Both are 5 Letter Words

angerWith his voice as cold as black ice on a winter road, the nephew kept repeating, “That type of thing should never happen. It wasn’t fair to my aunt.”

I agreed with him.

Every time.

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 anger 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 must pause.


There was no nephew. 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. And there was no aunt. The “type of thing” that “should never happen” could include many different possibilities:

  • A social worker made a promise to bring a list of local companies for caregiving options, but never followed through.
  • A home health aide didn’t properly dry off the patient after a bath.
  • A hospice physician had scheduled a visit with 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.

Calls like that one are rare. Very rare. I’m not exaggerating when saying I’ve made thousands of phone contacts with grievers, and nearly all range from a brief “We’re all okay” to heartfelt chats. But with this call, instead of learning about a person’s unsettled 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, just like all other institutions, is perfect. The staff, patients, and caregivers are all . . . human. Usually the right words are said at the right time, but (unfortunately) the wrong words can be said at the wrong time. People experience the same situation, but have differing interpretations. Maybe a sister is grateful that a nurse or chaplain’s comments are refreshingly honest while her brother deems those same words as 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 disturbing 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 was masking 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 fellow known as me): 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 useless. If we believe we are in control of our life, grief shoves us into daily chaos. If last year, before the dying and death, we could handle a 10-part to-do list, how come starting (but never finishing) one thing now stumps us? Grief is a sneaky, churlish, petty companion. Grief can be so, so, so hard to live with . . .

So why not be angry instead? Grief and anger are both five letter words, often competing for our attention.

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.)

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  1. Nope, Hospice is not perfect. Some situations can’t be resolved. You can’t fix what you didn’t break.

    Some of us are coming into the hospice experience with our own baggage and some of that baggage can’t be resolved with hugs, supportive conversations or good care.

    I have enjoyed reading your book. I was amused when reading the 8 things one should never say because I’d heard one of them just a few weeks before and agree with you that it stung. I felt like I needed to help the person who said it understand why what they’d said was not helpful and then I wanted to defend myself what I was feeling and why. I knew that I would say something I meant and those words would damage the other person and certainly our relationship and there was already enough hurt and I would cry and they would ask me to stop and I was not sure how likely that was so I said nothing. I thanked them for being there for me and felt like I might explode. They have no idea that their words were anything but what they intended. At the time I decided I was just, in that moment, caught without my defenses up. While reading your wonderful book I realized that keeping my guard up meant I could not process what was happening in the moment. I wondered how many times I’d committed one of the terrible 8 and wished I’d had your book in my hands, floating around my brain sooner. I think that list of what not to say and what to say should be printed on every memorial service bulletin. You can’t force people to read it but maybe those of us who are just not the most tactful speakers would appreciate the help in the moment. Thank you for your book A Companion for the Hospice Journey.

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