Roy Remer: Zen Caregiving

And I this happened again when my younger brother got very ill, and I saw it up close and personal because my sister in law in the very beginning decided that she was going to be his major caregiver and she had no training whatsoever, and she refused to get support and she basically quit her job to care for him. And it didn't make any sense to me. And as it turned out, she didn't really do very well. She was constantly stressed. It actually changed her personality and got

to the point where she was alienating the family. And so caregiving is a very very big deal. And as we'll learned today, one in five households in the US are dealing with caregiving, and it translates to about sixty three million people. Our caregivers. These are people the air hospice care are somebody who's had a stroke or someone's

very very ill and they are caretaking. Now, we chose this program because this is something that isn't discussed very much, which is the caregiver not necessarily the person who's ill. It's more the stress and the strain of caregiving. And many of us just say, you know what, I love this person and I'm going to be their provider without really having any training, an understanding, or a support system.

And as I've just mentioned, this can be a serious life changing event because you're going by doctor's orders, you're going by therapy, you're setting up appointments for this person. If they're not bedridden, I mean, the sky's the limit, and then more seriously, ill they are, especially if it's a hospice situation. And this is what happened with my grandmother who had dementia. My grandfather, who was a physician, tried to take care of her. So you can see

my one family has three examples. My grandmother, my grandfather, and my brother who all were dealing with serious illnesses. In fact, you know, in some cases they were terminal. And in my grandfather's case, he tried to take care of my grandmother as she began losing her mind, and it got to the point where he couldn't deal with it anymore because she would go out and walk around the yard. A couple of times he lost her because she took off and she was walking down the street.

It's yeah, I mean, you can get a sense of just how important and it is to have training. He eventually had to place her in a nursing home, which is you know, a skilled labor, skilled nursing facility where she got the care she needed. And you know, he was relieved of this you know situation, this constant care. And I've had friends whose parents were failing. Again, I mentioned my own brother who towards the end had to have around the clock care. It's a full time job.

It's a full time job. So today we're going to learn about end of life care or care for somebody who is seriously ill, not well. But we're gonna look at it from a Buddhist zen Buddhist tradition, and I think you'll be pleasantly surprised at what the outcomes are

of the various case. Today is that we'll discuss today and more importantly, how the caregiver can approach these life changing situations with more understanding of what they're going through and how to make it more of a positive outcome. So today's program is Zen Caregiving, How to care for yourself while caring for others, And my guest is Roy Reemer. We have a new book we're featuring this week. It's called Zen Caregiving, How to care for Yourself while caring

for Others. And what is a fascinating fact about this new book is that the author has not only tagged a statistic that is mind blowing, he is also opening the door for an understanding in the what we don't want to call it dying process, but the transition. I'm going to use the word transition process of a friend of a relative and what that means. One in five, According to this research, one in five households has a caregiver associated with a person. And this calculates the sixty

five million individuals. My guest today is Roy Reemer. He is an educator, end of life caregiver. He is the executive director of the Zen Caregiving Project in San Francisco, and I'm really happy to have them, not only because we haven't talked enough about transition in our culture. It's it's kind of a dark subject for a lot of people, but I think it's extremely important and this new book, Zen Caregiving is a focus not only in that process, but also what it means to incorporate Zen, the Zen

mindfulness aspect. So Roy, welcome to Destiny. Thank you for having on the program.

practical activities of caregiving. You know, how to transfer someone from a wheelchair to a bed, how to clean someone up, how to administer medications, change a wound dressing. But for us, our sweet spot where we focus is on the emotional resilience of caregivers, offering approaches and ways to build emotional resilience and so this is really relevant and it's often overlooked among caregivers. For family caregivers, you know, you mentioned the statistic one in five. I think it's up to

about sixty five million caregivers in the US. So if we haven't been a caregiver, we can pretty much count on being in the role at supporting a friend, a family member, a loved one when they need support around it dealing with an illness, So this becomes really relevant.

