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Summer is here, and the natural world is exploding with life. While so many human beings stayed at home this spring, you may imagine what a ‘field day’ plants and animals have had. Our connection to all things growing is as old as our species, and we reap a myriad of benefits when in touch with nature - rejuvenation, stress-relief, increased health, sustenance, joy, creative inspiration, to name just a few.
For those unable to get outside because of social isolation or activity-limiting illness, there are many alternative routes to those life-enhancing rewards.
In this series we will discuss why and how nature is so beneficial to us and we’ll share some resources to help you bring some of the natural world to your own environment, wherever you are.
In later installments of the series we will visit the world of trees, which we know give us improved health in ways large and small. Their ability to provide oxygen, shade, medicine, and beauty is unmatched in our planet’s flora. Later, we’ll journey to the wilderness and find out how the natural landscape can improve our wellbeing and inspire our creativity, even when we are sitting indoors.
In Part 1 we start closer to home, as we explore gardens, gardening, and the therapeutic role played in our lives by our involvement with plants.
The human instinct to control our natural environment seems to have existed from our earliest days. Once we mastered the hunting and growing of ample food supplies, evidence teaches us that our ancestors began to design and plant for pleasure. Human knowledge of plant life expanded through trial and error to include nutritional, medicinal, and eventually purely aesthetic uses. When we looked at a beautiful landscape perhaps the pleasure we felt gave us the urge to try to reproduce it.
For millennia, gardens have been created as places of solace, escape, and relaxation. They have been catalysts for creativity, inspiring countless works of visual, literary and musical art. Their design is seeded in the imagination and nurtured by experiment and conditions, the only ‘rules’ being those of climate and space.
Ranging from the most grandiose and formal to a few simple containers on a sunny windowsill, there is a style to please everybody. Whether private or public, gardens can be manifestations of personal statement and cultural pride. They are sites of solitary, family, or community activity, which know no boundaries of age, geography or wealth. During times of war and, recently, pandemic, edible produce has been raised in ‘victory’ gardens, allotments, small plots and indoor pots. Anyone can garden with a minimum of material, (and most gardeners love to share or swap); very few people are immune to the enjoyment of being in one.
Before we continue, take a moment to enjoy this gallery of plants and gardens, and observe your responses to each of them:
There is a quiet thrill to be found in cultivating a life force other than our own, and wonderful moments of surprise when plants enforce their own will and spring up in unexpected places. As we nurture gardens, so do they nurture us.
Beyond their cultural, historical and social importance, gardens and gardening provide profound physiological benefits. They stimulate all our senses. One or two plants in an indoor pot can do this, or a richly planted garden outdoors. We know that aromas can trigger memories, colors can affect our emotions, shape and form feed our ability to use logic and enhance memory. Likewise, certain natural sounds can reduce our heart rates, and the taste of something healthy and fresh can encourage appetite. The physical activity of gardening on any level can improve fitness and motor ability.
Because they engage all these senses, it is clear that gardens bring huge rewards. For persons with cognitive deficits or impaired motor skills, they have a particular value: – the cerebral cortex of the brain, where sensory information is processed, is stimulated by the sights, smells, sounds, tactile textures, and taste of plants and gardens. The cerebral cortex is also where motor function is controlled and voluntary movement regulated, and it is the area of the brain responsible for processing language, planning and organizing.
The physician and writer, Oliver Sacks, explains the value of gardens:
"As a writer, I find gardens essential to the creative process; as a physician, I take my patients to gardens whenever possible. All of us have had the experience of wandering through a lush garden or a timeless desert, walking by a river or an ocean, or climbing a mountain and finding ourselves simultaneously calmed and reinvigorated, engaged in mind, refreshed in body and spirit. The importance of these physiological states on individual and community health is fundamental and wide-ranging. In forty years of medical practice, I have found only two types of non-pharmaceutical “therapy” to be vitally important for patients with chronic neurological diseases: music and gardens." (from “Why We Need Gardens” in Everything in its Place: First Loves and Last Tales).
This year more than ever, many of life’s most sustaining activities have by necessity become virtual ones. While many of us may not be able to travel or experience the beauty of gardens in person, the internet can take us there with a larger number of options and more stunning videography than ever before.
The New York Botanical Garden, a National Historic Landmark and the largest Garden in any city in the United States, is a wonderful source of information, beauty, and escape. Their website offers marvelous virtual tours through their gardens, ranging from spring flowering bulbs and blossom trees to roses in high summer. Tutorials by NYBG experts can be found there and on YouTube to help you with indoor plants and outdoor flowers and shrubs. If you want to grow some of your own fresh vegetables their website also features guides especially tailored for children and beginners.
