SOUL FRIEND
Anam Chara offers residents, caregivers insight on cycle of life

JIM SHEELER

Beatrice Tufford's 101-year-old body lies underneath a portrait of her late husband, illuminated only by flickering candle flame. Her mouth is half-open. Her eyes are closed. The window above her is open. The room is cold. A pink rose lies on her chest. It is beginning to wither. "I remember the first time I was alone with a dead body," says Peggy Quinn, speaking in a near-whisper. "It was scary to me, because I didn't know what to expect. I didn't know if there would be an odor. I didn't know if it would look strange after time. "That experience really changed me, because I saw how beautiful the natural body is. They can even grow younger." She strokes Tufford's wiry gray hair. "Many times, I've seen them grow younger and younger.”

Three Days

Sheets of dry ice are positioned underneath the body; the bed sheets are chilled by the winter air. A quilt covers Tufford's body up to her neck. The unseen dry ice will preserve the body over the next three days, as dozens of people visit for the last time the woman they all called "Bea." For some of Bea's friends, it will be their first time alone with a dead body. For others, Bea will be one of hundreds of people to whom they've said goodbye. For all of them, it will be a farewell for which they've been preparing. Inside this small house in North Boulder, as in many traditional nursing homes, death is anticipated.

In this place called Anam Chara, death is embraced.

Wandering, not lost

Beatrice Tufford was found a few years ago, walking aimlessly, without shoes or a coat, on Colfax Avenue in Denver.Classified as a "wanderer," Bea was placed in a locked ward in a Denver hospital. Nearly 100 years old, she had outlived her immediate family, and had nowhere to go. So she wandered.If anyone asked, Bea would describe in detail her life story; how her family moved to Boulder at the turn of the century, traveling in a horse-drawn carriage. She would tell of the grand picnics at Chautauqua. When prompted, Bea loved to tell stories of running up to the edge of the fence of her Boulder farm, where all the kids would gather to marvel at those new gasoline-powered contraptions "going boom boom boom" down the dirt road. She always smiled when she told of "the miracle of Boulder" -- how the mountain air cured her brother's asthma."Yup," she would say in her always polite, true-West drawl. "We had a soft spot in our heart for Boulder." She pronounced the town's name "Bowl-duh."Over a plate of her favorite foods -- fried chicken and vanilla ice cream -- Bea would talk about her 40-plus years working as a secretary for Union Pacific railroad. She also would tell of meeting her future husband across the fence at Boulder's Pioneer Cemetery, and burying him 62 years later. These stories -- as they are so often -- likely would have gone untold. They were stories Peggy Quinn wanted to hear.

Unlocking wisdom

As a registered medical technologist at St. Joseph Hospital for 16 years, Quinn saw death almost every day. "Death in the hospital for me was horrible," she said. "Whenever someone died, they would just pull the sheet over the head and say, 'Shhhhh.' That was it." After watching her mother die in a hospital, Quinn began looking for alternatives for people facing the end of their lives. Instead of covering up the bodies, Quinn looked for a way to uncover the often unspoken wisdom of the dying. In 1992, Quinn opened a nonprofit, eight-bed home care house in Denver and dubbed it Anam Chara. In 1997, Quinn opened the second Anam Chara home, a 10-bed facility at 1795 Quince Ave. in Boulder. Some of the residents of the Denver home, including then-100-year-old Beatrice Tufford, were transferred to the Boulder house.Translated from Gaelic, Anam Chara means "Soul Friend." At the Anam Chara homes in Boulder and Denver, Quinn and her staff say they take the translation literally. Death is discussed in the open. Funerals are held in the living room. Residents are remembered long after their hearts stop beating. "When I started studying medicine, I was going to find the cure for cancer," Quinn said. "Maybe I have. "The cure is how you die."

