Getting Ready for the End

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

Back before Christmas, you may recall that Janet decided that she was tired of fighting and wanted, to go be with God. However, our son and his family visited over Christmas and that visit has been like a tonic for her. As things sit right now, her attitude is much better and she is wanting to resume PT — all good stuff. But having said that, she is still basically living on yogurt. We have tried a few other things, but the result is always the same: choking.

So for now, things are better, but as with most things related to HD, “better” is always a relative term that can change at any moment. So I’m enjoying the present respite and refusing to worry about the disease’s next phase — I’ll worry about that when it gets here…


In the past, I have written about the process of letting go that a family goes through, and let’s be honest, the final stage in this process — physical death — is going to be traumatic enough without needing to worry about (for the lack of a better term) the logistics of dying. Please note that several of the things we’ll be covering could have legal implications depending on where you live. One of the things that has surprised me about this blog is how far it has reached. As I sit here writing, the blog has been accessed from more than 30 countries. For this reason, I have no way of knowing what local requirements might exist in your local jurisdiction. So please check with appropriate authorities for what legal requirements you might need to satisfy.

Much of what we are going to be talking about falls under the heading of End of Life Planning or Final Arrangements. Hence, the first important point to make is: Do not wait for the “End of Life” to formulate your End of Life plan! In an ideal world, spouses should have addressed at least some of these issues as soon as they were married, but when you are young and are convinced that you live forever, matters like these are often avoided because it can be uncomfortable to consider your own mortality. If you have been in the group just, “kicking the can down the road”, it stops now. There’s no road left.

The matter is especially urgent if your loved one has, or has just been diagnosed with, a degenerative condition like Huntington’s, Parkinson’s or Alzheimer’s. For much of this planning, you are going to need their input which means that you need to be discussing these matters while your loved one still has the mental capacity to communicate their thoughts and desires. For example, if your loved one is nonverbal and not eating, that is not the time to be trying to figure out whether they would want a feeding tube.

Maybe it was because we were older when we got married, or more likely this is just who Janet is, while we were still dating she and I talked about issues like what level of life support we desired in the case of a catastrophic illness or accident. Most young couples discussed wedding plans over candle-lit dinners, we discussed the pros and cons of feeding tubes and ventilators.

It is important to note that while you don’t have to agree on everything, you do need to know what your spouse wants for him/herself. Whether you are legally assigned as their medical power-of-attorney (MPOA) or just recognized as the “next-of-kin” you have, at the very least, an ethical responsibility to speak for them and not insert your own wishes into the process. When making these arrangements, you can discuss, advise and counsel, but at the end of the day, it is their life and (right or wrong) it is their decision to make.

The other thing you have to decide is what happens after they die. Ever since Janet discovered that she did not have Hepatitis as a baby (long story) she has wanted to be an organ donor and so has been signed up for years. However, a couple years ago we realized that the exact circumstances of her death could compromise her organs for use in transplants. Therefore, as a backup plan, she made arrangements to donate her whole body the McGovern Medical School at the University of Texas to help train future doctors. Alternatively, if your loved one wants a traditional burial or cremation service, now is the time to make those arrangements and, if possible, make pre-need payment arrangements.

Next, the surviving family — and the caregiver in particular — need to be thinking about how they want to spend their time the day that their loved one dies. Do they want to spend the day:

  1. Praying, crying together and consoling one another
  2. Running around the house like a crazy person looking for phone numbers and legal papers

Obviously, Option A is preferable, so now is the time to be making that day possible. First, you need to know what actions will need to be taken, and who needs to take them. I spent a chunk of time while I was in the Air Force flying with “The Peacemakers” the Strategic Air Command, or SAC. One of the things that SAC loved was checklist, because checklists are a great way to make sure everything that needs to happen, does. When the stuff starts hitting the fan in a serious way (whether it is World War 3 starting, or your wife dying), it can be easy to get emotionally overwhelmed. The checklist provides a point of focus and a list of things that you can do to manage the situation.

To create your checklist go back over your arrangements and decide what things need to be done, the order on which they need to be done and who is responsible for doing each of them.

For Janet, if she dies at home we know that the number for hospice as our first call. They will, in turn, contact the organ donation folks and the medical school to determine the final disposition of Janet’s body. Next, we have a list of family members that we need to contact as well as our pastor and a couple folks from church. By the way, that contact list includes an item to update this blog with a notice that I have it written. All I need to do is fill in the date and time, and post it. If it sounds strange that I would get online at a time like this, well, regardless of which of the 30+ countries you live in, you all are family too, so I want you to know. Finally, there are the legal calls to the life insurance company, social security, and the state agency that is providing disability services for Frannie. She has learning disabilities and her mother dying impacts (in a good way) the services that she can get.

