Hospice Work: Your Own Idea or Were You Poorly Advised?

heart in hand

“What do you say when people ask how you can work in hospice?”

Near the end of a long Friday, at the end of another tough week, a colleague posed that question.

That question. That question.

I won’t share the details of our conversation because—like everything in hospice—confidentiality is a priority. But I will tell you my co-worker had several demanding visits in a row with patients. Everyone with a job they enjoy has difficult days like my colleague. But in hospice, all of patients—the scared or angry person, the silent or talkative person, the openly sharing or hide-the-feelings person—are dying. They will not get better.

And so, hospice workers wonder if they truly helped the patient and their family.

They wonder if someone else might’ve said the “right” words or made the “better” decision.

They resist clichés or platitudes to bring comfort in a time of overwhelming crisis, but then it’s as if there’s nothing to say.

When visiting homes where a family’s world is falling apart, just before knocking on the door, they may contemplate (for a selfish, exhausted moment) scurrying back to the car.

There are frustrating days.

There are hollow words.

There are awkward silences.

While I have answered the “how” question in many ways, two reasons are constants. One involves comparisons. The other is simpler.

By background, I’m an ordained Christian minister of word, order, and sacrament. In simplistic terms, word means preaching. Order involves responsibility for the administration of a church, including (yikes) paperwork and personnel issues! Sacrament refers to the rituals of faith, primarily communion and baptism in my United Methodist tradition. There are other rituals, with some described in less formal language: like hatch, match, and dispatch or marry, bury, and baptize. Those are well-worn phrases, rooted in old-time “insider” humor. I spent much of my ministry with the “match” and “dispatch” (or “marry” and “bury”). Which is to say I’ve done hundreds of weddings and even more funerals.

Now retired, looking back over my career, I always preferred funerals over weddings. What a Gloomy Gus guy, eh?

How many brides and grooms worry about color schemes, fret about who to invite, have flower girls wailing along the middle aisle, or worry about groomsmen with hangovers following the bachelor party? The caterer’s food was too cold, too spicy, or runs out. And by the way, the DJ played the music too loudly and the wedding cake mimicked the Tower of Pisa. Weddings can be wonderful! But many I dos are accompanied by high prices and higher stress.

Please, let me have a funeral. Sure, we all complain about the costs of the American funeral. And families drink, argue, and—as with weddings—the nephew who sells drugs or the second cousin’s second spouse that drinks too much aren’t invited . . . but arrive anyway.

Comparisons are negative and unfair. But I have them! Funerals aren’t fun, but they confront everyone with the seriousness of life.

My second reason is simple. People tend to be more honest in the time of death, in the “dispatch” and “bury” time. When a loved one is dying, we want them to be at peace. We don’t want them to suffer. What we say to them matters. How we listen is active and focused. When I help someone plan a funeral, they may not know exactly what they want, but they rarely worry about color schemes or seating arrangements.

We live in a culture that reveres strength: ah, the strong, silent type. We seek to control everything. We trust science, technology, and medicine will guarantee longer, healthier lives. But dying thwarts our best plans. Death shatters the illusion of control. Grief’s turmoil causes us to feel like we’re drowning. All modern advances seem futile in the face of the primal truth of mortality.

I believe I am at my best when I am vulnerable. When I don’t judge another, but listen. When I wait my turn to speak. These things are more likely to happen when death inevitably elbows its way into life. When, in hospice, I asked someone “How are you doing?” I waited for the answer. How many times in a day or week do we pass someone with a hasty version of “how you doing,” but keep rushing in the opposite direction?

My work in hospice encouraged me to stand still, make eye contact, pay attention. I told the participants in the grief support groups I led that I understood what they were feeling, and I also didn’t understand. I told them many of their reactions were normal, but none of those reactions will ever feel normal. I told them they shared common ground, but that every person’s experience is unique.

In my over forty years of ministry, I worked small and large churches, in campus ministry, and in hospice. I felt called to this work, immersing myself in the joys and pains of other lives. Frederick Buechner, a favorite author (and minister), shared about a conversation he had about his calling:

“I hear you are entering the ministry,” the woman said down the long table, meaning no real harm. “Was it your own idea or were you poorly advised?” And the answer that she could not have heard even if I had given it was that it was not an idea at all, neither my own nor anyone else’s. It was a lump in the throat. It was an itching in the feet. It was a stirring in the blood at the sound of rain . . .” [from The Alphabet of Grace]

Those in hospice probably won’t continue in the job unless they feel a call. Perhaps, it’s like a lump in the throat. Or a desire to comfort the dying and their families.

I love the question, “Was it your own idea or were you poorly advised?”

Ha! I’ve been poorly advised in the past! I’m sure I’ve given, and will give, poor advice. But my hospice colleagues (the doctors, nurses, home health aides, social workers, volunteers and chaplains) taught me this: being with others in the time of dying was a privilege. I know I was helped—becoming more vulnerable, more hopeful—when accompanying others during the dying and the grief.

Why does someone choose to work in hospice, where so many die and so many are grieving?

For many, it is a calling to help others live.

(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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