

In choosing hospice massage as my career, I have always been a private contractor. I find no difficulty in being paid for my services if I am clear about my fees in the initial phone call.

Bridging the gap between compassion and asking for payment, however, takes a great willingness to work on my feelings of self worth, recognition of the skill I bring to the bedside, and viewing my clients as whole individuals.

This is a multi-faceted topic and I look forward to many more postings, and to your comments.

Comments are always welcome and encouraged

Blessings Irene Smith

www.everflowing.org

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