aging

Why ageing is all in the mindfulness

wildmind meditation newsMargaret Jennings, Irish Examiner: Meditation and ‘knowing ourselves in a deeper way’ can reduce our anxieties and fears about getting old, and increase our acceptance.

IN 1981, Timothy Sweeney returned from a long meditation retreat and told his mother, with whom he had a “very difficult” relationship, that he would have to discontinue it, if she didn’t change.

His mother was 65 and had, he says, a “lot of unfinished business, emotional baggage”, and had pain from spinal surgery.

Sweeney, then 27, and his mother were living in California. She decided to do a ten-day meditation retreat with Jack Kornfield.

“She was still herself, the Jewish …

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Can meditation really slow ageing?

wildmind meditation newsJo Marchant, Mosaic: Is there real science in the spiritualism of meditation? Jo Marchant meets a Nobel Prize-winner who thinks so.

It’s seven in the morning on the beach in Santa Monica, California. The low sun glints off the waves and the clouds are still golden from the dawn. The view stretches out over thousands of miles of Pacific Ocean. In the distance, white villas of wealthy Los Angeles residents dot the Hollywood hills. Here by the shore, curlews and sandpipers cluster on the damp sand. A few metres back from the water’s edge, a handful of people sit cross-legged: members of a …

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Meditation, memory loss, Alzheimer’s and aging

Gordon Richman, Washington Times: Alzheimer’s is devastating and terrifying. Our grandparents are fighting it now, our parents preparing to fight it, and we know that we’re next. A recent bittersweet NPR piece explained that in order for most currently-conceived Alzheimer’s drugs to work effectively, patients would have to start treatment early– up to 20 years early.

Most of us, as much as we fear Alzheimer’s, don’t want to take a cocktail of drugs for something that may or may not happen in 20 years. Although there are brilliant scientists and physicians working on helping people with Alzheimer’s (and those who might suffer from it in …

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Fighting loneliness and disease with meditation

Amanda Enayati, CNN: Anyone who sees meditation as a hippy-dippy endeavor has found his or her view increasingly challenged by science in recent years.

Meditation and other contemplative practices are continuing to claim their place at the table of mainstream medicine.

This is true for a slew of reasons: chief among them, the recognition that hordes of us are stressed out, that stress wreaks havoc upon our bodies and that the practice of meditation has significant and measurable stress-reduction properties.

In a recent study led by J. David Creswell, assistant professor of psychology at Carnegie Mellon’s Dietrich College of Humanities and Social Sciences …

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Mindfulness meditation reduces loneliness in older adults

For older adults, loneliness is a major risk factor for health problems — such as cardiovascular disease and Alzheimer’s — and death. Attempts to diminish loneliness with social networking programs like creating community centers to encourage new relationships have not been effective.

However, a new study led by Carnegie Mellon University’s J. David Creswell offers the first evidence that mindfulness meditation reduces loneliness in older adults. Published in “Brain, Behavior & Immunity,” the researchers also found that mindfulness meditation — a practice that dates back 2,500 years to Buddha that focuses on creating an attentive awareness of the reality of the present moment — lowered inflammation levels; inflammation is thought to promote the development and progression of many diseases. These findings provide valuable insights into how mindfulness meditation training can be used as a novel approach for reducing loneliness and the risk of disease in older adults.

“We always tell people to quit smoking for health reasons, but rarely do we think about loneliness in the same way,” said Creswell, assistant professor of psychology within CMU’s Dietrich College of Humanities and Social Sciences. “We know that loneliness is a major risk factor for health problems and mortality in older adults. This research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults.”

For the study, the research team recruited 40 healthy adults aged 55-85 who indicated an interest in learning mindfulness meditation techniques. Each person was assessed at the beginning and end of the study using an established loneliness scale. Blood samples also were collected.

The participants were randomly assigned to receive either the eight-week Mindfulness-Based Stress Reduction (MBSR) program or no treatment. The MBSR program consisted of weekly two-hour meetings in which participants learned body awareness techniques — noticing sensations and working on breathing — and worked their way towards understanding how to mindfully attend to their emotions and daily life practices. They also were asked to practice mindfulness meditation exercises for 30 minutes each day at home and attended a daylong retreat.

