Forests teach us gently to accept the cycle of life

Dementia and the mid-life breakthrough

Forests teach us gently to accept the cycle of life

Forests teach us gently to accept the cycle of life

Mid-life is a time when many of us have the opportunity to care for a person living with dementia. Whether that person is your parent, partner or friend, their diagnosis can be life-changing.

The term ‘mid-life’ is often associated with another word: ‘crisis’! Dementia is unlikely to be the only challenge we have to cope with at this time. Facing empty nests, health scares, relationship breakdowns, career collapses (or all of the above), few of us sail through mid-life without experiencing the loss of something significant that we relied upon for our sense of identity or security.

My initial reaction to the losses experienced during this period was resistance – a big fat “No!” But I’ve come to appreciate that the stripping away of the familiar and the certain was an invitation to step into another (and wonderful) phase of life.

Researcher Brené Brown writes and speaks about the power of vulnerability. In her book, The Gifts of Imperfection, she famously reframed what she could have labelled a ‘nervous breakdown’ as a ‘spiritual awakening’. It may feel like a big ask, but even a tentative “Yes” in the midst of the chaos is enough to start transforming the mid-life crisis (and even our experience of our loved one’s dementia) into a time of unexpected blessings.

Looking back, I recognise that what I most needed to learn during mid-life was how to get out of my head! My busy brain needed to quieten down – to stop analysing, judging and trying to fix everything – and learn how to simply be.

There are many sources of support that can help us find our way through the challenges of mid-life. Two practices helped to transform my mid-life muddle in general, and my experience of Mum’s dementia in particular.

The first was a technique called Heart-focused BreathingTM that I learnt from my HeartMath® coach. Simply shifting my attention to my heart and my breath for short periods throughout the day created moments of calm in my previously unpunctuated life. I learnt to put down my burden of stress, rather than allowing it to snowball and become overwhelming.

The other was a Nature Solo practice. Every week I would spend a few hours silently observing nature and applying what I noticed to my life. One of the most valuable things I learnt was to accept without judgement each successive stage of life and to recognise its unique and inherent gifts.

Practising calm and acceptance transformed the times I spent with Mum and my experience of her dementia journey. Learning to be quiet and observant in nature enabled me to spend time quietly with Mum, not having to talk but simply savouring the experience of being together.

Shifting attention from my busy brain to my heart and breath, spending unhurried time in nature, and being present with my mother in the last years of her life – these may not seem like much as a list of ‘achievements’ but they have fundamentally transformed my life.

What started as a mid-life crisis feels now like a mid-life breakthrough.

Participants in the STRiDE Theory of Change workshop - Johannesburg, 12-13 July 2018

STRiDE – towards a National Dementia Plan

Participants in the STRiDE Theory of Change workshop - Johannesburg, 12-13 July 2018

Participants in the STRiDE Theory of Change workshop – Johannesburg, 12-13 July 2018

Imagine South Africa developing a National Dementia Plan! This is a goal of the STRiDE project – ‘Strengthening responses to dementia in developing countries’ – coordinated by the London School of Economics and Political Science (LSE) in collaboration with Alzheimer’s Disease International.

Involving seven developing countries, STRiDE aims to build research capacity to help these countries respond, in ethical and sustainable ways, to the needs of growing numbers of people living with dementia and their care partners.

To determine a work plan for the four-year project, University of Cape Town academics Margie Schneider and Crick Lund facilitated an initial Theory of Change workshop in Johannesburg, attended by more than 20 people from government departments and the NGO and private sectors.

Nobody knows what the extent of dementia is in South Africa. The statistics just don’t exist. Furthermore, government has no dementia-specific policies or plans. So, it’s good to know that the South African research team will be investigating the prevalence, impact and costs of dementia on people with the condition and their families. This evidence is essential if government is to start recognising dementia as a priority.

Other focal areas of the STRiDE project include reducing stigma; understanding the costs of providing unpaid care; developing research capacity (which includes appointing a full-time early-career researcher); and making research tools and evidence available to the participating countries.

The STRiDE workshop was a valuable opportunity for people who care about dementia to share their concerns and map a way forward. The group agreed that the ultimate impact of the project would be that:

The ability of people with dementia to live a meaningful and dignified life is maximised; and family and carers have the necessary support and resources for wellbeing and to be protected from undue financial hardship.

