When we are in pain, it’s hard to think straight.
Most people want to die at home, in our sleep, and pain-free. Hospice knows how to do this. It has powerful medicines which are not just from the pharmacy. Its team structure is designed to act from a wholistic perspective of body, mind and spirit. The doctors, nurses, aides, psycho-social and psycho-spiritual support of social workers and hospice chaplains are generally called by the Higher to do this work ….and having said that, they (we) are fallible humans. As a hospice chaplain, I have seen good passings and could-have-been-better ones but the fruit of each hospice tree is always better than without their support.
Begin with hospice early.
Every end is different but it saddens me that so many people lose out on making the most of the time they have left by fear of hospice. They lose out on chances to put themselves in the drivers seat and craft a passing that is satisfying and a gift to all who witness it.
A good end starts here, wherever you are and right where you are. Most of life is easier in community. A good death is the same. We need a faithful team of family, friends and a hospice, which understands your desires and wishes. It takes a bit of time to speak it into existence, so we need to use our time well.
A hospice team, which listens and serves is the best.
Hospice needs a captain to listen and guide it to act on the wishes of our client-patient. Love, miraculously, does this without anyone’s help through the many hands, which show up to serve. However, if communication with the one who is ill is still possible, it should guide the team. I see our job as offering back as much dignity and control in one’s own passing for as long as possible. The best hospice teams do this by listening and serving as Dr. Rachel Naomi Remen defines it because hospice, unlike the medical model, is not about fixing or really even helping:
Helping, fixing and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole. Service is a relationship between equals: … service strengthens… Fixing and helping are draining, … but service is renewing. When we serve, our work itself will renew us.
Finding a local hospice that listens, serves and fits you is worth the effort. Interview them. Interview the leadership: the director of nursing, RN/case manager. Ask how long the team has been together? Follow your heart and mind here: do you feel valued and heard? I recommend, as a hospice chaplain, even to have conversations with the psycho-social-spiritual members, too.
BODY: Getting Comfortable
Hospice makes our last days comfortable. The physical medicines used are powerful and used properly lengthens the quality of life - not shortens it. These are medical options, and adjusted as you change. Each time the team meets they are reviewed. Speak up and say what is working and what is not. It is important to feel heard but it is also important to listen here. Escalate until the dialog is balanced…or switch hospices. You have that right
MIND: Feeling Safe ENOUGH to Speak Truth
No matter what your spiritual or faith tradition, or the lack of it, we are all ultimately here on the edge of not-knowing what is next. Uncertainty rules here, which is uncomfortable at all times, but it may be particularly terrifying to the logical and rational part of our minds which have no framework or possibility for fixing this; so that piece of us, our mind, simply circles in fear. Faith is tested. Fear is not where we want to be at our end or in our life, for that matter. Consider Einstein here:
SPIRIT: Wisdom of the Higher
Here, we need to remember the Higher. Your faith leads. God also accompanys our loved ones who are walking with us to the end of life, but not the end of love. It is our human journey. As Ram Das says, “We are all just walking each other home.”
Stay in the drivers seat as you are able. Speak your wishes to your loved ones. Entrust one to speak for you when you may not be able to. Choose your hospice & team. Every human being is unique, but in death, we are all on the same return journey…Know that, no matter our plans, Love is at the helm and, at some point, we all slide over and give the car keys to God.