Uniting Science and Emotions to Promote Healing

The pillows were too hard. The food was too cold, and the drink was too warm. The room was too dark, and the sun was too bright. Comfort in a hospital bed, for a patient with limited mobility, remains beyond reach.

The first days after my daughter’s stroke felt like we lived in a horror version of Goldilocks and The Three Bears. However as a mother on a mission, I learned through trial, error, observation and research how to support a hospital patient.

As I sat beside my daughter the days after her diagnosis, I wanted to make everything right. I craved the ability to fulfill my motherly responsibilities only to fall into depression when I could not, until I remembered a lesson a supervisor drilled into my head when I worked to manage situations beyond my control.

Circle of Influence

He would hold up his hands, construct a large circle and say, “Circle of concern.” Then adjust his hands to sign a small circle, “Circle of influence.” He repeatedly reminded me to focus my energy on things I could control.

Control the controllable then release the uncontrollable

My friend coached me to recognize the difference between the two and reminded me not to waste energy worrying about events beyond my control, a lesson I never mastered but continually practice.

(Since it is not my lesson to teach, I reference The 7 Habits of Highly Effective People by Stephen R. Covey. A brief explanation is found in Stephen Covey's Circle of Concern and Circle of Influence. )

This message pushed me out of a sulking depression and set me in motion to determine what I could control in my daughter’s recovery.

Maslow’s Hierarchy of Needs

Psychology teaches that humans require their most basic needs to be fulfilled before they feel safe, grow, and mature. Abraham Maslow formulated a theory named Maslow’s Hierarchy of Needs that outlines the different levels from basic to more complex located at the top. Research demonstrates for a person to grow, certain variables should be provided. The graphic below illustrates the progression to self-actualization.

I looked at my daughter, her body wrapped in a rough cotton, generic hospital blanket, nourished delivered through an IV, surrounded by family. Her most basic needs were met — at a minimum.

As I observed Kari in the hospital bed, I believed she needed to feel safe, to grow healthy and begin healing. Distraught and knowing her medical condition rested in the hands of the staff, I created a vision of an environment to promote healing. Then began the mission to change the variables within my circle of influence.

Physiological

Food and water

The first area of concern rested in the physiological realm, rudimentary body functions. Armed with a Styrofoam cup of ice chips, I spooned tiny pieces into Kari’s mouth and dispensed small drops of water. Nurses warned that fluid could carry bacteria to her lungs and cause pneumonia so I acted cautiously.

Immediate relief appeared on her face; her eyes reflected appreciation. The nurses provided lemon cotton swaps to clean her mouth and brush on her lips. As time went on, lip balm provided relieve.

Because Burt’s Bees Balm was a familiar part of her regular, daily routine, a small hill of tubes piled on the bedside table, donated by friends who knew her obsession. Her smile acknowledged success encouraging me to continue to explore ways to provide comfort.

Restful slumber

Sleep came and went, but comfort seemed out of reach until we learned how to efficiently position her body. Because the doctors required the bed elevated at 30%, she constantly slipped into a crumpled, distorted lump without the ability to shift and find comfort. With a person on either side of her bed, and a folded sheet placed under her posterior, she could easily be adjusted by lifting and pulling the sheet.

Dan, her husband, brought her favorite ultra-soft, plush, fleece blanket from home. Once positioned and cocooned, we added an over-sized, malleable body pillow in a silk case that absorbed her and induced slumber. With comfort came relaxation and peaceful slumber.

We progressed to the second level of Maslow’s pyramid by examining ways to provide Kari security.

Safety

Following doctor’s orders, we lived in the shadows the first days allowing rest to strengthen her body and mind. We waited with the curtains closed, lights dimmed and spoke in whispers to minimize distractions. Thinking this behavior would promote rest, we limited noises to muffled reassuring voices.

However as one day bled into another, I noticed her irritation at the whispers. She interpreted the silent conversations as information we hoped to hide; she believed we held secrets that threatened her safety. Once we became aware of her suspicions, we talked in normal volumes providing assurances that her situation improved daily, and we hid nothing.

Employment of purpose

Before long, I noticed the hospital staff often asked the family questions, which removed Kari’s ability to make decisions and control her own destiny. When she was well, Kari would never have accepted surrendering to the will of others so questions started to be directed to her.

At first, she could only respond with simple gestures or eye movements, but she began to control her life conveying the message that healing required her to be an active participant. Prior to this, we talked about her and not to her. Once we acknowledged Kari’s need for inclusion, we created situations where she became an actress in her own story.