It is encouraging that this research programme will make a valuable contribution to the development of a National Dementia Plan, and enable the development of policies to improve dementia care in South Africa.

Gathering ideas to inform the 'map' that will guide the development of a National Dementia Plan for South Africa

Gathering ideas to inform the ‘map’ that will guide the development of a National Dementia Plan for South Africa

Nature palettes encourage us to observe nature closely

Nurtured by Nature – caring for those who care

Nature palettes encourage us to observe nature closely

Nature palettes encourage us to observe nature closely

Nature gave Mum and me countless ‘moments of joy on the Alzheimer’s journey’, as Jolene Brackey puts it in her wonderful book. Whether it was enjoying the physical benefits of walking along the river in the fresh air and sunshine, having a cup of tea in the shade of a tree, or imagining creatures in the clouds, nature was always part of our times together.

It was these experiences that inspired Dementia Connections to create ‘Nurtured by Nature’, a workshop for those who care for people living with dementia. In this workshop, participants experience and reflect on the value of a range of nature-based activities for themselves and the people they care for.

Workshops are opportunities to learn from and be inspired by one another. As a facilitator, I always come away with new insights and ideas. Here are some gems shared by dementia care professionals at a workshop held in Johannesburg in May.

On the feeling of being in nature …

  • I’ve never felt such a silence and sense of belonging in nature before. I want to share this sense of belonging with people who feel lost and alone.
  • I’m taking home the peace and tranquillity that nature brings.

On the value of nature to caregivers …

  • We work long hours and sometimes it feels like we can’t even manage a five-minute break. Then you feel like you’re losing it. You need to be calm so that you don’t become irritable. It’s important to take that five minutes of peace.
  • I will eat my lunch away from my desk, and personally reconnect with nature. I will take the feeling back and encourage my colleagues to take five-minute breaks, sense what is around us, and relax and get calm in the midst of nature.

On the value of nature to people living with dementia …

  • I had never really noticed nature before I started working with people living with dementia and noticed how nature calmed them and brought them peace.
  • Sometimes you don’t need a pill; you can use nature.

On getting to know what brings joy to elders in our care …

  • Make time to interview residents in depth before they move into the care home. Find out who they are, what is unique about them, and what brings them joy.
  • Get to know the residents and engage with them in ways that are relevant to their lives. Get to know what makes them happy so that they will enjoy what they are doing.

On practical ways to make nature part of the care culture …

  • Connect and engage more with people one-on-one. Take them out if they want to go. If they don’t want to go out, take nature to them. Bring in pets and pot-plants.
  • Make nature part of the routine of people living with dementia, so that they know they will go out and expect it.
  • Make time to sit and relax in nature. It calms you down and you feel the impact.
  • When we take residents out for a walk, let’s not just think of it as physical exercise. Let’s make these walks more stimulating and encouraging by talking with the resident and pointing out things. Encourage them to stop, sense and enjoy their surroundings: look, touch, feel and smell.
  • Take people outside where they can feel the sun, enjoy the fresh air, admire the flowers, listen to the birds, and feel open and free. Invite them to walk barefoot … watch the night sky …

Stories of good practice that inspired us …

  • Activities at care homes included a birding group, nature outings, and getting residents involved in preparing food for regular picnics on Fridays.
  • A carer planted vegetables amongst the flowers in a resident’s garden. The resident loved to watch her caring for the garden.
  • One couple developed a dementia-friendly garden at their retirement village to encourage people to experience nature with their senses and enjoy the fresh air. After the workshop they decided to start a garden on an upstairs balcony to benefit people living upstairs who were unable to visit the garden.

Mediating the nature connection experience …

One of the valuable insights from this workshop was that ‘connecting with nature’ is not necessarily automatic; we may need another person to mediate the nature experience for us. The care partner has a valuable role to play in helping the person living with dementia to engage with nature. They can do this by drawing attention to phenomena and responding to things that the person notices. Familiar experiences in nature provide many opportunities for sensory appreciation and reminiscence. Sharing experiences in nature allows the person with dementia to enjoy a double connection – both with nature and with a caring human being.

 

Connecting to nature was a calming, relaxing, uplifting and spiritual experience.
It fulfilled my need to relax and be re-energised
.”