Bea's Long Night
Just over a week before Beatrice Tufford's death, on a moonless night, Peggy Quinn curled up on the living room floor at Anam Chara, making her bed of the yellow foam egg-crate material that lines the mattresses of the elderly residents.
At 4 a.m., she was awakened by shouts. "Peg-gy! Peg-gy!" the cry came over the makeshift intercom system. Upon racing up the stairs and opening the door, she found Bea in another room, in another reality."You tell that slumgullion I don't steal things!" Bea shouted at nobody, her eyes unfocused. "He said I took that little girl's dress off the clothesline. Well, I don't steal clothes off'n poor people because I'm poor, too!" Quinn recognized Bea's face. She had seen it many times before. As people get closer to death, they often have visions, seeing angels, talking with dead friends and parents. In Bea's case, Quinn reasoned the woman's mind was trying to resolve an incident that may have occurred when she was a child. "We know you would never steal anything, Bea!" Quinn shouted in Bea's good ear. "You don't worry!" After much convincing, the 101-year-old was back in bed, drifting off, her chest rising and falling slowly. From the back of her throat emanated an eerie, soft, popping sound -- a sort of human static.It's a sound caregivers know well. They call it the death rattle. If that sound were to stop, there would be no application of cardiopulmonary resuscitation; most of the residents at Anam Chara expect to die there, and few of them want to be hooked up to a respirator. "It's the quality of life that we care about," Quinn said, "not the quantity." Suddenly, Bea began to sneeze; a frightening sight for a 101-year-old. She sat up in bed, taking a deep breath, and sneezed again, shaking her whole body. She took another deep breath in anticipation, and closed her eyes. After a few seconds on the verge of sneezing again, she paused, and smiled. "That one stayed where it belongs," she said, thumping her chest.
The old Bea was back."I'd like a donut and a nice big cup of coffee," she said.

Alternative care
Instead of smelling like an antiseptic nursing home, whiffs of lavender drift through Anam Chara. A tiny machine in the corner vaporizes the flower oil into the air. Though most residents are overseen by traditional physicians who make house calls to the home, the patients' daily maintenance is decidedly alternative. Many receive regular massages. Some of the caregivers practice aromatherapy, herbal and ancient healing methods. At the same time, most of the patients take prescription pharmaceuticals. "We work in conjunction with doctors," Quinn said. "In Anam Chara, we work in such a way where we can have doctors come here, and other support teams around them, so that we don't put them in a nursing home." Some independent medical personnel who have patients at the house say the model has its merits. "Here, the patients seem to need a lot less medication, and I think a lot of it has to do with the extra attention," said Anne-Marie Gordon-Leon, a registered nurse who works with Hospice of Boulder County and Colorado Home Care. "In a nursing home, the staff isn't telling the patients they love them. (At big institutions), there's compassion, but it's not the same level of caring." By working in collaboration with Hospice of Boulder County, Anam Chara aims to help people who cannot live alone die in a place that feels like home. "What they're doing is very compatible with the hospice philosophy," said Connie Holden, executive director of Hospice of Boulder County. "We want aging and dying to be seen as part of the life cycle, not something to be feared, but something to be enhanced." Because of the nonprofit's shoestring budget, the Anam Chara homes lack some of the amenities of other nursing homes and assisted-living facilities. But according to Barbara Scholten, a registered nurse who has worked with Anam Chara patients for the past three years, the staff at Anam Chara makes up the difference where it counts. "I go into some beautiful homes, homes with beautiful furniture, expensive carpets, and most of the people there are just sitting around watching TV," Scholten said. "Anam Chara isn't that way. It's not always pretty to look at on the inside, but here, they care for the people. They really care for the patient. The care that those people get is unbelievable. It's not just the physical, it's the spiritual. I like that place."

Making Time
In the Anam Chara kitchen, Kert Hubin prepared breakfast. On the refrigerator, somebody had hung a picture of a rainbow, clipped from a newspaper.
"What led me here? Death, actually," Hubin said. Like many caregivers at Anam Chara, Hubin is working as part of an internship in gerontology and long-term care management at the Naropa Institute. "Old people are sort of pushed to the side in this society, because nobody wants to deal with aging," Hubin said. "Also, in dealing with the elderly, you have to learn to deal with your own mortality, and nobody wants to do that." The group of volunteers and paid staff at Anam Chara spend hours sitting with the home's residents. They give massages, they work crafts, some of them even sing and play instruments. Most importantly, perhaps, they take the time to listen. "In today's society, nobody wants to slow down, and when you get old, by nature you slow down," Hubin said. "Most people can't handle it. They come into a setting like this and ... maybe it's the same reason people have trouble sitting through church services, or classical music, or funerals. "You've got to respect the emptiness."

