I agreed with him.
The nephew’s aunt—who’d raised him since his single-parent mother had died before he entered kindergarten—was the most important person in his life. Her final days in hospice, as far as he was concerned, became her worst days.
Based on the brief chart notes I’d scanned about this sixty-something woman, I hadn’t expected any frustrations about hospice. When I phoned not long after her death to ask how he and the rest of the family were doing, his anger shadowed our entire conversation.
Here, though, I should pause.
I am making most of this up, based on my thousands of calls to people grieving in the first days after the death of a loved one. There was no nephew. No aunt. And the “type of thing” that “should never happen” could’ve been many different possibilities:
- A hospice staff person ignored the patient or the family.
- A social worker made a promise to bring a list of local companies for caregiving options, but never did.
- A home health aide didn’t properly dry the patient off after a bath.
- A hospice physician had said she’d visit the family in the morning, but didn’t arrive until late afternoon.
- A chaplain said a prayer that was explicitly Christian, but the patient was Buddhist.
I could keep adding to this list of disappointments. All of them are possible, but none of what I mentioned happened to this fictional family with a nephew desperately hoping his beloved aunt would have a calm, easy, gentle death.
In his view, she did not have a “good” death.
I agreed with him.
I don’t have many calls like this, but they happen. Instead of hearing about the person’s up and down days as he or she struggles with the waves of grief, I got anger. Instead of a daughter grateful for how well the hospice treated her father in the last month of his life, I got anger. Instead of a sister overwhelmed by the business demands of her brother’s estate, I got anger.
No hospice, or any human institution, is perfect. Mistakes happen. Sometimes the right words are said at the right time . . . but (unfortunately) sometimes the wrong words are said at the wrong time. People experience the same situation, but have differing interpretations. Maybe a sister hears a nurse or chaplain’s comments as refreshingly honest while her brother deems it demeaning and insulting.
Did the “type of thing” the nephew described really happen to his beloved aunt? I don’t know. I wasn’t there. As difficult as it was to listen to his non-stop anger and his repetition of complaints, I knew one thing: whatever happened, his perception was that a wrong did take place.
I promised to share his concerns with the appropriate administrators. No one should have unsettling events adding to the anguish of a loved one’s final days.
After the call, with the phone back on its cradle, my office quiet, and with the clouds beyond my window drifting lazily across the sky, I brooded. His anger had pierced my heart.
Though without the courage to “confront” the nephew in a cold call type of contact, I wondered if anger masked his grief? I could be wrong. Still, as I observed those floating clouds against the endless blue, and continued to hear the roiling hurt echoing from his voice. I suspected he was like others I’ve encountered (including, of course, the guy in the mirror): when a loved one dies, grief staggers us. It makes us feel crazy. It makes us feel isolated. However competent we think we are, we can suddenly feel incompetent. However in control we are, we spin out of control. If last year, before the dying and death, we tackled a 10-part to-do list, how come starting (but never finishing) one thing now stumped us? Grief can be a sneaky, churlish, petty companion. Grief can be so, so hard to live with . . . so why not be angry instead?
Anger, such a seductive feeling, tempts us into lashing out at anyone who may have contributed to our loved one’s death. It’s their fault.
Anger, which feels like action, lures us into identifying every bad experience as intentionally directed at us and at our beloved.
Grief demands the passage of time and thoughtful, tough work. Anger is instant gratification.
I’m confident the nephew’s complaints will prompt positive changes. He may never be satisfied with any “results,” but his concerns all had merit.
But where I still grieve, though in insignificant ways compared to the nephew’s loss, is that he will continue to be fed by and led by only his anger.
(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)by