family

INSPIRATIONAL GERONTOLOGIST TRANSFORMED DEMENTIA CARE

nancyvalko Alzheimer's, assisted suicide, Compassion & Choices, dementia, end-of-life, family, food and water, inspiration, medical, medical ethics, mental health, nursing, palliative care, VSED

I don’t normally read obituaries but this obituary I recently read in the January 11, 2024 Wall Street Journal titled “Naomi Feil, Who Transformed Dementia Care, Dies at 91” was inspiring and, most of all, educational!

MY STORY

When I was 13, I became a volunteer in our local nursing home to help feed the elderly patients, some of whom had dementia. I loved it but was told I should be feeding the patients faster instead of listening to their stories.

When I said that these stories were great and really enjoyed by all the patients at the table, the nurses told me that most of the stories were probably not true anyway!

When I began my nursing career in 1969, patients with dementia were often considered just “difficult” or even “crazy”. Some were put in restraints for safety but that just seemed to agitate them more. I found that sitting and listening to them helped a lot.

So I have long had an interest in people with dementia-most often Alzheimer’s disease, not only because of the patients I cared for as a nurse, but also because of my late mother and brother who also have had the condition.

That’s why I have written blogs about the condition such as ““Repairing Our View of Dementia” and “Five Things my Mother (and Daughter) Taught Me about Caring for People with Dementia”, hoping these blogs would help other caregivers, patients and their families.

NAOMI FEIL’S STORY

Naomi’s obituary is subtitled “Instead of forcing people to remember facts, she helped them express their anger and sorrow. She found it made all the difference.”

Here are some excerpts from the obituary:

“Caregivers, struggling to help people with dementia, often see their role as offering scraps of reality—reminding them what year it is, for instance, or who is in the White House.

Naomi Feil had a different strategy. As a social worker in nursing homes, she resisted the impulse to yank disoriented people back to her reality. Instead, she sought to enter their realities and affirm their emotions. Rather than offering a cup of tea or chirping that everything would be fine, she helped her charges express their anger and sorrow—and found they often were more at ease afterward.”

In the 1960s and 1970s, Feil devised what she called the validation method for dementia care. She wrote books, led workshops and established 24 validation-training centers in 14 countries.

Feil’s ideas have become fundamental to what is now called person-centered dementia care, which focuses on discovering individual needs and preserving dignity rather than following standard routines, said Sam Fazio, a senior director of the Alzheimer’s Association. In such care, he said, “You’re meeting them in their reality versus expecting them to meet us in our reality when they are no longer able to do that.” (Emphasis added)

NAOMI’S HISTORY

“When she was 4 years old, her Jewish family fled Nazi Germany. They eventually settled in Cleveland, where her father was the administrator of a nursing home, which doubled as living quarters for her family. Some of her earliest friends were very old people.”

“Her work was with the troublemakers other staff members avoided. These were the blamers, the martyrs, the moaners, the wanderers, the yellers, the pacers, the pounders whom nobody wanted,” she wrote in one of her books, “The Validation Breakthrough.”

“Sometimes nursing assistants tied people to their chairs so they wouldn’t wander off and make trouble. When she tried to engage with these misfits, a nursing assistant scolded her: “You’re getting them all worked up…. You can’t help them. I’ve been working here for five years, and I ought to know.” 

“Feil persisted and gradually learned from her encounters. ‘I learned not to contradict, patronize, argue, or try to use logic or give insight,” she wrote. Instead, she made clear she was listening. If an old person imagined the nurses were stealing her jewelry, Feil might say, ‘You loved that necklace, didn’t you. Who gave it to you?’ She could share the emotion and then explore deeper.” (Emphasis added)”

As a social worker in the 1960s and 1970s, she developed her methods through trial and error. “

“No lies

“She opposed the idea of telling comforting lies. Lies could be detected, even by those who seemed most deluded, and that would destroy trust. When an old woman said she needed to see her mother right away, Feil wouldn’t point out that her mother was dead. Nor would she promise that the mother would visit soon. Instead, she would make it a conversation: ‘You really need to see your mother! What would you like to tell her?’”

“You don’t argue, you don’t lie,” she said in a TEDx talk. “You listen with empathy and you rephrase.”

When old people were weepy, it was a bad idea to tell them things weren’t so bad, she found. It was better to let the tears flow and talk about what made them sad.”

CONCLUSION

While so much more is known now about dementia and developing treatments, many people still consider it a fate worse than death and a burden on their family. Some have even chosen assisted suicide or voluntary stopping or eating and drinking (called VSED) through “right to die” organizations such as Compassion and Choices.

But, as I wrote last February in my blog “Alzheimer’s Association Ends Agreement with Compassion and Choices”, the Alzheimer’s Association has now ended it’s agreement with Compassion and Choices (the pro-assisted suicide organization) stating:

“In an effort to provide information and resources about Alzheimer’s disease, the Alzheimer’s Association entered into an agreement to provide education and awareness information to Compassion & Choices, but failed to do appropriate due diligence. Their values are inconsistent with those of the Association.

We deeply regret our mistake, have begun the termination of the relationship, and apologize to all of the families we support who were hurt or disappointed. Additionally, we are reviewing our process for all agreements including those that are focused on the sharing of educational information.

As a patient advocacy group and evidence-based organization, the Alzheimer’s Association stands behind people living with Alzheimer’s, their care partners and their health care providers as they navigate treatment and care choices throughout the continuum of the disease. Research supports a palliative care approach as the highest quality of end-of-life care for individuals with advanced dementia.” (All emphasis added)

Good for the Alzheimer’s Association and as I can personally and professionally attest, caring for people with dementia can be a wonderful- if sometimes challenging- experience, for healthcare providers and especially the person with dementia and their families!

