The Panorama Yoga Team & Embracing Life

Written by Panorama resident and Yoga Instructor, Charles Kasler. August 2016

Embracing LifeOn June 9th the Yoga Team presented to a full house for the daylong Embracing Life Conference at Panorama. Our topic of course, was how yoga and meditation embrace the moment as well as support end of life. Many people don’t realize this is the main purpose of yoga/meditation – attuning to the present with an open heart and quiet mind. It reduces stress and brings equanimity. And it connects us to a greater Presence – something universal that is beyond the personal.  

Yoga in the parkWe divided the participants up for yoga in the park, chair yoga, and restorative yoga. There was a very positive response and people were refreshed and ready for their next workshop. It also gave them a preview of our program at Panorama that continues year after year. 

On June 20 we gathered in the pea patch in a vigil for the last hour of light on the longest day of the year – an annual event for our yoga program. As an extra treat, we saw a double rainbow. 

rainbowOn Aug 27, I taught a free workshop on diet – an essential part of the yoga lifestyle. This was the next in our ongoing workshop series – Living Well With Yoga. 

Our next social gathering will be at Fall Equinox for high tea. We often bond deeply in our shared experience of yoga and meditation – a silent support group. Social gatherings give us a chance to visit, enjoy each other’s company and deepen friendships.  

On October 22 we will continue the yearlong Embracing Life theme with the fall mindfulness retreat – Embracing Life Mindfully. Except for 2 short dharma talks, we will spend the entire time practicing in silence for a direct experience of meditation, embracing the present.

the yoga team

The Panorama Yoga Team of resident instructors – Charles, Jean, and Connie.



Alternative Therapies: Complementary & Integrative Medicine

Written by Panorama staff. July 2016

Embracing LifeThis collaborated event by Embracing Life and Social Services was a forum made up of six experts of different backgrounds, practices and fields. The purpose of this forum was to discuss complementary and integrative medicine, but what do those mean? Complementary medicine is when an individual uses non-mainstream medicines alongside conventional medicines. When non-mainstream medicine is used in place of conventional medicines, it is considered alternative. Integrative medicine combines both approaches in a coordinated way. The forum experts all spoke on different types of medicine or medical treatments that can be used as complementary or integrative medicine.

The members of the forum were Connie Ruhl, Michelle Bilodeau, Sonia Telesco, Kelly Golob, Tom Griffith, and Pamela Firth.

Connie is a retired Speech & Language Pathologist, as well as a certified yoga instructor. She discussed meditation and started with having the audience do a short meditation exercise. She explained that the purpose of meditation is to awaken us and provide clarity and personal renewal. Meditation is readily available to anyone and is adaptable to everyday life. Through meditation, we can learn the art of detangling our minds, learn skills of calmness and be at peace with oneself.

Michelle has a Master’s degree in Acupuncture & Oriental Medicine and is the President/Founder of Hilltop Eastern Medicine Associates. She discussed Eastern medicine, namely acupuncture & herbal medicine. She stated that Eastern medicine considers the body to be like a garden, that all body parts are interconnected. There are different types of treatments in Eastern medicine, like meditation and Qi Gong, but acupuncture and herbal medicine are the most commonly known. Acupuncture, from an Eastern medical perspective, can help balance symptoms that occur from imbalances and complex energetic systems inside our bodies. When balance is restored, these symptoms diminish and, over time, disappear. From a Western scientific perspective, acupuncture can help reduce inflammation in the body, modulate the immune system, balance neurotransmitters in the brain, increase circulation and oxygen levels and many others.

Sonia is a massage therapist who specializes in providing medical massage for injury treatment and rehabilitation, as well as relaxation massage for stress reduction and wellness. While she emphasized that massage therapy is not a cure, it can help promote comfort and care. Massage therapy is an approach to hands-on comfort and is a tool used to assist the body in its own healing process. It is also a method of manipulating muscles and tissues, creating greater blood flow, calming nervous systems and reducing stress.

Kelly is a chiropractor who combines traditional chiropractic methods with contemporary sports medicine. His main focus when treating a patient is to discover why the patient’s pain or medical issue is happening. By helping you learn and understand your body more, chiropractors can more easily get to the cause of your body problems. Kelly states that his goal is to help his patients stay active and help them continue doing what they love to do.

