The Practice of Vipassana Meditation vs. Care Partnering for a Person with Alzheimer’s

Lax Kenia, a college friend from India, visited me and Sumi at our home in Michigan in November 2018. A few days later I went to Costa Rica with him, six other college friends, and their wives. Lax has been an accomplished Vipassana meditation practitioner for many years.

I recently learned the meaning of Vipassana, which is a Buddhist meditation practice. It’s a compound Sanskrit word of Vi, short for Vishesh and means special or distinguished, and Paśyanā, meaning insight. Putting it together, Vipassana means looking for ‘special insight’ into the true nature of reality or truth. Practitioners learn to develop a clear awareness of exactly what is happening while it happens.

A month after our trip to Costa Rica, in December of 2018, Lax went for a demanding thirty-day Vipassana retreat in Mumbai, India. Every day for him was filled with rigorous meditation sessions that started at 4:00 am. For the entire thirty days he could not speak with his fellow practitioners, use sign language, or gestures. Lax wrote about his experience and his article was published in the March issue of a Gujarati language magazine in Mumbai called Prabudh Jeevan, which translates to Awakened Life. I enjoyed reading Lax’s concise and well-written narration and got a great deal of insight into the practice, process, and expected benefits of Vipassana meditations.

Lax’s article led me to reflect on the main goals of Vipassana, namely, cultivating morality, Samavṛtti (equanimity), and mindfulness to live in the present. Now, one can voluntarily achieve these goals by arduous and voluntary practice. Or, one is thrust into practicing them, as I have been as Sumi’s care partner.

Every minute of caregiving I am faced with challenges to maintain my Samavṛtti, mindfulness, and live in the present. In situations where Sumi’s behavior is difficult from anxiety, anger, aggression, or apathy I have to figure out how to soothe and calm her. If I get angry or frustrated it creates more anger and aggression in her. So, cognitively, I have to practice equanimity and mindfulness by being attuned to every detail throughout the day, which is watching ‘what is happening while it happens.’ May it be waking Sumi up, showering her, toileting, cleaning, dressing, preparing her meals, or feeding her. I have found that I am learning the goals of Vipassana not by choice but by being forced into it.

Furthermore, by practicing Vipassana one learns to tame three poisonous vices: greed, anger, and ignorance. To do this one must turn them into positive energies, such as: greed into generosity, anger into compassion, and ignorance into wisdom.

Greed is not necessarily related to hoarding money or hedonistic possessions. Greed can be about your time and self-indulgences. When I am taking care of Sumi I turn my greed of self-centeredness into generosity by devoting my time for doing many helpful things for her safety, hygiene, and well-being—I have to think about her first to ensure she is okay. And when she is okay, I am okay too. It’s like a mother-child relationship! This increased awareness from a ‘me first’ mindset to a ‘you first’ mindset has made Sumi’s and my lives easier. Once I became a care partner with a ‘you first’ mindset, I developed empathy for everyone I interact with.

In regard to anger, there are many occasions where I get frustrated and angry while taking care of Sumi. But slowly and steadily I have learned to turn these feelings into compassion. I have to be mindful that when Sumi is difficult it is not her but the disease and when she smiles it is not the disease but her true self.

And it is interesting to note that ignorance is not being turned into knowledge, as there is a big difference between knowledge and wisdom. Knowledge can become self-righteousness, whereas wisdom can be more forgiving, more encompassing.
 
As shown below, one way to understand wisdom is that it is a combination of knowledge, experience, natural and nurtured skills, contemplation, and self-insight.

Wisdom is gained by self-insight and self-analysis. And being willing to learn and cultivate personal growth by acquiring new skills and making new relationships and new friendships. Learning to recognize a ‘sense of proportion,’ like essential vs. frivolous or control the controllable and manage the uncontrollable. Also, to look at life differently and understand that priorities and values, including our own, are not absolute. Wisdom is aided by developing an awareness of life’s ambiguities such as poor health, traumatic events, calamities, etc. and by increasing gratitude and acceptance. I found reading exhaustively on the subject of Alzheimer’s disease and listening more, in general, helped too.

I am reminded of the Indian epic Mahabharata. If you are not familiar with the story it goes like this:

Dronacharya, a royal guru and maser of military arts, was restricted to only teach members of the royal family. He gave Arjun, a royal, formal archery training but when Eklavya, a non-royal, asked for training Dronacharya had to refuse him. Rather than feeling dejected, Eklavya decided to learn archery on his own. He created a statue of Dronacharya and resolutely practiced archery in front of the statue. Over time he became an accomplished archer—even better than Arjun.

Just as Eklavya received inspiration from Dronacharya’s statue, I have received inspiration to practice a reversed form of Vipassana from Sumi.

I say a reversed form of Vipassana because a true Vipassana practitioner first develops mindfulness and insight in order to gain compassion which would potentially make them a good caregiver. This is shown in the diagram below:

But for me, as a care partner, I am starting in reverse. Being thrust into becoming Sumi’s care partner has taught me compassion which has led to my self-insights which can develop into mindfulness. See the diagram below:
 
This reversed process can even be extended to Mother Theresa in India. She became the ultimate caregiver to the sick and dying and gave them dignity in their death.

In my reversed process I may never achieve the level of special mindfulness and insight attained by Vipassana practitioners. However, our ultimate goals are the same even though we are approaching them from two different directions—like two sides of the same coin!

P.S. Someday, I would like to meet an accomplished Vipassana meditation practitioner who has a spouse with Alzheimer’s disease. I’d like to understand how formal training in Vipassana meditation has helped them be a good care partner.