Are Near-Death Experiences Real?

nancyvalko brain death, CPR, end-of-life, family, medical ethics, organ donation

In a November 4, 2022 Medscape article titled “‘Lucid Dying’: EEG Backs Near-Death Experience During CPR”, researchers found brain wave recordings taken during in hospital cardiac arrest resuscitation (cardiopulmonary resuscitation) lends support to near-death experiences reported by some people who survived cardiac arrest.

In the Medscape article and according to lead investigator Sam Parnia, MD, PhD:

“These recalled experiences and brain wave changes may be the first signs of the so-called ‘near-death’ experience, and we have captured them for the first time in a large study,” lead investigator Sam Parnia, MD, PhD, with NYU Langone Health, says in a news release.

Identifying measurable electrical signs of lucid and heightened brain activity during CPR, coupled with stories of recalled near-death experiences, suggests that the human sense of self and consciousness, much like other biological body functions, may not stop completely around the time of death, Parnia adds.” (Emphasis added)”

According to the article, the researchers used “audiovisual testing of awareness with continuous real-time EEG and cerebral oxygenation monitoring” during the resuscitation.

While only 53 of the 567 patients survived (9.3%), 28 survivors completed interviews with 11 reporting “unique, lucid experiences during resuscitation.”

According to Dr. Parnia:

“Our understanding of death has gone through a seismic shift in the last few years,” and

“The biological discoveries around death and the postmortem period are completely different to the social conventions that we have about death. That is, we perceive of death as being the end, but actually what we’re finding is that brain cells don’t die immediately. They die very slowly over many hours of time,” Parnia noted. (Emphasis added)

Dr. Parnia presented the findings November 6 at a resuscitation science symposium at the American Heart Association (AHA) Scientific Sessions 2022 in Chicago.

The Medscape article also noted that not everyone agrees:

“Ajmal Zemmar, MD, PhD, with University of Louisville, Louisville, Kentucky, noted that several studies, including this one, “challenge the traditional way that we think of death — that when the heart stops beating that’s when we die.”

The observation that during cardiac arrest and CPR, the brain waves are still normal for up to an hour is “fairly remarkable,” Zemmar told theheart.org | Medscape Cardiology.

“However, whether there is conscious perception or not is very hard to answer,” Zemmar cautioned. 

“This type of research tries to bridge the objective EEG recordings with the subjective description you get from the patient, but it’s hard to know when conscious perception stops,” he said.”

WHAT DOES THIS ALL MEAN?

Over the decades, there have been many studies of near-death experiences and an October 31,2022 Medscape article by a nurse practitioner who describes how both negative and positive near-death experiences can impact an individual.

There is even a 2020 Frontiers in Neurology article “The Neurology of Death and the Dying Brain: A Pictorial Essay” that explores some of the potential effects of issues like near-death experiences on the clinical determinations of death and organ donation.

But whether or not you believe in near-death experiences, there is one crucial lesson here: We must always treat any ill person-awake or presumed unconscious-with the respect due any person when we talk to and care for them.

I have often told the story of “Mike”, a young man catastrophically injured in a car crash whose doctor said the if he survived, he would be a “vegetable”. We nurses talked to Mike and eventually he started to respond to us but not the doctor.

Mike was shipped off to a nursing home but almost two year later, he returned to thank us and told us he was getting married. When we laughed and told him how he started to respond to us but not the doctor, Mike became very serious and said he would not respond to the doctor because he heard the doctor call him a “vegetable”!

CONCLUSION

But my favorite story is about working on a medical floor caring for an elderly gentleman who was dying and showed no awareness of his 4 adult sons sitting at his bedside.

I encouraged his sons to talk to him, but they said they didn’t know what to say and didn’t think he could hear anyway.

I took the man’s hand and noticed that it was strong and callused like a man who worked with his hands.

I asked the sons was their dad did and they all started relating stories about his love of farming and then told funny stories about how their dad reacted to their antics growing up.

Pretty soon, all the sons were laughing and telling their dad how much they appreciated him as I quietly left at the end of my shift.

When I returned the next day for my next shift, I was not surprised to learn that the dad had peacefully died during the night with his sons at his side. But I was surprised to find that one of the sons stayed until I came back and wanted to talk to me.

“Lady, you were right! He did hear us!” he told me.

It turned out that the sons had continued talking to their dad after I left and when they said they were ready to leave, their dad opened his eyes, looked at them, smiled and then closed his eyes and peacefully died.

What a wonderful memory for his sons-and me!

New Study Shows Stem Cells and Prenatal Surgery Can Help Babies with Spina Bifida

nancyvalko abortion, disability, family, medical ethics, prenatal testing

Spina Bifida is a birth defect that occurs when the spine and spinal cord do not develop completely in an unborn baby. The resulting opening in the spine leaves  the spinal cord and nerves exposed.

That exposure can cause damage leading to paralysis or mobility problems, a buildup of excess fluid on the brain, and infection.

Spina Bifida can sometimes be diagnosed during pregnancy by a blood test, ultrasound or amniocentesis. Sometimes the diagnosis is not made until after birth.

Before the 1990s, treatment for severe spina bifida involved surgery on the baby after birth to close the defect but the procedure could not repair already damaged nerves.

In 1997, the first prenatal surgery was done and in 2011 and 2020, major studies showed that prenatal repair resulted in better outcomes.

