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Spirituality and Hospice

By: Toni Brasted (Chaplain)
When people find out what I do for a living, it is not unusual to hear them say, "That must be difficult work," or "I could never do what you do", or even, "That sounds depressing."
Providing spiritual care for people and families dealing with life-limiting illnesses, however, Anchoris one of the great privileges of my life and my ministry. It is a blessing to be able to walk alongside people on the final stretch of their life's pathway. I hope that I am able to give them as much as they give me in return.
They frequently remind me of the importance of my priorities in life. Hospice patients do not have time or energy to waste in unimportant pursuits. They focus on what really matters, making sense of life, being spiritually ready to die, living as fully as possible in the moment, enjoying the company of loved ones and finally saying goodbye to them.
What a lesson for each of us! I suspect all of us would be happier and wiser if we lived each day focusing on the people and values that are important to us and living in the light of spiritual realities.
Is working with the dying and their families difficult, unpleasant or depressing? Not at all! Their gift to me is that they remind me how I should live my life. That is perhaps the greatest blessing that anyone can receive from another human being.
Interacting with dying patients, I need to see myself as a sort of facilitator between them and the world of the spirit. Helping them to pray however, in the way that is most natural for them, became my goal.  
Convinced that a spiritual connection would make their moment of death more peaceful, I want to facilitate this encounter with the Spirit (or their spirit) before they take their last breath.
I feel that it is also my job to remind them that not all relationships in our lives are pain free. Terminal illness reminds us that it is time to bring our relationships to closure. This often involves letting go of resentments and learning to forgive. It is a difficult task, but it is also the way to set ourselves FREE. As a third party, I often can offer some missing objectivity that is healthy and helpful. I may also be able to facilitate communication between the dying person and their loved ones, to facilitate forgiveness and hopefully allow healing to take place.
Their relationship with God also may need attention. It often encourages them to talk to me about any questions, worries, frustrations, or anger they may be feeling toward God or their faith tradition.
Expressing aloud their feelings toward God can sometimes lessen their concerns. Expressing these feelings may also help them to come to a point   of   acceptance concerning death.  
To effectively work with the dying is primordial to learn not to judge people’s reactions (or lack of it) when they suffer a loss.  It is necessary to understand that how a society handles grief is not just an individual challenge, but a collective one. Our culture emphasis on the quick fix creates impatience with grieving and a low tolerance for the slow journey through sorrow. The language of “closure” falsely suggests that grief can be neatly wrapped up and put away. Families are often scattered across the country, making the reality of the loss remote for the individual’s loved ones. Yet, grief is an experience that permanently changes us.
Following the death of a loved one, in one degree or another, we all need help. As 76 million baby boomers creep up the ladder of years, grief is there to meet them. More than 2.3 million people die in the United States each year. Almost a million people are widowed, and those who die usually leave behind adult children. As the U.S. population ages, more Americans are experiencing firsthand the pangs of grief, which knows no racial, financial or religious boundaries.
I am now completing my 16th year of hospice work. Hospice became my career. A career that has developed fast and a career that I had not planned. God has his way to place us in the right place at the right time. In 1999, while attending a church service at a church that I visited only occasionally, the pastor asked help for one member of his congregation that was sick and needed a caregiver. I volunteered to spend a few hours a week with this stranger. She was on hospice care. I had the opportunity to be at her bedside during the last hours of her life. She was in comma. I talked to her believing that she could hear me. My goals were easing the fear of the unknown and at the same time increase her trust in God. She died fifteen minutes after I left her room.
Feeling that I had helped her through the last moments of her life, I decided to volunteer for hospice and do the same for others. That is how my unplanned hospice career started. Many jobs changes happened since. I have learned a lot about hospice's administration, but I still love doing the “field” work which put me on the bedside of the terminally ill patient, because I firmly believe that it is the job that God wants me to do.
Having the privilege and honor of working with hospice patients, it seems that there just isn’t a way, to put into words, the valuable lessons that those that are so close to leaving this world have to teach us. What we say and do every day to the ones we love may be the last chance to say or do something for them.
This comment is not meant to scare you. It is a reality check. Life is limited. No one, not one person, is immune from death. I see it every day. It is not scary, but it is a journey in itself and a teacher, to teach us that we want to look back and say I didn't fill my life with anger, I remembered to love because this day can be my last. I remembered to live and be grateful for the privilege of being alive.  I have witnessed people of all races, ages, genders, and sexual orientation let go of the life they have come to know.  One thing becomes clear, "everyone learns to love the life they have been given."
Grief and loss has been part of my life since my childhood and I know that sooner or later it will visit me again. It might come in the form of a death of a loved one or in the form of my own death. If someone would ask me today: Did your early grief experience and the work you do today, make it easier for you to accept your own death? I would say: It all depends when it will come. If those that I love now have already departed, it probably will be much easier. If I have to leave behind the one I love, probably it will be very difficult.
As a dear friend said before his death: The hardest thing to face at the time of death, is the need to walk away from love. Living behind the love we share on this planet, seems to be the hardest thing to deal with when we know death is near. That is why I believe in hospice care. The months, weeks, and days before death can be compared to the pregnancy and labor before a birth. Hospice team work with the family and friends of a dying person, like midwives preparing for a birth, help a person move from one world to another. The goal of hospice is to make this labor of dying, this journey from one reality to the next, as meaningful and as peaceful as it can be.  During the preparation for the final journey: fear, anxiety, and troubling questions, often surface.
Hospice organizations provide spiritual care to help guide a person toward a state of peace and acceptance. The hospice chaplain accomplishes this by helping them acknowledge their fears, anxieties, and questions, and by helping explore why a particular feeling or set of feelings may be surfacing.
A hospice Chaplain will also help a person in hospice care to access his/her own inner resources, those places where he/she is able to find healing, or peace within. For example, some people are nourished by music; others are moved by guided meditation and prayer. In essence, a chaplain tries to help a person find the holy or sacred in their own life.
Hospice chaplains are careful not to impose their own belief systems on patients; they do not try to convert you or to judge your beliefs, practices, or lack thereof.
Hospice chaplains respect your way of viewing life and he or she is not here to push you but to encourage you to sort through and resolve feelings and issues that are causing concern and difficulty to you and/or your family. “We do not come in with the intention to convert the person.”
Many times religion and spirituality are confused. Spirituality encompasses people who are religious and have connection to a faith tradition, as well as people who do not perceive themselves to be religious at all. A person can be both spiritual and religious but a person does not have to be religious, to be spiritual and/or to have spiritual concerns. Religion has to do with faith concerns, denominations, traditions, doctrines and rituals. Religious concerns can be Christian, Jewish, Hindu Buddhist, Taoist or other expressions of religious institutions.
Since we all process things in life differently, some people come into hospice care already at peace with themselves and their God.  Quite often they need little spiritual care or guidance, while others rediscover faith and hope—or find them for the first time. Some prefer to process everything privately, and refuse to discuss these matters with a spiritual counselor.
Regardless of your present emotional state, if you or a loved one has entered upon the end-of-life journey, remember … Hospice care is available to lead you through this painful, but very meaningful time of your life.
The time to say good-bye is a very difficult time for any one of us.  You do not have to walk this road alone. Let us hold your hand and...
"We'll walk with you along the way..."
For more information on Hospice Care and/or Bereavement support, please contact: Toni Brasted, Ph.D, CG-C, at Divine Mercy Hospice Services – Phone: (702) 202-0763.