What If a Hospice Patient Asks: “Will I Get Better?”

lie or truth

The simplest of questions are asked before someone enters into a hospice’s care. Versions of those questions continue after a hospice staff has arrived at a home or facility to serve the needs of a dying patient.

Simple doesn’t mean easy.

Simple can be the hardest of all.

The hospice patient asks . . .

  • Will I get better?
  • What is wrong with me?
  • When can I walk again?
  • Must I take all those drugs?
  • Why aren’t I hungry?

I’m sure other equally “simple” questions have been asked. Truly, what is more straightforward than a person wondering when or if they might regain the strength to walk? Or to want to know why they feel so “off?” Or to request why new medications are supposed to be taken?

How will you respond to your loved one when she or he seeks an answer that you already know? This nice (or not so nice), hopeful (or not so hopeful) person you care about (or feel obligated to provide care for) merely wants to know what is happening.

In many relationships, the answers come easily. There are loved ones, long before becoming a hospice patient, that understand the cancer’s severity. They are able to discuss the best and worst of what having “six months or less to live” means. Many physicians, long before you or your loved one enters into hospice care, regularly communicate choices and options as the COPD, ALS, leukemia, or other diseases impact the body. Everyone—patient, family, caregivers, medical staff—are generally on the same page with the diagnosis and prognosis.

No secrets.

No surprises.

No whispering.

Wouldn’t it be great if all patients and their caregiving families were “on the same page?”

They are not.

And so, when your dying loved one asks one of those questions with its easy-to-understand words that can be difficult to openly express and emotionally costly to answer—such as Will I get better?—how will you respond? Which of these six options would you choose:

You promise someone else—a nurse, doctor, family member—will answer.

Will I get better?

You: That’s probably a question for the nurse. She’ll be here tomorrow and it’s probably best if you talk to her. You know, she’s the expert on these things. We should wait to hear what she says.

You chatter on like a smarmy politician and never answer.

Will I get better?

You: Hey, I mean we all are hoping and praying that you could better. Didn’t you say you were feeling better yesterday? I mean every day is going to be different. Remember when were kids and we would be sick on Monday and then great by Tuesday? Or what about Aunt Tootsie, who everyone figured was gonna die after her accident, and the next year she still brought her god-awful potato salad to the family reunions? You never know what’s going to happen, right? Any-who, you know what they say . . . when the going gets tough, the tough get going! That’s you!

You change the subject to something else.

Will I get better?

You: Have you eaten anything today? I mean, I always get a little hypoglycemic whenever I forget a meal. How about if I get you something to snack on? Maybe that vanilla pudding you ate a couple of bites of yesterday? Isn’t it your favorite?

You answer with a big fat lie.

Will I get better?

You: I think you’re a little down today, but I’m sure you’ll get better. You’re going to beat this. Those doctors don’t really know you. You’re a fighter, not a quitter.

You tell a nice, white lie.

Will I get better?

You: Let’s just focus on today. We all know this is serious, but didn’t I tell you what the pastor said in last Sunday’s sermon: when God closes a door, He opens a window. Let’s both look for the window, huh? I’m praying for you to get better!

You are honest.

Will I get better?

You: _________________ . . .

+      +      +

Isn’t honesty the best policy?

Well, I suppose sometimes it’s not.

If the person entering into hospice’s care has a form of dementia, family members and caregivers often rightly choose to avoid truth-telling. Because of dementia, labeling their explanations or silences as lies would be unfair. I’m also confident that some reading my six suggestions could give me unique examples about their family. Leo Tolstoy’s oft-used comment on families—Happy families are all alike; every unhappy family is unhappy in its own way.—is undeniably correct. Unhappiness, with its companions of anger, envy, grudges, regrets, and more, may prevent any possibility of healthy communication about dying, death, or the grief that follows.

But for all the rest, what prevents us from providing the obvious, easiest, and most truthful response when confronted with an illness that means there are six months or less to 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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  1. My best friend was dying. We talked about this five years before she actually died. We both had gone to Divinity School. We understood but that didn’t make it easier. It just made it more difficult. I was her caregiver for those last five years. She was on hospice care for a couple weeks before she died.

    I know hospice is good. Sometimes it can be horrible. Luck of the draw, I guess. Usually there is a team. The nurse can make or break it. The one we had – broke it.

    Every day. Every single day, she would say to me, “She’s not going to make it.” “She doesn’t have long now.” “Maybe she’ll die before I come back.” So many variations on the same theme.

    The last day the nurse was scheduled to come, I called another friend and asked if she would come and stay while the nurse was here. My other friend came right away and I drove off. I couldn’t take the nurse saying that one more time.

    My friend and I knew death was near. We prepared (as much as you can) for it. It was a sacred time. That nurse was like fingernails on chalkboard screeching through what was holy.

    I was gone a long time. A long time. That nurse was waiting for me!

    “I had to wait till you got back. I just have to tell you, I’m pretty sure she’s not going to last 24 hours.” And, then she left.

    When my other friend left I went outside and screamed into the storm. “DAMN YOU! DAMN HOSPICE! DAMN IT ALL!”

    My friend did die that night. And it was quiet. It was holy.

    I never saw that nurse again.

    • Pat:

      Thanks for your comments. While hearing hospice stories about an RN that often made your day “worse” than necessary with her announcements is sad, they do happen. I have no idea if you ever complained to this nurse’s hospice supervisor, but it would’ve been appropriate. If anyone reads this, and is currently struggling with staff from a hospice, I encourage letting the hospice know. I would like to think that a hospice would respond and try to correct/improve the communication between staff and caregiver.

  2. Pat I am so sorry this was your hospice experience. As a hospice director I stress to all my staff to “not play God”. We focus on the day and the symptoms that need managing. Unfortunately not everyone has the empathy skills to know how others are feeling about the things they say. It sounds like social work and/or chaplain would have been very helpful in this situation. And I agree, please let the hospice know how you feel. It may be that nurse has no idea how she made you feel. It could be a great education to that nurse and others so nobody else has this experience. My condolences for the loss of your dear friend ❤

    • Dear Jody,
      First, thank you. As a chaplain myself, I do know that we are all human. I had a great lesson being on the other side of chaplaincy. Going into it, I felt I didn’t need a chaplain and my friend didn’t want one either – after all, hadn’t we sat in the same kinds of classes as this unknown chaplain did? We both had gone to Divinity School, not seminary so we felt we had a global outlook, too. Well, i was wrong. The chaplain came by mistake and he was wonderful. Absolutely wonderful. I cannot say enough good about him. I’m glad there was a mistake in his coming.
      I wrote to Larry and let him know that I did write to Alive Hospice and told them about my experience. I told them the good and the bad. At the time, the bad was more lived. Yet, when I called the triage nurse during the night – oh, she was incredible. I told her about the day nurse and also told her I didn’t have any false hope. The triage nurse said, “Yes – but we can always be hopeful even if intellectually we KNow.” I needed to hear that…yes, intellectually, my friend and I knew death was near. We were not afraid to say the words. The nurse who came to pronounce couldn’t have been better. It’s funny how the other nurse was the one that stuck with me when there was a lot of good. I didn’t write to Alive Hospice for quite awhile. I was able to let them know about the good…but I sure didn’t want anyone else to go through what I did and hopefully, the day nurse got some training…extra training. Thanks again, Jody and Larry – Pat

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