But now, in an October 10, 2022 Medscape article “Stem Cell Treatment Helps Babies with Spina Bifida”,  a clinical trial at UC Davis Health is showing that a new stem cell treatment-given while the unborn baby is still in the womb-appears to be effective at reversing paralysis and other problems caused by spina bifida in newborns.” (Emphasis added)

But, as the article rightly states,:

“The researchers have expressed caution about drawing full conclusions so far, but the treatment appears promising. They plan to release information about how the babies are doing at developmental milestones throughout the study process.” (Emphasis added)

The clinical trial started in 2021 and involves myelomeningocele, “a severe form of spina bifida where the spinal canal doesn’t fully close before birth, leading to spinal cord damage.”

According to the article, “So far, three babies have received the unique treatment, which is delivered while a fetus is still in the womb.”

DIAGNOSIS AND TREATMENT

Today, prenatal testing is routinely offered to pregnant women, but abortion is too often offered or recommended when prenatal testing shows a possible adverse diagnosis like spina bifida.

According to the Spina Bifida Association, the condition can often be diagnosed before birth:

“There are 3 tests, but, it is important to remember that no medical test is perfect and the results are not always 100 percent accurate. Spina Bifida can be detected in utero by one of the following tests: 

  1. A blood test during the 16th to 18th weeks of pregnancy. This is called the alpha-fetoprotein (AFP screening test). This test is higher in about 75–80 % of women who have a fetus with Spina Bifida.
  2. An ultrasound of the fetus. This is also called a sonogram and can show signs of Spina Bifida such as the open spine.
  3. A test where a small amount of the fluid from the womb is taken through a thin needle. This is called maternal amniocentesis and can be used to look at protein levels.”

Ironically, one of the big health institutions in my city that provides “Pregnancy termination for women choosing to terminate a pregnancy due to fetal abnormalities or maternal health conditions” also has a Fetal Care Center that uses prenatal surgery not only for spina bifida but also for other conditions such as amniotic band syndrome, twin-to-twin transfusion syndrome, airway/trachea obstruction and blocked urinary tract, etc.!

CONCLUSION

When I had my last child in 1985, I was offered but refused amniocentesis. In my case, it was offered because I had previously had Karen, my daughter with Down Syndrome and a severe heart defect.

I knew that both procedures carry a risk of miscarriage and that I would never abort a child because of a disability. I also knew that such procedures can only test for some of the thousands of known “birth defects” and I personally met families who were erroneously told that their child had a defect but were born healthy. I also knew how to find help if any of my children-born or unborn-had a possible health a problem.

Some people asked if I was brave or stupid. I told them that I was just well-informed after researching both amniocentesis and CVS (Chorionic villus sampling)

(Today, we have routine non-invasive prenatal screening blood tests called NIPTs but the Federal Food and Drug Administration issued an alert on April 19, 2022 “Genetic Non-Invasive Prenatal Screening Tests May Have False Results: FDA Safety Communication:

“While health care providers widely use NIPS tests, none have yet been authorized, cleared, or approved by the FDA. The accuracy and performance of NIPS tests have not been evaluated by the FDA and these tests can give false results, such as reporting a genetic abnormality when the fetus does not actually have one.” (Emphasis added))

But most importantly, I told them that my daughter Karen was a blessing who helped change many lives for the better during her tragically short life-especially mine.

After Karen died, I became a volunteer babysitter for many children with a range of disabilities and their parents also told me how they became better people because of their child with a disability.

Life must be our highest priority!

The War Against Crisis Pregnancy Centers Escalates

nancyvalko abortion, culture, family, family planning, pro-life

When the Dobbs v Jackson Women’s Health Organization draft decision by the US Supreme Court to return abortion law to the individual states was outrageously leaked, I wrote about the pro-abortion violence perpetrated on crisis pregnancy centers and the threats against Supreme Court judges.

Now, Senator Elizabeth Warren of Massachusetts is not only strongly protesting the final ruling but also states:

“With Roe gone, it’s more important than ever to crack down on so-called ‘crisis pregnancy centers’ that mislead and deceive patients seeking abortion care,” said Massachusetts senator Elizabeth Warren, promoting her bill. “We need to crack down on the deceptive practices these centers use to prevent people from getting abortion care, and I’ve got a bill to do just that,”

Her bill titled the “Stop Anti-Abortion Disinformation Act” or “SAD Act” directs the Federal Trade Commission to “promulgate rules to prohibit a person from advertising with the use of misleading statements related to the provision of abortion service.” It would also allow charities to be fined $100,000 or “50 percent of the revenues earned by the ultimate parent entity” for disinformation, although the legislation itself does not define the prohibited speech.

Joining Senator Warren on the bill are Senators Hirono, Schatz, Booker, Smith, Klobuchar, Sanders, Murray, Merkley, Blumenthal, Feinstein, Wyden, Gillibrand, Markey, Warner and Markey.

Speaking with reporters in July, Senator Warren stated that:

“In Massachusetts right now, those crisis pregnancy centers that are there to fool people who are looking for pregnancy termination help outnumber true abortion clinics by 3 to 1. We need to shut them down here in Massachusetts, and we need to shut them down all around the country. You should not be able to torture a pregnant person like that” (All emphasis added)

This pronouncement was met with derision, even from some reporters.

A CRISIS PREGNANCY DIRECTOR RESPONDS

Heidi Matzke, who heads a Crisis Pregnancy Center in Sacramento, California was eloquent in describing the violence her center has faced as well as responding to Senator Warren’s point that centers like hers must be shut down:

“We have had to stop operations of our mobile clinic. We’ve had to hire 24-hour onsite security. We’ve had to add cameras. We’ve had to arm our staff with pepper spray,” she said, adding last week a man with a machete showed up and was stopped before he could inflict any harm or damage.”