The researchers found that eight weeks of the mindfulness meditation training decreased the participants’ loneliness. Using the blood samples collected, they found that the older adult sample had elevated pro-inflammatory gene expression in their immune cells at the beginning of the study, and that the mindfulness meditation training reduced this pro-inflammatory gene expression, as well as a measure of C-Reactive Protein (CRP). These findings suggest that mindfulness meditation training may reduce older adults’ inflammatory disease risk.

“Reductions in the expression of inflammation-related genes were particularly significant because inflammation contributes to a wide variety of the health threats including cancer, cardiovascular diseases and neurodegenerative diseases,” said Steven Cole, professor of medicine and psychiatry and biobehavioral sciences at the UCLA School of Medicine who collaborated on the study.

While the health effects of the observed gene expression changes were not directly measured in the study, Cole noted that “these results provide some of the first indications that immune cell gene expression profiles can be modulated by a psychological intervention.”

Creswell added that while this research suggests a promising new approach for treating loneliness and inflammatory disease risk in older adults, more work needs to be done. “If you’re interested in using mindfulness meditation, find an instructor in your city,” he said. “It’s important to train your mind like you train your biceps in the gym.”

In addition to Creswell and Cole, the research team included UCLA’s Michael R. Irwin, Lisa J. Burklund and Matthew D. Lieberman and the Cousins Center for Psychoneuroimmunology’s Jeffrey Ma and Elizabeth Crabb Breen.

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Yoga can enhance quality of life and slow cellular aging in caregivers

For every individual who’s a victim of Alzheimer’s — some 5.4 million people in the United States alone — there’s a related victim: the caregiver. Spouse, son, daughter, other relative or friend; the loneliness, exhaustion, fear, and most of all stress and depression, takes a toll

While care for the caregivers is difficult to find, a new study out of UCLA suggests that using yoga to engage in very brief, simple daily meditation can lead to improved cognitive functioning and lower levels of depression for caregivers.

Dr. Helen Lavretsky, professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues report a further benefit as well: a reduction in stress-induced cellular aging.

The report appears in the current online edition of the International Journal of Geriatric Psychiatry.

As the U.S. population continues to age over the next two decades, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia. The detrimental burden on them, in terms of their own lives, can be severe.

For example, says Lavretsky, who also directs UCLA’s Late-Life Depression, Stress and Wellness Research Program, “We know that chronic stress places caregivers at a higher risk for developing depression. On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.” What’s more, many caregivers tend to be older themselves, leading to what Lavretsky calls an “impaired resilience” to stress and an increased rate of cardiovascular disease and mortality.

While medication can improve depression, many caregivers may be opposed to the use of medication because of the associated cost and drug side-effects. That consideration motivated Lavretsky and her colleagues to test a brief mind-body intervention for stress reduction.

The researchers recruited 49 family caregivers who were taking care of their relatives with dementia. Their ages ranged from 45 to 91 years old and included 36 adult children and 13 spouses. The participants were randomized into two groups. The meditation group was taught a brief, 12-minute yogic practice that included an ancient chanting meditation, Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes every day at the same time for eight weeks.

At the end of the eight weeks the researchers found that the meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning, compared with the relaxation group. In the meditation group, 65 percent showed a 50 percent improvement on a depression rating scale, and 52 percent of the group showed a 50 percent improvement on a mental health score. This compared to a 31 percent depression improvement and a 19 percent mental health improvement for the relaxation group.

The researchers also found that meditation increased telomerase activity and thus slowed cellular aging. Telomerase is an enzyme that maintains the DNA at the ends of our chromosomes, known as telomeres. Telomeres are associated with a host of health risks and diseases, which may be regulated in part by psychological stress. In the absence of telomerase activity, every time our cells divide, our telomeres get shorter and shorter, until eventually, they become so short the cells die. If high telomerase can be maintained or promoted, though, it will likely promote improvement in telomere maintenance and immune cell longevity.

In the study, the meditation group showed a 43 percent improvement in telomerase activity compared with 3.7 percent in the relaxation group.

“Although the relation between mental and physical health has been previously documented, the mechanistic links are beginning to be understood at the cellular level,” said Lavretsky.

“To a varying degree, many psychosocial interventions like this have been shown to enhance mental health for caregivers,” she said. “Yet given the magnitude of the caregiver burden, it is surprising that very few interventions translate into clinical practice. The cost of instruction and offering classes may be one factor. Our study suggests a simple, low-cost yoga program can enhance coping and quality of life for the caregivers.”