All Prayers
A few nights before Bea's death, Quinn held her hands as the two prayed together."Hail Mary, full of grace. Holy Mary, pray for sinners, now and at the time of our death ... " The two said the prayers they've both known since childhood. Later that night, Quinn would sit with another patient, joining in on Buddhist chants. She also knows Jewish prayers. At the home, seemingly every religious holiday imaginable is celebrated, and pieces of all religions are borrowed and assimilated into daily life. "It's all about the spirituality; the religion doesn't matter," Quinn said. "Among our residents, we have everything from a Christian fundamentalist to a channeler. It's trans-spiritual." Leaving a dead body out for three days is known as Buddhist tradition -- Buddhists believe it takes three days for the consciousness to fully leave the body -- but Quinn points out that the three-day period also has ties to Christianity, that Jesus Christ was resurrected on the third day following his crucifixion. In Bea's room, the two continued to pray, but Bea only made it halfway through the Lord's Prayer before stumbling. Quinn continued to recite the prayer as Bea faded in and out.
"Forgive us our trespasses ... I'm sorry, sometimes I forget," Bea said. "No, you did real well," Quinn said. "I know God heard you."

'Replacing the Nursing Home'
Officially, Anam Chara is licensed by the state of Colorado as a personal care boarding home, and by Medicaid as an alternative-care facility. Unofficially, the agencies aren't exactly sure what it is. "We had a meeting recently with the state, and they said we didn't fit into any categories," Quinn said. "Finally, one guy said, 'It sounds to me like you're replacing the nursing home,' and we went, 'I think you're finally getting it!' They ask, 'Are you assisted living? Are you a nursing home?' We're neither, we're a home, where people live and die and play." As a nonprofit, Anam Chara has received grants and low-interest loans from the city of Boulder, which provided $100,000 towards the purchase of the home, and from the state of Colorado. "My sense is that it's a unique model; it's an interesting model that provides a pretty humane approach to addressing the needs of the elderly who need housing combined with services," said John Pollak, a housing specialist at the state of Colorado division of housing, which has provided Anam Chara with more than $79,000 in low-interest loans.
"It's different than your normal institutional model," Pollak said, "And that was one of our reasons in funding it, to support an innovative approach." Care at Anam Chara costs $3,000 per month, but Medicaid patients, which make up 80% of residents, pay only $1,300 per month, or about $30 per day. The rest of the care costs are made up by donations and grants. In comparison, Quinn said, some nursing homes receive four times as much Medicaid money as Anam Chara. "It's certainly much less expensive to taxpayers than having people in a Medicaid-supported nursing home," Pollak said. "It's something we want to watch to see if it's a model that will work in other places."

Father and Son
In the living room, 91-year-old Ulysses Groves sat in an easy chair, oxygen tubes clipped to his nose. Nearby, his son Gene sat in the same position he had for the past three hours, on a small green pillow, holding his father's hand. At times, one of them would doze off; sometimes they just gazed at one another.
Ulysses spent most of his life in Indiana, working construction around the world. In 1983, he was named "Citizen of the Year" in his town in Illinois, where he helped build a senior citizen's center. After his son brought Ulysses a thousand miles away, Quinn says it's up to the larger community to pay him back. Many people openly marvel at the relationship between Ulysses and Gene. Bringing family members into the home is one of the most important elements to making a place such as Anam Chara work, Quinn said. For patients such as Bea, the staff members take it upon themselves to become part of their extended family. For the Groveses, the bond seemed to strengthen the closer the time came for its inevitable break. As his father neared death, Gene would sleep on the couch, or the floor, in the home. Together, they would look at photo albums; together, they would talk about Ulysses' past, and his future. "I'm still seeing the light," Ulysses said one night as he drifted off to sleep. His son grasped his father's hand. "The light is inside you, Dad."