Often we're thrown into the role completely unprepared, and in the early days it may be kind of a light lift, but then as illness progresses, especially in cases of dementia, the burden becomes quite heavy and it can take a real emotional toll, not to mention physical toll on the caregiver. So Zen Caregiving Project began as Zen Hospice Project back

in the mid to late eighties. It was a project within the San Francisco Zen Center, and so our roots are very much in the Zen tradition, the Soto Zen tradition, to be precise, And what we found early on was that these approaches are really really useful, really supportive in showing up fully for someone who's not just living with terminal illness, but living with long term chronicle illness. And so Zen, the literal translation of Zen coming from Chan

in the Chinese tradition is meditation. So Zen is really about the direct experience of the present moment. And as a caregiver, there's a lot of emotional chaos in the experience of living with an illness. So when a caregiver has the ability to drop into present moment awareness and quiet the mind chatter what I call the thinking mind, where we can begin to ruminate or get obsessed with what may happen next, you know, all that's a distraction.

When we can drop into present moment awareness, we're really much more available to the person we're caring for and we offer we deliver better care.

want to teach these approaches as early as possible. And these are really well, I consider them to be life skills, not just caregiving skills. So we talk about the reciprocity of care. We are delivering care to someone, but we're getting a lot out of the relationship ourself and so we're in this together in a kind of absolute sense. You know, we talk about no separation between ourself and others, right, So just to make the point that we're really in

this together. So if I'm overwhelmed and stressed, You're going to pick up on my overwhelm and stress. And we talk I talk about this in the book. You know, we as humans, we have these mirror neurons in the brain. We're constantly responding to each other. And we've all noticed this when we're with someone who's very upregulated, who's agitated. If we're not paying attention to our own body, our own mind, we begin to get a bit upregulated and agitated. Well,

the opposite is true as well. If I'm calm and grounded, I can have a calming and grounding influence on others. And there are other benefits of integrating mindfulness into caregiving, which I'm happy to speak to. But you know, it's this idea that if I can maintain my own steadiness, my own equanimity, and the care relationship, it's going to be beneficial for the person I'm caring for.

systemic infection in his body. And this is just an example of how caregivers they They repress what's happening in their body, in their hearts and minds, for the sake of continuing to be able to show up to deliver care well for my dad. Fortunately, he survived until after my mother died and then he went into the hospital and he healed from that. But if a caregiver goes down, so to speak, because they're just emotionally overwhelmed or so

physically exhausted, they cannot go on any longer. That's obviously not good for the caregiver. It's not good for the person who's receiving their care. It creates a new level of crisis in the relationship. So these techniques that are introduced in the book are designed to help the caregiver maintain their emotional wellbeing so that they can stay in the role for the long run, for as long as they need to be in the role.

of yourself. And I describe this as kind of weaponizing It's a bit little dramatic, but weaponizing self care for professional caregivers are paid caregivers working within a health system where case loads are really really high. The burden is enormous. It can be insulting to have someone in administration say, you know, you need to take better care of yourself when the system that these people are working within is

just over burden and it's unhealthy. I think of the practices that are introduced in the book as moment to moment self care. We're not talking about getting away to the spa or you know, even finding the time to take yourself out for a wonderful dinner. Those things are wonderful, But the practices that are being introduced in the book are practices that we can apply in all the activities that we're already engaged in in our life. You know.

I make the point in the book that if one were to go out and buy themselves a meditation cushion, a zafu, or you know, buy a bell and find a place in their home where they can set up a quiet, beautiful spot and meditate for thirty minutes every day, that would be wonderful. They would probably begin to see the most progress. However, we can use all the activities we already engage in, whether it's washing the dishes, folding the laundry, you know, sitting with someone and assisting with

their feeding. We can use all those sorts of activities to cultivate and deepen mindful awareness. And I'm really quite inspired by, you know, Dogan Zenji, the founder of Soto Zen, because he figured out that it was necessary to take these practices that were perhaps you know, limited to a priestly class and show commoners how to integrate these teachings

and practices into their own life. And so that's really what I'm trying to do, trying trying to find a way to show people how these practices that come out of this rich spiritual tradition can be integrated into one's own life, whether or not we have any interest whatsoever in formalson practice.