The pilot results were “striking,” she said, given the improvements that were shown in mental health, cognition, and telomerase activity over a short eight weeks at a mere 12 minutes a day. “We found that the effects on cognitive and mental functioning and telomerase activity were specific to the Kirtan Kriya. Because Kirtan Kriya had several elements, including chanting, mudras (hand gestures) and visualization, there was a ‘brain fitness’ effect in addition to stress-reduction that contributed to the overall effect of the meditation.” Lavretsky plans a follow-up study to provide further confirmation of this potential mechanism in a neuroimaging study of Kirtan Kriya.

Recently, UCLA launched its new Alzheimer’s and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

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Meditation has positive effects on mood and anxiety in patients with memory loss

Researchers at Thomas Jefferson University Hospital determined that mantra-based meditation can have a positive impact on emotional responses to stress, fatigue and anxiety in adults with memory impairment and memory loss. Their findings are published in the recent issue of the Journal of Alternative and Complementary Medicine.

Their study placed 15 older adults with memory problems ranging from mild age-associated memory impairment to mild impairment with a diagnosis of Alzheimer’s disease on a regimen of Kirtan Kriya, a mantra-based meditation, for 12 minutes a day for eight weeks. A control group was assigned to listen to classical music for 12 minutes a day for eight weeks.

Earlier results from the study showed significant increases in cerebral blood flow in the prefrontal, superior frontal, and superior parietal cortices as well as improvements in cognitive function.

“We sought to build on this research to determine if changes in cerebral blood flow (CBF) had any correlation with changes in patients’ emotional state, feelings of spirituality and improvements in memory,” said Andrew Newberg, M.D., director of Research at the Jefferson-Myrna Brind Center of Integrative Medicine.

“Age-associated cognitive impairment can be accompanied by depression and changes in mood. There is data suggesting that mood disorders can aggravate the processes of cognitive decline,” adds Newberg.

Study participants who performed the mantra-based meditation reported some improvement in tension, fatigue, depression, anger and confusion, with observed significance in tension and fatigue over the control group. There was no significant change observed in spirituality scores.

Single photon emission computed tomography (SPECT) scans examined areas of participants’ brains—or regions of interest (ROI)—based on areas previously found to be affected during meditation tasks, and that serve a number of cognitive and affective responses, at baseline and eight weeks.

Significant correlations were observed between the change in CBF and the change in patient-reported mood states. Areas including the amygdala, which has a role in the formation and storage of memories associated with emotional events; and the caudate, thought to be highly involved in learning and memory, correlated with depression scores while the prefrontal cortex, inferior frontal lobe, parietal region, and cingulate cortex correlated with feelings of tension. Significant correlations between the improvement in scores for confusion and depression and change in verbal memory suggest that the improvement in feelings of confusion and depression was related to the cognitive improvement.

“This study is one of a growing body of neuroimaging studies to illustrate the neurological and biological impact of meditation, highlighting brain regions that regulate attention control, emotional states, and memory.

“It is a first step in understanding the neurophysiologic impact of this and similar meditative practices,” says Dr. Newberg.

This research was funded by the Alzheimer Research and Prevention Foundation, Tucson, AZ.

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Aging as a Spiritual Practice, by Lewis Richmond

Here is a mindfulness practice from Lewis Richmond’s book, Aging as a Spiritual Practice: Think of your life and its major events as a horizontal line. Your past stretches to the left of wherever you are on that line; your future stretches to the right. The events that stretch into the past are clear and unchangeable; the future is blurred: you don’t really know what events will eventually occupy that line or how long the line will eventually be. Think of this as horizontal time.

Title: Aging as a Spiritual Practice
Author: Lewis Richmond
Publisher: Gotham Books
ISBN: 978-159-24069-0-6
Available from: Amazon.co.uk, Amazon.co.uk Kindle Store, Amazon.com, and Amazon.com Kindle Store.

Now let’s move from horizontal time to vertical time. As you breathe in, imagine your breath moves up in a column from your cushion or chair. Breathing out, imagine the breath sinking down into the same place. “This vertical movement doesn’t go anywhere in space,” writes Richmond. “It doesn’t move from a certain past to an uncertain future. It just rests continually in the same spot.”

His book is full of interesting practices and ideas like this one.

When I read the title of the book, with its sub-title “A contemplative guide to growing older and wiser” I feared the worst. Would this book be drenched in denial and in piousness?