Click here to tour the gardens or watch their free tutorials: New York Botanical Garden at home
If you would like to explore some of Great Britain’s famed gardens, including Kew Gardens, National Trust sites and The Royal Horticultural Society’s Chelsea Garden Show, this collection of virtual tours is not to be missed: Enjoy virtual British gardens
Whether in real life or virtually, the pleasure we can take in gardens and gardening is available to us in every season. We observe in the life cycles of the natural world an echo of our own finite existence, but there is comfort there in abundance. The careful preparation of a plant pot or a flower bed, and the expectant anticipation of our success, feed our sense of hope. The excitement of seeing a young shoot first emerge from our soil is hope brought to fruition.
"And don't think the garden loses its ecstasy in winter. It's quiet, but the roots are down there riotous." - Rumi
Click here to read more about the the physical and mental benefits of gardens
To read a recent study comparing the health effects of natural vs city landscape click here: Experimental Study on the Health Benefits of Garden Landscape
To read about gardens in history:
When the COVID-19 pandemic forced millions into a form of hibernation, many found themselves existing in a much quieter world, some even experiencing long periods of silence. Some have found the opportunity to think and create in that unusually quiet space; others, (for most of us are social beings), have reached out on phones, FaceTime, and Zoom to feel a connection they have missed. Not everyone has that luxury, and many are painfully isolated – often the disempowered, the victimized, the poor, the sick.
Recently, regardless of the extent to which communities have lifted some social distancing restrictions, hundreds of thousands of citizens have been impelled to march en masse to protest violence and discrimination against people of color.
Whether in silence or in clamor, these sentinel events have emphasized the importance of listening to (and really hearing) others, and the importance of speaking up loudly for those who need support.
In this second installment of our series on Spiritual Care in Difficult Times, The Reverend Susan Trucksess, a Connecticut Hospice Pastoral Care Volunteer, examines the profound spiritual connection made when human beings sit in silence together, and the comfort and healing of solidarity, whether words are spoken or not.
Presbyterians are wordy. Presbyterian ministers highly value the Bible as the Word of God, emphasizing Word. Presbyterian preachers preach long verbose sermons (Some might even say “endless.”) Presbyterian pastors use lots of words in conversations and communications with parishioners. (Some might even say “repetitive”). I am a Presbyterian minister...thus I tend to be wordy.
For many years I served in church settings. Then, in retirement, I came to Connecticut Hospice as a volunteer in the Pastoral Care department doing in-home care. I believed I had some experience to offer. Instead I learned I had much to learn... such as about the power of silence.
Naturally, in the course of my vocation, I had spent a lot of time with people in various straits of life, including but not exclusively those who were facing death. Now those at Connecticut Hospice who are moving toward the end of life in their homes are my “parishioners,” and our exchanges can have a different tone, a different quality, to them.
Often I walk into a home or a care center, sit at the bedside, and find that silence will be the most profound medium between the patient and me. Perhaps Mrs. Jones is presently too tired to talk. Maybe Mr. Gonzales has lost the ability to speak. Perhaps Rebecca is too angry or too sad to even look at me. John may be in a coma. What do I say in those situations? What words do I use? Of course, I can and do read from the Bible, the Torah, the Qur’an, if that seems appropriate or desirable. I can offer prayer, a blessing, an anointing, and spoken expressions of comfort and hope. And sometimes, sometimes, I can just sit in silence. As the Persian poet Rumi said,
"The quieter you become, the more you are able to hear".
At first, I have to admit, that seemed awkward. No words, no response. What was I doing there? What was I offering? Accomplishing? Nothing fancy, nothing bold, nothing noteworthy. It was humbling. And then I realized that was exactly the point, that is the point. In these moments I am sharing in the very human condition.
Each of us there - the patient and I - are going to die. Perhaps one sooner than the other, but each of us is living in the movement toward death. I am overwhelmed by a feeling of connectedness, of tenderness.
When two people (or more) know that we are in the process of being human, there is something that can happen between us. Something big, something grand, something tenderizing can take place in our midst. A kind of joy. All the things that normally distance us from one another become small and insignificant.
We will not be here forever, but we are here together now, and Spirit is with us. There can be joy in the midst of suffering, and life in the presence of death, as the wonder of life, death, and the mystery of life beyond death unfolds for all of us.
