Hospice

Thanks to Poopie, for passing this along.

This is a beautfully written story. I'm still saying, 'wow'.

I got a call from the Hospice bereavement counselor yesterday. She asked me if I'd be willing to train new volunteers on making grief and bereavement calls.

This is a huge honor. I've only been making solo calls for a couple of months, and now they want me to train new volunteers.

Wow.

She said that I take meticulous notes and can tell by the notes that I take that I have meaningful conversations with the people that I call. Yep I do and I do. I was glad that she didn't comment on my sloppy writing.

She wants new volunteers to listen to me make calls and show them how to document a file. Having people listen in to my calls feels rather invasive to me but I know that it's helpful to hear how these calls go because making calls like this can be intimidating. I still get intimidated every once in a while when I read some of the case file notes. I've taught myself to take deep breaths and acknowledge that if I'm not meant to make that call, then the person on the other end of the phone won't pick up.

There are calls that I won't make, but that's only happened twice. For example, I saw in the case file that the wife of the patient had early onset alzheimers. I didn't feel equipped to handle a conversation with someone who may not remember that her husband was dead, or even that she had a husband. I felt that this call was better left to a counselor.

I am glad that I have been given the 'permission' to only do what is comfortable to me. Although there have been very few situations that have caused me anxiety, it's nice to know that I have no reason to fear any situation. I hope that I will be able to pass this assurance on to others who want to volunteer.

I'm really excited about this.

I had a pretty powerful experience today while making my Hospice calls. It seems that every time I write about my Hospice calls I mention how amazed I am at the timing of things. Today was no exception.

While on my way to Hospice House, I gave my brother a call. It has been a couple of weeks since I've talked to him and I wanted to see how he was doing. After talking to him I turned on the CD player and the next song was one that always makes me think about my brother and sister. I'll post the lyrics at the bottom of this post.

I have a unique bond with my brother and sister. One that comes from shared circumstances beyond normal childhood experiences. The relationship with my sister is vastly different from the relationship I have with my brother, yet I love them both fiercely and I'd gladly lay down my life for each of them. I mean that with every fiber of my being.

My sister is nine years younger than me and we seem to have switched roles in our lifetime. I used to be her protector and now she is mine. She is the protector of my secrets and most sacred thoughts. She gives me a safe place to share my joy as well as my fear. There is no doubt in my mind that we were meant to be sisters even though we do not share a biological bond. The bond we share goes much deeper than biology.

As I listened to the song in my CD player, I thought about how blessed I am that we love each other the way we do. I've had friends who, even as adults, do not get along with their siblings. This always makes me sad for them because there is something special between siblings that is hard to explain. For me, it's solid and it's unconditional.

When I got to Hospice House and pulled my first file, I saw that it was that of a man who had died in his mid-fifties. I had five phone calls to make: one to his daughter, and calls to his siblings. As I read further, I saw that at the moment he died, two of his siblings were each holding his hand. I have in the past imagined myself in this exact scenario, leaving this world with my brother on one side of me and my sister on the other.

While reading through the file I imagined what it would be like if I had to watch my brother or sister die and it was too painful to think about. I was almost afraid to pick up the phone and start making the calls, but I'm so glad that I did. I spent almost two hours talking with this man's siblings and was so touched by their bond. They each took turns caring for him at the end of his life and they shared very different, yet equally loving experiences. Just like my bond with my sister and brother, they each had unique and very strong bonds with each other.

Two of them shared with me how they never got along when they were kids, but as they grew older they became closer and closer. Now their greatest joy is when they get to spend time together. I could hear the love they felt for each other as they shared stories with me. And even though the death of their brother was sad, they have wonderful memories of the time they spent with him.

One sister said, "Taking care of my brother never felt like a chore to me because I loved him".

Today was truly a beautiful experience for me. How could I not love what I do when I am provided experiences such as this?

When I got in the car, I played that song again and it had even more meaning than it ever. I'm not sure I'll ever hear it again and not think about this family and the service and love that they showed for their brother.

