The support many of you have given the residents of The Mansion, a Medicaid Assisted Care Facility in Cambridge, N.Y, has been profound, meaningful, one of the most uplifting and affirming things I have ever been involved with. Thank you, you have done more good than you can imagine.

I want very much to keep it going, and that, I think, suggests it is healthy to outline some boundaries for all of us.

I want to take a few minutes to spell out what I think are the best, most effective, practical, humane, inexpensive and  loving ways to help the residents. People’s interests and enthusiasm for helping the residents are building, and I am flooded with suggestions, requests for information and well-meaning proposals.

That is a good thing, but also a challenging thing.  I want to share my ideas about how best to help the residents, I owe you that.

This help, I think, should be simple, inexpensive and practical. I don’t want to burn out, I don’t want you to burn out, I would hate to see the residents overwhelmed or abandoned.

What they most need is to know they are not forgotten and that people in the outside world care about them. This is not about money, but heart. They love your letters and photos, they read them, store them by their beds, share them, and then read them again.

Cards, letters and notes are also inexpensive, and that means they may be ongoing. I would hate to see the bar for gifts rise to the point where people cannot afford them and they lose some of their original meaning. A gift that might seem exciting to you might be bewildering and complex to a Mansion resident.

When I ask residents what they most want and need, they almost always say the same thing: letters and cards and photographs. Personal connections. They rarely ask for material things, there is not much use for them there.

Many of you are asking me to provide detailed lists of the residents needs and characteristics so that you can tailor your gifts.

I can’t do that, both for privacy reasons and because each of the residents are very different from one another.

They live  mostly in small, single rooms, they do not have much storage space, sometimes their physical or memory issues affect what they can do. There are varied health concerns. Some are ill, some are not clear about what they might want, or even be able to use some kinds of gifts, or remember what they wanted them for.

I am not comfortable compiling those lists. I can and will post the first names of residents who would like to receive  your messages, but even that changes almost continuously. Some of the residents remember me, some forget me the minute I leave their rooms, one woman believes I am there to sell Red.

In some cases – Connie comes to mind – the residents have specific needs and requests and I will be happy to share them, in consultation with the staff.

Your targeted gifts to Connie – yarn, patterns – have changed her life, and she is a model for how the residents can be helped. And she is learning how to ask for what she needs (like patterns for crochet baby hats and blankets.) Every staff member and many residents now have mittens and scarves made by her with your yarn, and soon, newborn babies will have her caps to wear.

I should point out, though that her room is filling up with boxes, and if there are too many more, we will have to donate them to other institutions.  That would be a  waste of your resources and also add to the work of the staff. When I see a practical need like that, I will share it, but everyone there is different, and what helps Connie is of no use or value to someone just across the hall.

Just yesterday, people suggested building more ramps, partnering up with other institutions, having the residents donate clothes to newly arriving refugees and for lists of biographies, interests, personal histories and many other things. To me, those requests stretch the boundaries of what is appropriate. The idea is to support, not rescue.  It’s about personal connection. I am getting Facebook messages, e-mails and social media posts filled with well-meaning ideas about help for the residents. They are not realistic, and it is my job to help people understand how to help.

This is a precious thing, I want it to work.

There are things we can do and things we cannot do.

First, the focal point of my therapy work must be Red, and his very effective work. We visit the Mansion three or four times a week, usually for brief periods, and I try to take photographs in order to show the residents there as the wonderfully diverse and open people that they are. I don’t want to lose that focus. It is what I do. I try to get to know the individual residents and Red touches a deep chord of memory and affection for them.

That is hard and demanding work, for him and for me. I also write books, take photos,  help run a farm, publish my blog and am deeply involved in the refugee crisis. I have to manage my time as well, without over-extending myself or burning out. I want to be there for the long haul.

I seek to capture the humanity of the residents and to remind the world that they are there, and in need of love and connection. We place them in special out of sight facilities, we keep them alive by any means at all costs. But we pay little attention to how they live or what they love. You are changing that for these residents.

I practice clear boundaries in my own dealings with the Mansion. I do not ever advise them on patient care, I don’t tell them how to run an assisted care facility, or propose new programs or changes or structural improvements. I don’t give the staff advice, or do more than I know is helpful.  It is very difficult to operate an institution like that in America, where many hearts seem to be turning to  stone. They know what they are doing.

I also don’t want to drain the resources of those of you who have been so generous.

I had to stop doing hospice work for a while, because I was seeing too many people, and they all died, as hospice patients do. We all  have to guard our resources and energy, I don’t want to wear out, and I don’t want you to wear out either, or drain your own resources. I hope this is a long haul, that this support will be there next Christmas. So that means we all have to manage it.

Once again, I think the best help is measured, simple, continuing and inexpensive. If you do send material things, small, fun gifts work the best – pinwheels, figurines, custom-made cards and letters.

It really helps to send messages and notes regularly, and focus special attention around the holidays. Like Christmas, Valentine’s Day or Easter. It is a wonder to see those bulletin boards fill up with letters and photos and note cards. I could cry when I see the residents eagerly reading their letters. Sometimes it is the simplest things that accomplish the most.

That approach is working well for everyone I think, it doesn’t overwhelm the residents, burden the staff, or tax my own ability to help. The Valentine’s Day Party was a remarkable thing to see, it brought tears to many eyes.

The Mansion is a Medicaid facility, there are few additional resources, and there are likely to be even fewer. They do not have the time to do much more than they are doing. The staff is always busy.

The Mansion is a living, organic institution. Residents come and go. There are often new residents. Some residents leave, they go to hospitals or nursing homes, or visits with their families. Some change and require different kinds of medical care and supervision. Some want to hear from the outside world, some don’t. Some can’t really manage gifts, even store them and make room for them. Lists do not have a long life span there, and I don’t care to be updating them constantly.

Cards and letters and photos are much-loved and shared. On holidays, there is the chance to focus a bit more, those gift bags were a sensation, and everyone had something to open. It transforms sometimes bleak and lonely days into bright and even joyous experiences.

The idea is to bring comfort and connection to people, we are not going to change the universe or the reality of care for the aging in America. It is important for me to keep those goals in mind.

I hope this is helpful to you, you prove to the world that people are good, given the chance. You are, in fact, an Army Of Good. For this to work, we will need to have a continuing conversation, and I promise to do your part. Many blessings to you and thanks for listening. Let’s keep it going, now more than ever.