Tom is a licensed primary care naturopathic physician. Naturopathy, or naturopathic medicine, is an alternative medicine that uses a wide array of “natural” modalities, including homeopathy, herbalism, and acupuncture, as well as diet and lifestyle counseling. Tom emphasized that we need to learn how to listen to our bodies. He stated that there are four practices of naturopathy:

  1. Do no harm to the patient
  2. Treat the cause of the disease
  3. Treat the whole person
  4. Know that the body wants to heal

Naturopathy is based on the idea of self-healing. With this in mind, Tom states that the goal is to empower patients to take care of themselves and allow them to make their own choices. Physicians are simply there to guide choices.

Pamela is an occupational therapist and a certified Jin Shin Jyutsu instructor and practitioner. Jin Shin Jyutsu translates to “art of the creator through man of knowing and compassion”. It is a mechanical technique that allows us to harmonize and balance ourselves by using our hands along 26 sets of energy lock points on our bodies. According to the Jin Shin Jyutsu website, it is “an art of harmonizing the life energy in the body” by releasing tensions that are the causes of various symptoms in our bodies. According to Pam, our bodies are made up of energy pathways that feed life and energy internally. When one or more of these paths get blocked, it can cause discomfort or pain and will continue to disharmonize the other energy paths. Using this style of acupressure, you can experience physical, mental, cognitive, and spiritual harmony and restore balance to your body.

The take away from these informative presentations is there are many treatments and techniques to explore, whether complementary, integrative, or conventional. Only you can know what your body is experiencing and feeling. It is important to search for what fits you and to advocate for yourself in order to embrace your life to the fullest.

Embracing Life presents “Five Wishes”

Written by Panorama staff. June 2016

Embracing LifeWhen first arriving to this particular session, I was unsure what to expect out of Five Wishes. The only information I had was the event description which states, “Five Wishes is an easy-to-use legal document written in everyday language that lets adults of all ages plan how they want to be cared for in case they become seriously ill. It is unique because it speaks to all needs: medical, personal, emotional and spiritual. Five Wishes also helps structure discussions with your family and physician.” It was assumed that this was going to just be a discussion of how to fill out this legal document. Instead, it was an uplifting, enlightening, and helpful discussion that allowed everyone to take something away from it.

Carol Johnson was the facilitator for this Embracing Life session. She is a health care counselor and handles end-of-life issues. Her light humor and relaxed persona helped make the atmosphere less negative and depressing. It was more than just a lecture about how to legally fill out this document; it was a discussion in how to ensure that everyone’s end-of-life wishes were fulfilled.

Carol started off by asking the audience why they came today to learn about Five Wishes. The following responses were:

  • Doing it for children, spouse, loved ones, etc.
  • Ease my mind
  • Love for my family
  • To create ease for family & loved ones

In essence, according to Carol, everyone was there to “get their ducks in a row”, to further ensure that their wishes were heard and fulfilled. She then had everyone state how they felt dealing with end-of life issues. The following feelings were stated:

  • Scary
  • Stressful
  • Depressing
  • Sad
  • Sensible
  • Frustrating
  • Accomplishing

While most of the feelings were negative, there were a few that felt discussing and dealing with end-of-life issues enabled them to be furthered prepared for the future. Carol then went through the entire Five Wishes document and what it entails. The main purpose of this legal document is to list how you want to be treated when you are seriously ill. It gives you the tools to help you talk to friends, family and doctors, so that they will know exactly what you want. The document allows you to make the following decisions and choices:

  • Who you want to make healthcare decisions for you
  • Where you want to die
  • Life support decisions
  • Wishes for your loved ones to know
  • How you want to be treated
  • How you want to be remembered

These are just a few of the topics and choices that you can make in the document. The ideal part about Five Wishes is that all the decisions are in one document.

By the end of the discussion, those initial negative feelings concerning end-of-life were lessened. Carol made the discussion fun and entertaining, showing the audience that end-of-life discussions do not need to be scary and depressing. Regardless of age, knowing how you want to spend your end-of-life is important. Although it is hard to discuss such a heavy topic with family and loved ones, it will create ease for them when they have to make those decisions for you. Ensuring that your wishes are heard and fulfilled is important and will truly enable you to “embrace your life” until the very end.


