By Douglas Lobay, ND

COVER STORY: The Lobay Viewpoint

There is something magical and inherently healing about the heat and the light of fire from a wood stove.  Our wood stove was located in the basement of our house on the outskirts of our small town.   My father fabricated our wood stove from a large hollow steel cylinder welded together with pieces of metal, a door, a damper and a large triangular flume with piping that attach to our brick fireplace. During the cold and harsh winter months, our woodstove would be lit, burning wood fuel and warming our house.  The fire would burn all night and supply all our heating needs.  The last ember would burn out by the early morning. 

Marion was my mother, and she was generally a kind soul with a loving heart.  She was a traditional homemaker who grew her own garden and made wonderful and nourishing meals from scratch.  She canned her own food and made her own bread.  She also knitted and crocheted sweaters, socks, mittens and blankets.  She could also have a temper and she could verbalize her displeasure to a person or circumstance she didn’t like.  She experienced her share of loss and tragedy.  Her first husband passed away suddenly from drowning.  Her second child died from crib death when only a few weeks old.  Her first born and eldest passed away in a car accident when only eighteen years old.  She turned to religion to seek answers to the pain and loss she experienced.  She studied with several different Christian groups but never really committed to one faith.  She chose instead to read the Bible daily.  Her favorite book in the Bible was the poetic book of Psalms.

At the beginning there were subtle signs.  She would often forget places and names.  She would get dates, time and numbers confused.  She misplaced things and couldn’t remember where she left them.  She would brush off these momentary lapses and make whimsical excuses.   She would then accuse her husband of not listening to her and following instructions.  After he suddenly passed away, her symptoms worsened.  Stories became more convoluted and a mix of reality and memories of the past.  One moment she would talking totally cogent and logical and then drift off into something that bordered fantasy.  Her short-term memory faded, but she could still remember vivid details of her distant childhood and early adulthood.   She was diagnosed with vascular dementia. 

Dementia, whether formally diagnosed as Alzheimer’s disease, vascular dementia or some other cause, is a scourge of a disease.  It is insidious and progressive and robs a person of their so-called twilight of their life or golden years.  As her memory deteriorated, she was placed in a bright and beautiful but somewhat sterile care home with other similar aged infirm and decrepit individuals. She seemed to adjust to her new living arrangements fairly nicely.  As she grew older, she became frail and weaker, lost her appetite and ability to walk unaided.  One nurse told us she would often wake up in the middle of the night while still dark outside and sing songs from her past.  She passed away peacefully in the early morning one day in January after they couldn’t wake her to give her medicine.

I am going to miss our telephone calls.  I could often remember phoning my mom from anywhere and anytime and talking to her and asking her advice.  When I moved away to college and university, I could phone when I was down or despondent and say “Hi Mom….” When I graduated and went to naturopathic school in Seattle, I could always phone home and have her answer.  As I travelled to different places around the world, I could still phone home and talk.  After I got married and lived in a different city than my parents, I could still phone home and talk to Mom.  As her illness progressed, the phone calls dwindled.  She would often have trouble hearing me, would get me confused with someone else, or inadvertently hang up on me.  She talked about the incidences that happened long ago to people who have long since passed.  And then the phone calls stopped.

Spouses, children, and caregivers of patients suffering from dementia and other neuro-degenerative diseases are exposed to a variety of stressors.^1-3 They experience a range of emotions ranging from confusion, grief, fear, sadness, anxiety, depression, embarrassment, loss, rejection and guilt.  More than anything, I felt a certain amount of guilt and powerlessness to do anything.  I am forever grateful to my younger sister who was my mother’s primary caregiver during this time.  I moved away to go to school when I was young and practiced naturopathic medicine in a different city.  I was busy with work, my wife and raising a family.  I didn’t see my mother as often as I would like.  Yes, there were phone calls, but she was not tech savvy and we couldn’t have virtual visits.  During the Covid pandemic, the care home was under strict lockdown for months.  I only had a few brief visits outside her window.  My last visit was just after Christmas when I was able to visit her in person.  She was confined to her medical bed.  We talked about things that were both real and imaginary and punctuated by brief smiles and laughter.  I held her hand, told her I loved her, gave her a kiss on her forehead, and that was the last time I saw her.

            As I sit back and reflect on my mother’s life, I try to think about what legacy she left behind.  Like everybody she had her share of good and bad, ups and downs, tragedy, and triumphs.  She had good qualities and some not so good qualities.  Her relationship with my father was punctuated with episodes of acrimonious discourse.  At times he drank too much, and she didn’t like that.  Despite their shortcomings they still had a half decent relationship.  After he passed away, she would always say that she missed and loved him.  We had a fairly good middle class up bringing.  My mom was a stay-at-home mother, and my father was a shop foreman at the Ministry of Highways.  We lived in a sprawling rancher home on one acre of land with a big organic garden.  We had all sorts of toys, including motorcycles, go-karts, and snowmobiles.  We were involved in many sports, including hockey, baseball, soccer, and skiing. We grew up in a time of black and white television and just five original channels.  We grew up in era before electronic gaming and cell phones.  We had the freedom of the hills and roamed outside over mountains, hills, ponds, and meadows.  I know I was blessed to have a happy and caring childhood.