So to open up into something bigger than ourselves can be really quite supportive. And I want to acknowledge that a lot of caregivers do this naturally because of the religious tradition that they may be practicing within. The other thing that I think is important and to share is caregiving is a transformative experience like illness. Caring for someone who's dealing with an illness changes us, whether we want it to change us or not. So I use the

lens of initiation or rights of passage. I view caregiving as a rights of passage. And so the suffering that may be part of the caregiving experience is really the chrystalis of change and growth and transformation that this human being who's in the role of caregiver is going to go through whether they want that kind of change in transformation or not, whether they're aware of it or not.

So as we know about rights of passage, the threshold experience, the experience of intense challenge and difficulty brings with it gifts, gifts of wisdom and realization. And so I've seen so many caregivers come to us to take our classes where they're really frightened. They don't think they're going to come through this experience, they don't think they're going to survive it. But what I love seeing is this glimmer of hope that they will not only survive, but they'll thrive in

the experience. And when the experience ends, as everything ends, they're going to have these gifts that they can then share with others around them, and their family and their community who someday will be in the role of caregiver.

So I think this really shifts things into a more spiritual context where we recognize that there's real growth potential here and that can give us hope, and that can give a real sense of purpose and meaning when we feel like we're just at the end of our rope, then you know, there's the compassion piece, right, So I like to remind people you would not be showing up to offer care to a loved one if you weren't

a compassionate being. And a lot of caregivers are quick to say, well, I didn't have any choice in this. I was thrown into this, And I remind them, you know, you do hear these stories of you know, a spouse learning that their partner has this illness and they say, this is not for me, you know, and they kind of check out. But caregivers are really showing up because they're compassionate beings. But as humans, our heart opens and

our heart closes. It's just very natural, and when we're stressed out, it's easy for the heart to begin to shut down. So I have this whole section on compassion where we break down the process of compassion, and we're reminding people of what's actually happening when we experience it, both towards others and towards our self, and how to

feed compassion. And as we feed compassion, we open up to our connection, our inherent connection to not just the person we're caring for, but to all beings, and we begin to recognize that this sense of self isn't limited to the one who's in this body. You know who's in this mind, but everything around us.

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lot of choices out there, Factor has been around. They've been doing it for a while and their food is excellent again. Factormeals dot com slash Earth Ancients fifty percent off and use code Earth Ancients fifty off. My guest today is author Roy Reemore, who has written a new book called Zen Caregiving, How to care for yourself while caring for others, and reports are that over sixty three million people are dealing with some kind of care giving lifestyle.

I have been present with my grandfather's passing. He wanted to pass at home, and we had different family members around somewhere in medicals, a couple of doctors in the family who approach it much differently than somebody who is totally oblivious to the dying process. And I'm curious about the Zen approach to hospice because this is something that you've been doing, and I'm curious how you approach it

and how you teach the process of transitioning. I'd be curious to hear, you know, the technique because I can't say. I mean, I was with my grandfather, but I don't know if it's something that I would sign up for, you know, hospice volunteer or something just because of my personality. It's like I can save you, I can give you the remedy, you know, and it's something that you need to open to and understand. This is the person's time to go, or perhaps they're in a very bad health

condition that doesn't look good. Maybe if they survive fantastically, but what's the mindset at each well?

This is the nature of things. So to live that knowledge, to recognize that this is just the way it is, it kind of normalizes the fact, depersonalizes the reality of death, the end of this human life. Now you know that's the absolute truth in relative circumstances, especially with a family member, that doesn't do as a whole lot of good necessarily.

Maybe it does after years of practice. But the reason, you know, our volunteer program is so wonderful and so supportive and beautiful is that when we're experiencing a loved one's death, there is just so much emotional entanglement that

really obscures what's actually happening in this moment. Whereas when you're a volunteer and maybe you've known someone for a few weeks or even just a couple of days, you can sit at the outside of someone who's dying and become this very clear, open hearted presence that invites them into this space that is all about this present moment where we're not bound by all the joys and successes of life, or all of our mistakes and foibles that we've experienced in this lifetime. It's about what is here

in this moment. And you know it sounds very beautiful, but not always. But you actually see this when someone can surrender to the present moment in those week, days, hours leading up to their death. You know, we at zen Hospice Project at the time, we used to have this beautiful six bed residential care facility and people would sometimes say, ah, that's that place where people go to die, and I would say, well, actually, this is where they go to live as fully as possible until that last breath.

