Letting go and welcoming in

Your new life will cost you your old one. It's OK.

Mica Gray

Mica Gray is a wellbeing practitioner working in adult mental health. She is training to be a counselling psychologist.

A family with a mother holding a small child, look up and to the left.

Eduardo Fernando on Unsplash.

Last week my family laid my great-grandmother to rest. A few hours afterwards, we celebrated my cousin's birthday.

It felt strange to go from a place of death to a place of life in the space of a day. One minute I was throwing flowers into the open grave of a woman whose earthly life has come to an end and the next I was in a restaurant handing flowers to a girl whose life as a woman is just beginning. The contrast was a bit surreal, but much of life is like that; beginnings and endings flowing into each other. The transition between the two events was made easier by the fact that the funeral did not really feel like one. In alignment with my great-grandmother’s spiritual beliefs, the ceremony was very simple. It was over in less than four hours and featured a short reading of spiritual texts and quiet, reverent reflection. There were no solemn looks, no songs of lament, no dirt shoveling, no loud wailing or aunties and uncles dancing to Beres Hammond at the reception. Instead, there was just the quiet nod of acknowledgement that her spirit has journeyed on.

Though I missed the eulogies and shared tears that usually detail funeral services, I appreciated the simplicity of the ceremony. I appreciated the way death was described as a transition of the spirit into a new kind of life, the way it was treated as something so normal. Which in fact it is. Death is happening around us every day yet as a society it is something that we struggle with - whether it’s the death of a loved one, a career, a relationship or a part of ourselves. Our attempts to curate eternity with anti-aging procedures and technological permanence betray how deeply uncomfortable we are with the inevitability of endings in our modern world.

And to be honest, of course we are. The loss of loved ones shakes entire worlds. Job losses throw our lives into instability and leave us feeling unsafe. The loss of youth and power challenges long held ideas of identity and invites existential anguish. Divorce carries with it its own special grief. The pain of these experiences makes it hard for us to embrace when things are ending in our lives and make it hard for us to let go, even when we need to.

And we do often need to.

What fears, habits, thoughts or behaviours need to be given to the earth? What cycles or patterns do we need to bury and mourn so that we can usher in new and better ways of being?

Lately I’ve been thinking about the saying ‘your new life will cost you your old one’ and how true that is in many areas of our lives. In my own life, I recently started a new role at work that has cost me the comfort of my old one. I have had to give old versions of myself to the ground and shed skin so that I can continue to grow into the space of it. This new year of doctoral study has cost me Saturdays spent lazing around with friends, new relationships have cost me old patterns of behaviour and new depth in old relationships have cost me pride and ego.

At each point of transition, I have been asked to leave something behind to experience something new and it seems like so many of us at the moment are being asked to do the same. People are moving houses, leaving jobs, leaving seats of power, churches, ending relationships, wrestling with friendships, forming new ones and experiencing ego-deaths.

Like my cousin, some people are exchanging adolescence for adulthood. Others, like my great-grandmother, are exchanging their earthly bodies for their spiritual ones.

In this moment individually, politically and spiritually - it seems like we’re collectively being asked the question: what are we needing to let go of? and then what do we need to welcome in? What fears, habits, thoughts or behaviours need to be given to the earth? What cycles or patterns do we need to bury and mourn so that we can usher in new and better ways of being?

When life asks us questions like this it can feel overwhelming or intimidating to confront, but it is always necessary. I have found that when you do not allow yourself to grow out of old skin you will suffocate within it. The times of transition that we find ourselves in ask us to trust that something greater is unfolding. They ask us not to resist change but to flow with it. Not to forsake the present or the future by holding on to what has gone to the grave, but to be open to what is next.

As strange as it was last week to celebrate a birthday after a funeral, it was a reminder that though endings are painful we can embrace them because they usher in new beginnings. It was a reminder that funeral clothes can be exchanged for dancing shoes and that mourning can be exchanged for joy.

Overall, the day was a reminder that if we make room for it, life can follow death, both in this earthly life, and into the next.

Selah.

This article was first published on Substack. Follow Mica there.

Article

Ageing

Care

Change

Death & life

20 September 2024

6 min read

A Tolkien poem helps a nurse understand the ravages of dementia

'Not all who wander are lost.'

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

An elderly woman wearing headphone looks up and to the side with a big smile.

Playlist for Life

Not all who wander are lost.

Often written on a care home wall, on an inspirational poster, these words are usually set against a forest background, or compass, for added effect. They have also been used as the title of a conference paper discussing so-called smart trackers for people with dementia, whilst, Not all who wander need be lost is the title of a concise guide to navigating the heartbreaking challenges when a loved one is diagnosed with Alzheimer’s disease or other dementia.

As a care home nurse for more than ten years, I have seen residents wander - not lost but “walking with purpose”, as it is sometimes known in the caring community. “Nobody gets up and walks without a reason,” says Suzanne Mumford, Care UK's Head of Nursing, Care and Dementia; perhaps they are easing pain, or boredom, or looking for something that they can’t describe. I remember residents exploring, enquiring into self-made mysteries solvable only by themselves, examining everything from door handles to another resident’s buttons, even escaping with surprising speed. Walking with them, often in silence, can bring a sense of relief, comfort and companionship.