Autumn leaves spark creative ideas for cards

Autumn leaves spark creative ideas for cards

journeyman

True friendship

journeyman

I don’t enjoy boxing. I have never understood why anyone would pay money to watch a couple of people intentionally beat each other up. So, on a recent flight, I wouldn’t have chosen to watch Journeyman – a film about a boxer – had it not been one of the top-five movies recommended by the Emirates entertainment channel. Now I’m glad I did.

Journeyman is written and directed by Paddy Considine, who also stars in the leading role as middleweight boxing champion Matty Burton. The programme notes summarise the action:

As he approaches the end of his career [Matty] knows that he must make his money and get out of the game, to secure a home and future with his wife and baby daughter. After a titanic fight … Matty collapses on his living room floor, a delayed reaction to a devastating punch. Awaking from the coma, the real fight begins. Suffering from memory loss and with his personality altered, Matty must begin to piece his life back together as his world disintegrates.

Dementia is not just a condition affecting the elderly. It can also follow a traumatic brain injury (TBI) caused by a blow to the head. Recent research conducted in Denmark revealed that the overall risk of dementia in individuals with a history of TBI was 24 percent higher than those without a history of TBI. A single severe TBI could increase the risk by as much as 35 percent. Suffering a brain injury in your 20s can increase your risk of developing dementia in your 50s by 60 percent. It’s therefore not surprising that there is a category of dementia known as ‘dementia pugilistica’ (boxer’s dementia).

But that’s not the point of this story.

The movie provides a poignant insight into the life-changing impacts of TBI on the patient, their family members and friends. Initially, Matty’s boxing friends desert him. They just don’t know how to relate to him as a physically broken man who can’t remember their names. Matty’s wife Emma (Jodie Whittaker) steps into the role of full-time care partner, but she eventually leaves him as his unpredictable and sometimes violent behaviour threatens her safety and that of their baby.

A crisis causes Matty’s friends to realise the extent of his need for support. What follows is a moving tale of friendship and solidarity – of buddies who accompany and encourage Matty on his long journey toward rehabilitation and the restoration of his most treasured relationships.

If you get the chance, watch it.

Dementia can cause strong emotional reactions in the care partner

Transforming the Dementia Journey

Dementia can cause strong emotional reactions in the care partner

Dementia can cause strong emotional reactions in the care partner

“When we are unable to change a situation, we are challenged to change ourselves.” Viktor Frankl

When people are diagnosed with Alzheimer’s disease, or any other form of dementia, they and their care partners embark on a long journey of loss. We tend to focus on the losses experienced by the person with dementia – the deep forgetfulness, and the inability to cope with the activities of daily living. But care partners experience huge losses too – of companionship, conversation, support, security, and the comforting familiarity of the one they love who seems to be disappearing.

Dementia is a hard, hard journey. Researchers at UCL, London’s Global University, found that about 40% of family members caring for a person with dementia developed anxiety or depression, which often led to burnout, ill health, and a breakdown in care for that person.

They investigated people’s coping strategies and discovered, to their surprise, that care partners who coped best with the dementia journey were not necessarily the best problem-solvers. Rather, they were the people with the emotional capacity to accept the situation and find ways to manage it. The researchers also identified dysfunctional coping strategies, which included resistance, annoyance and avoidance, including substance abuse.

When you think about it, this finding makes sense. For the most part[1], dementia is not a condition that can be cured, so dementia itself is not a problem to be solved. Of course, there are numerous practical problems to be solved along the dementia journey, and a problem-solving attitude is very helpful. But the core competency in dementia support is emotional resilience.

Dementia demands of the care partner considerable acceptance, equanimity and emotional maturity. If we have not yet developed these qualities, but are willing to accept the invitation, caring for a loved one with dementia is the ultimate crash-course in emotional self-regulation!

So, how do we build emotional resilience for the dementia journey? What are the attitudes, practices and habits in your life that help you to feel centred, to release the burden of stress, and to overcome setbacks?

I am in the process of developing an on-line course that will focus on demystifying dementia, developing emotional resilience, and finding practical ways to connect with and honour a loved one who is living with dementia. If you would like to be kept informed, please send me an email and I’ll let you know when we’re ready to roll!

 

[1] Dr Dale Bredesen’s ReCODE protocol offers some hope, but requires strict adherence to a highly personalised therapeutic programme.

Share opportunities to care by drawing up a roster of visits from friends and family

Keeping connected as caregivers

Share opportunities to care by drawing up a roster of visits from friends and family

Share opportunities to care by drawing up a roster of visits from friends and family

This disease is isolating. Friends recede, family members back away.  – Support group member.