No piousness, I am glad to say, and no denial of reality. Lewis Richmond writes with honesty, clarity and humanity and his book contains much to interest readers of all ages. Actually he sounds like a guy you could sit back and have a beer with though as he’s a Zen Buddhist priest I assume he’ll be having the green tea.

He notes that we age one breath at a time. “When you observe your breath, you are not just passing through time; time is also passing through you.” No denial there but his concept of ageing one breath at a time adds a new dimension to mindfulness of breathing and to acceptance of what comes to us.

He is full of interesting perspectives like this. Consider non-judgemental attention. “… most people in the second half of life are paying close attention to the body in term of stamina, vigor, skin care, diet, weight loss, and attractiveness. But how many of us pay attention to our bodies without judgement? How many of us actually experience our bodies just as they are?”

That’s a fascinating question to bring to our mindfulness practice – and not just for those in the second half of life.

I was particularly taken by his “pebbles of life” practice. This comes from a fellow Zen priest who keeps a bowl of pebbles on a shelf beside a statute of Buddha. Each pebble represents a week of the rest (as he estimates it) of his life. Every Monday morning he removes a pebble from the bowl and returns it to the driveway he took it from.

This strikes me as an excellent way to cultivate an appreciation of the passing weeks but of course it involves turning towards the passing of time with death at the end of the journey. When I described this practice to a mindfulness class, all agreed it sounded like a very good idea. Then they began to change it around: how about using the practice to mark the passing of the year with a pebble for every month? Or how about putting a pebble in the bowl for every good experience we have? I was fascinated to see how quickly the need to escape from the contemplation of the ultimate ending of life asserted itself – and I have to admit that I haven’t yet gathered up the thousand pebbles I would allow myself for my own bowl.

Throughout his book Lewis Richmond tells stories of his own health and ageing experiences, of the experiences of others and explains aspects of Buddhism with admirable and enviable clarity.

In our era in the West, ageing has been described as a financial time bomb waiting to explode. People who grew up as the culture began to worship youth, now find themselves growing old. Those of us who are in the second half (or fourth quarter) of life must find a way to navigate our way through time bombs, the demands of the culture and our own health issues.

Anyone who wants to navigate with clarity,humour and mindfulness will enjoy this book.

His previous books are Work as a Spiritual Practice, Healing Lazarus, and A Whole Life’s Work.

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“Ten Thousand Joys and Ten Thousand Sorrows”: an interview with Olivia Ames Hoblitzelle

This book is intensely personal. Was it difficult to write?

Yes, at times it was difficult to write, but I felt a great sense of purpose. just before Hob died, I promised him that I would write a book and his voice would be in it. That became like a covenant between us. Also, I felt compelled to write the book. I realized that our background with meditation and the wisdom traditions gave us valuable perspectives which could be helpful to others. I hadn’t seen any books about how spiritual perspectives or practices could help with Alzheimer’s, and that’s what had helped us more than anything. In fact, the book can be helpful for people dealing with any serious illness and no matter what their spiritual tradition.

How did Buddhism and meditation help you and Hob to deal with his illness?

More than anything else, our Buddhist practice and understanding made a profound difference to both of us in handling his decline. Through meditation one learns to find an inner refuge – a place of stillness – in the midst of all the changes and challenges. When we accept how much we can’t control, that everything is impermanent, we can begin to step out of our struggle with life. Meditation helps one develop equanimity and acceptance of whatever comes up, and that is a great help in dealing with the losses and heartbreak of Alzheimer’s. To be realistic, meditation is not a panacea, but it is a tremendous support for which both of us were very grateful.

Title: Ten Thousand Joys and Ten Thousand Sorrows: A Couple’s Journey Through Alzheimer’s
Author: Olivia Ames Hoblitzelle
Publisher: Tarcher/Penguin
ISBN: 978-1-58542-827-4
Available from: Amazon.co.uk or Amazon.co.uk Kindle Store, and Amazon.com or Amazon.com Kindle Store.

How did Hob’s way of viewing his illness – and the world – help you to accept the situation?

He had a great sense of humor and a wry outlook on life. That helped a lot. Humor breaks the tension of difficult situations. It’s a gift because it shifts perspectives and allows you to laugh. On one level, he couldn’t believe he had this diagnosis. Even quite far along, he kept saying he was going to beat it. On another level, he was totally open and told everyone he had Alzheimer’s, which bowled people over. Many people don’t know there is something wrong with them or else never talk about it. I think Hob’s openness was a great help to him and everyone around him. Certainly it was for me.