And you see this. Yes, people are most of the time aware that the end is coming soon, but they're really just trying to squeeze out of life every precious moment and so it really can put people in a place where they recognize the preciousness of each passing moment and that's where they want to dwell. So as a caregiver, you know, there are certain things we can do to help the person we're caring for prepare themselves for the

very end of life. And you know, one example that comes to mind that I cover in the book is the life review process. So this is a necessity that we as humans have to reflect upon the life we've lived. The relationships that we've had in this lifetime, and to steep in the wonder and in the pain of what we've experienced in this life, so that we can kind of set that story aside, so we're not, as I was saying before, bound by or anchored to what has

already passed. We can better surrender to whatever comes next, to the great mystery, if you will. And as a caregiver, you can serve a really important role by eliciting stories from the person you're caring for. And you know, some people are going to be receptive to that kind of storytelling and others aren't going to be interested, and you have to honor what they're interested in or capable of

sharing with you. But just to to present to them this clear, open container for them to pour their stories into, so to speak, is a really really useful endeavor going in with no agenda. You know, this is really important piece too, because this idea of a good death, this is so subjective. You know, there's been so much talk in recent years about, you know, helping people have a good death. Well that's really up to the person who's

experiencing the death to decide for themselves. What is a good death.

So you know, by the time someone reaches their death and hopefully at the end of a long, rich life, you know there have been so many causes and conditions that have led them to this moment that there's this idea of compassionate detachment. Right, I'm not responsible for the causes and conditions that have led up to this moment.

As a family member, maybe you do have some responsibility and to what has happen and leading up to this moment, because relationships are complex, but I think it's a real gift actually to step away and acknowledge this is the death that this person is getting and I cannot fix this. I cannot change this. You know, there's I think a

lot of freedom in that. And one of the reasons why this is so important is if we're too locked into a fix it mindset, then the person we're sitting with becomes kind of an object to fix or change, and that gets in the way of deep human connection. And one of the beautiful things about maintaining mindful awareness and a caregiver relationship is that it addresses or satisfies

this core human need. Personally, I feel it's the greatest need of someone dealing with an illness, certainly terminal illness, is to feel the sense of connection to someone else, to feel really witnessed, to be to feel really seen. And if I'm too focused on fixing a problem, they're not going to have that experience, you know, Yeah, to.

you know, these days, so many teachers have emerged. You know, there are so many people out there who have done trainings as death duelos, and people who have physicians and otherwise who have used their experience of being people being with people at the end of life who are now

beginning to offer to others what they have learned. So one area that has really changed was recognizing and addressing the multicultural diversity in the end of life experience, because the way people die can be very much determined by the culture in which they've lived, and unfortunately, you know, there are still some real disparities in the kind of care that people receive depending on you know, what color their skin is, or you know, how much annual income

they or their family makes. Right, So this is starting to be really acknowledged and in dressed and addressed by different teachers. And this I think is really really beautiful, amazing.

open arted presence. So this is really hard for a lot of people, you know, for a lot of family caregivers, they feel such a sense of responsibility. You know, I'm blessed by having, you know, just wonderful in laws. My father in law has been very, very ill, and at least twice we thought he was at the very end of his life. But he's come back to a large degree, I think because of the intense, loving support of his wife.