She also called Ms. Warren statements “horrific”:

“Pregnancy centers give away $266 million of free medical services and resources to communities all over this incredible country. And her words are just incredibly hurtful.” (Emphasis added)

She also said her center provides fully licensed OB/GYN care with medical professionals and that “most of the women working at her clinic have had an abortion before and many believe their lives would be ‘so much different’ if they had gone to a pregnancy center.”

CONCLUSION

Personally and as a nurse, I have had experience with women considering abortion as well as women (and men) who relate how they were damaged by an abortion. They need compassion and real help.

Crisis pregnancy centers are a wonderful resource and even Sen. Warren acknowledges that crisis pregnancy centers outnumber well-funded abortion clinics by 3 to 1. There’s a lesson in that.

But most importantly, I wish that all of us would realize that abortion is a tragic loss of a life regardless of the circumstances, not a political cause to celebrate!

A Crisis Pregnancy Close to Home

nancyvalko abortion, adoption, culture, economics, family, law, pro-life, sex ed

A few days ago, I read an article from one of the medical news sites I subscribe to titled Would You Like to Keep This Pregnancy?’ I Asked My 13-Year-Old Patient–Having a choice can help end cycles of poverty among marginalized teen patients”.

Of course, the doctor/author was pro-abortion and the article was horrifying to me. I thought how differently a pro-life healthcare provider would handle the situation and remembered a news article I wrote in March, 1998 for the National Catholic Register newspaper.

Here is the news article:

“A Crisis Pregnancy Close to Home“

When it’s your own unmarried teenage daughter facing a staggering ‘choice,’ are you still pro-life?

“Mom, I’m pregnant.” When these words are uttered by your unmarried teenage daughter, it’s a heart-stopping moment for any parent. When the parent is a committed pro-lifer, the shock is often overlaid with stunned disbelief, shame, and guilt. “Hasn’t she been listening? This isn’t supposed to happen to my daughter!” and “How did I fail her?” are common first reactions. I know.

This Christmas, my 18-year-old daughter quietly told me that two at-home pregnancy tests came out positive.

Marie, named after the Blessed Mother, had long been my “worry child.” A brittle crust of teen rebellion had long covered a soft, sensitive heart, leading to a constant round of minor and not-so-minor infractions and arguments. Lately, though, her life seemed to be coming together. A“B” average at college and a job she loved lulled me into a sense that the worst was over. She confided that she thought she was falling in love and we talked about the pressures and temptations such strong emotions bring. Street-wise and assertive, I thought she was “safe.” But, as countless other parents have also discovered, my child lives in a world that too often considers virginity a disability and chastity an old-fashioned ideal.

The one bright spot in that night of tears and fears was that abortion was never considered an option by Marie: “Mom, I couldn’t kill my baby!” Although I was heartbroken by the circumstances of this pregnancy, I couldn’t help but feel proud of her for having the courage and common sense to reject the abortion “option.”

Surprisingly, she said all her friends were against her having an abortion and a few who had been leaning “pro-choice” were now rethinking their position. Two of her friends actually threatened to physically stop her from having an abortion even before she told them that she would never abort.

We didn’t resolve everything that first night or even later. Adoption or keeping the baby is still the big question and one that will involve a lot of prayer, thought, and discussion. It hasn’t been easy, but facing this crisis together has taught both of us so much already. What the future holds for Marie and her baby is uncertain but, with prayer and love, it is still a future bright with promise for both of them.

A Common Stereotype

A January 1998 New York Times article, “Many Women Make No Link Between Abortion and Politics,” perpetuates a common stereotype-the pro-lifer who chooses abortion when a crisis pregnancy hits home. Writer Tamar Lewin states, “Almost every abortion-clinic counselor can reel off stories of patients who say that they have always opposed abortion but that their own situation is different, or men who bring their pregnant wives or teenage daughters to the very same clinics that they have long spoken out against.”

But conversations with people active in the pro-life movement reveal a very different picture. Not surprisingly, pro-life people willing to help total strangers with a crisis pregnancy are also ready to help and support their own sons and daughters facing the same crisis.

“You think it’s the blackest day in your life when your daughter tells you she’s pregnant,” Lucy R., long active in the pro-life movement, says. A smile lights her voice. “But it’s really the beginning of a great blessing. That little boy (now six years old) is the light of our lives.” She credits prayer and pro-life principles for that happy ending.

Janet B. was a young professional when her sister told her that she had had an abortion without their parents’ knowledge because although their mother and father were strongly pro-life, the sister was sure they “just couldn’t take it (an unwed pregnancy).”

When Janet herself became pregnant out of wedlock, her parents became her biggest supporters. “We became so much closer,” she says. “My sister was wrong.” Interviews with pro-life supporters around the country reveal that this kind of family support during a crisis pregnancy appears to be the norm, not the exception.

Marcia Buterin RN, founder of Missouri Nurses for Life and active in the pro-life movement for 25 years, has had broad experience with pro-life parents whose daughters or sons have had crisis pregnancies. “It almost seems like an epidemic sometimes,” she says. “Pro-lifers are not immune from what is happening in the rest of society.”

But, she says, the reaction of the parents she has known has been invariably positive despite the heartache at discovering a son or daughter has been sexually active. She also says that, in the vast majority of cases, the young women keep their babies rather than releasing them for adoption. This echoes statistics which show that more than 90% of unmarried mothers keep their babies, almost the opposite situation of a generation ago when most of these mothers chose adoption. Thus, pro-lifers are not only supporting their daughters and sons during their pregnancies but also are usually involved in helping to raise their grandchildren.

Waning Support for Abortion

Not only do pro-lifers appear to routinely reject abortion for their unmarried children, society seems to be slowly starting to change its attitude toward abortion and the unmarried. According to the latest New York Times/CBS News poll, not only has support for abortion-on-demand eroded by an estimated 8% since 1989, but public support for abortion when pregnancy threatens to interrupt a woman’s career or education has also dropped 14% and 8% respectively.