Lucky are we that have siblings.

Here are the lyrics.

Whenever You're In Trouble
Lyrics - Donny Osmond
Album - What I Meant To Say

Tell me from the heart
in your eyes I see the pain
It’s tearing you apart
let me take it all away
You know someone believes in you
when they love you no matter what you do
You know you are home
and you're not alone

Whenever you're in trouble,
whenever you may need me
I will fight for you,
I will help you through
Whenever life’s deceiving
I'll give you new meaning
No matter where you are,
you're always in my heart
Whenever you're in trouble I will be right here

Sometimes you're gonna find
nothing goes the way you planned
But whatever’s on your mind
I will try to understand
You know someone is by your side
when they help you through the darkest night
You know you are home
and you're not alone.

Now's the time
to share what you're feeling inside
No matter how long it takes
no matter how many mistakes
Oh, now’s the time
to reach and you will find
that whenever you need me to care
I'll always be there

Whenever you're in trouble,
whenever you may need me
I will fight for you,
I will help you through
Whenever life’s deceiving
I'll give you new meaning
No matter where you are,
you're always in my heart
Whenever you're in trouble I will be right here

I love you bro and sis....

Thanks FTS for giving me the opportunity to talk about Hospice work. Although I'm very passionate about it, I don't allow myself to expound on it too much for fear of exposing myself to be a zealot.

Your question was:
What do you find the most rewarding part of your hospice work ? What is the hardest part of it? Exactly what services do you perform, both for the patient and their family, and for how long? Have you met people who have affected you, and how have they?

The most rewarding part of Hospice is the fact that I'm given constant reminders of what is, and what isn't important in life. It seems that when I'm in most need of a 'nudge' of some sort, a reminder is presented to me while I'm participating in my volunteer work. It's almost something I've begun to count on, and it's certainly something I pay close attention to. I remember when I first started volunteering with Hospice, I was even more of a workaholic than I am now and my life was extremely out of balance. As I listened to these people who were at the end of their life, I rarely heard them talk about important work was to them. Family and friends were the things they spoke of. This was probably one of the largest lessons I've taken away from Hospice. My life is more in balance than it has ever been because I've placed work down the ladder a few pegs.

The hardest part of Hospice is to keep myself from becoming overwhelmed with emotion when I'm talking to a Hospice patient or their family. I'm an extremely empathetic person and tend to take on the emotions around me, whether it be at work, home or at Hospice. It's a fine line to walk when you want people to know that you truly care about their situation and welfare, but then stop short of becoming so emotional that they are no longer the center of attention. We are taught several techniques to keep from getting outwardly emotional and I use them a lot. It's important that I added the word "outwardly" in that last sentence because we cannot keep ourselves from feeling the emotion. That takes away from the human experience. The feeling is there, the trick is in not showing it too much.

It's also difficult to not take some of the work home and dwell on it. I found that especially hard when I was in patient care. It was difficult to grow to care about a family and then have to move on after the patient passes on. It is also difficult for the family to accept. I've had families want me to continue to come visit and care for them after their family member died. But I can not. It would not leave me time to care for new families.

When I first started with Hospice, I was in patient care. This meant that I would visit patients in their homes and care for them while their primary care givers went out and ran errands or did things for themselves for rejuvenation. I've had patients that have lived for almost the full six months, and patients that I never met. Hospice is designed for people who have a life expectancy of six months or less to live. More often than not, patients are referred to Hospice or 'give in' to Hospice only days before they are gone. There are several factors for that, which I won't expand upon here. I am sad when this happens because people who have experienced Hospice go on and on about how much better their life quality was after they started Hospice services. 'Our' job is to make things comfortable for the patient and easier for the family.

In patient care, I'd do anything from just sitting in a room and reading, to full on patient care (washing, shaving, changing beds, changing bed pans, etc.) You are not required to do anything, but are allowed to do as much as you're comfortable with, with the exception of administering medications. This was something we were not legally allowed to do. I think that was the part that scared me the most. What if the patient was in severe pain while their family was gone and needed it and I couldn't give it? This never happened, but I was always on guard.