But it's really difficult for my mother in law to sit down and to be still as supportive as that can be, right, And people are sometimes just wired that way, that's just how they are. So you know, I'm often encouraging people, even if it's just for two or three minutes, to stop what they're doing, just to be fully present. You know, give that person you're caring for those two three minutes, and you know, see what you notice. And I think, really that's what we're talking about when we

talk about bearing witness. This word bearing is it's beautiful to me. You know. It really addresses this idea of being with suffering, right, which is compassion. So we're bearing whatever shows up. And it can be easy to want to turn away from suffering. Even after all my years of practice, I still experience this. I sit with someone on a regular basis who has a really horrible chronic illness, and because of this person's life experience, I become the

recipient of really difficult stories and from childhood trauma. And there are moments where, if I'm not trying to offer comfort or fix the situation, I want to get up and get away from this. I admit it, you know.

And so in those moments when I notice that core inclination, which I think is primarily a fear response, you know, because I'm trying to flee, right, it's that flight response, I remind myself, Roy, all you need to do, all you need to do here is stay for one more breath, be here fully for one more breath, and then another and then another. That's all you need to do. Just be here, listen, bear, witness. Nothing else is being asked of you. And it's not as if I'm dismissing the

pain and anguish that's being shared with me. But I'm just reminding myself that I have the capacity to be here with this person, to witness this suffering, and my only job is to make her feel a sense of connection to something more than what she's describing or her current circumstances.

we know this to be true. There are people walking around out there who have endured suffered such trauma we can't even imagine. And I think when that describes our life experience, it can be easy to get stuck in those stories and to feel tethered to those stories, and so we return to them again and again. But you know, I have this deep trust that in telling those stories of something that in a sense is no longer relevant, that the processing of those stories, there's something healthy that

comes of it. You know. Another chapter of the book is focused on storytelling, and this is a really important piece to caregiving. I think because so many caregivers experience so much social isolation, you know, it's important for them to be able to be witnessed and to tell their stories. And they deserve to have their stories told, So I encourage people wherever they can to find opportunities to share story. And for a lot of caregivers that's not going to

be welcomed, or it may not even be possible. And if that's the case, for someone out there listening, go to your journal, or go to the memo app on your phone and just let those stories move through your body and be expressed orally, because there is something I think really worthwhile and healthy in that act of reflecting upon an experience through story.

has really changed. We've become so incredibly efficient and communicating with each other through you know, text messages and whatnot that I feel like people are losing the capacity to not just listen to story, but they're losing contact with the wonder that can come from hearing someone tell their story, you know, and caring for someone is so much about storytelling, like we want to you know, there's this whole body of work that's referred to as narrative medicine, and it's

so healthy for people who are dealing with an illness to tell their story. And I think it's also true for someone who's caring for someone with illness. Like, sharing story can be really good medicine for someone who's caring for another person.

do this one on one. But in these circles, someone will share a story and then as a guide I might mirror back to them elements of their story so that they are able to see their story and their

experience in a slightly different way. So I feel like this is the metabolizing of experience by being able to utter allowed a story or to put it to paper, and then as we're speaking our story, we're hearing it, and then we might gain insights that we would not otherwise gain, or it's an easy way to recognize the

patterns of behavior we get stuck in. So if I have some default attitude towards, you know, particular activity or particular thing that someone might say, by sharing it with someone else, I get to reflect upon, Ah, wow, that's kind of a common pattern. You know, maybe I need to look at this, but I would say, you know, ultimately, it just helps us feel more connected.

is what it means to be human. You know your circumstances are uniquely yours, but to suffer in this particular way, you know you're not alone. This is just what it means to be human. And I think that soothes or addresses feelings of isolation in the role that can be so common to caregivers.

intentional breaths. So just pausing and paying attention, or as a colleague of mind says, your breath and allowing your attention to follow three breaths in and out, you know, this can stimulate that parasympathetic nervous system, which will begin to calm the body and mind. So that's I have to admit, I find it hard that someone wouldn't be able to find time to follow three breaths in and out. And then you know, once you pause once during your day to do that, then you can begin to integrate

more experiences of this right. And I would recommend to people that when they pause to do this, they even place a hand upon their chest over their heart and just sense into that touch. You know, this can be really useful. The other piece that I would say is feel your feet in contact with the floor beneath you. If you can get outside and stand upon, you know, a patch of exposed earth, all the better, And you know, remind yourself, I am connected to something much bigger than myself.