A clear majority of the people polled did not feel these circumstances justified abortion. Undermining a basic abortion rights tenet that familiarity with abortion increases public acceptance, the same poll showed that “personal experience” was twice as likely to be given as a reason for becoming less favorable towards abortion rather than more supportive of abortion.

At the same time, a new wave of pro-life sentiment appears to be rising in a most unexpected place-the young people who have grown up under the shadow of Roe. The Times/CBS News poll showed even less support for abortion on demand among 18-29 year olds (29%) than among the general public (32%). The Alan Guttmacher Institute, the research arm of Planned Parenthood, has noted that “in recent years, fewer pregnant teens have chosen to have an abortion.” Even the media is beginning to notice. In a Jan. 21 New York Times article “A New Generation Rising Against Abortion,” writer Laurie Goodstein interviewed an eclectic group of young people attending a Rock for Life concert and found thoughtful and strong pro-life support even among those sporting tattoos and punk-style clothing.

Some explained that they began considering the value of life after losing friends to suicide, drug overdoses, and automobile accidents.

Goodstein also noted that many of the concert-goers she interviewed said that they arrived at a “right to life” position on their own and that, to be consistent, they also opposed the death penalty and assisted suicide and supported abstinence.

Countering Rock for Choice and other groups which help raise money for abortion rights groups, Rock for Life is a relatively recent phenomenon which reaches young people through the potent medium of music. Concert organizer Bryan Kemper told Goodstein that 15 concerts have already been staged and that there have been 110 bands “willing to perform for gas money.” Rock for Life is not the only sign that the pro-life movement is connecting with a new generation. Teens for Life, started in 1985, is a national organization run by young people encouraging teens to speak up for life and get involved in community activities. It has chapters throughout the country and continues to grow in numbers.

Another positive sign is the increasing number of pro-life groups springing up on college campuses. And not just on religiously-affiliated college campuses. MIT, Princeton, and the University of Texas are among colleges which not only have pro-life groups but also have websites on the Internet.

What Helps, What Hurts

But trends and statistics do not meet the needs of the individual young woman and her family suddenly facing a crisis pregnancy. The first reactions of parents and others to the news is extremely important to the woman and can even make the life-or-death difference for the unborn baby. When the first reaction is anger or a stern lecture about premarital sex, the young woman can feel abandoned and, in her despair, decide that eliminating the baby will make everyone feel better.

Parents and friends of young men and women coping with an unwed pregnancy are often unsure of what to say or how to handle the situation. One newer resource developed to help with this problem is a video and pamphlet called First Words: Can Our First Reaction to an Unplanned Pregnancy Save a Child’s Life? produced by American Life League.

The video tells the stories of four young women who faced an unwed pregnancy and encountered a range of reactions from friends and family. In their own words, these young women share how these reactions influenced their decisions about whether or not to abort their babies. The pamphlet is written by Cathy Brown who candidly tells her own story and offers helpful advice to parents and others.

But deciding against abortion is only the first step in a crisis pregnancy. The decision about whether to keep the baby or release him/her for adoption is often the most agonizing question for a young woman. Questions about insurance coverage and prenatal care, maintaining or losing a relationship with the father, the reactions of other children in the family, etc. are some of the practical and immediate concerns. Birthright and other pro-life pregnancy counseling centers can be a big help to families struggling with a crisis pregnancy.

Members of the family’s church can also help provide much needed spiritual and emotional support as well as involving the community in the nurturing of a new life.

For parents, especially pro-life parents, embarrassment and feelings of failure are common and understandable. It’s hard to put aside such feelings and concentrate on the feelings and needs of a son or daughter. But, as Donna B., a long-time pro-life activist and herself the mother of a pregnant teen, says, “Abortion is the real failure. It’s OK to be proud when your daughter chooses life.”

Nancy Valko writes from St. Louis, Mo.

Rest in Peace, “Melissa”

nancyvalko bereavement, Covid 19, culture, disability, end-of-life, faith, family, inspiration

I have written blogs about my elderly friend “Melissa” (not her real name) and some of her health care experiences to explain some of the pitfalls elderly people may encounter when they get seriously ill.

I have known “Melissa” for decades and, with her permission, she agreed to my writing about her in my blogs. She was thrilled to hear about my 2018 blog “Covid 19 and Nursing Homes”   and my 2020 blog “Don’t Write Off the Elderly”.

She even told me she like the name “Melissa” better than her real name!

I first met Melissa when she was in her 80s through her daughter who is also one of my favorite people.

Both were involved in planning the beautiful wedding reception at my home when my second husband and I were married in 2008. Melissa even remembered my favorite flower and made beautiful centerpieces with them for every table.

After Melissa could no longer drive, I took her to Mass at her parish and then to Chic-Fil-A on Fridays for breakfast with her daily Mass friends until she couldn’t physically make it.

I then visited her on Fridays and was inspired when she accepted hospice care and the care of her family with grace and gratitude.

Eventually, she spent her last days in a bed near a large window where she could watch the birds at her birdfeeder and have some of her beloved flowers at her bedside.

During that time, Melissa and I laughed a lot, prayed together, chatted about current events and family, and watched funny videos and old episodes of TV shows she enjoyed like “Barney Miller” and “Bewitched”.

She also told me many of the fascinating stories behind the pictures of her and her family covering the walls of her room.

Melissa died peacefully on May 6, 2022, at her home at the age of 99 years, 9 months and 5 days, lovingly cared for by her family and great home health and hospice providers.