Embracing Life presents: Life’s Third Act

Written by Panorama staff. June 2016

Embracing LifeThis Embracing Life session was a combination of TED talk, Life’s Third Act, and an audience discussion. The TED Talk, given by Jane Fonda, re-examined the old metaphor for aging and people’s new life expectancy. People today are living on average 34 years longer than their great-grandparents. This extra time is what Fonda calls “the third act.” Before, age was seen as an arch: you’re born, you peak at midlife and then you die. However, with these extra three decades, Fonda suggests a new metaphor for aging. Instead of a peak-decline arch, she states that aging is like a staircase. Aging, in her words, is “the upward ascension of the human spirit, bringing us into wisdom, wholeness, and authenticity.” This additional act gives us extra time to ascend upward, to reflect and free ourselves from the past, review our life, and better our quality of life.

After the short TED talk, the audience was broken into small groups and asked to discuss a number of questions. The first question was regarding the old metaphor of age being like an arch. The groups were asked the following questions:

  • What were your role models for “old age”?
  • Who were the old people in your youth?
  • What were they doing with their time?
  • What was “retirement” for them?

After several minutes of discussing, there was a large consensus among the audience. Many in their youth saw old people working hard and never experiencing retirement. Old people had to live with their children or grandchildren as they were unable to live on their own comfortably. Nobody retired and working until the day you died was accepted.

The next questions discussed the extra 30 years that have been added to our life expectancy. The questions were:

  • How can we re-imagine this new phase of our lives from a decline into a developmental stage of life with its own significance?
  • How do we use this time?
  • How do we live it successfully?

There were a large variety of answers from the audience. Some wanted to use the time for self care, especially since there are more options and resources that offer self care nowadays. Some wanted to use the time to help others and contribute to the world. Others wanted to use it for self reflection, strive to make their third act successful, and develop wisdom around reflection. The groups discussed what was important for them to embrace in their third act. Whether that is staying in touch with friends, enjoying the things you love, furthering relationships or enriching the world, this new additional act allows more time to embrace our lives.

Jane Fonda quoted a German psychiatrist in her talk, Viktor Frankl, who spent five years in a Nazi concentration camp. He wrote this while he was in the camp: “Everything you have in life can be taken from you except one thing, your freedom to choose how you will respond to the situation. This is what determines the quality of life we’ve lived – not whether we’ve been rich or poor, famous or unknown, healthy or suffering. What determines our quality of life is how we relate to those realities, what kind of meaning we assign them, what kind of attitude we cling to about them, what state of mind we allow them to trigger.” As we become older and gain more time, we gain the ability and chance to learn more about ourselves. We learn to embrace ourselves, our freedom, our spirit, and our bodies. By reflecting on our life experiences, we can become wiser and become whole. With this extra time, we gain the chance to enjoy the things and people we love, gain wisdom, embrace our new additional time and continue to ascend with into our age potential.

Music & Parkinson’s – An Embracing Life Session

Written by Panorama staff. May 2016

The monthly meeting of the support group, Living with Parkinson’s, was a bit different Embracing Lifethis month. Embracing Life brought on choir director and voice teacher, Troy Fisher, for this May meeting. The purpose of this session was to give people with Parkinson’s a safe place to work on activities to help strengthen their voices and express themselves freely. If I could use just one word to describe this particular meeting, it would be “fun.”

Troy had the class start with breathing exercises, inhaling deep breaths and releasing. As the group moved onto tongue and humming exercises, Troy actively engaged with the group. His lively and energetic personality made these normal exercises more entertaining and enjoyable. Then, the real fun began.

Troy had the class sing “Getting to Know You” from the King and I. Each receiving a paper copy of lyrics, the group sung along with Troy. They sang the song several times, working on singing it by memory or increasing their singing volume. Volume was an important topic to this group. Nearly everyone who has Parkinson’s experiences a soft and hoarse voice, making their speech hard to understand and hindering their communication abilities. Troy commented that when a person loses their volume from a disease like Parkinson’s, your pitch tends to lessen, causing a softer and lower voice. He said that if you want volume, you up your pitch, even if it means just going up an octave. He used one particular exercise with volume. He had each group member say their name normally. Then, he had them say their names again, upping their pitch just a bit. The change in volume was drastic! Even if a person feels like they’re yelling, knowing they have the capability to communicate is worth it.