The second thing you can prepare ahead of time is a binder containing all your legal documents to include: Will, hard copies of the MPOA paperwork, insurance papers, birth certificate, an up-to-date list of the medications they were taking, and so on. If you are working with a hospice organization, they can advise you on what you should have available. Note that this binder can also come in handy if the need ever arises for you to bug-out fast due to a fire or natural emergency.

Finally, and I can’t stress this point strongly enough, make sure everyone in the immediate family understands the arrangements that you have made ahead of time. You don’t need the added drama of someone getting angry because they didn’t understand the plan. Remember also that when “The Day” finally comes, people (including you) can express what they are feeling in a variety of ways. Some may get busy “doing stuff”, some may pray quietly, some may wander around aimlessly, some will want to sleep, and some may develop a sudden urge to play a video game or watch an absurd, pointless program on television. And some, remembering a past incident or hurt that the disease caused, may want to get angry and yell.

Try to organize sufficient family time combined with times that let everyone process as they need, as long as their behavior isn’t disruptive to the others. When there are disagreements, try to remember the real reason for the upset probably has nothing to do with what the argument is about. Rather, it’s because you all have just lost someone that was part of your life.

So, how about an 11th commandment: “Thou shalt cut each other some slack.”

In Christ, Amen ☩


A prayer for when you are preparing for The Day…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for Your wisdom and care. But today I want to bless you especially for the promised eternal life that You have waiting for {The name of the person for whom preparations are being made.}. As I work to complete the preparations for their trip home to You, give me wisdom to make the right decisions, and when the day comes for their departure, please fill out home with your holy angels to soothe old wounds and to remind us of the reunion that lies ahead. Amen”

Reaching Further Out, #2

One of the things that I have recognized the need for is a place to expand the scope of what the blog talks about by adding supplementary posts covering other material that is related to the weekly updates, but which don’t fit well into those conversations.
This is one of those additions.

I had not originally planned to have a follow-up for last Sunday’s regular post, but earlier this week I read something online that changed my plans. What I saw was a Facebook post from Corrie Harris on an HD support forum. It was so good and to-the-point that I knew I had to give her words broader exposure. So here they are. I have touched up the formatting a bit, and fixed a couple misspelled words, but the heart, love and message are all Corrie’s:

In Christ, Amen ☩


01/04/2020 00:40

So, I have been contemplating whether or not to type this out and hit the send button — or just not post and continue to suck it up.

There is a scripture that says, “…Rejoice with those who rejoice and weep with those who weep…” I don’t know how many years I’ve been on the Huntington’s support group pages and have known each of you, but I have known a few of you for over 5 years, all online. We get close because we are all going through similar things. You were and still are my ONLY support. My only cheerleaders. The only place I go when I want to vent or rejoice. Until about 18 months ago, most of my time online was spent either in questions, research, agony, complaining, or being stressed out of my mind by my husband Richard’s HD symptoms and new-found personality.

Many of you have been there for me and I will always appreciate each one of you for that. Your presence reassured me that I was not alone in my pain. But now, with thanks to God, a better HD team, better meds for Richard, and an absolute change in my own attitude and heart, that season has melded into a new one. I see my husband, and the marriage covenant in general, differently. Things are now in the “happy” and “going good” zone, but I still feel a little alone here in my JOY.

I think it has bothered me for a while, but I couldn’t put the exact words to the emotions I was feeling — now I think I understand. I realize that reading a post saying, “I’m having a good day.” can be hard to read when things are falling apart in your own life. I know how hard that can be because I have been on the other end of that relationship!

But, I now realize that the JOY and the good times, days and moments are equally as important to share, so we can rejoice with and encourage each other. Frankly, too many caregivers suffer alone and die early deaths because in the end they are undone by the disease they are fighting. Without encouragement, the tragedy, heartache, anger and pain of this disease sucks the life out of us.

A spirit of complaining and drudgery does NOT help any of us. In fact, it kills us, and it kills our families. It makes it such that our children never want to come home for the holidays or even to visit. I have not handled all of these things well in the past, so I guess more than anything I am just wanting to say that we need to celebrate each other as much as possible, and to not forget that laughter and joy is excellent medicine. Love is a healer and hope gives LIFE.

I have avoided this group for a bit because (as I said before) I was feeling isolated due to how well things were going. But now I’m back and I’m putting out these honest thoughts in hopes that I can help to build an authentic community that is healthy and helps to produce life-giving and long-lasting friendships. This disease is brutal and we all need friends, especially friends that understand.