A devout Catholic, Melissa was unafraid of death and knew she would meet her late husband and her son who died at age 4. Another son unexpectedly died at 56, shortly before Melissa.

Melissa generously donated her body to Logan College to help future doctors with their education.

After her funeral Mass, her family had a Celebration of Life event with pictures and stories about her life. There was a lot of laughter and some tears as we all talked about Melissa and what she meant to us.

CONCLUSION

Melissa and her family are an inspiration to me and an example of how to have a good death, something that seems impossible to many people.

I visited her the day she died peacefully and comfortably, but not awake.

She died just as she hoped.

We will miss you Melissa but we will never forget you!

Rest in peace.

Finding Hope, Healing and Purpose after a Devastating Tragedy

nancyvalko bereavement, education, faith, family, grief

I met Polly Fick a few years ago after I gave a talk about physician-assisted suicide and my own daughter’s suicide in 2009.

Polly told me the tragic story of her and her husband’s loss of their daughter, son-in-law and baby granddaughter. She also told me what she and her husband were doing to bring awareness of postpartum depression because of this loss. She and Frank hope this information may help or even save another mother and her family.

Polly has been spreading this message on local radio and most recently in the December 22, 2021 St. Louis Review Catholic newspaper article titled “St. Francis of Assisi couple finds hope through tragedy in spreading awareness of postpartum depression”

THE TRAGEDY

Polly and Frank were very close to their daughter Mary Jo Trokey and son-in-law Matthew and celebrated with them when their new granddaughter Taylor Rose was baptized in 2018.

Tragically, all three of them were found dead when Taylor Rose was 3 months old. Investigators believed “that Mary Jo, possibly suffering from postpartum psychosis, killed her daughter and husband, then died by suicide.”

Polly Fick and her husband, Frank, were stunned. “We had no idea she was going through this,” Polly Fick said.

The Ficks have since dedicated themselves to raising more awareness of postpartum depression and related illnesses. Now the members of their parish are also spreading the word about resources through their involvement with Postpartum Support International (PSI) as well as local groups mentioned in the article.

“When this sort of thing happens, you either grow from it or you end up being broken by it,” Frank Fick said. “As horrible as it was, we wanted something positive to come from it.”

POSTPARTUM ILLNESSES

According to PSI,:

“While many parents experience some mild mood changes during or after the birth of a child, 15 to 20% of women experience more significant symptoms of depression or anxiety. Please know that with informed care you can prevent a worsening of these symptoms and can fully recover. There is no reason to continue to suffer.”

“Postpartum psychosis is a rare illness compared to the rates of postpartum depression or anxiety. It occurs in approximately one to two out of every 1,000 deliveries, or approximately .1% of births. The onset is usually sudden, most often within the first 2 weeks postpartum.” 

Postpartum Support International runs a helpline (1-800-944-4773), in-person and online support groups, a mentor program and a directory of care providers. See http://www.postpartum.net/

GRIEF SUPPORT

The Ficks were moved when their parish held a prayer service the evening the family learned about the deaths.

“People that I didn’t even know stepped forward,” Polly Fick said. “Left things on the porch. All of the South County deanery (parishes) really stepped up to the plate. And people prayed for us.”

“We would not be sitting here right now without the support,” she said. “It’s only by the grace of God.”

CONCLUSION

Polly and Fred Frick’s willingness to publicly talk about their tragedy has led to significant new information.

As the St. Louis Post-Dispatch October 28, 2018 article titled “Following tragedy, St. Louis hospitals renew commitment to postpartum mental health” reported:

“Until recently, mental health screenings were not standard for pregnant women and new mothers even though at least 20 percent will experience depression or anxiety that can be exacerbated by hormonal surges, lack of sleep and the demands of an infant.

The screenings can be lifesaving — as many as one in five deaths of women in the postpartum period is caused by suicide.”

and in 2018, “the American College of Obstetricians and Gynecologists issued new “fourth trimester” recommendations for women’s ongoing care after childbirth, including a full assessment of their emotional well-being. The American Academy of Pediatrics also recommends depression screenings for new mothers at all of the baby’s checkups during the first six months.”

Nothing can bring back our deceased loved ones but Polly and Fred Frick are an inspiring example of how help, hope and healing can be brought out of even the most devastating tragedy.

Our “Covid” Christmas

nancyvalko Covid 19, culture, education, faith, family, law, medical ethics, vaccines

My husband and I were excitedly looking forward to finally having all our blended family members to our home for Christmas this year but Covid 19 almost ruined it. We will forever remember it as the “Covid” Christmas.

We felt fortunate that one of our families was driving to Ohio for an early Christmas with their vaccinated in-laws before driving home in time for our Christmas celebration, especially after we saw other people around the country waiting in lines for hours to get a Covid test before the holidays. We were also glad that they decided to drive when we saw thousands of airline flights delayed or cancelled because of Covid, bad weather and staffing shortages.

However, it turned out that one vaccinated in-law in Ohio attended a large rock concert a few days before the Christmas celebration. Although he showed no symptoms at the time, our youngest grandchildren started to cough and get sick on the ride home.

Early on Christmas morning, the parents were notified that the in-law now tested positive and they tried frantically to get covid tests for themselves and the grandchildren, one of whom was recently diagnosed with asthma. But there were no covid testing kits available and the pediatric emergency room near them told the parents that they could not do a covid test unless the children were admitted.

After two days, they all finally got their covid tests and were negative.

They missed the Christmas party with the other relatives but celebrated with us grandparents a few days after Christmas and it was wonderful.

HOW COULD THE DEARTH OF COVID 19 TESTS HAPPEN ON CHRISTMAS?

