Archive for Death

A Hospice Chaplain is Quantifiably Wrong

(*Photo by John Rothwell.)

“The nurses do things that can be quantified,” one of our hospice chaplains announced, “which is not like what us chaplains or the social workers do.”

With hospice, a patient is supported by a “team” of doctors, nurses, social workers, chaplains, home health aides, and volunteers.

Was the chaplain, a person and a professional I respect, correct?

What is quantified? It’s a word describing precision, numbers, and comparisons.

A nurse may ask a patient what her or his pain is like on a scale of 1-to-10 or (especially if a patient can no longer talk) to choose from a range of emoji faces depicting happy smiles to grim anguish. Nurses increase or decrease the precise dosages of medications based on experience, information, and established guidelines.

The medical staff in hospice—and this is one of the tough parts of patient care—needs to regularly report how a patient is declining. If a hospice patient demonstrates consistent improvement in their physical health, they certainly still have an illness (and can’t stop the aging process), but they may no longer be eligible for the hospice benefit.

  • Is the patient losing weight?
  • Does he require stronger doses of pain medication?
  • Is she eating less, or only liquids, compared to last week or month?

Yes, nurses quantify, with specifics, to discern a patient’s changes. Read More →

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Please, Don’t Say Hospice or Mention Death

How do you share openly about dying with those that don’t want to speak or hear the word, “Death?”

How can a hospice staff—whether home health aids, chaplains, or nurses—explain who they are and what they are doing when a patient’s family instructs them not to mention the word, “Hospice?”

In our patient care meetings, especially with newly admitted hospice patients, a month doesn’t go by without mentioning one or both of these questions.

Since hospice involves caring for the dying and supporting the bereaved after death, sometimes the staff can’t talk about their real work with the people they serve.

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What word do you use for death?

  • Is a person lost?
  • Have they transitioned?
  • Are they gone?
  • Did they pass?
  • Is your loved one in a better place, standing at heaven’s gate, meeting Saint Peter, or with the angels?

Since the beginnings of my ministry, I have used dying, death, and died. I suspect, over the years, in person and on the phone, I have upset people with those unadorned words. Read More →

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Tormented by a Quick Death

I recently talked to a man who received a call from his eldest brother. Of course, it was late at night . . .

I recently talked to a man who received a call from his eldest brother. Of course, it was late at night . . .

A number of months ago, I wrote about deaths that linger.

What about a loved one who dies quickly? Is that different?

I don’t mean sudden, traumatic deaths such as fatal accidents, natural disasters like the recent earthquake in Italy, or from bullets in war zones (and sadly in places like San Bernardino or Orlando or . . .). What about the 30% of deaths in hospice that occur within seven days? And within those national averages, some are in hospice for barely 24 hours. Being with a hospice for a week or less is unsettling. But when the care—and the death—all occur before the next day’s sunset, the unsettledness can become a hurricane of raw emotions, abrupt decisions, and instant regrets.

Hospice professionals know that when a loved one dies that quickly, most of the staff assigned to the patient and family won’t meet them. No one, other than nurses scrambling to manage the most urgent needs, had time to physically be with the patient who went from dying to dead in a handful of hours. A few days later, a chaplain or social worker will call to offer condolences . . . but she or he seems a stranger. More hospice staff will support you during your time of grief, but (again) they will be voices on a phone or letters in the mail.

Hospice professionals also know that many sudden deaths can be explained because of the inevitable, cruel progression of particular illnesses. But some can’t be explained. Read More →

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