The group and Troy spent the rest of the session singing other songs and doing some dance movements. Troy’s engagement with the group brought out more laughter, smiles and energy at the end than in the beginning of the session. He left the group with a great message that can apply to everyone. He stated that everybody can sing and should sing; everyone should experience the joy of participating and not just listening. By giving the group tools to improve their speech and communication ability, Troy was able to give the group the chance to gain a better quality of life.

Palliative Care: What Is It? – An Embracing Life Session

Written by Panorama staff. May 2016

This Embracing Life session was facilitated by Julie Ostling, RN & BSN of Assured Embracing LifeHospice. Many people hear about hospice care, but what is palliative care? Julie had the answers, but first, she wanted to hear from the audience. She started off by asking the audience what questions they had to ensure she covered them during her presentations. Some questions or topics were:

  • Palliative care at Panorama
  • Palliative care vs. hospice care
  • Different types of palliative care that are available

Julie supplied the audience with a packet of information, all of which she covered during her presentation. She initiated it by stating that palliative care is a relatively new concept and is available locally. Palliative care is meant to help relieve suffering and improve quality of life for people at any stage in a serious illness, whether that illness is curable, chronic or life-threatening. Palliative care focuses on comfort and management of symptoms, including physical, emotional and spiritual symptoms. But how is hospice care different? While palliative care helps people at any stage of a disease, hospice care is a specific type of palliative care for people who likely have 6 months of less to live. Julie emphasized this particular statement: “Hospice care is palliative, but not all palliative care is hospice care.”

Another part of palliative care is that it helps increase comfort for the patient and the family by lessening pain and stress and controlling symptoms. When it comes to different types or forms of palliative care, Julie states that every form of palliative care is different, depending on the illness, person and/or situation. There is no specific type or form of care.

There are many forms of palliative care in the community. Ten years ago, St. Peter’s Hospital started an in-patient palliative care that consists of MD’s, ARNP’s, RN’s and Social Service support. There is also outpatient palliative care at Group Health Clinic & Providence Community Palliative Care. Home setting palliative care is possible, but an individual must meet Home Health criteria for homebound status. As far as palliative care at Panorama, depending on your situation, you can seek palliative care from the many sources in the community.

Julie’s presentation was informative and resourceful. She referred the audience to multiple sources that can provide a form of palliative care or offer information. After her presentation, the audience discussed the “Death with Dignity” law and how palliative care is being used more often.

Going hand-in-hand with the “Embracing Life” theme, palliative care is a wonderful choice for people who need help with physical, psychological, social or spiritual distress as a result of illness treatment. Seek out the sources in your community and have the conversation with your physician. You’ll never know what is out there unless you look or ask!

Intergenerational Forum – On Life and Issues of Death & Dying

Intergenerational Forum at PanoramaWritten by Panorama staff. May 2016

“Do you remember thinking about death when you were younger? Or even thinking about aging for that matter?

As we age, our perception of life and thoughts about death change but is it something we can talk about? How do we bring it up with our kids or grandkids? These are some of the questions we’re exploring with our year long Embracing Life program.

One concern of vital importance for each of us is communicating to our loved ones how we want our lives to go on as we age and what a good death looks like to each of us as individuals. If there comes a time when we need their support at the end of life or if they need to make decisions on our behalf, we can feel more confident knowing our wishes are understood.

In exploration of this, we hosted an Intergenerational Forum which included a panel of 4 High School Seniors and 4 Seniors Who Once Were in High School. The four high school seniors joined us from Timberline, South Sound, Riveridge, and North Thurston high schools, while the four “young but not as young” seniors were all Panorama residents. Questions were posed to each age group and surprisingly, we found more commonalities than differences.

1) What is old?

High School Seniors:

“Old is not a number; it’s how mature you are.”

“Old isn’t necessarily a thing you have to be; it’s all about mentality.”