This is part of what Connecticut Hospice is all about - and it comes in many forms of caring for patients and families - with words, and without. It comes in a touch, a bandage, an injection, a bath, a warm meal, a smile, an assurance, a hope, a prayer. It comes from nurses and doctors, social workers, administrators, chaplains, aides, volunteers who cut hair, bring art supplies, music, (or dogs), transport to appointments. It comes through in-person interactions and in phone calls. It is soft and it is firm, compassionate and professional. It is caring and tending and accompanying. It is the Connecticut Hospice way. And we would be honored to serve you should you need us.
Peace and blessing, The Rev. Susan Trucksess, Pastoral Care Volunteer.
To read more on Presbyterianism: https://en.wikipedia.org/wiki/Presbyterianism
To find out more about 13th Century Persian poet Rumi's works: Rumi - America's best-selling poet
Rumi's life, death and legacy: Rumi biography
Writings on stillness: Stillness as action
Pablo Neruda on being quiet: Sylvia Boorstein reads Pablo Neruda poem
How U.S. Representative and civil rights leader John Lewis learned to use words for change: Excerpts from 'Preaching to the Chickens'
Connecticut Hospice was fortunate on the May 27 Town Hall to enjoy the partnership of world-renowned epidemiologist and Dean of the Yale School of Public Health, Sten Vermund, MD, PhD, in educating its staff.
Dr. Vermund shared his wisdom with Connecticut Hospice staff on COVID-19 protections for health care workers and their families, answering questions on a live Zoom conference, and covering a wide range of topics, including –
With permission from Dr. Vermund, we are pleased to share the entire session with you. We hope you will find this conversation interesting and informative, and we are sure you will glean some insights and reassurance from his knowledge.
Read Dr. Vermund’s bio here:
Read more about Dr. Vermund’s work here:
For all those isolated by illness and the pandemic, actress and Broadway star, five-time Tony Award nominee Laura Benanti has some joy to share, and we have been asked to help bring it to the Connecticut Hospice community and others who may not be active on social media and might be in need of connection during this time.
Benanti and social activist friend Kate Dieter-Maradei created SunshineConcerts, a free livestream concert series to connect an intergenerational audience.
This spring thousands of high school students across the country were bitterly disappointed to discover the musical productions they had spent months rehearsing would not be staged. On Twitter, Benanti invited students to share videos of the performances they weren’t able to give because of COVID-19.
The #SunshineSongs social media campaign went viral with millions of people joining the virtual audience for students’ heartwarming performances.
Benanti received thousands of videos from all over the country, (her friend Lin-Manuel Miranda watched many with her), and the story was featured on Good Morning America, Vogue, People and the NYTimes, etc,.
Benanti and Dieter-Maradei decided to turn this outpouring of expressions into something positive. The SunshineConcerts project livestreams performances by the best of the student submissions and includes performances by Laura Benanti, and other special guests so that elders and teenagers can come together in music.
Watch the The Sunshine Concert livestream Saturday, May 30 at 6pm! To make the event special, virtual tickets and playbills can be printed.
Download your SUNSHINEBILL Playbook here.
Download your Sunshine Concert ticket here.
Please share these details with anyone you know who is living in isolation during the Coronavirus Pandemic.
Pastoral Care is a core service of hospice care, an integral member of the interdisciplinary team that brings care to all hospice and palliative care patients and families. During difficult times, many seek solace in their spirituality, while others have many questions, and plenty of doubt, about where to find spiritual support.
It seems especially important to offer some reassurance while so many are struggling with current events. On this page we will be posting a series on how pastoral care providers at Connecticut Hospice see their mission, and how patients and families feel strengthened by their support, whether they follow a particular faith system or not.
In the first of this series, Jamie Johnson, Connecticut Hospice Pastoral Care Volunteer, defines how she sees Spiritual Care, and describes how it is given to hospice and palliative care patients in our in-patient setting and to patients at home throughout Connecticut.
Everyone has a worldview, a perspective on what is right or wrong, what is most important, what gives them comfort and inspiration, and why things happen. For many, their worldview is formed by their religion and faith communities. Others look to their human connections, to nature, to service, to love, something larger than themselves. This acknowledgement and embrace of something larger than ourselves, however you define it, is spirituality.
When crisis happens—unexpected change like losing a job, injury or illness, death—people turn to their sources of comfort and support, their spirituality, to make sense of what is happening. Some people pray to God, light a candle, meditate, take a walk outside, speak to a friend, clergy, or a therapist, create art. Sometimes, though, the crisis is so overwhelming they aren’t able to access that support. At Connecticut Hospice, this is where the chaplains and volunteers of the Pastoral Care department step in.
A sign in the Pastoral Care office reads:
Chaplains help create a sacred space for people of all faiths and cultural beliefs in stressful, life changing, or transitional moments to find meaning, hope, connection, and comfort by enabling them to identify and draw upon their inner strength.
