It is one thing for a friend to ask how in the world I can deal with hospice work, but quite another matter when a patient asks me. The way Shirley put it was, “How can you do this job when you have to keep losing people you get to know?” I stumbled out an answer to the effect of Alfred, Lord Tennyson’s “ ‘Tis better to have loved and lost than never to have loved at all.” (No, that quote is NOT by Shakespeare.) To myself, and to my readers here at offbeatcompassion, I will comment on Shirley’s query more searchingly. First of all, it is always of note when a patient says something like that, because it makes me wonder what is behind it, and what it might have to do with her own feelings about losing other patients she got to know very well and who had died before she did. Unusual for a hospice residence, for one stretch of time, several patients had been pretty alert and visited each other and smoked with each other out in the back before most became bedridden or died. Shirley’s comment possibly touched on her sorrow of anticipating that some day, she herself would lose everyone and everything when her time came.
Anyway, I will stall no longer about how her question applies to me and anyone else who works with hospice patients. Why was Tennyson right? I think one thing Shirley was implying was, okay, I only get to know my patients for a relatively short time, and this keeps happening over and over, so is the pain of losing them worth the pleasure and experience and reward of having known them in the first place? The answer for hospice caregivers, as well as for me, is yes, otherwise turnover in this field would be pretty frequent. I once heard at least for chaplains that the average number of years they spend in hospice work is about eight years. That to me sounds plenty long, so there must be a reason for it other than masochism. And it certainly cannot be the pay!
Sure I miss some of the patients I get to know well and find more in common with, like Shirley herself. But the mourning is brief, as the relationships are. When I lose members of my own family, just like everybody else, grieving is not a pretty picture. But I think because patients are strangers and not exactly friends no matter how much we like each other, the grieving is simply not intense or prolonged as with family. On top of that, I must maintain a professional distance in order to think carefully about what a patient needs to talk about and what kind of response will best help them. This leaves me mostly the “better” and easier part of grieving. Such grieving touches on the memories of the interesting things they said or showed me, such as advice about how to relax, pictures of them posing with famous people, or even an audio of a band they played in. At most I may feel wistful about a particularly endearing or admirable person. Writing about some of them in this blog or on Twitter is also an outlet for honoring their memory and my feelings about them.
If you do “this kind of work,” how do you handle the constant leave taking?