I belong to a number of on-line dementia support groups. Recently I posted a comment about research that shows that connection to community is the most important factor influencing our health – even more than a healthy diet, exercise or not smoking.

I wasn’t prepared for the reaction! My post was the proverbial last straw for a number of exhausted caregivers. Whether caring for a partner 24/7, or juggling responsibilities for children, work and frail parents, many people commented that they just couldn’t find the energy, respite, or hours in the day to keep connected to friends and to their communities.

To illustrate this challenge, one support group member described an average day: Work 8-5, Monday to Friday. Come home, make dinner, clean, clean her and get her to bed, laundry, clean, log in to support group, bed at 11 and start all over. No calls from friends, no drop-by’s, can’t meet up after work. Stay social? Yeah, right!

Here are some reasons why caregivers said they had become isolated:

  • There’s a big stigma around dementia; friends don’t want to visit because they don’t know how to relate to my loved one any more.
  • My partner with dementia has become very jealous. He doesn’t want visitors and he doesn’t even like me talking on the phone.
  • It’s time-consuming and stressful to organise social engagements. Some friends are also caring full-time for their parents and don’t have time; others don’t understand that if an emergency happens I’ll have to cancel at short notice.
  • Some family members keep their distance and are unwilling to get involved; they have no idea how demanding it is to be a full-time caregiver, but they criticise me from afar. This is both unhelpful and deeply offensive.
  • Some of us don’t like delegating or asking for help, so we end up training others not to offer their assistance.

One person observed: This isolation is a twofold problem. First, you need the socialization daily to stay healthy, but second, when your loved one passes, if you have not nurtured your network of friendships, you may find it has evaporated.

How can caregivers keep connected to friends and community?

When full-time caregivers are unable to take a break, their physical and emotional health can suffer. We need to stop trying to do it all and get help.

Here are some suggestions from the online groups:

  • Look for resources in your area that will help you manage some tasks so that you can take a break.
  • Join an online and/or face-to-face support group and share ideas and encouragement with others who are also caring for a loved one with dementia.
  • Find out if there are day care centres or social groups in your area that accommodate people with dementia and their care partners. Socialise with people who understand.
  • Caregiving is a team effort, so get good at delegating. Sit down with your family and close friends and figure out how each person can contribute to caring, visiting, housekeeping and financial or administrative tasks. Choose something you enjoy doing.
  • Draw up a roster of regular visits from friends and family members who live nearby. Those who live further away can pay a professional carer to relieve the person who provides daily care. They can also spend a holiday with their loved one and allow the regular carer to take a longer break.

If you are the friend of a caregiver, learn how to communicate with their loved one who has dementia. Then offer to spend a couple of hours a week with the person – and mean it! Enable your friend to get out and have some fun, or visit them together for tea, and pick up clues for helpful jobs or treats you could offer.

Community connections are vital for our health. Let’s strive to reduce the stigma associated with dementia and to create Dementia Friendly Communities where both people with dementia and their caregivers are welcomed.

 

 

 

 

 

 

Bill and Mum Skyping John in London

connection – the silver lining

Bill and Mum Skyping John in London

Bill and Mum Skyping John in London

When our mum got dementia, my sister Kathy lived in the same town in South Africa, I lived about 50 km away, and our brothers Bill and John lived in Nepal and the UK respectively. In our globalised world, far-flung families are commonplace.

In the early stages of dementia, Mum continued travelling to the UK to visit John and her sister. But after a few years, it became clear that international travel was just too confusing for her.

It’s easy to focus on the losses that dementia brings … of independence, adventure, and connection with the extended family. But looking back, Mum’s growing dependence and vulnerability also created new opportunities.

The greatest blessing resulting from Mum’s inability to travel was an annual visit from Bill and John. Mum was a magnet who drew her children to herself, and we all benefited from the opportunity to get together far more regularly than we would otherwise have done.

A parent’s vulnerability gives members of the family the opportunity to offer a bouquet of care made up of their individual – and often complementary – gifts, abilities and resources. The person who lives closest may be most involved in day-to-day practical support; while one who lives overseas may be able to contribute more financially, and give more concentrated time and attention when they do visit.