This is spiritual care. Chaplains and volunteers offer their compassionate, calm, open presence to all people, from those in traditional faith communities to the “spiritual but not religious” and the “nones.” They will listen and provide support based on the careseeker’s beliefs.
Pastoral Careworkers do not preach or lecture; they do not judge or condemn. They sit at bedsides, hold hands, and hold space for people to process what troubles them; they may also offer prayer, ritual, or readings as appropriate.
If hospice patients or families need particular religious care, the department will contact local clergy. A prayer room is always available for prayer and meditation. Roman Catholic Mass is celebrated weekly, with communion available to those who can’t leave their rooms. Interfaith services are also performed regularly.
To support people of diverse beliefs, the Pastoral Care department works with the entire Connecticut Hospice team.
The Arts Department provides engaging and inspirational art projects and music at the bedside. Pet therapists bring dogs around for tender, loving care. Social workers listen and guide. There are special, handmade blankets on each bed to surround patients with color and warmth. Even our location on the shore of Long Island Sound offers a restorative breath of fresh air to patients and their loved ones.
The Pastoral Care department is here to help and support you during difficult and challenging times.
Jamie Johnson, Pastoral Care Volunteer, Connecticut Hospice
For information about different religions and spiritualities: Harvard Divinity School's Pluralism Project
For a series of inspiring podcasts on spiritual questions: Yale University's The Quadcast
To hear Yale University’s Shades of Yale perform uplifting spirituals: Amen & We Shall Overcome
To read A Prayer for Our Time, by The Rev. Frederick J. Streets, ’75 M.Div, Senior Pastor of Dixwell Congregational Church, New Haven, CT: A Prayer for Our Time
Resources on spiritual care and chaplaincy training:
Association of Clinical Pastoral Education
Association of Professional Chaplains
To learn more about Prayer Shawls and blessing blankets: Prayer shawl ministry
To donate new blankets to Connecticut Hospice, contact [email protected] or [email protected]
On a recent spring day, Sybil was brought down to the sunny lobby of Connecticut Hospice inpatient hospital in her bed. Social Work and Arts Department staff had collaborated over several days to orchestrate what was to happen when she got there. Her view through the floor-to-ceiling windows took in more than just the lawns stretching down to the sparkling water of Long Island Sound. On the other side of the glass, positioned six feet apart or more, were some of her closest family members. As staff music therapist Hannah Righter played “You’ll Never Walk Alone”, a favorite family song learned specially for this event, Sybil’s brother-in-law held up a large, colorful sign festooned with hearts, that read “Happy Anniversary”. Other family members held up phones to share this special day with a daughter in Tennessee. Her husband Don, sitting next to a vase of fresh tulips on a small table, leaned right up against the glass and spoke to her on a cellphone.
“It is so difficult not to be able to be with my wife now. Knowing I will see her through the window brings great joy”, he said before arriving. “I am very lucky to have such a wonderful family. I could not ask for more.”
As Hannah played “Five Foot Two, Eyes of Blue”, Sybil flashed a wide smile and sang along, tapping her hand.
This is how a couple who met days after Don’s return from service in the U.S. Army celebrate their 63rd wedding anniversary during coronavirus. When visiting guidelines are severely restricted by state executive orders, and parties must be made up of only a few, who cannot even hug each other, some have found a way to celebrate anyway.
Throughout the world, models of not only health care provision, but also basic human interaction, are being upended by the COVID-19 crisis.
How is hospice care adapting to this new landscape? How are patients and families continuing to receive the type of care and support which are the cornerstones of hospice care? In this article, we take a look at the ways in which Connecticut Hospice has adapted or transformed some of its programs both to meet patient and family needs, and to meet the challenges intrinsic to these times.
To enumerate the many changes and challenges, limitations and restrictions that have been placed on society in the past couple of months, and on health care providers in particular, is possibly redundant when the local and national news covers them almost exclusively on a daily basis. However, the ‘new normal’ presents specific challenges in a hospice setting, where one-on-one support, touch, unlimited family visiting, pet therapy, volunteers, bereavement support groups, and art and music therapies have been integral to hospice care for decades.
But hospice workers have always been resilient, resourceful and collaborative. Their work with patients and families has always required that they find alternatives, offer resources and solutions, empathy and understanding. This is especially true when one of the outcomes most wished for by the patients and families in their care – the cure of their incurable disease - is often beyond anyone’s capabilities.
