The Anatomy of Breathing

Movement Modalities: Dance, Housework, Breathing

Ballerina by Robert le Madec, French, 1899, via Wikimedia Commons.If dance is the poetry of motion, then writing about dance can be a way of entering our embodied experience more fully, the way a poet enters each word of the poem. With this in mind, we might take one step at a time, paying attention to one moment of mindful awareness after the other. The pace can be slow or rapid, reverent or careless; perhaps lighthearted; certainly watchful.

What do I mean by watchful? Simply that if you are dancing, you will open your mindful eyes and observe the contents of your conscious awareness from one breath to another as you turn your right toe out and step to the side. You will also feel the way the sacrum guides your hip to rotate the leg, while your thigh opens out, just slightly, as the spine turns. The breastbone lifts the ribs and your weight shifts into the step, with the music already flowing along with your body, carrying you into another place, another step, another rotation.

And within the ribs beats the heart, nestled in the cardiac notch of the left lung, and the heart throbs between and behind your two lungs, the lungs swell with the in-breath and yield with the out-breath.

And now, can we imagine how each in-breath draws some physical elements of the world into our bodies, while each out-breath pours some physical remnants of our bodies back out into the world?

What does it mean, I ask myself, that my body is the medium for an exchange of gases between myself and the threadbare hemlock tree in my back yard? What does it mean that my body, as I drive to work in my car with the windows down on a spring morning, serves to filter the air and give it back to nourish the trees that line the road?

“Dear trees,” I would pray out loud every morning. “Dear trees, help me to keep breathing all day, no matter how fearful I am.”

“Dear trees,” I would pray out loud every morning as I drove to my new job in publishing in suburban Boston, “dear trees, you are so beautiful. You there, you raise your branches over my head, your early buds swell at the tips in droplets of pea-green, of silky burgundy, you there, your trunks so solid, your roots deep and black-barked down in the dark, roomy soils near the river, dear trees, you are so beautiful. Help me to keep breathing all day today, no matter how fearful I am when I answer the phone.”

So simple, you might say, dear trees, it should be so simple for me to answer the phone in my cubicle, to say ‘Prentice Hall Social Studies, this is Mary Ann.’ So simple, but because I am so new, and because I don’t have the training to do my job, and because there doesn’t seem to be any system to bring me up to speed in order to complete my assignments, I am aware, as I observe my supervisor’s pursed lips and scrabble through the papers piled on my smooth, putty-colored work surface, that each day’s work is not enough work. Each answer I give to my colleagues’ questions is not a sufficient answer. Each breath I take is not enough breath.

Imagine the experiential anatomy of breathing when you work in a job you love.

Now, imagine that it is many years afterwards and I am in a job I love, for which I am profoundly qualified. Imagine the experiential anatomy of breathing when you work in a job you love, a job in which it matters that you are a kind person. Imagine the way the breath is the very embodiment of taking in kindness and giving out kindness, over and over again. Not a Mother-Teresa kindness; not something superhuman, but just an ordinary, clumsy, this-is-the-best-I-can-do kindness.

I have to breathe a lot in this job I love, as I care for elderly people in their houses, old houses full of memories and things. I breathe a lot and I’m sweaty. I have to squat and pick up dropped laundry from under the bed. I have to wash my hands in the sink in the laundry room and dry them on a terry cloth towel. But each breath is enough.

Imagine how my body dances as I fold the laundry and put it away, as I step to the right, bend, pull out the drawer, press the stack of soft turtlenecks into the drawer, shove the drawer closed, and turn and step to the left again. My limbs and spine loosen, my ribs expand and the lungs open and the heart beats faster, the breastbone shifts and flows with the spine, the tailbone rises and turns me first one way, then another.

Imagine that my ribs shelter the lungs and my breath feeds the blood and the ligaments draw the ribs together in a curtain of protection.

Breathing Ornament 04Now, imagine that you drive home from a job you love, the windows down in your car, the trees receiving your breath by the side of the road. Imagine that you learn about the experiential anatomy of breathing on the job. Imagine that you see, for the first time, the prodigies of flesh within us all.

And so, perhaps, dear ones who read and write and read again, you will experience the gifts of kindness, of life, of movement, of yielding, of letting go, of falling into bed, and breathing through the night, and drawing breath again, as you rise for a fresh love, a fresh day.

— Mary Ann Barton

Glossary for this post:Experiential Anatomy,” writes dance/movement teacher Susan Bauer, “is a creative / humanistic approach using movement, touch, drawing, partner work, and creative writing to embody and personalize your learning.  One’s experiences become the basis for understanding one’s physical body and movement potential.” I liked the clip below of famed teacher Bonnie Bainbridge Cohen demonstrating Initiating Movement from the Coccyx.


Painting credit: Ballerina by Robert le Madec, French, 1899, via Wikimedia Commons.