“The older you get, the more you mature as a person; it’s about how you grow.”

Panorama Seniors:

“Being old is a privilege; you can really appreciate the wonderful things around you and let go of the petty things.”

“I’ve enjoyed every era of life.”

2) What do you want your life story to be? How will you “Embrace Life”?

High School Seniors:

“I want to do the most I can to help people; I want to be remembered as a good person.”

“I want to know that other people enjoyed life because of my presence.”

“I want to know that I built something good. It’s so easy to tear apart but I want to know that I built.”

“I think about how I want to feel at the end. On my death bed, what will I wish I did more of? Top of the list, for me,  is time with family.”

Panorama Seniors:

“Are we making a difference? That’s something I’ve come to think about every single day as I’ve gotten older.”

“My mother always said ‘To make life worth something you must live with as much joy as you can.’ and that’s something I’ve tried to live by.”

3) Do youth today have respect for seniors like the generation before them did?

High School Seniors:

“Lack of respect comes from lack of empathy.”

“We just have to understand that we’re not different; we were just born at different times.”

“We have to know that one day we have the option to be what they are.”

“Contact is crucial to find common ground – to work together to grow the community as a whole.”

“{If intergenerational communication was more common} kids wouldn’t be so scared of growing up.”

Panorama Seniors:

“Each generation thinks the next generation is not as good as they were. But maybe they could be better. It varies from person to person.”

“Lack of intergenerational communication contact creates a lack of understanding and respect. Communication bridges that.”

“{My wife and I}…participate in Road Scholar and have had the opportunity to see our grandkids interact with kids their age in a positive way – that helps provide perspective for us.”

“I must be the only 80+ person playing online Playstation but I get to interact with multiple generations in the game and we talk generally about everything together.”

“We have so much in common – if only we just talk to each other.”

4) Do you talk about death and dying?

High School Seniors:

“We do talk about it but in the way of living your life.”

“I don’t really think about death. I don’t want to think about it. I want to have a life where I know I built something bigger than death – I built life.”

“A lot of younger people don’t think about their actions now; they don’t think ahead to the legacy they will leave behind.”

Panorama Seniors:

“I look forward to the time when I can speak openly with my family {about death} & we can express our love.”

“We’ve dealt with the administrative issues {of death} but not the deep stuff, such as what we want our legacy to be.”

“When you’re really young, you just don’t relate to it. When we get older, we think much more about the manner of death we want.”

“The difficulty is family members struggle with hearing us talk about it and hearing our wishes.”

“Many times, grandchildren can talk to grandparents easier than they can with their parents. It’s a good thing to talk to grandparents.”


Register online for our Embracing Life Conference (June 9th) for an opportunity to learn about how to talk to your loved ones about your legacy and your wishes.

To read about last year’s  Intergenerational Forum visit this post.

Embracing Life Discussion – A Physician’s Perspective

Embracing Life - 3The third discussion of the yearlong initiative, “Embracing Life”, was led by Dr. David Fairbook. With a physician background, he led a discussion from this standpoint, discussing chapter 7 of Atul Gawande’s book, Being Mortal. The chapter focuses on hard conversations, mortality, and medical choices. Making plans and communicating them are vital to ensure that we get what we want at the end of life, especially when we are unable to speak for ourselves. Dr. Fairbrook discussed cases of patients and the differences between communication and medical choices. At the end, he presented residents with key questions to think about:

  1. What do you really understand about your illness?

  2. What are your biggest fears and concerns?

  3. What goals and hopes do you wish for?

  4. What trade-offs are you willing to undertake?

Although we desire full details from doctors and physicians and expect to have important life changes discussed with us, communicating our questions, wants, and fears to our doctors is just as important. We expect doctors to share this information, but we are just as responsible for asking those hard questions. It is important to make plans and discuss those plans with loved ones and relatives. We may face a day where we are unable to communicate what we want and have to leave it up to others to make those hard choices. Asking those hard questions and discussing those difficult topics with ensure that we get what we want at the end and are thoroughly prepared for the end of life.