Now I am in grief and bereavement support. My job is to call the families of people who have passed on and perform a grief assessment. We listen to them to see if they are having issues over and above 'normal' grieving. There really is no such thing as 'normal' grieving, because everyone does it in their own way, but there are things that are abnormal. Suicidal thoughts, closing off from the outside world, violence, etc. I listen for hints of any of those things in our conversations and refer them to our staff counselor if necessary. But normally, I just listen. Some calls are five minutes of "I'm fine" and "I don't need anything", to an hour of just listening. There have been calls that have affected me to such a degree that I need to get up and walk around the gardens for a while before I can continue. There are calls that have made me blush. There have been many calls that have connected me in such a way with the person on the other end of the phone that I wanted to hang up and go hang out at their dining room table with them. Those calls are the most rewarding for me. It's the connection of talking spirit to spirit. It's almost palpable.

If I could pass on one thing I've learned about grief it would be to reach out to as many people as possible and use the grief support available to you whether it be church, Hospice support services, or whatever. The people who actively participate in their own well being are the ones who do well. It's almost like night and day. Many of the people who take an active part in their own well being go on to offer their support to other people. It's really rewarding to hear about their journey.

While this answer is getting rather long, I don't want to end before answering the last bit of the question: Have you met people who have affected you, and how have they?

Everyone I touch through Hospice (well, except the "I'm fine" phone calls) affects me in one way or another, but there are two people who have affected me over and above anyone else. One was my first Hospice patient. She reminded me of myself- the overdoing self. She held tight to the same things I hold dear. Family, independence and service to others. I met her while she was still able to get up and around. She didn't have a lot of energy, so she used me as her conduit to do things for her family. She'd have me cook dinner for her husband EXACTLY the way she cooked for him. It was important to her. She supervised me while I cleaned her house EXACTLY like she would have. Eventually, she didn't have the energy to even do that and she started giving up those things. At first it was very difficult for her do to this and she cried from the sheer frustration that she couldn't 'DO' anymore. When she gave in and allowed others to 'do' for her, she did it with grace and I hope that I'll be able to do the same when my time comes.

The other was a 50+ year old man with ALS, an insidious disease the slowly robs you of the use of your muscles; eventually rendering you unable to breathe. I think it's the cruelest of diseases because your mind is very clear up to the end.

This man used to be very active as a volunteer with forest trail cleanup. When I met him he didn't have any use of his body anymore and took a long time to gather enough breath to get many words out. He was in the Hospice house while his family went out of of town for a wedding, so I only had the opportunity to meet him once. It was my job to feed him lunch on the day that we met. Due to his lack of muscle control, lunch was a two hour process. Since he couldn't talk and eat, I talked to him about various things. Eventually, I got on the topic of a hike I took the previous day. It was then that I saw his eyes light up, so I knew I hit on a topic that was very dear to him. What I remember so clearly about this man is that even though he had to speak very slowly, I could *feel* the passion behind every word when he spoke of the forests and trails. It made me so sad that this man who was clearly such an avid hiker could no longer even feed himself.

Not too long after he died, I ran across some of the trail volunteers while on a hike to my favorite 'thinking spot'. I asked one of them if she knew him, but she didn't. I kept on hiking down to the bottom of the trail to my 'thinking rock'. There was another group of trail volunteers sitting by the falls eating their lunch. As I sat there and looked around at the beauty surrounding me, my thoughts were interrupted by the woman I had passed earlier. She invited me to come over to talk to the other trail workers because many of them did know this wonderful man. He was a part of their team. It was an emotional, almost spiritual time for all of us as we talked about all of the things that this man had contributed and what a wonderful human being he was. It was hard to not feel a spiritual connection as we were surrounded by such beauty.

I dedicate every hike I go on to this man and I think about him several times during my hikes. Even though I only spent two hours with him, he's someone that I will remember forever.