Words of Wisdom
During the last few nights of her life, Bea continued to hover between lucidity and dementia. At first listen, her ramblings easily could be dismissed as senility. For someone willing to listen intently, however, they were at times wise and profound. "I'll rest, but I must be getting on, soon. I've lots to do. I've got to grease my buggy wheels," she said while lying in bed one night. "I'll be getting more time for rest soon, but now I must be rolling on home. When I get there, I'll build a little fire, make a little warmth, and take it as it comes. It will be a never-ending field." Sitting by her side, Quinn prompted Bea to talk more about what she saw as death approached. "It will be quite a change when it comes," Bea said. "I've looked in on parts of it, and there's ample change. It will be quite a change, that it will. "Maybe it will be good, maybe it will be bad, but we still have our bright moonlight, we still have our sunny days. "Yep, I 'spect I better be moseying on home."

Just Sitting
On the morning of Dec. 22, Maria Asztalos found Bea dead. After 101 years, hers was an obituary for which many people strive: "She died peacefully, in her sleep." After calling her doctor, Asztalos sat in the room much of the day with Bea, just sitting. Working in nursing homes for the bulk of her life, Asztalos has seen hundreds of deaths over the years. At Anam Chara, she is given a chance to do something that she says they never had time for at the institutions. She cried. "Everything about our medicine is quick, fast. Nobody takes the time to grieve," she said as she sat with Bea's body. "The institutions do the best they can, but when you're forced to speed things through, it's hard to connect with people. So when they die, it's just, 'Here's the mortician, put 'em in the garment bag and clean the room.' "The people I've worked with here are not afraid of being in that space with death, and are not afraid of it [death]. That's the openness." After her work in nursing homes, Asztalos attended the gerontology program at Naropa, completed an internship with Hospice of Boulder County, and then found Anam Chara. "People ask, 'Why would you want to do that? Why would you want to see people die? That's so sick and depressing,'" she said. "Well, let me tell you. It's not depressing. It's not sick. There is something really powerful. Without sounding sappy, the more you relate to it in your life, the happier you will be. Instead of doing it all in the last year of your life, it's a grieving process over the years. "This is what being a human being is about. It's about grief. You learn from it. You grow from it." Despite the grief, and perhaps because of it, Asztalos says she looks forward to each day of work at Anam Chara. "I find that when I come here, I experience miracles every time. The rewards are humongous," she said. "There are a lot of really small joys that happen to make my days and weeks." One of those joys was seeing Bea. Though Asztalos says the old woman could, at times, be "a hellcat," very stubborn, sitting and listening to Bea's stories made the hard times worthwhile.
"It's not always a rose garden. It's like a relationship," she said. "Sometimes it's blissful; sometimes it's hell." The work can be tormenting on the mind, too. It's another reason Asztalos chooses to sit with the body. "You realize right smack within yourself that this is going to be all of us," she said, nodding toward the body. "Maybe not today, maybe not tomorrow, but it makes you think, 'What are you going to do with your life?' "It's all part of the deal. It's having your buttons pushed. It's the full grieving experience; it's not just going to be all nice. It's going to be really grueling, and you're going to have to work on your own shit. That's one thing for certain, if you're going to do this, you're going to have to work on your own shit." Inside the room, the minutes passed silently. Asztalos remained next to Bea, just sitting. "Have I said goodbye?" she finally said. "I don't know if I actually have yet. I don't think I have. I'd like to just come up here and spend some time with her, to think about what we shared. I've grown as a human being from knowing her, and she has from me, and that's what life is about. It's that coming together. And it's timeless."