So when infectious disease protocols and government executive orders limit close one-on-one contact with patients in the inpatient setting to certain staff, those staff-members must carry ever broader shoulders; they may be the only living beings patients can see for now and they must be almost all things to all people. The exception to this is when a patient nears the very end of life when hospice tenet dictates that no patient should die alone. Unlike the current policy in many hospitals, where COVID+ and other patients are not permitted visitors, at Connecticut Hospice, up to two family members may come at that time.
When patients cannot see facial expressions, now covered by masks and face shields, creative medical school students like Shayna Zanker step up to create large laminated badges featuring the friendly smiling face of each staff member.
Teamwork and professionalism under fire has allowed CT Hospice staff to pivot with agility, and to continue to offer excellent care and supportive programs to what is inarguably one of the most vulnerable populations.
The changes undertaken are not limited to emotional or psychological adaptations; technology is playing a huge role where physical contact is not possible. Social Work and Arts staff collaborate to facilitate 'virtual' visits using Facetime, Skype, Messenger, Zoom, etc. as well as taking people like Sybil to the lobby for family visits from the other side of the atrium windows.
Tele-Chaplaincy is now a staple of Pastoral Care. https://www.hospice.com/pastoral-and-spiritual-care/ Chaplains are praying with patients and families together on FaceTime. For Christians, communion is not held with tangible sacraments, but is spiritual and virtual. The advice that Reverend Warren Godbolt, Director of Pastoral Care, learned in theological school has taken on another layer of meaning these days –
“When you can’t find God’s hand, trust God’s heart”.
Bereavement support https://www.hospice.com/bereavement-program/ has been transformed by the COVID-19 pandemic as well. As in-person support groups were by necessity suspended, group members were contacted to inform them of on-line resources, including a Grief Group via Facebook by grief expert David Kessler. Group members are also encouraged to call the CT Hospice Bereavement Department for phone support any time. As on-line support is now being utilized much more during this time of social distancing, links to resources have also been added to the Bereavement page of the CT Hospice website and Connecticut Hospice Facebook page. Jennifer Stook, Bereavement Director, adds
“Every day we are learning new ways to connect to people needing grief or bereavement support and we are open to being creative while observing HIPAA regulations and privacy for those seeking assistance.”
Home care https://www.hospice.com/hospice-home-care/ staff have faced an array of challenges to their routines and work habits. PPE (personal protective equipment) is of course high on the priority list of caregivers who visit patients in homes and nursing homes, even in normal times. The extra layers of protection now required have to be changed, sanitized, or discarded, continually throughout the day. Some families desire to have no in-person visits in their homes currently at all, so ‘tele-health’ and careful communication and observation by phone or internet is a new option.
Home Care and Inpatient staff were already learning to navigate a range of new technologies connecting them with patients and each other throughout the past few years. The pandemic has accelerated that process. As Eric Smith, Information Systems Specialist, puts it:
“What was supposed to be a transition taking many months, became a transformation that has taken only a few weeks. We’ve taken a broad leap from a traditional information technology environment to one where we can provide and support patient-centered care anywhere, anytime, and on any type of device. We still have a way to go, but we are much, much further along in the process.”
Besides assisting patients and families to visit each other virtually, the Arts Program https://www.hospice.com/arts-program/ has digital exhibitions and music performances lined up to be broadcast on in-house bedside TV channels (for those without laptops or smartphones) until Arts staff and volunteers are permitted to return to making bedside visits.
The John D Thompson Hospice Institute, CT Hospice’s educational arm, https://www.hospice.com/jdt-hospice-institute/ hosts hundreds of interns and students in a normal year. Now, some of those students are finding helpful and creative ways to remain engaged. Students from Yale’s School of Organization and Management are hosting training courses for staff, and Medical and Nursing students are donning PPE and helping in both outpatient and inpatient settings.
Perhaps the most moving example of the indomitable spirit of Hospice care has been the outpouring of generosity and involvement by CT Hospice Volunteers and the community at large. Early in the crisis, a Governor’s order suspended volunteer activities in hospitals. In Hospice care, volunteers serve in every discipline, and while they cannot now visit to help in person, this has not stopped them from remaining engaged on every level.
They have made hundreds of masks, sent music and messages on YouTube and Facebook videos, written articles, made phone calls, recruited donations of food and PPE. In the community, armies of furloughed workers are using sewing machines and 3-D printers to produce much-needed PPE, restaurants are donating meals, and everyone is banding together to help each other through the crisis.
The following has been making the rounds recently –
“FEAR has two meanings – Forget Everything And Run, or, Face Everything And Rise”.
The first option is not in the lexicon of hospice workers. Almost everything has changed in a few weeks. Almost. The mission and spirit of hospice care remain, stronger than ever.
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