By the way, I celebrated our 32nd wedding anniversary today by posting the news on Facebook. Richard saw the post and liked it, but there was no other response. I haven’t had a gift, a card or even a real hug in nearly 5 years. Richard can no longer provide those things, and that breaks my heart. For many years I was selfish and angry and could not see the difference between the HD and him, but now I do. Lord, have mercy on me for when I didn’t! Richard would love me back if he could. I know it.

Corina


A prayer for when you are having a moment of clarity…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for the clarity that you bring to my life. But today, I want to especially bless you for the clarity of understanding that I now have, as fleeting as it may be. In scripture, you told Abraham and his descendants to set up monuments or institute holy days so they will remember Your goodness and blessings. Lord, please be a living monument in my heart. Never let me forget the lessons that I have learned, or the perspective on life that you have brought me. Amen”

Which Way is Up?

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

Resuming where we left off last week…

Even though Janet and I read together all the information on the web about HD, in the beginning I have to admit that I didn’t really grasp the significance of the disease. For several years, it really wasn’t too bad – in hindsight at least. At the time, of course, I was confused and had no idea how to deal with what was happening. Neither could I imagine what was coming.

Then one day all semblance of a normal marriage relationship went out the window as she got angry and started yelling that I was trying to drag her “down to hell” by sleeping in the same bed with her. Although it had been years since we had been “intimate”, she was suddenly concerned that I was divorced.

To make matters worse, she has began to experience something called perseveration. This symptom causes her mind would get stuck on an idea and she can’t let it go. One time she asked me if I had paid the rent 7 or 8 times over the course of an hour. Each time I answered that I had, and she accepted the answer – but only for 5 minutes or so and then she’d ask again.

But even as she got sicker and sicker, I tried to maintain the relationship with Janet as an anchor, a reference point of stability. One of the interesting dynamics in our marriage was that, as a math teacher, she was always very organized and believed in taking life one, carefully planned, step at a time. For myself, on the other hand, my personal motto has always been: “Just get started, inspiration will come!” Together, we had always made the differences work, but if she was no longer the smart, capable, organized and rational half of our team, what was left? And who was I?

As I write this, I am realizing how appropriate the image of an anchor truly is. Unfortunately, the anchor that I have counted on for so long is losing its hold on reality, and I feel adrift and rudderless. At times, I feel as though I don’t even understand my own mind, feelings or needs. Even as Janet’s anger becomes violent producing bruises on my chest and arms, I instinctively tell myself that despite what the doctors say, she really is OK – she HAS to be OK – so I must be the crazy one. Is this part of the grieving: resisting letting go of what was?

I know that it certainly ties into my fear of being alone. Looking back, I realize now how much of my life has been driven by that fundamental fear – and yet here I am again, facing a future of TV dinners and cold beds. In popular culture, there is the image of the crazy “cat lady” who lives as a recluse, alone with her 90 cats.

I wonder what the male equivalent (who doesn’t like cats) would be?


Irrespective of whether you are on the path of grief yourself, or are witnessing someone else’s struggles, there is one thing that you need to grasp up front. It’s very easy to underestimate the power and range of grief. For example, it is possible to grieve for many things: a lost loved one, a lost career, lost youth, and so on. Likewise, grief is not simply feeling “sad” over the loss of someone or something, grief is no mere emotion. True grief shakes the mourner’s world to its very core because it calls into question their most basic assumptions about themselves and the world in which they live. Ironically, love can have the same effect, but whereas love calls us to reevaluate ourselves in relationship to others, grief highlights our isolation.

The next important point is that the opposite of “grief” is not “faith”. If the mourner is a Christian, one of the hurdles that they may have to get over is the idea that their pain means there is something wrong with them spiritually. They may think, “If I just had more faith, then I wouldn’t be feeling this way.” In response, they may go out and read books and inspirational tracts in an effort to force themselves to be more “faithful”. Unfortunately, such self-powered efforts almost fail because they are based on the faulty assumption that faith is something that I can generate on my own – all I have to do is grit my teeth hard enough.

The truth, however, is that faith is not human-generated. As Paul points out concerning faith in his letter to the Ephesians, “…it is not of ourselves; it is the gift of God…”. The bigger problem, though, is that the whole premise is flawed because grief is not even about a lack of faith. To see this, consider the story of Jesus at the tomb of Lazarus, and the one bible verse that every Sunday School kid learns by heart: “Jesus wept.” Regardless of how you interpret Jesus’ tears, Jesus could not (by definition) be faithless. His grief was a very real, very authentic part of His humanity, and so is ours.