Embracing Life Discussion – Shared Decision Making

Written by Panorama resident, Judy Murphy. March 2016

Embracing Life - 3The Wednesday discussion group of 22 people was small enough to allow a give-and-take among the facilitator and the attendees. We focused on the Shared Decision-Making model of the patient-physician relationship, discussing choices that patients need to make and the obstacles to making them.  In shared decision making, the physician presents options and the patient makes choices with the physician’s guidance.  This model was exemplified in “Being Mortal” by Dr. Gawande’s father’s terminal cancer diagnosis and how he and his family responded to it.  The importance of communication with family and medical providers was emphasized.  Several people mentioned that we need to be cautious about information we find on the Internet and suggested that second opinions and fact checking are very important.

Other topics surfaced as well, such as what constitutes quality of life, particularly for someone with dementia. Concerns expressed by residents included how to make your wishes known well in advance of illness, being sure the family, physicians and institutions have appropriate paperwork, and the need for families to come to an understanding and acceptance of the parents’ wishes.  Children do not always agree, and if that is the case, the medical power of attorney is extremely important.

Obstacles to making appropriate decisions included

1) Expense of medical care that could impoverish family members

2) Regrets about one’s life and poor choices one may have made

3) The wish to please family and physicians

4) Not acknowledging that one is dying

5) The desire to not burden spouse and family.

We also discussed differences in cultural attitudes towards death and dying, the need for us to face these realities, the importance of palliative care and hospice, and the gift of having time to say good-bye to friends and family. One suggestion many found helpful was writing letters to children about your feelings and things that are meaningful to you.  A common sentiment was that the dying process gives us an opportunity to enrich our relationships with others.

All agreed that living at Panorama is a gift in this regard, and the need for facing difficult subjects is made easier by being able to talk about them with like-minded people.

Murphy Bio

A Resident’s Perspective – Embracing Life at Panorama


Written by Panorama resident, Deb Ross. March 2016

Embracing Life - 3In the first week of March, Panorama initiated a year-long program called “Embracing Life,” based on the principles expressed in Atul Gawande’s book Being Mortal. The first event, sponsored by the Panorama Library, was a PBS Frontline film about Gawande and his ideas, shown to a full house in the auditorium. Three discussion sessions were scheduled for the following week, to explore the issues raised in the book and the film.  Embracing Life 1st Discussion GrpI had the honor of facilitating the first session on March 8. I asked the participants to answer three questions: What makes your life worth living? What have you already done to achieve or prolong this? and What do you plan to do in the next twelve months? The answers were far-ranging and inspirational. Here are some of the common themes:



What makes my life worth living?

  • Keeping Mobile/Travel
  • Preserving Health
  • Family
  • Panorama neighbors and friends, and other friends
  • Music
  • Reading
  • Learning
  • Beauty
  • Crafts
  • Spouse
  • Mental Health/Memory
  • Spiritual Issues
  • Sense of Humor
  • Enjoying Life
  • Love


What have I done, or plan to do, to achieve or prolong this?

  • Moving to Panorama!
  • Getting important documents in order: wills, other legal documents, powers of attorney Talking with family and making sure they are on board with wishes
  • Getting finances in order
  • Taking care of health
  • Dealing with stuff (downsizing, inventory)
  • Finding ways to keep spouse happy and healthy
  • Finding alternatives when I can no longer do certain things due to health, mobility, sensory issues
  • Having a positive attitude, enjoy life as it comes every day
  • Being prepared for change, seize opportunities
  • Taking classes such as Brainfit
  • Moving to Quinault when advisable
  • Using time wisely, and taking control of my own schedule
  • Taking steps to preserve ability to continue in independent living, including calling on Hospice when the time comes


This list doesn’t adequately capture the depth and variety of responses. One couple, who had both been widowed, met here and married two years ago, and take great joy in each others’ company. Another finds spiritual sustenance by helping others. Another said he greeted every day with delight at being alive and healthy. The two overriding themes expressed by our residents were first, that the pursuit of happiness is the most important thing to them, in all its many forms; and that moving to Panorama was a huge step towards achieving that goal.

I look forward to participating in the forums and sessions around the theme of Embracing Life over the next several months, and continuing to learn both from residents and presenters how we can embrace life, while recognizing our own mortality.

Deb Bio_Edit