Were any positive shifts in your relationship brought about by Hob’s illness?

The most important shift was the deepening of our love for each other. I kept reminding him that we were in this together, and that I would stand by him to the end. I tried to feel into his situation, to walk in his shoes, as the expression goes. Often my heart broke open with compassion and love for him. The frictions of relationship pretty much fen away, and you realize that you’re mainly living with the love. That’s a hidden blessing.

There was also a big shift from his fierce independence to his needing to become more dependent on me. I both accepted that reality and suffered with it. Both of us went through a gradual process of surrender – for him, to the inevitability of his losses; for me, to accept that those losses were “in the natural order of things,” one of my favorite expressions for keeping a balanced perspective.

Being Hob’s primary caregiver, was it difficult to balance his needs with your own? How did you work though frustration?

Keeping one’s balance is a constant issue! Burn out is a huge hazard for all caregivers, so was determined to honor my own needs. I arranged for regular time away to write, meet a friend, be in nature, or just let down. I asked good friends to come and be with Hob, take him for a walk, have lunch with him. I thought about this balance issue a lot and plenty of times I lost it!

When I got worn out and frustrated, I’d do anything to get a tiny respite; go to the garden, just sit and breathe, or be alone for a cup tea. Sometimes I was so exasperated, I’d drive off and in the privacy of my car, I’d shout or roar — any sound that helped to release my pent-up feelings. Sometimes I broke down, and it turned out tears were the most important relief.

Or I’d do exactly the opposite, surprising even myself. I’d choose to move toward him, push through my own feelings, and say, “I need a hug.” That would totally soften the frustration. I came to see that as a kind of spiritual practice, because I was choosing to make a loving gesture instead of collapsing into my own feelings.

How did you and Hob handle tough subjects like death and loss?

We were really fortunate here. First of all, we had our meditation background. Meditation is about acceptance and letting go, invaluable qualities in the face of loss. Then we had both been involved with hospice work where you’re constantly living with issues of death and dying. Finally, we could both talk about the subject of death relatively easily, and we did. Even with some of our closest friends when he was talking about wanting to end his life early.

With Alzheimer’s, loss seems to be a constant reality. Sometimes Hob grieved his losses, but given his nature, he usually made light of them. Other times he simply couldn’t believe what was happening to him As for me, I grieved quietly because my sadness upset him, and why add that to his burdens? Anybody dealing with Alzheimer’s will tell you what a heartbreaking illness it is. I think we do a lot of our grieving as we go along in both little and big hits. It’s important to acknowledge and feel the grief That’s human, after an, and if you don’t, it’s apt to come out in physical symptoms.

What is the ‘doorway practice’ and how did it help you during Hob’s last months?

The doorway practice evolved after he began passing out unexpectedly, and I realized that any of these episodes could be the final one. So whenever I came to the door of the room where he was resting, for example, I’d prepare myself for the fact that he might have died. This inner preparedness came to me naturally. Mysteriously, it wasn’t heavy at au. Rather, it intensified the preciousness of life, of our time together, and yet let me be prepared for whatever might happen. I know it helped me deal with his passing out episodes with equanimity That doorway practice would arise spontaneously. I’d feel remarkably calm determined and strong. Again meditation helped me a lot. One could say meditation is a preparation for crisis management!

What general advice would you offer to someone who is caring for a partner with Alzheimer’s?

  • Accept that this is one of the most difficult challenges you’ll ever face.
  • When you realize that you’re their lifeline in a dissolving world, every supportive and loving gesture is a gift to them.
  • For me, when one of my spiritual teachers suggested that caregiving was an opportunity for me to practice the positive qualities of compassion, patience, generosity, and kindness, it helped give meaning to the humblest of tasks.
  • Have compassion for yourself when you feel frustrated, impatient, or angry, because caring for an Alzheimer’s patient is a Herculean task.
  • Ask friends and family for help! People want to help out, and there’s a real risk in becoming isolated.
  • Know what gives the patient comfort or reassurance. For us, it was always touch, physical closeness, music and beauty.

There are many more answers to this question in the Reflections, Suggestions, and Seed Thoughts at the end of each chapter.

How has your life changed since Hob’s death?

Obviously losing one’s spouse is a heart wrenching loss, but I was determined to continue living as fully as possible. And I did. By writing the book, I was integrating the enormity of the experience and harvesting the insights that come with retrospect- a complex mix of grieving, creativity, and honoring our last chapter together. My greatest wish is that the book continues to be helpful, and hopefully our gift to others facing similar challenges.