What I didn’t know was that this is a quotation from a poem by JRR Tolkien, published in The Fellowship of the Ring seventy years ago. The actual line is - “Not all those who wander are lost”.

All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.

From the ashes a fire shall be woken,
A light from the shadows shall spring;
Renewed shall be blade that was broken,
The crownless again shall be king.”

We first hear this poem in Chapter Ten of Book One, as Frodo reads it in the postscript of a letter from Gandalf. As I read it, the imagery of being lost, withered, frost-bitten, in darkness, burned and broken, speaks something, in poetic picture language, of the ravages of dementia, the harrowing losses, the valley of tears. It brings to mind residents unaware of familiar objects or surroundings, looking straight through loved ones without a flicker of recognition, losing also language, continence, mobility and the ability to swallow.

The TV presenter Fiona Philips recalled an agonising decline in her mother as she succumbed to Alzheimer’s, describing how, in the final stages, her mother “spent whole chunks of time just sitting and staring ahead, only able to give out a series of sounds”. Fiona herself now lives with dementia. “'It’s devastated my family and it’s the biggest health and social care challenge we face as a country,” she says.

I once interviewed retired doctor Jennifer Bute, who lives with dementia. She talked of time travel (perceiving herself as living in a time from her past); disorientation to place and person; frightening hallucinations when old memories are seemingly ‘unlocked’; and ‘emotional unzipping’ when agitation and anxiety increase, often in the late afternoon or evening in something poorly understood as a symptom, known as ‘sundowning’.

Yet there is something more to this poem – each of the pains has a promise – not all who wander are lost; the old that is strong does not wither; and, most poignantly, deep roots are not touched by the frost. In dementia, it is true that deep roots are untouched, that an enduring aspect of a person’s identity never truly withers, though it may be mostly unseen. Something remains. Oliver Sacks the famous neurologist emphasised that, even in the late stages of Alzheimer’s, the person is still ‘alive inside’ (the inspiring documentary with this title is recommended). In stunning real-life stories, he has shown how music appears to ‘call back the self’, awakening moods, memories and thoughts that had seemingly been lost. He refers to music’s extraordinary ‘neural robustness’ and describes one man, unable to tie his tie or find his way to the stage, yet able to perform a perfect piano solo. In one life-affirming, must-watch, tear-jerking video, gospel music was shown to enliven, calm, focus and engage a man simply known as Henry.

Watch Henry

Singing can “provide islands of arousal and awareness like nothing else can”, according to Alicia Clair, Professor of Music Therapy. I’ve seen singing bring the person into the present for a passing moment, illuminating a face that seemed far away. One otherwise-silent lady completed the chorus of ‘Daisy, Daisy’ before descending into dementia again. Others have laughed, clapped, danced, embraced and even shed a silent tear during music therapy sessions, when music elicits memory. Doll therapy meanwhile has sometimes restored and revealed a sense of nurture, purpose, care and pride, with residents feeding their new friend before accepting their own food, folding its clothes and taking care of it cradled in their arms. Though it divides opinion, a doll can preserve dignity if it de-escalates agitation or engagement in physical or verbal abuse; a sense of dignity also comes from the person being able momentarily to give care rather than receive it.

“From the ashes a fire shall be woken, A light from the shadows shall spring; Renewed shall be blade that was broken,” continues Tolkien's poem, and, though not the original intention, these powerful images of renewal and restoration paint a picture of something known as “paradoxical lucidity”, or unexpected cognitive lucidity and communication in some patients with severe dementia, especially around the time of death (though sometimes long before).

Anecdotes are recorded of “unexpected, spontaneous, meaningful, and relevant communication or connectedness in a patient who is assumed to have permanently lost the capacity for coherent verbal or behavioral interaction due to a progressive and pathophysiologic dementing process”. Some scientists are seeing them as a paradigm shift in the understanding and perhaps even treatment of dementia. I will never forget when a woman in the late stages of dementia, with little spoken language, was brought back to the nursing home weeks after hospital admission; she had been perilously ill. With bright eyes, she took my arm and, as if the mist had cleared for a moment, spoke warmest words of thanks to me for helping her on the day she collapsed. In another fleeting and irreproducible moment, a lady wished me happy birthday, before continuing her silent walk around the home. Witnessing such an event is ethically and emotionally transformative.

The concept of remaining ‘alive inside’ even when abilities, language and memory are eroded by dementia is taken to the next level in Christianity, which teaches that life continues even after death itself. The Bible speaks of new life beyond the grave; the fire shall be woken, a light shall spring. And there will be a crown (and the gold will glitter). The Crown of Life is referred to, being bestowed upon "those who persevere under trials." Dementia is one of life’s severest trials; a cross to bear. In the 1912 hymn “The Old Rugged Cross”, another cross is spoken of, being the cross of Christ at his crucifixion. Clinging to that cross, living out a Christian life, the hymnwriter wrote of “exchanging the cross for a crown” at life’s end. After ashes, hope awaits the Christian.

Playlist for Life is a charity encouraging people to create playlists for people living with dementia.

Playlist for Life