For myself, the basic problem at this stage of our journey, was that I needed Janet to be healthy more than I needed me to be healthy. After more than 30 years together, I only recognized myself as part of that relationship, that marriage. I was scared witless that when she died, I would in some way disappear too. I felt alone and disconnected. Even in church, I often felt like the odd man out because the people who were paying attention and saw my pain often just sat with their hands folded hoping I wouldn’t look at them. Rare was the week where I didn’t break down in tears during the worship service.

Please don’t get me wrong, the people in the church I attend are not bad, heartless people. Like all the folks sitting in all the pews of all the churches in all the world, they are imperfect people saved by grace. They just didn’t know what to do, so out of fear for doing the wrong thing, they did nothing. Which, ironically, is the only thing worse than doing the wrong thing.

Still, sometimes I did get the support I needed. One Sunday was particularly hard and as usual I was crying quietly, when suddenly I felt arms wrap around my shoulders. The lady sitting behind me had seen my upset and reached over the back of the pew, put her arms around me and just held me for about 5 minutes until the tears stopped. She never tried to cheer me up or verbally reassure me. In fact, she never spoke at all: words weren’t needed.

Thinking back on that incident and others, I’ve come to realize what people that are grieving really need. Hint: it’s not the stuff you read if you try Googling, “How to comfort the grieving”. The problem with the advice that you get from sites written by psychological experts is that they concentrate on giving you lists of things to say and not to say. However, the result is that if you follow that advice you end up sounding like a “psychological expert” and not yourself.

When someone is grieving openly in church or elsewhere, they are expressing an openness that is seldom seen in other situations. They have given up all pretext of maintaining composure or proper public decorum and their inner emotional state is on display for the whole world to see. What they need, more than anything, is for the people with whom they interact to show the same level of openness. Or to put it another way, they are crying from their heart, so they need you to be reaching out to them from your heart. (Please read this paragraph again.)

One of the most wonderful examples of this type of expression was my oldest daughter when she was a toddler. If she saw someone crying in church, she would go and climb up on the pew next to them, take their hand and cry with them. At that age, she didn’t understand why the person was crying, but she didn’t need to. Many times that simple act opened up the person so they could start talking about their pain – the first step in healing.

The real name for this type of expression is “authenticity”. Speaking from personal experience, I can assure you that people who are grieving have enough on their plate that we don’t have the energy to try and figure out right and wrong. Thankfully, being authentic isn’t that complicated, just look into your heart and say or do what you find that God has put there.

And don’t sweat saying the wrong thing. I would rather hear one statement that didn’t come out “quite right” but was said from the heart, than a 1000 psychologist-approved platitudes that you don’t mean.

In Christ, Amen ☩


A prayer for when you aren’t sure what is real or true…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for who You are. But today I especially want to bless You for being real. Sometimes the world seems so full of inauthentic people and situations that I feel like I’m lost in a carnival fun-house. So, thank you for the people in my life who are willing to reach out and feed my soul from the bounty that you provide. And when I am unsure and don’t know which way to turn, please remind me that I can always depend on you. Amen”

How We Got Here…

This post describes, in part, the effects of a degenerative neurological condition called Huntington’s Disease. Any negative behavior on the part of my wife should be attributed to that condition. Any negative behavior on the part of myself should be attributed to my need for God’s ongoing grace.

My wife Janet and I were married in 1985, and for many years, things were good – which for me was a welcome change of pace. Before I met Jan, I was married and divorced two other times. Someday I may talk about those experiences, but for now we’ll start in 1985 when things were going right. While it was true that we had to move for work more than I would have liked, on the whole, life was good.

Before you knew it, we were well on our way to our “happily ever after”. I had a good job in Ohio, we owned a house, and had two kids (one boy and one girl), a dog and two cats. Then one sunny morning in September 2011, things changed. As a result of 911, my job went away and the only work I could find was in Lexington, Kentucky. This is important because we decided in order to keep the kids in school, I would take an apartment in Kentucky and drive home on weekends. Consequently, I didn’t recognize the changes in Janet for a long time.

All I saw at first was small stuff. Her temper got shorter and she started forgetting things, but the temper wasn’t that bad and we were both getting older. Who doesn’t have “senior moments”? Unknown to me, our son was catching the brunt of the problems. During the week when I wasn’t there, the arguments were getting increasingly irrational, and she would at times be incredibly demanding, insisting that things be done in exactly one way. Plus if Janet asked you a question twice and you didn’t answer it both times using the exact same words, you were, “…changing your story…” and obviously lying.