Link to this post:

Another post in Movement Modalities:  Nia Dance Poem


Demystifying Home Care

Editor’s Note: The following essay began as a guest post for OpenPlacement, a company that links seniors and their families with providers of senior housing and home care services. In writing this piece, I’ve relied on my experiences as a professional caregiver, but the views expressed are my own, not those of my employer, and I did not receive any compensation for the essay. The client in the story, Mrs. Josie Delancey, is not a real person, but the issues underlying her fictional character are drawn from real life. — MAB

Woman Sitting by the Window (detail) by Tivadar Kosztka Csontváry

Woman Sitting by the Window (detail) by Tivadar Kosztka Csontváry, via Wikimedia Commons.

Every few months, I find myself standing on the doorstep of a new client, ringing the doorbell.

Who will she be? I wonder, this new member of the community of elders whom I meet in my work as a certified nursing assistant and companion to elders.

What family photographs will I see on her walls, what medicines on the table by her bed?

Will I have the skills she needs? Will she accept help from me, a person she’s never met?

Looking back on these moments of mystery on the doorstep, I’m struck by how high the stakes are when we try to help frail and vulnerable people as they grow older. When a family calls my agency to ask about home care, chances are this is just one step in a long journey. Perhaps their mom is struggling to cope at home with illness or injury. Perhaps their World-War-II-veteran husband has escalating memory problems that trigger agitation or even rage. Even in more fortunate circumstances, asking an elderly person to consider home care is a big step.

My hope in this essay is to demystify home-care by telling you something about it from my point of view as a practitioner with eight years of experience in the field. This work is by its very nature private, yet as the baby-boomer generation ages, there will be more and more elders who need the assistance of direct-care workers in order to live safely at home. That’s why I write about my experiences — taking care, of course, to preserve client confidentiality by changing any identifying details about my clients and their families.

Client Story: Mrs. Josie Delancey

Suppose you are an adult daughter named Alicia, and I’m here to help your mother, Mrs. Josie Delancey. You and your mother have met with my agency’s staff to discuss her situation. At age 85, Mrs. Delancey has been living alone in your family home since your dad died five years ago. But lately you and your three siblings have seen a big decline in her health. She was hospitalized twice in the past year, once with pneumonia and more recently with a fractured wrist. Her arthritis makes it difficult for her to stand up from a seated position. She’s no longer able to drive, and has become increasingly sad and listless. Her once-immaculate house fills up each week with discarded newspapers and used cat-food cans. She’s been losing weight and needs help with using the toilet as well as cooking, cleaning, medication reminders, and rides to the grocery store.

As you can see in this scenario, you and your mother have already given us lots of information that will help me do a good job. My supervisor has worked with you to set up a care plan that specifies what tasks your mother does independently, where she needs a little help, and where she needs substantial assistance.

Home Care Map

Indeed, since my agency uses secure email and web-based documentation tools, the information flows quickly and easily between the family and the client, agency supervisors, and caregivers like me in the field. Today, as I meet your mother and set about making her breakfast, I have a mental Home Care Map in my head that will grow and change with each visit.

Home Care Map for Mrs. Josie Delancey

Client Home Care Map

Tools of Support

Included in my mental Home Care Map is a list of intangible Tools of Support. It’s been my experience that the emotional support a caregiver can offer is just as important as the assistance we provide our elderly clients in the activities of daily living. As caregivers, we need both strong arms and kind smiles. When clients or family members resist care, or when something about our presence triggers some negative response from a client, we need to be able to work with the situation as tactfully as possible.

I remember visiting a friend of mine who was under hospice care, years ago, before I embarked on my career as a caregiver. I noticed that the hospice caregiver would help my friend get situated on the toilet and then wait outside the bathroom, with the door barely ajar. It was a small detail, but my sense was that in respecting my friend’s privacy at this vulnerable moment, the caregiver was supporting her independence and autonomy.

Appreciating Family Caregivers

Finally, I would like to express my appreciation for the family caregivers with whom I have worked over the years. A couple of years ago, I worked with a family caring for their 82-year-old father. He loved baseball, so for Father’s Day his son bought him a tablet device with a link on the home page to the Baseball Hall of Fame website. He especially loved the online exhibit, Picturing America’s Pastime. Looking at the pictures and telling stories about games he remembered gave this elderly man hours of enjoyment. I’ll always remember the thoughtfulness of the son’s gift and the joy it gave his father.

About the Author

Mary Ann Barton is a certified nursing assistant, elder companion and blogger who writes about health, healing, and caregiving for elders, their family members, and their paid and volunteer care partners. She finds joy in singing and is writing a book about finding rest and renewal as we care for others. See more by clicking here.

Self-Care Diary: Friday, 11/22/2013

Retro 37This is Day Five of my experimental series, Self-Care Diary. For seven days, I’m sharing the things I’m doing to maintain my health and well-being. Then, at the end of the week, I’ll offer some observations on how things went. What are your favorite self-care activities? Does the word “self-care” make you cringe? I invite you to contribute your comments, or you can email me, mabarton01 [at] verizon [dot] net.

Friday, 11/22/2013

Breakfast: The usual brown rice with soy milk and spices; 3 c coffee.

