Hospice’s Two for One

two for oneBack when working as a hospice chaplain, one of the newer social worker suggested that we visit together. We shared various patients as part of their hospice “team.” I recall that two of those patients lived a long and winding drive from our office. Carpooling was a good use of resources. Additionally, the families wouldn’t be interrupted by multiple phone calls from multiple staff trying to schedule multiple visits.

Everyone loves more phones calls and visits, right?

On the way there, I said, “You know, this does defeat part of our impact.”

“What do you mean?” the social worker asked.

“We won’t get much of a chance for one-on-one encounters. A lot of what we do is based on being with the patient or family member. Having another person around changes that.”

“Oh,” was mostly what she replied. She was young. She was new. On we drove, excellent stewards of hospice resources.

At the first visit, the husband was the patient. Chairs encircled his bed. Since he was hard-of-hearing, I initially stood beside the bed, speaking loudly. He kept chatting; I listened. Occasionally I’d raise my voice to pose a question. Hey, one of my gifts is being loud. During that time the social worker and the patient’s elderly wife and daughter retreated to the living room.

Later, I joined the women in the living room. “Perfect timing,” the social worker said. “We were just talking about . . .” And soon the wife and daughter asked how to best engage their eighty-something husband/father in a conversation about dying. I could answer, because he and I had just shared about his feelings. They also welcomed my comments about how much his wife represented an essential part of his spiritual support. “Really?” the wife marveled. “He said that about me?” She grinned, obviously pleased.

Our next visit was awful, and awe-filled. As soon as we arrived, the patient’s mother asked if I’d pray with her son. He’d entered the last stages of a vicious struggle with cancer. His mother, up from Los Angeles, was desperate to comfort her dying child. Barely forty, he appeared closer to seventy. Barely alive, he was surrounded by his family’s love. As soon as we entered, the social worker joined the patient’s exhausted wife and daughter at the tiny but cluttered kitchen table. This wife and daughter were dramatically different from our first, earlier visit. The wife was soon to lose the love of her brief life; the daughter, with her shy smile and bright eyes, was not yet ten. Weary from tending to her husband and anxious to respect her mother-in-law’s needs to help, the wife gratefully shared with the social worker.

What I knew, after we left, was that the social worker and I had both prayed. Perhaps my way was more formal, with my words concluding in the traditional, Amen. But the social worker’s presence at that kitchen table felt like a version of physical “prayer.” Her presence reflected the wondrous Biblical tradition of Elijah at the cave’s entrance on Mt. Horeb, listening for God, whose voice came not in the earthquake, but in the blessed silence. (Or the still small voice, as I Kings 19:11-13 is often translated.)

We each contributed in our own ways. There were prayers and presence, words and silence. Each family member received the time and attention they deserved. Often it is good for nurses to be accompanied by social workers, for chaplains to join with home health aides.

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And it also better if the extended family all contribute to the caregiving.

Even though there may be conflict—a family’s troubles often become even more obvious when confronted by a loved one’s (or disliked one’s) dying—figuring out ways to work together helps everyone. Don’t get along with your siblings? Always argue with your parents? Why not rake leaves or mow the lawn outside while another does the “inside” chores? Or try (try, try, try) to put old arguments aside and share a little or a lot of the caregiving.

Too many caregivers are alone. A time of dying can be a time of healing.

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Earlier, ever the fool, I’d said to the social worker, “A lot of what we do is based on being with the patient or family member. Having another person around changes that.”

Yes, it changed everything . . . and all for the better.

How wrong I’d been. How right the day felt.

(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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