You know, I am here because of this great mother Earth that I'm standing upon that I'm feeling myself in contact with. And you know, people can take that in a lot of different directions. If they're feeling a lot of stress, if they're feeling a particular big emotion, they can give that stress. They can give that emotion back to the earth, and Earth will compost that for them, but to feel that sense of connection, and what that does is it puts someone back in their body and

the sensations of the body our present moment experience. It can't be otherwise, you know. Then we start to layer stories on it, and then we leave present moment awareness. But you know, when we're paying attention to sensations in the body, we're in the present moment. So I think these are good practice. I'll name one more and then we'll move on, I guess, But in your pause or otherwise, just remind yourself that I'm human and I'm doing the best I can and that's all I can do. That's

all I can do. I'm showing up for this and I'm going to make mistakes and that's just the way it is. Yeah, but I'm showing up and I can hold my experience when I mess up or when I'm struggling, and that's how I can keep moving forward.

than yourself. The natural world mirrors back to us the reality of impermanence and the way that even as elements die away, you know, it's giving way to something new, to emerge, something as worthy of our awe as the thing, the plant, the tree, the mountain, whatever is falling away again. You know, when we're in an experience of intense grief, our mind is really contracted. So if we can open up to be aware of what else is out there,

I think this can be really helpful. It just breathes some space into the experience.

is the container that holds this narrow human experience. This beautiful human experience that includes death and dying.

designed for certain industries. Medicine is one of them, and some of the language is showing that at some point you can take a diagnosis, process it through AI and it will give you an idea of how to treat it with your doctor's you know, approval, And but I'm just curious in your field if AI has been approached at all.

I'm sure many of your listeners are familiar with the area of Death Cafe, these venues to gather and talk about death and dying. I've been part of this group for several years now, and one of our participants, a dear friend of mine, is quite enthusiastic about the potential of AI, and he posed some questions to AI about impermanence and death and just asking it to reflect upon

a particular loss he was dealing with. And what came back, I have to tell you clip was just beautiful and it brought me great joy because it was a harvesting a reflection of the collective intelligence of what we as humans know about death and dying. That was I was blown away by that. It was really impressive.

we teach for caregivers. We have one self paced course which I think is really strong that people can participate in in their own time.

to an end. And when you get ill and you are you know, pronounced terminal, your diagnosis is terminal, that's not something that a lot of people want to talk about. And I've seen this in other families. I've seen this with other people. And that's why people like Elizabeth Kobola Ross and others began writing about this, because our ancestors understood that dying is a part of living. But it's a challenge to think about it, you know. I mean, I don't I don't want to be I don't want

to die. I had a heart attack and it freaked me out, you know, a few years ago, and I was like, oh my god, this is it. But the truth of the matter is that I haven't processed it enough. You know, we're kind of out of whack in the West. We're just all about collecting stuff and are we have a great deal of just funk. And that's why having somebody like Roy on the program who does practice zen meditation and approach to life otherwise known as mindfulness, this

is a critical aspect of everyday life. And I'm not saying you have to go and sit with somebody who's dying in hospice, but it's something that we need to be more aware of. And it's really critical to understand and to take in that our time on the planet as a physical being is limited now metaphysically, if you talk about and you bring up past life, that's a whole different animal. And some people are like, Okay, I'm going to take off. I'll come back in another lifetime.

I have a couple of friends that are like, I am not coming back to Earth. It's just such a goddamn mess here. I do not want to come back. I'm going on another planet. And there's a lot of case work for that too, because there's a lot of belief, especially among a Native indigenous people, that you can come from another planetary system and incarnate into a physical Earth human. And that's why a lot of people are kind of feeling like they're not quite adapting to the norms of

this culture, the Earth culture. So anyhow, the sky's a limited on this, but I hope you enjoy that. And his book's coming out very shortly and I think it's a good one. All right, that's it for this program. I want, I think my guest today, Roy Reemer, coming to us from northern California. As always, the team of Gaeltour, Mark Foster, Faya Pavar. You guys rock all right, take care of you will and we will talk to you next time.