Singing: 15 minutes of chanted prayer in the tub. Later in the day, 30 minutes of singing in the car; I also sang for my co-workers.

Companion-animal love: My cat Ginsberg and I are sofa-pals. We sit together on the sofa in the living room. She purrs, I read my email and browse posts in the LinkedIn Elder Care Professionals and Alzheimer’s & Dementia Professionals groups. My husband shows me silly cat pictures from Imgur and Reddit. We laugh. It’s slightly misty outside. Just for this moment, life is complete.

Lunch: Pork stir fry, 1 large Fuji apple.

Travel and socializing: I drove up to Portsmouth, NH and met my Caring Companion Home Care coworkers for chai and conversation. To my surprise, they presented me with a card and two Amaryllis bulbs in rustic, birch-bark containers in honor of my fourth anniversary with the company. Wow!

Social snack:  Chai in Portsmouth. In my food plan, I allow myself three meals a day plus occasional snacks when I think that a social occasion warrants it. But I don’t allow myself to eat after dinner.  

Dinner: 5-cup Big Bright Salad with minor variations, as usual. (See Monday’s diary for details.)

Meditation: 20 minutes of seated meditation on the breath.


Joyous Paradox Receives a Recommendation

One of my joys here at the Joyous Paradox blog is connecting with other people who share their stories of offering and receiving care.  Last month, I shared blogger Beth Stilborn’s article on “Reading Aloud to the Elderly” with you. Last week, she wrote about Joyous Paradox. With her permission, I’m reprinting her post below. Thank you for the recommendation, Beth. — MAB

Joyous Paradox (Blog Recommendation)

In late March, I was contacted by someone who had read my blog post about reading aloud to the elderly, and wanted to repost it on her blog. After reading some of her blog, I quickly agreed.

Those of you who have known me for some time know something of the journey I went through with my elderly parents in the last years of their lives. We had always been a very close family (I have no siblings, which likely drew my parents and I even closer). When both parents fell within five days of each other, and ended up in nursing homes (separate ones), it was difficult for all of us. I talk about how reading helped us, particularly Mum and me, in my blog post. A blog like Joyous Paradox would have helped enormously as well.

Joyous Paradox is written by a woman who is a health care professional working in the field of eldercare. This is a personal blog, not a professional one, but it brings a wealth of experience as well as compassion and understanding to every post. In her own words, Mary Ann writes “about health, healing and caregiving for elders, their family members, and their paid and volunteer care partners.”

Mary Ann knows the challenges that elders and their families face. She also knows how to deal with those challenges and struggles in a way that honors the person. She says, “My colleagues and I emphasize wellness, supporting our clients in activities that bring them joy and satisfaction.” She recognizes the value of things such as reading, poetry, music, the arts — the clinical care of aging people is of great importance, but so is care for the mind, heart, and inner spirit. Joyous Paradox is filled with heart and spirit.

I am grateful that Mary Ann discovered my blog post on reading aloud to the elderly, because that connected me with her, her blog and her work. I am joyous as I share this resource with you.

As Rosalynn Carter says of caregiving, “there are only four kinds of people in the world – those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.” Mary Ann’s blog will help us in all those stages.

— Beth Stilborn, By Word of Beth

Three Sweet Gifts for Elders and Their Caregivers

Breathe Mug from Stress ResourcesNow that the wild flurry of December holidays is over, I’m settling back into a more relaxed relationship with the subject of gift-giving. From the safe vantage point of mid-January, I view my family’s upcoming birthdays with equanimity, knowing that my husband (February) and son (March) already love me and do not require proof of my love for them in the form of perfect presents.

Still, I think that the art of the gift can be well worth practicing, both for the giver and the recipient. With that gentler approach in mind, let me suggest three sweet gifts* for elders and their caregivers to raise the spirits in any season.

1. Breathe Mug:  Perfect for elders and caregivers alike, Stress Resources’ new mug reminds us to take a healing breath. Also available, the Breathe Mug and Meditation CD, four mindfulness meditations by nurse/meditation teacher Pamela Katz Ressler with guitar music composed by Louis Arnold.

2. Miniature Canvas on Easel:  Add visual interest to mealtimes with a festive place card. Use a colorful felt-tip marker to write a loving message on a miniature artist’s canvas. A plate stand makes an attractive holder. I found everything I needed at the West Concord (MA) 5 & 10, but you could order small stretched canvasses online at Dick Blick and plate stands at Plate Stand Source.

3. Scrub tops and pants:  Bring charm and comfort to the daily tasks of care with affordable custom clothing from Sassy Scrubs. Sized from XXXS to 6XL, these medical scrubs are a practical gift for men as well as women. Choose from over 1400 prints and solids in cotton, polyester, or blends. The Snappy Scrub Top, which opens in the front, can be a good selection for a loved one who spends a lot of time in bed.

Finally, may you enjoy the intangible gifts of ease and contentment in the year to come.

Note: These ideas are freely offered and I do not receive any compensation from the companies mentioned.