'Growing Younger'
The day before her funeral, Beatrice Tufford's body remains in the same position, in the same room. For Quinn, it's another body that has "grown younger." "When you're surrounded with the attitude of love and growing, bringing joy and fulfillment in your life, when you can have that attitude of, 'I'm grateful for my life, and I have no regrets,' those are youthful attitudes; that's how we grow younger," Quinn said. "So they may not be able to walk, but they can have love, and express love, and have feelings of warmth and gratitude, and that makes you younger; even though the body may be dying, the spirit is younger. Also, you see the body grow younger as it softens, as you don't have regrets and resentments. You become fulfilled, and you get to share community." Quinn derived the Anam Chara name from the Gaelic words describing a woman who was present at both births and deaths in ancient Celtic villages -- a woman who served as the town's designated midwife and mourner. The name reflects Quinn's belief in the similarities between birth and death. The problem, she says, is that one is celebrated, and the other, all too often, is shunned. In line with the holistic mission of Anam Chara, Quinn and her staff often invite children and parents with newborn babies into the home, allowing the elders to remember their youth as they die. "I'll never forget one instance in Denver, when our 96-year-old grandma Geraldine, holding this newborn baby, was able to talk about her upcoming death. She looked at the newborn, and she said, 'I'm going where you just came from.' There was this sense of fulfillment of coming and going, of birth and death." As Quinn looks around the room, she finds an old photo album, one she looked at many times with Bea. She looks at each page, flipping through the old photos of the old woman as a wife, a young woman, a baby. As she turns the pages, near the end of the album, she stumbles across something she hasn't seen before. In the corner of one page is pasted a small yellowed newspaper clipping -- it's a poem that Bea must have cut out decades ago. The poem is called "Sketches," by Ben Burroughs. Her voice wavering, Quinn reads the words aloud. "Death need not be a horrid thing ...that makes mankind afraid... for many times it seems to play ...a tender serenade ... the secret to a happy death ... is faith and fervent prayer ... those who pray for faith will find ... a peace beyond compare ... death is part of God's great plan ... it comes to one and all ... and so we should be ready ... whenever it may call ... be righteous and we will dwell ... with God who rules on high ... one thing is for certain ... all of us must die."

Old Little Boy
Nine-year-old Damien Contizano sits on the floor of the Anam Chara kitchen, surrounded by crayons. The woman smiling back at him from the his drawing is 101 years old. He picks up another crayon, and draws her wings.
"She loved to play hide and seek," Damien says of the angel emerging on his sketch pad. "We would hide, and she would yell, 'Ollie oxen free!' She also used to talk about the railroad and taught me a song: "Someone's in the kitchen with Di-nah Someone's in the kitchen I know ..." When Damien first met Bea, he was considered by many a problem child, diagnosed with attention deficit disorder and other psychological troubles that ran the alphabet of acronyms. Many of his teachers considered him out of control. "I've been workin' on the rail-road," Damien continues to sing, stretching to remember the words. "I've been workin' on the rail-road Just a little bit long day ..." When his mother -- who worked at Anam Chara -- first brought Damien to the Denver home, Bea was almost 100. In her presence, Damien was calm. In his presence, she didn't need to wander. Together, the two once-lost causes sang and played for hours. "(Bea) felt he was an old soul, way beyond his years," said Nancy Contizano, Damien's mother.
During their meetings, Bea would tell Damien the stories of life on the farm, of life before everything sped up. "Now, he really likes ancient things, that's what keeps his attention," says Damien's mother. "We visit Homestead City, a museum of sorts that shows how life was like 100 years ago. That's one of his favorite places." Damien holds up a copy of a book, the first book he ever read, the one he carries with him everywhere. Before he ventures up to Bea's room, he wants to read the story they used to read together. He reads the book slowly, pronouncing each word deliberately, until he reaches the last page. "Grasshopper was tired," he reads. "He lay down in a soft place. He knew that in the morning, the road would still be there, taking him on and on to wherever he wanted to go."

Saying Goodbye
Inside Bea's room, Damien holds his crayon drawing of his old friend, which he has planned to hang on her wall. He approaches her body alone, and strokes her hair without speaking. He turns to his mother, and then focuses again on Bea.
Quickly, he kisses her on the forehead. He lifts up the rose on her stomach, and slides under it his angel.

Volume II, Issue 41; April 15 - 21, 1998

All content copyright © Boulder Planet, LLC 1998 unless stated otherwise.