By this time, doctors were getting involved because Janet had also developed a thyroid condition and (due to the thyroid problem) sleep apnea. In addition, the HD also beginning to cause physical symptoms, like her legs wouldn’t stop bouncing. The Ohio doctors guessed a lot about what the problem could be – some said it was RLS (Restless Leg Syndrome), others said that it was something else. To tell the truth, nobody knew what was going on – maybe that’s why it’s called a medical “practice”.

Eventually, I got a permanent job in Pennsylvania. Because our son had graduated high school that fall, he left for college and the remaining three of us moved on to PA. But by then, the physical problems were getting worse to include choking on food and occasionally biting her tongue.

We eventually discovered the truth when we went and saw a neurologist in Pennsylvania. After running dozens of tests and having them all came back negative, he told us that there was one more disease that we should check. He said it was called Huntington’s Disease and that it was a degenerative neurological condition. He said we should go home and look it up online before deciding to take the test. Through our research we discovered that HD has no cure, is 100% fatal and (to top things off) is hereditary so both our kids could be at risk. We also learned that the average lifespan of a patient after diagnosis was about 15 years.

In the end, we decided to go with the test – which came back positive. That diagnosis was 11 years ago.


My name is Michael Porter, and that was the beginning of Janet and I’s new road together. Along with the medical changes came realizations that nothing was going to be the way we had planned. No golden years growing old together, no travelling to visit the grand kids – nothing. It was like our entire future had been stolen from us in a moment.

A while later, our son became engaged to a beautiful young woman from Texas. When my future daughter-in-law heard that I had done a little preaching in church, she asked if I would be willing to share a short message at their wedding. I said yes, and began considering what I wanted to say. They were getting married on a Saturday, but not just any Saturday. They were getting married the day before Palm Sunday.

As I read the gospel text for Palm Sunday (Jesus’ triumphant entry into Jerusalem) I was struck by that situation’s similarity to a wedding party. In both cases, there were revelers galore. Moreover, these party goers were all convinced that they absolutely knew what the outcome was going to be. The joyous crowds on that long-ago day in Jerusalem knew that Roman oppression was soon to be a thing of the past; and on October 20th of 1985 my new wife and I knew that we would be together forever – except we were all wrong.

So this is basically what I shared at our son’s wedding: At times like this we happily make plans and promise the future, but the fact of the matter is that the future is not ours to promise. Reality can intrude on our hopes and dreams in the form of illness, death and disappointment. In 33 AD Jerusalem, reality took the form of Good Friday crushing the hopes of political liberation but opening the way for Easter and a far greater liberation than the mere overthrow of Rome. In the same way, we have the promise of Easter that when our hopes and dreams fail, it is because God is brushing them aside to make room for something better.

After the service, the responses to my message were rather muted to say the least. It was, after all, not your typical marriage sermon. It wasn’t happy and uplifting, there were no hearts and flowers, and the new couple’s “sweet forever” was never mentioned. Our new daughter-in-law summed up the thoughts of many when she described it as, “…sort of a downer…”. However, I got a very different response from many others, specifically long-time married couples. As one old gentleman who had been married to his sweetheart for 55 years said, “About damned time somebody told these youngsters what they really needed to hear!”

Often when we hear the word of God being spoken from a pulpit we feel that the preacher has, through study and prayer, acquired some divine understanding of scripture that they are now sharing with us. While that sort of sermon does from time to time appear, the truth is often messier. Thanks to the Holy Spirit, the words that are spoken are often not the same as the words that were written. So in the end, the preacher often needs to hear the message too. Such was the case for Janet and I. Our wedding hopes were lying in shattered pieces on the floor, we needed to hear that God was making room for something better. We needed to learn a new kind of faith – a faith not that the future we have planned will come to fruition, but a faith based on the proposition that we have no idea what the future will hold, but that it will still be OK. We needed to have faith that something was being prepared, even though we had no idea what it was.

In Christ, Amen ☩


A prayer for days when you can’t see the way ahead…

“Blessed are You, Lord God, King of the Universe. It is right that I should at all times and in all circumstances bless You for Your many gifts, but too often I only thank you for what I know and understand. The truth is that even when I don’t understand the involvement of your hand in my affairs, I can know that your will is there working for my good. Even when I am blind to the blessings that you are preparing for me, I can know that the preparations continue. So I ask you God not to show me your hand, or reveal your hidden blessings. Rather, I pray for the faith to trust in you even when I can’t even begin to comprehend what you are doing. Amen”