Resources

In the beginning, resources to provide security proved elusive. In fact, we felt afraid and off-balanced because of the unknowns. However, propelled by the mission and vision to fulfill Kari’s needs by creating a healing environment, strategies formed. I admit these were never consciously defined but through reflection, can recognize when a plan evolved.

I started reading aloud to provide information and stimulus. Aware Kari probably heard words with little comprehension, simple texts were chosen in an effort to establish communication.

The introduction of music, one of her passions, relieved physical tension. The voices of Garth and Randy Travis resonating in the background offered comforts from home.

I specifically remember the night Jodi, Kari’s daughter, reminded us her mom slept with a fan app that dispersed white noise during the night. How could I forget after the night I shared a bed in their camper and the noise kept me awake all night. But yes, for Kari it provided comfort, and Jodi’s inspiration proved valuable as it blocked out the nighttime interruptions in the hall. Small interventions fashioned refuge for our daughter’s fragile body.

Property

The surroundings looked like… .well . . . a hospital room. Not an environment that yelled, “Good morning. It’s time to get better.” If this was to become Kari’s home away from home, personal touches needed to be added.

We strung colorful yarn above her bed and fastened pictures of family and friends who smiled down at her day and night. These pictures proved valuable in therapy because they became prompts to recognize faces and remember names.

On the shelves sat framed pictures, a softball signed by all the players of Jodi’s softball team, crystals with healing powers, and a multitude of items shared by beloved friends.

A bulletin board held twenty-three get well cards from Kari’s kindergarten students and colored pictures from her daughters. Assembled items bathed her senses and allowed memories to drift in and out as her brain remained fuzzy due to trauma.

Climbing to the third rung of the pyramid took little effort as sharing love with Kari came naturally.

Love

Family and friends

After the stroke, Kari accomplished little by herself. For an independent woman, this increased frustration. I remember once prior to her stroke, Dan told me Kari had a backache. When I asked how she hurt her back, his response made me laugh. He explained she carries everybody and everything on her back. A true statement! She failed at sharing the workload, and I remember her saying, “It’s easier to just do it myself.”

However, in the hospital, she readily accepted our help; she had no choice.

Tasks once thought daily routines required new efforts. We filled the toothbrush with paste, wiped the sleep from her eyes, brushed her hair and at times held the spoon that provided nourishment.

We never said Kari can’t do something and instead, “Not yet.” As quickly as possible, she took back each responsibility. Sometimes, probably too early which at times had us holding our breath and praying but provided her the confidence to accomplish more each day.

Amazed, I watched family and friends perform acts of love. When video chatting with her best friend in another state, words flowed less obstructed. They created a natural, joyous conversation. When her niece ran into the room and yelled, “Kiki,” a warm embrace raised the temperature in the room.

When Kari and her sister, Kat, cleared the room and ate dinner together, laughter overflowed to the hallway. To have been a fly on that wall!

And all the sadness disappeared when Jodi or Eliza climbed in the bed with their mom to cuddle — all became right with the world.

Esteem

A patient who is dependent on others, struggles at the fourth tier of Maslow’s Hierarchy, at least Kari did. It was not until she went home that she gained confidence. In her natural environment, she filled the role of Mom because her daughters needed her. In return they provided her respect that built her confidence.

With each passing week her accomplishments pushed her to attempt more. She went from barely getting around with a walker to walking around the block with a cane to walking slowly without any equipment. Thanks to constant therapy she became able to brush her hair, make a meal, and read short texts.

Whenever Kari tried something new, we waited and encouraged her progress. Sometimes success was limited but as each attempt showed progress, her dedication to achievement of her goals grew stronger. Her positive self-esteem allowed her to challenge herself and her successes increased her confidence. My heart filled with pride at her determination.

Self-Actualization

Human’s were never intended to live life permanently self-actualized. Think of it as an emotion. We may be happy with life but we are not happy all the time. Life is like riding the waves of the ocean. There are highs and lows.

I believe Kari, like all people, feels like the water is deep but she keeps swimming. However, after the tsunami life hurled at her, she keeps her head above water. By tapping into her creativity, (she has started drawing with her left hand), increasing her problem solving, (mandatory due to her disabilities), accepting the facts that life will be different and understanding that we are all mortal, Kari lives a fulfilling life.

Her experience provides an example to every patient that healing is possible and every caregiver that support is invaluable.

You can read all of Kari's stories in Understanding the Power of Not Yet: Accepting the Challenges of New Beginnings