As I wrote in my January 7, 2021 blog “When Can We End Lockdowns for Covid 19?”:

“the FDA (food and Drug Administration) approved the use of several rapid Covid 19 tests, some that can even be done at home. This can be a gamechanger with some experts saying that the massive distribution of rapid self-tests for use in homes, schools, offices, and other public places could replace harmful sweeping lockdowns with knowledge.

And as the FDA (Food and Drug Administration) itself has reported:  

“Since March 2020, the FDA has authorized more than 400 COVID-19 tests and sample collection devices, including authorizations for rapid, OTC at-home tests. The FDA considers at-home COVID-19 diagnostic tests to be a high priority and we have continued to prioritize their review given their public health importance.” (All emphasis added)

However in a December 21, 2021 interview, President Biden was said to “express some regret that he didn’t ramp up necessary supplies before the nation got hit with yet another winter coronavirus surge” and announced a plan for the government to “distribute 500 million free rapid in-home test kits in an effort to slow the spread of the virus” and admitted  that ““I wish I had thought about ordering half a billion [tests] two months ago”.

However, as reported on December 24, 2021 at webmd.com:

“President Biden has promised Americans that 500 million coronavirus tests will be available for free, but the kits won’t arrive for several weeks or longer”

and

“the Biden administration hasn’t yet signed a contract to buy the tests, and the website to order them won’t be available until January, according to The New York Times“.

CONCLUSION

I have been writing blogs on the various aspects of the Covid 19 pandemic for almost 2 years and I am frustrated by the missteps, lack of accountability and the constantly changing rules that often seem to often be more based on politics rather than science.

We need to demand better from ourselves, our leaders and our country to become a healthier nation mentally, physically and spiritually.

My 2000 Voices Magazine Article: Who Wants a “Defective” Baby?

nancyvalko abortion, adoption, civil rights, disability, education, faith, family, law, medical ethics, prenatal testing, pro-life

This month, it was revealed that President Joe Biden “wants Congress to pass a law making abortions legal up to birth” after the US Supreme Court refused to temporarily block the Texas Heartbeat Law.

While talking to a friend about this, I remembered a 2000 Voices magazine article I wrote about why every unborn child deserves protection and she asked that I send it to her. Sadly, this magazine is no longer publishing.

This is the article I wrote that appears on my other blogsite that contains articles, op-eds, etc. that I wrote up to 2014, when I started this blog. The reflection at the end of this article was published by the National Down Syndrome Association and was-to my surprise-eventually reprinted in several other countries.

Voices Online Edition
Summer 2000
Volume XV, No. 2 – Jubilee Year

Who Wants a “Defective” Baby?

by Nancy Valko, R.N.

“Of course, no one wants to adopt a defective baby. ” This was said with much emotion (and not much charm) by an older gentleman in a class at a local university where I was speaking this past April. I had been invited to discuss the legalities and effects of Roe v. Wade from a pro-life point of view to a class of senior citizens studying the Constitution and the Supreme Court.

While several of these senior citizen students defended abortion as a matter of complete privacy for the mother, their arguments centered around the “need” for legalized abortion as a solution for social problems.

Since I had told the story of my daughter Karen, born in 1982 with Down Syndrome and a severe heart defect, the pro-abortion students were extremely vocal about the personal and societal justifications for aborting a baby like Karen. Hence the statement about no one wanting to adopt a “defective” baby.

“Happily, sir,” I told the senior student, “You are wrong. Even back when I had Karen, I found out from the National Down Syndrome Association that there was a list of people waiting to adopt a baby with Down Syndrome. Just the night before, I added, I had found a new website for matching prospective parents with children who had chromosomal and physical defects.”

The student refused to believe that this could be true.

The effects of Roe v. Wade
Life of the mother, incest, rape and fetal defect are the four hard cases usually cited to justify what has now become abortion on demand. All of these are uncommon reasons given in the estimated 1.3 million abortions every year; but the possibility of having a child with a birth defect is a common fear nearly all expectant mothers experience and, not surprisingly, polls show that the majority of the public support abortion in this circumstance.

Although I have always been pro-life, I could understand the fear underlying these poll results — until my own daughter was born.

Just two weeks before the birth of my daughter Karen, I saw a mother trying to pry her young son with Down Syndrome away from a display case at the supermarket. She looked exhausted.

“Please, Lord,” I silently prayed, “Let this baby be ok. I can handle anything but Downs.”

When Karen was born with Down Syndrome, I was stunned. But I was quickly put in touch with mothers from the Down Syndrome Association who replaced my fears with information and realistic hope.

Then a doctor told me the truly bad news. Karen had a heart defect, one so severe that it seemed inoperable and she was not expected to live more than 2 months. That certainly put things in the proper perspective.

What “pro-choice” really means
It turned out later that Karen’s heart defect was not quite as bad as originally thought and could be corrected with one open-heart surgery, but I was shocked when the cardiologist told me he would support me 100% if I decided not to agree to the surgery and allow her to die. This was especially hard to hear because, as a nurse, I knew that the doctor would have been otherwise enthusiastic about an operation offering a 90% chance of success — if my child didn’t also have Down Syndrome. Apparently, even though Karen was now a legal person according to Roe v. Wade by the fact of her birth, this non-treatment option could act as a kind of 4th trimester abortion.

It was then that I realized what pro-choice really meant: Choice says it doesn’t really matter if a particular child lives or dies. Choice says the only thing that really matters is how I feel about this child and my circumstances. I may be “Woman Hear Me Roar” in other areas according to the militant feminists, but I was not necessarily strong enough for a child like this.

I also finally figured out that Roe v. Wade’s effects went far beyond the proverbial desperate woman determined to end her pregnancy either legally or illegally. The abortion mentality had so corrupted society that it even endangered children like my Karen after birth. Too many people, like the student in Supreme Court class, unfortunately viewed Karen as a tragedy to be prevented.

