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My hospice training

Hearing some good—and some terrible—advice for helping the dying

My hospice training

(Illustration by Krieg Barrie)

“Save others by snatching them out of the fire,” Jude 23 says. That sounded like a good description of visiting dying people, so I followed an insistent friend to a hospice volunteer training meeting.

I was a little surprised that participation would require a 12-hour orientation. But not really. By this time I know that everything is complicated. There would be the forms to fill, criminal background check, TB testing, Hep B shot, coaching in proper hand-washing techniques, quarterly enrichment seminars, tips on how to speak, tips on how to listen, tips on how to enter a room. I had ludicrously imagined visitation to be a matter of getting in the car when you have a free hour and going to the nursing home to find a lonely person.

To be fair, just because something is obvious doesn’t mean it isn’t needful to say. At times I was convicted by the “obvious”: “Greet the person when you walk into the room.” “Smile.” “Make eye contact.” “Be a good listener.” “Gently touch shoulder or knee.” “Think about what the other person is saying to you.” “Never argue.” I thought about my habits with my family. Every bullet point on the syllabus seemed a peremptory B-minus or C-plus struck on my virtual home report card. 

I don’t want to be boorish, but I don’t want to lie. There is a hell, and there is a heaven.

A list of “Dos and don’ts” of what to say followed. “Don’t say to a person in dementia: ‘Do you remember when …?’ Say instead, ‘Tell me about …’” “Don’t say, ‘You can’t …’” “Don’t command; ask or model.” “Begin conversation socially or with a prop.” To the family, don’t say, “I know how you feel.” Don’t say, “He’s in a better place.” Don’t say, “It’s part of God’s plan.” “Avoid statements that begin with ‘you should.’”

I’m a nervous wreck. I don’t do well with too many instructions on how to walk into a room. It tends to produce in me the “centipede effect” where the poor self-conscious insect who once ambled merrily along starts tripping over his own legs.

Besides, I got stuck on the part about the “better place” and “God’s plan,” and the organization’s recommended substitution: “Assist the family in discovering, exploring, heightening, nurturing, honoring their own spiritual beliefs to find comfort and peace on their journey. WE NEVER IMPOSE OUR BELIEFS; RATHER, WE SUPPORT OUR PATIENTS.” I thought of Screwtape’s words to Wormwood: “How much better for us if all humans died in costly nursing homes amid doctors who lie, nurses who lie, friends who lie …”  (C.S. Lewis, The Screwtape Letters).

I don’t want to be boorish, but I don’t want to lie. There is a hell, and there is a heaven. What do I do with that when the choice is between politeness and truth and there’s about 24 hours left till this woman meets her Maker because the hospice just changed her status to the “active” category? 

There was some discussion of what is “normal” for the grieving families. I had trouble with the venerated Kübler-Ross “five stages of grief”: “denial, anger, bargaining, depression, acceptance.” It gave me the creeps, to tell the truth—the very idea of being locked into an inevitable sequential morbid psychological endgame. And I know it isn’t true. In her book on grieving the untimely loss of her husband in a plane crash, Patti McCarthy Broderick writes:

“I chose, instead, to bank my life on Scripture being true. … As I armed myself with this truth from God, many of my friends … thought I was in denial. The truth is that I understood what I had lost more than they could ever know, but I was intent on hanging onto God’s promises: ‘For I know the plans I have for you,’ declares the Lord. …”

I do know the denial-anger-bargaining-depression dance firsthand. But my understanding from the Bible is that we’re supposed to fight it, not roll over to it: “Fight the good fight of the faith.” Just because something is “normal” doesn’t mean it is not to be exhorted against. Corruption in government is normal. High school taught me that “normal” is a statistical, not moral, concept.

I may not be back for the rest of the 12-hour orientation after all. But I will work on a “gentle touch on the shoulder” at home, for sure.