If anyone reading this is interested in becoming a Hospice volunteer, please with questions you may have and I'll be happy to answer them.

Thank you again, FTS, for allowing me the opportunity to write about something that brings me a lot of joy.

Yesterday while making my Hospice calls, I had an encounter that made me cry.

I work very hard at keeping my emotions in check when talking to the families of those that have passed on, and I do a really good job of it. Some of the calls that I make are very painful to hear, especially for someone like me. I feel that I was blessed (or is it cursed?) with an extra dose of empathy for other people and I sometimes can literally feel the pain coming from the other end of the phone.

This is one of the reasons why I'm glad that we're not supposed to do much of the talking. We're just there to listen. Sometimes the lump in my throat feels like a grapefruit and I know that there is no way I could talk at any great length without exposing my emotions.

Yesterday was one of those days.

Before I make a call, I review the file to pull out pertinent information, such as what the deceased did for a living, what their interests were, how long they were suffering, how many other relatives were involved in their care, etc. Some files have several calls to make, upwards of 4-5 calls in regard to the same person. Between what I've learned in the file and what the family members tell me, I get to know that person who passed on very well. This is one of the things that I love about doing this; I love hearing people's stories. There are so many interesting things about the people around you, if you will only take the time to listen.

Yesterday, I made a phone call to the son of a woman who passed on in early January. The woman had lingered for a very long time. A woman answered the phone, so I asked if I could speak to (son of patient). She asked me who was calling and I told her my name and that I was calling on behalf of Hospice Bereavement Services. Her voice started quivering as she told me that (son of patient) had recently died. She answered yes when I asked her if she was his wife. At that point, I quit being Hospice Bereavement Services, and just became a voice on the other end of the phone. I shut the file so I could concentrate on what she needed to tell me. It was no longer about our patient and her son, so she was not a "client". She was just another human being who needed to talk to someone. She shared some memories of their life together with me, and that seemed to bring her comfort. She went on to tell me that her husband went very quickly, and she felt it was because of how long his mother had lingered. This was just another testament to how much control people have over their own death experience.

When I hung up the phone, I cried. Maybe it was the surprise of calling for someone who had died that caught me in this emotional state. I don't really know. I started thinking about hanging up my hat for the day, but instead I challenged myself to move past whatever caused these unexpected and uninvited emotions. I had a strong feeling that I wasn't done for the day and there was someone else I needed to call. So, I got up and opened the door leading to the garden in the middle of the Hospice House, sat on a bench and listened to the birds for a while.

It was my original plan to make four hours of calls and then leave at 2pm. After I was able to pull myself back together I made another hour of calls. When I looked at the clock and saw that it was now 1:45, I knew I was on my last file. I also knew that as long as I didn't get on an call with someone experiencing extended grief issues, I would be able to make it out of there by 2pm.

I opened up the last file for the day and saw that this patient had a husband and a daughter to call. The first phone call, to the husband, was brief. "I'm OK." "Yes, I've been reading the information you've sent." "I'm OK." The call was very brief, less than 5 minutes.

Then I called the daughter. When I asked her how she'd been doing these past few weeks, she never talked about herself. She only talked about how her dad needed support and how she was working very hard at taking care of him. Whenever I'd try to bring the conversation back around to what SHE was feeling and what she was doing for HERSELF, it became apparent that she was having a difficult time understanding that this call was to support her, not her dad. Eventually she allowed herself to be supported by me and then she admitted that she needed help with her grief but added that she didn't want to "be a bother".

I reminded her that just as she has been such a wonderful support for her father, she also needed to allow someone to support her.

It was then that I knew why I didn't end my calls after the call that had me in tears. I was talking to myself, just as much as I was talking to the person on the other end of the phone.

She agreed to a follow-up call from the counselor, but I'll never know if she really *heard* what I was saying. My relationship with the family stops the moment I hang up the phone.

*I* heard what I was saying, and I'll just hope that she did too.