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“Ten Thousand Joys and Ten Thousand Sorrows,” by Olivia Ames Hoblitzelle

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To be clear from the start, this book is worthy of the rich praise it has received. The inner jacket liner contains three pages crammed with accolades from what could be easily construed as the Who’s Who of leading contemporary spiritual leaders and health professionals. The book is a moving and loving story of this extraordinary couple’s experience.

It is a love story. It is a love story written from the deeply touching and personal perspective of a remarkable woman living through her equally remarkable husband’s dementia and death. The book covers the six years from his first symptoms to his death as she emotionally lived the various pieces of their life together as it changed profoundly. The book is drawn from her journals, giving the reader the direct expression of her emotions as they went through her. The theme and tone of the book are both poignantly captured in a phrase that is the Postlude to the narrative, “Dance me to the End of Love,” a line drawn from a Leonard Cohen poem. The book is a dance in its delicate movement, its cadence and its intimate flowing emotion. The reader is watching lovers dance, from inside one of the dancers. It is sweeping love story between two extraordinary people who, as we learn from the book, and feel from its author, have each lived extraordinary lives.

Title: Ten Thousand Joys and Ten Thousand Sorrows: A Couple’s Journey Through Alzheimer’s
Author: Olivia Ames Hoblitzelle
Publisher: Tartcher/Penguin
ISBN: 978-1-58542-827-4
Available from: Amazon.co.uk or Amazon.co.uk Kindle Store, and Amazon.com or Amazon.com Kindle Store.

The extraordinary qualities of the writer, of her husband and of their lives together are stamped throughout the book, from the jacket liner to the back cover. This entices the reader; gives a sense of wonder and awe to the experience of the close connection with their lives, their struggles and their needs, each of them, to come to so ordinary a thing as death. It is a strength of the book; two sparkling, talented people who lives have soared above us in a glorious flight of remarkable accomplishments, experiences, encounters, facing together an ignoble debilitating illness and the commonness of death. This also is a puzzle for the reader.

What is so very extraordinary about the lives of the writer and her husband removes them from what is all too ordinary, the plight of most people and families who face the same challenge. When we bring to mind the estimated 5.4 million Americans who suffer from Alzheimer’s Disorder, and their 14.9 million unpaid caretakers we are carried to a different and less exalted reaction than the one we are left with at the end of this beautiful and extraordinary experience. Every family’s story, of course, is different and singular. What is incongruent is that we cannot conceive of most of these millions (millions that will swell in a few decades to tens of millions in what has been described as an epidemic) as extraordinary. We cannot conceive of these millions having the resources financially for the care that is described in “Ten Thousand Joys and Ten Thousand Sorrows”. We cannot imagine millions having the homes in Vermont and in Cambridge, Massachusetts. We cannot imagine millions with the support of a large network of loving and distinguished friends, and of renowned spiritual leaders. We cannot imagine millions dying peacefully in their homes surrounded by loving caregivers. In this way the ordinary and the extraordinary are juxtaposed too nearly. We suspect the wreckage of dementia on the many millions and their families is something quite different than what this book has told of. We suspect that so many die alone. We suspect that so many are broken by the financial impossibilities of good care. We suspect the isolation and loneliness of those families who cannot afford care, who chose to leave their jobs to care for their stricken relatives, whose world then becomes a small one of long and weary days and sleepless nights. We know of the number caretakers who die early, earlier than their loved one with Alzheimer’s. We know of those who live with Alzheimer’s much longer than the six years described so movingly by Olivia Hoblitzelle, many of whom, unlike her husband, dwell in silence or are unable for years to remember who is in the room with them or what they did or said two minutes ago.

So we remind ourselves that “Ten Thousand Joys and Ten Thousand Sorrows” is a particular story about particular people. It is a tender and touching love story that can give us comfort and inspiration. It is not about us. But may still be a help to us. The “Suggestions” at each Chapter’s end may be practical reminders for some of us. The “Seed Thoughts” also at the conclusion of each Chapter will be consistently useful to us (“May I cultivate compassion toward myself and others”, May I find new ways of handling my negative emotions.” “May I accept the challenge of this situation”, “Let me be calm”).

“Ten Thousand Joys and Ten Thousand Sorrows” is uplifting for us in the way that all stories of courageous struggle are. And it brings that us that sweet and painful poignancy of all powerful love stories.

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