You Can Impact How

“You can’t change what’s going to happen, but you can impact how.”

One of the most challenging-yet-rewarding, scary-yet-confidence building, aspects of seminary for me was Clinical Pastoral Education (CPE). This immersive, full-time 3-month experience in a Boston teaching hospital taught and shaped so much of all that I learned for ministry and chaplaincy. In the school classroom and study groups I learned facts and abstract about pastoral care compared to the lived reality of hand holding, fear-hearing, anger-validating, grief-witnessing on the different hospital units. That was more than 20 years ago yet there are people and moments and details and conversations still holding fresh in my mind.

The first of those transforming moments came on my second day as a CPE student. I was sent to the Diabetes Surgical Unit to see a patient who was facing amputation surgery that afternoon due to diabetes complications. She was terrified, angry, and tearful. The pre-op medication given to her to help her to relax did little, if anything, to even take the edge off her terror and anxiety. Her nurse hoped that a pastoral presence would help to ease her.

Full of book knowledge from the courses I had taken so far, I confidently headed from the chaplain’s office to the elevator. I was eager to put theory into practice, to offer comfort and calm. The confidence I had when I got onto the elevator quickly crumbled over the five-story ride.

Who did I think I was that just because I had had a few seminary classes on pastoral care that I could offer anything helpful, calming, encouraging to this woman on the worst day of her life? That was not confidence, that was arrogance. Although I got off the elevator and continued walking towards her room it took every resistance muscle to not turn around. I don’t belong here. I can’t do anything good for her, and in fact I can make it even worse. I kept walking forward but wanted to turn around and run.

As I neared her room my mouth was dry, and my mind was blank. I had absolutely no idea what to say, what to do. I said a quick, silent prayer for guidance; realizing I had been too nervous and overwhelmed to even think to do that before.

Stepping into the doorway of her room I heard words in my ear so clear and close that I turned around to see who was speaking to me, but there was no one there.

The words were spoken a second time. “You can’t change what’s going to happen, but you can impact how.”

The peace and assurance that came with those words led me through the door and to her bedside. She was curled up on her side, sobbing into her pillow. I pulled up a chair and sat beside her and took her hand in mine. Acknowledging her fear and anger, she gripped my hand tightly and began to talk.

She was so alone and so afraid. Lying in bed, waiting for the inevitable of that day, the aloneness of her thoughts was deafening. No friends or family were able to be with her as she waited and could only watch the clock. The nurses and staff were busy so peeked in the door occasionally but couldn’t stay.

She was physically and mentally prepared for life after this life-altering surgery. She had time to prepare, to mourn the loss of her leg, to ready her home. What she was overwhelmed by was not what I had anticipated hearing. She had already done so much work—spiritually, emotionally, and physically. Her fears and her tears were about the “excruciating” waiting. She just wanted someone to wait with her.

She spoke, I listened, we prayed. The amount of time we shared together was not even noticed as we were lost in it together. When it was time to leave for surgery, she was ready to go. I walked alongside her stretcher as far as was allowed.

“You can’t change what’s going to happen, but you can impact how.”

I had feared saying the wrong thing, or not saying anything that she needed to hear. What she needed though was someone to listen, not someone to speak. Silence, presence, a calming touch, was the impact she needed. In my own doubts and insecurities about offering support and care to this woman, I would have never imagined that what she needed was time, presence, and attention. We were not together to change what was going to happen, but to impact how it happened.

“You can’t change what’s going to happen, but you can impact how.”

Those amazing, guiding words still resonate within me in the world of Alzheimer’s/ dementia pastoral care, writing and teaching. They are a sacred mantra when ministering to those with memory loss and to their caregivers and loved ones.

Until there is prevention or a cure, there is nothing that can be changed for the course of the disease process. It can be slowed with some medications and there are plateaus that come as a pause, but the path keeps going on further and deeper. Impacting the path of the disease process is exactly what can be done, and it can make all the difference to everyone involved.

“You can’t change what’s going to happen, but you can impact how.”

Recognizing the gift, possibilities, and opportunities of impacting the effects, the limits, the losses, the isolation, the behaviors, the challenges, the griefs, the stressors, the hellos and goodbyes are indeed the comfort of spirituality for those who live in the world of dementia.

Anyone who loves, who care for, someone living with a memory loss illness, can impact how the path is traveled. Finding education and support is as ongoing as the illness. Each stage, each change along the way, can be impacted in ways that are positive or negative. Reaching up and out for support, knowledge, insight, and practical tips makes all the difference in how the path is traveled and how the journey ends. Each experience, each path, each journey, is as unique as the travelers. There are diverse needs, wants, hopes, perceptions and expectations.

On the days that are hard, long tedious, or overwhelming and everything feels to be beyond your control, or the times that you are grieving the losses of your loved one as the memory loss disease progresses, there is the hope and comfort in the knowledge that you have control over the impact. On a journey with a decline and process that has no cure, there is such hope, strength, and encouragement in knowing that there is a positive influence in your control.

Perhaps the impact you make comes from knowing a favorite song or food or activity that is the perfect distraction on a difficult day. Perhaps the impact comes because you are sensitive to particular triggers around mealtimes, showers or situations that could quickly being overwhelming. Perhaps the impact you make comes as inspiration and creativity because you are open to unexpected possibilities and aha moments. Perhaps the impact you make is not for the person in your care but for your own needs and wants as a caregiver.

You can’t change what’s going to happen, but you can impact how. That is my hope and wish for you. This disease can unfold over quite a long journey, yet with knowledge, planning, and support, you can affect and influence what that journey will be like for you and your loved one. May the ways you discover how you can impact what is going to happen be ways that bring hope and comfort as they sustain you on this journey.