I remember two things that my brothers did to remind Mum of their love while they were away. When Bill visited from Nepal, he would bring an album of annotated photographs to share with Mum, and leave it with her so that Kathy and I could reminisce with her. John established a standing order with the local florist, who delivered a bunch of mixed flowers every fortnight with a cheerful message from John on the card. Mum was always delighted when the new flowers arrived!

Every two weeks, Mum received a bunch of flowers from John

Every two weeks, Mum received a bunch of flowers from John

Four years before Mum passed away, she moved to a specialised dementia care home called Livewell. The flexibility and responsiveness of the staff enhanced the whole family’s experience of Mum’s last years. We truly felt ‘at home’, being able to gather as a family at the home to share meals or celebrate special days.

The home embraced communications technology, providing opportunities for Mum to communicate with Bill and John via Skype. They also communicated regularly with the whole family by email, keeping us all informed and involved, even at a distance.

One of the gifts of caring for Mum during her 15-year dementia journey was that it drew us together as a family. Strangely, even the dark cloud of dementia can have a silver lining.

brain healthy foods 3

Food for thought … Making brain-healthy choices

brain healthy foods 3

If you want to get people disagreeing, start talking about diets! From vegan to paleo and beyond, we can justify a confusing diversity of eating plans. So, as I write this blog about brain-friendly nutrition, I know that it won’t please everyone … and in a couple of years’ time, I might even want to change a few things myself!

Dr Dale Bredesen, author of the book The End of Alzheimer’s, recognises three main types of Alzheimer’s disease, which relate to what he considers to be the biochemical triggers of the condition, namely:

  • Chronic inflammation from infections and diet;
  • Shortage of supportive nutrients and hormones; and
  • Toxic substances, such as heavy metals and biological toxins.

Dr Bredesen has developed a comprehensive protocol called ReCODE for reducing the risk of Alzheimer’s disease. It includes dietary choices that reduce inflammation, provide nutritional support, and eliminate toxins in the diet.

Here is a brief summary of his dietary recommendations from The End of Alzheimer’s.

Green-light foods – eat often:

  • Wild-caught fish – salmon, mackerel, anchovies, sardines, herring
  • Free-range eggs
  • Cruciferous vegetables – broccoli, cauliflower, Brussels sprouts
  • Leafy green vegetables – spinach, kale, lettuce
  • Sulphur-containing vegetables – onions, garlic
  • Mushrooms
  • Resistant starches – sweet potatoes, swedes, parsnips, green bananas
  • Probiotic foods – sauerkraut, kimchi
  • Prebiotic foods – Leeks, onions, garlic, asparagus, dandelion greens
  • Herbal teas, green tea, black tea

Yellow-light foods – eat less often

  • Free-range chicken
  • Free-range beef
  • Starchy vegetables – potatoes, corn, peas, squash
  • Legumes – peas, beans
  • Nightshade vegetables – tomatoes, peppers, brinjals
  • Non-tropical low glycaemic index fruits – berries
  • Wine
  • Coffee

Red-light foods – avoid if possible

  • Processed foods – avoid packaged foods with lists of ingredients!
  • High-mercury fish – tuna, swordfish, shark
  • Dairy – have cheese, raw milk, plain yoghurt occasionally
  • Fruits with high glycaemic index – pineapple, mango, pawpaw, grapes, dried & canned fruit
  • Sugar
  • Simple carbohydrates – bread, pasta, rice, biscuits, cakes, sweets, cooldrinks
  • Grains
  • Gluten

In addition to Dr Bredesen’s list, other authors recommend bone broth, nuts, avocados, celery, olive oil, coconut oil, dark chocolate, pomegranate juice, turmeric, and rosemary. They warn against trans-fats, seed oils like sunflower and canola, artificial sweeteners, preservatives and MSG.

The beauty of this list is that what’s good for your brain is good for the whole body.

When we eat nutrient-dense foods, and avoid foods that cause inflammation or contain heavy metals, we nourish the body and allow it to heal. Healthy eating is one of the most important things we can do to avoid developing chronic diseases, auto-immune conditions, and even mental health challenges like dementia.

brain healthy foods 2

A daily dose of Nature does us good!

Healthy by nature

A daily dose of Nature does us good!

A daily dose of Nature does us good!

It is common knowledge that spending time outdoors is good for our physical and mental health, and yet many people with dementia live most of their lives indoors.