Medical progress or search and destroy?
In the late 1950s, a picture of the unborn baby using sound waves became the first technique developed to provide a window to the womb. Ultrasound in recent years has been used to save countless lives by showing women that they were carrying a living human being rather than the clump of cells often referred to in abortion clinics.

But while expectant parents now routinely and proudly show ultrasound pictures of their developing baby, there is a darker side to prenatal testing. Besides ultrasound, which can show some birth defects, blood tests like AFP testing and the Triple Screen to test for neural tube defects or Down Syndrome are now becoming a routine part of prenatal care. Amniocentesis and chorionic villus sampling are also widely available tests to detect problems in the developing baby. It seems that every year, new testing techniques are tried and older ones refined in the quest to find birth defects prenatally.

97% of the time, women receive the good news that their baby seems fine; but the tests are not foolproof, and they can only test for hundreds of the thousands of known birth defects. Relatively few such birth defects can be treated in the womb at the present time. Some women want testing so that they can prepare for a child who has a birth defect, but when the tests do show a possible problem like Down Syndrome, up to 90% of women will abort.

While some hail prenatal testing as a way to prevent birth defects, the effects of such testing has led to what author Barbara Katz Rothman calls the “tentative pregnancy” in her 1993 book of the same name. Although Rothman calls herself pro-choice, her studies of women considering amniocentesis led to her conclude that such testing has changed the normal maternal-child bonding in pregnancy and the experience of motherhood, usually for the worse.

“I might not be pregnant”
I observed this firsthand several years ago when I ran into an acquaintance and congratulated her on her obvious pregnancy. I was stunned when she replied, “Don’t congratulate me yet. I might not be pregnant.”

Diane, the mother of a 5-year-old boy, went on to explain that she was awaiting the results of an amniocentesis and said, “I know what you went through with your daughter but I can’t give up my life like that. If this (the baby) is Downs, it’s gone.”

I reassured her that the test would almost surely show that her baby was ok, but I added that if the results were not what she expected I would like her to call me. I promised that I would give her any help she needed throughout the pregnancy and that my husband and I or even another couple would be willing to adopt her baby. She was surprised, as I later found out, both by my reaction and the information about adoption.

Diane gave birth to a healthy baby girl a few months later and apologized for her comments, saying that she probably would not have had an abortion anyway. But I understood her terrible anxiety. Society itself seems to have a rather schizophrenic attitude towards children with disabilities.

On one hand, people are inspired by the stories of people who have disabilities and support organizations like the Special Olympics; but, on the other hand, many people consider it almost irresponsible to bring a child with disabilities into the world to suffer when prenatal testing and abortion are so available.

But as the vast majority of parents who are either natural or adoptive parents of children with disabilities will attest, all children are born with both special gifts and special limitations. No child should be denied birth because of a disability or even a limited life expectancy.

Women who do abort after a diagnosis of a birth defect are also hurt. Besides depriving themselves of the special joys — which occur along with the difficulties — of loving and caring for such a child, these women often experience unresolved grief, guilt and second-guessing instead of the relief and peace they expect.

A few years ago, a local hospital which performs late-term abortions for birth defects asked a miscarriage and stillbirth counseling group to help with their distressed patients. The group declined, citing the fact that the most reassuring message they give grieving mothers is that there is nothing they did or didn’t do that caused the death of their babies. Obviously, that was not a statement they could make to mothers who abort. There is a very real difference between losing and terminating a child.

How many of these mothers knew before their abortions that, in practical terms, there has never been a better array of services and support for children with disabilities and their parents? Or that their children were dearly wanted by prospective adoptive parents? Such information might have been just the support they needed to choose life for their children.

Final thoughts
Despite the best medical care, my Karen died at the age of 5 and 1/2 months, but the impact of her life has lived on. At her funeral Mass, the priest talked about how this child who never walked or talked had transformed the lives of those who met her.

Especially mine.

After Karen died, I sat down and tried to put into words what Karen and all children with disabilities have to teach the rest of us. The following reflection was published in the National Down Syndrome Association newsletter in May, 1984.

THINGS NO TEACHER EVER TAUGHT
In 1982 my daughter, Karen, was born with Down Syndrome and a severe heart defect. Less than six months later she died of complications of pneumonia. Karen may have been retarded but she taught me things no teacher ever did.

Karen taught me:

That life isn’t fair — to anyone. That self-pity can be an incapacitating disease. That God is better at directing my life than I am. That there are more caring people in the world than I knew. That Down Syndrome is an inadequate description of a person. That I am not “perfect” either, just human. That asking for help and support is not a sign of weakness. That every child is truly a gift from God. That joy and pain can be equally deep. That you can never lose when you love. That every crisis contains opportunity for growth. That sometimes the victory is in trying rather than succeeding. That every person has a special purpose in life.

That I needed to worry less and celebrate more.

Sources:

1. “Prenatal Testing”, by Nancy Valko, R.N. and T. Murphy Goodwin, M.D., pamphlet, Easton Publishing Co.

2. “Doctors have prenatal test for 450 genetic diseases” by Kim Painter. USA Today, 8/15/97

3. Rothman, Barbara Katz. The Tentative Pregnancy. Revised, 1993. WW Norton and Co.

4. “Advances, and Angst, in a New Era of Ultrasound”, by Randi Hutter Epstein. New York Times. May 9, 2000.

Nancy Valko, R.N., a contributing editor for Voices, is a former president of Missouri Nurses for Life who has practiced in St. Louis for more than thirty years. An expert on life issues, Mrs. Valko writes a regular column on the subject for Voices.

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