The Sound of One Phone Ringing

 

Offhand the answer to the following question might sound as obvious as choosing between getting a back rub while relaxing at the beach versus doing the back-breaking work of moving furniture around. If you were a grieving family member of a patient on hospice, would you prefer that the bereavement counselor telephone you or visit in person? If I could see a show of hands from my readers, my guess is that most of you would be wildly waving your hands in favor of the home visit. And if you could explain why, you and a few others chiming in might say something along the lines of, “A phone call is impersonal and quick. It doesn’t take much effort. A visit involves travel and a real time commitment, so that would show the counselor really cares. Besides, there’s nothing like someone being right there with us and understanding what we are feeling by seeing our expressions and gestures. Not only that, we can get a hug that way or a pat on the arm.”

In terms of supervisors evaluating the work of their hospice team, home visits, implicitly or explicitly, trump phone calls. So even hospice professionals themselves assign more value to home visits. They “count” more. I sometimes got skeptical feedback from the supervisor when “all I did” some days was to document that I made about a dozen phone calls.

Ah, but hold the phone. It wasn’t like I was being lazy about going out into the wintry mix and traveling twenty miles. It wasn’t like I was hinting that I was busy or did not let on that a visit could be in their future. If I do not include the calls where the bereaved did not wish to talk with a counselor at all, almost everyone I called preferred a phone call over a visit. You might then say that is because a grieving person can feel unworthy and small. Indeed. Thus if he/she did not out and out decline a visit and seemed at least lukewarm about my proposal, I assured them that for example I would “be traveling right in your area” and the like. Even with that sales pitch, there were relatively few takers. I did start to feel like a pushy salesperson by mentioning visits so much, so as I became a more seasoned chaplain, I learned that what mattered most was to get a conversation going then and there.

Some mourners not only wanted to talk on the phone when I called to offer condolences and see how they were doing, but also wanted to receive subsequent calls. I got to know one of them well enough to reflect why so many in her position did prefer calls over visits. For one thing, she did not have to worry about tidying up the house. For another, she could shed tears without my being aware of it. Nor did she have to feel obligated to talk a relatively long time; accepting a visit implies more of a time commitment. That is, a phone call gives the mourner more control over the length of the interaction.

By far the most interesting reason is the ability to hide feelings, which is something to explore in a future (next?) post. For now, it is of note that the bereaved can be low in energy, and that a visit may be far more taxing than a call. As in much chaplain work, the crucial element is not whether I talk with a person via the phone or Skype or face-to-face or for how long. My job is to deftly clear away the debris of small talk and thus join them in their effort to unleash what they most urgently need to say.

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Recent  Event:

 

September 18th Grief expert Chaplain Chaz Wesley  interviewedme on his radio program, From Grief to Grace. Here is the program  link:  Author Karen B. Kaplan on ‘From Grief To Grace, with Chaz Wesley’

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4 thoughts on “The Sound of One Phone Ringing

  1. Liz Adams says:

    It’s also good to recognize other ways in which the chaplain can help. By using email for people for whom the phone is difficult, for instance. And, as you say, Karen, respecting the family’s request. Hospice people hardly ever seem to grasp that their visits, useful as they are, leave both patient and family worn out from the sheer decibel level, for one thing, and the high energy rushing about of younger, healthy people in a house where someone is dying and the family is exhausted from care and emotional stress. We used to treasure the days when nobody visited. In fact my husband used to say, oh, we have a day off!

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    • Unfortunately, even in hospice, job requirements and/or the professional’s own need to feel useful can override the client’s needs. When I could circumvent a requirement where no harm was done, I did. For instance I was to phone bereaved family members again who declined any help at all (visits or phone calls) up to three times, in case they “changed their minds” as their bereavement process progressed. I discovered that such a changing of mind virtually never happened, so I simply documented that I called three times without actually adding to the client’s pain by repeating an unwanted call. As for email, only one person had requested email in my seven years as a hospice chaplain. But as the percentage of elderly people using email continues to rise, this request will probably become more common.

      When I did visit, I tried to observe the art of knowing when it was time to leave. I say “the art” because some people are afraid of imposing on the clinician’s time. The length and the quality of a visit do not necessarily correlate; if anything, it can be a negative correlation.

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  2. DJ says:

    Hi Karen,
    Thought provoking. I wonder how technology like skype and its many variations will change the bereavement call?

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  3. There are ever more gradations of the extent to which the family member can “let the chaplain in.” I suppose for a visual Skype call compared with an in person visit,, the family member would still feel less obliged to make it a long visit, and would only have to tidy up the space directly behind her. Compared with a phone call, the advantage for the chaplain is that he could observe all the visual cues that would help him choose the best way to move the conversation forward. So each form of communication has its advantages and disadvantages, both for the client and for the chaplain (or social worker, etc.).

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