Activities like walking, swimming and games develop physical fitness, stamina, strength and balance. Exercise improves a person’s mobility and reduces the risk of falls. It also stimulates the appetite, which often declines with dementia, leading to people becoming malnourished.

Fresh air really is good for us! Indoor air is often laden with chemicals from paint, furnishings and cleaning materials, as well as ‘germs’ like viruses and bacteria. Furthermore, the value of a daily dose of sunlight should not be underestimated. Sun on the skin stimulates the production of Vitamin D, which is vital for all our cells, and essential to building healthy bones and muscles.

Insomnia is a problem amongst many older people; but being exposed to morning sunlight re-sets our body clock, improving sleep patterns. So, rather than administering sleeping tablets, a morning walk may help to restore our elders’ natural sleep-wake rhythms.

The outdoors is not only good for our physical health; it benefits us mentally and emotionally as well. As dementia erodes a person’s thinking processes, they often become more emotionally sensitive and spontaneous. Being unable to tell others what they want or don’t want, people with dementia may become frustrated at not being understood, resulting in uncharacteristic outbursts or aggression.

Spending time in nature has been shown to improve a person’s mood. In one scientific study, people with dementia who spent time outdoors reported that they felt happy, calm, relaxed and free, and less depressed, anxious and stressed. This in turn resulted in fewer challenging behaviours like agitation, sun-downing, pacing, exit-seeking, and aggression.

There is growing concern about the use of neuro-psychiatric drugs to treat people with dementia. In most cases, ‘difficult behaviours’ are reactions to not having needs met. People may be trying to communicate that they are experiencing pain, discomfort, frustration or boredom; but instead of their needs being responded to, they are given drugs to pacify or restrain them. All drugs have side-effects, and these can be particularly devastating in the case of frail elders. Anti-psychotics and benzodiazepines, for example, are known to increase the risk of falls, and may even worsen cognitive function in people with dementia.

There is growing interest in non-pharmacological treatments of mood and behavioural issues in people with dementia. In one study, residents of a dementia care home who had access to the garden reduced their need for antidepressants and antipsychotics, and this resulted in a 30% decrease in the number and severity of falls.

Results like this are really encouraging – and not only for people with dementia. Let’s all get outside and enjoy a daily dose of Nature’s healing power!

Reading this book marked a turning point in my journey with Mum

Contented dementia – such a helpful book

During the early years of Mum’s dementia, I knew nothing about Alzheimer’s Disease. And, to be honest, I didn’t want to know. Denial is a common response to bad news.

By the time I stumbled upon the book Contented Dementia in a local bookstore, I really needed help. My usual ways of communicating with Mum were just not working. The more frustrated I became, the more stress and confusion Mum experienced.

Reading this book marked a turning point in my journey with Mum

Reading this book marked a turning point in my journey with Mum

Holocaust survivor Viktor Frankl once said that, “When we are unable to change a situation, we are challenged to change ourselves.” Mum’s short-term memory was failing. I simply had to accept the changes and adjust my expectations and communication style to suit her reality.

In Contented Dementia, Oliver James shares a method of dementia care that his mother-in-law Penny Garner developed while looking after her mother. Penny has a very special gift of observation, and developed her method by paying close attention to what caused her mother to feel calm or distressed. After her mother died, Penny went on to work with many more people with dementia, and eventually trained numerous carers in her SPECAL method (Specialised Early Care for Alzheimer’s).

Reading Penny’s story became a turning point for me in Mum’s dementia journey. I learnt two vital lessons. Firstly, don’t ask questions, and secondly, never contradict!

  1. Don’t ask questions: So much of our small talk is based on asking questions: “How was your week? Did you hear the news this morning? What did you have for breakfast? Where would you like to go for coffee?” But these questions are very troubling for a person with dementia. When your short-term memory isn’t working, these questions become confusing – even threatening – reminding you of things you can’t remember.
  2. Never contradict: Most of us believe that it’s important to ‘tell the truth’. So, when a person with dementia starts talking about people and experiences from their past as if they were in the present, it’s natural to want to correct them. But this is pointless. As short-term memory fades, older memories become far more real. It’s much better to allow time to warp and encourage our loved ones to enjoy their reminiscences than to upset them by insisting on accuracy.

Making these two changes made a huge difference in my relationship with Mum. I’m so grateful to Penny for sharing her wisdom – the fruits of her loving relationship with her mother and her ability to pay such close attention.

Jeff and Mum