In naturopathic school I befriended another student whose childhood in Idaho was marred by a strict and seemingly callous upbringing.  He told me that his father used to punish him mercilessly and his mother never told him she loved him.  He was scarred from his childhood.  His relationships were difficult and tenuous.  He couldn’t believe the relationship I had with my mother and how loving and caring she was.  After pondering on the matter, I came to the conclusion that the single most important legacy I got from my mother was “unconditional love.”

Unconditional love is loosely defined as a love or deep concern for another without any attachments or boundaries.⁴ A true mother’s love to a child is epitomized as an unconditional love.  I know that my mother’s love for me was an example of unconditional love.  To a point I knew she would love me no matter what I did, wherever I was or whoever I was with.  I know she could be harsh and discipline me at times, but I still knew above all else she truly loved and cared for me.  I am forever grateful for friendship, guidance and love she gave and showed me.

Many studies show that children shown unconditional love are better adapted, healthier and have superior stress resolve.  It is critical for the personal development of self-esteem.  Children not shown unconditional love tend to show more helplessness, anger, and resentment.  Children shown unconditional love are generally happier and more fulfilled.  They have better interpersonal relationship on many levels.  The expression of unconditional love is a template for emotional, physical and spiritual growth later in life.

One book I found helpful was called On Death and Dying by Elizabeth Kubler-Ross. She was a Swiss-American psychiatrist who wrote a watershed book about pain and loss of a loved one in 1969.  She suggested a five-stage model of grieving experienced by family members and care givers that included the sequential emotions of denial, anger, bargaining, depression, and acceptance.  At first there is denial or refusal to deal with the inevitablity of fate of someone’s life.  Then there is an anger or a strong feeling of dissatisfaction with the realization of this end.  Then there is bargaining and glimmers of hope.  After hope fades and reality endures, then there is a general feeling of despondency and dejection. After this, there is general acceptance of the inevitability of fate and the reality of destiny.⁵

Betty was smartly dressed as she came to my office to discuss the results of her heavy metal test.  She wore brown shoes, white slacks, and a tan blazer.  Around her neck was a chiffon scarf embroidered with spring flowers.  She wore dark gloves and black horn-rimmed glasses.  She was tall and slim and had a short, cute haircut.  Her husband of 61 years led her by the hand as she shuffled down the hallway. Betty suffered from dementia, probably Alzheimer’s disease, and couldn’t tell me what time and day it was, didn’t know what she ate for breakfast or where she was exactly.  Her condition had deteriorated somewhat since I last saw her—or she was just having a bad day.  She mumbled her words and vacillated in and out of consciousness during our visit.  Her test was quite good, and her levels of toxic metals was low.  I was at a loss as to what to suggest that might help her.  I casually suggested that we could contact the local health unit and arrange for a nurse or home care to deliver some at-home services.  I suggested that if Betty’s dementia progressed, we could think about placing her in a nursing home for care.  Walter scolded me for using the word dementia and said he was still perfectly able to care of her at home.  And besides their daughter would come over frequently, help out and give him some respite.   He said with a glimmer in his eye that there was always hope, maybe she would get some better and maybe the nutritional supplements would help more.  After concluding our visit Walter struggled to put Betty’s blazer back on and then they both shuffled down the hall and left.  I smiled.  He was very tender with her and he dressed her very nice.⁶

References

1. Lindren CL et al. Grief in spouse and children caregivers of dementia patients. West J Nurs Res. 1999 Aug;21(4) 521-37.
2. Moyle W et al. Living with loss: dementia and the family caregiver. Aust J Adv Nurs. Mar-May 2002;19(3):25-31.
3. Etters L et al. Caregiver burden among dementia patient caregivers: a review of the literatrure. J Am Acad Nurse Pract. 2008 Aug;20(8):423-8.
4. Hofmann SG et al. Loving-kindness and compassion meditation: Potential for psychological interventions. Clinical Psychology Review. November 2011;31(7):1126-1132.
5. Kubler-Ross E. On Death and Dying. Scribner Publishing. Scribner Reissue edition. New York, NY. August 2014.
6. Duggleby W et al. Renewing everyday hope: the hope experience of family caregivers of persons with dementia. Issues Ment Health Nurs. 2009 Aug;30(8):514-21.

Douglas G. Lobay is a practicing naturopathic physician in Kelowna, British Columbia. Dr. Lobay graduated with a Bachelor of Science degree from the University of British Columbia in 1987. He then attended Bastyr College of Health Sciences in Seattle, Washington, and graduated with a Doctor of Naturopathic Medicine in 1991. While attending Bastyr College, he began to research the scientific basis of natural medicine. He was surprised to find that many of the current medical journals abounded with scientific information on the use of diet, nutrition, vitamins, and botanical medicines. Besides practicing naturopathic medicine Dr. Lobay enjoys research, writing and teaching others about the virtues of good health and nutrition. He has authored several books, numerous articles, and papers and has taught many courses at seminars and colleges throughout his career. He is married to Natalie and has two daughters, Rachel and Jessica. He also enjoys hiking, hockey, skiing, tennis, travelling and playing his guitar.