Saturday, June 26, 2010

Hospice and end-of-life care: thanks Grandpa!

Today I discovered that one of my neighbors had been a hospice nurse for a number of years.  He visited his patients at home or in nursing facilities (this being a key principle of hospice care - to bring care to the dying person rather than transporting the person to a new location.)

In his experience death and dying are taboo subjects.  People are generally unwilling to talk about death and the process of dying.  "God forbid!" you are supposed to say if the subject of death accidentally comes up.  This lack of conversation and real communication about death and dying makes the whole process much more painful for families and much more complicated and awkward for everyone involved.

I look forward to talking openly about death as a part of life, as a transition from this world we know to the world beyond death.  Regardless of what people believe about an afterlife, the end-of-life process will be more manageable, if no less challenging, as we talk things through.  Hopefully before-hand.

What's the standard in the senior living industry?  Do marketing directors mention the dying process when selling the continuing care retirement community concept?  From what I've seen there is lots said about the care continuum from independence to assisted living and skilled nursing, "if the need arises".  But how do they communicate about death?  Or do they?

It reminds me of my 2 years working for a financial planning firm, selling life and long-term care insurance.  Our sales training encouraged us to skirt the issue of death, because although death sells in the media and on soap operas, it doesn't actually sell life insurance.  Even calling it 'life' insurance obscures the fact that you are not insuring life, rather you are insuring against the economic consequences of death.  Although death was rarely mentioned to prospective clients, the organizational culture where I worked sometimes used death for emotional leverage, to stimulate fear or shame (when appealing to love or duty failed), and hoping to sell insurance as relief.

I understand that the term 'life-care community' has gone out of fashion (now everyone is a CCRC instead) precisely because 'life-care' implies death.  But as my neighbor the hospice nurse pointed out: life is a terminal illness.  Everyone dies.  I'm not saying that death doesn't frighten me a little.  I am afraid to die: partly for myself - I don't like pain and don't want to 'miss out' on this familiar life; and partly for my family, my wife and kids who will be sad when I go.

But I am certain that death and the process of dying are not the worst things that can happen.

My maternal grandfather died this past Monday morning.  He was very dear to me and I am sad to lose his physical presence in my life.  But he was not surprised.  He was ready.  He had already embraced the process, which accelerated rapidly over the preceding 7 days.  He was in his own room, looking out on his beloved church across the valley with an ancient sycamore towering in the foreground. He was eager to be reunited with his wife of nearly 60 years, with whom he was more strongly connected than ever, despite the 5 years since her death.  And he was at home, surrounded by loving children, visited by friends and tiny babies, basking in the prayers and fond remembrances sent his way by others who could not be physically present.

I missed my grandfather's last week of life.  I was not at his bed side.  I was in the Outer Banks with my in-laws, on the annual beach trip that my wife and kids look forward to all year.  And I am content.  In the several years before my grandfather's death I frequently walked down my street and through neighbors' yards to visit him.  I had spoken to my grandfather at length the week before, and I had what I needed.  I told him that I was embarking on a new career.  He expressed his love for and confidence in me - and let me know that his previously-held concerns about my life-direction were gone.

So as my grandfather was dying these past months and this past week I experienced peace.  I knew he was in our Creator's tender care, and I was certain that his family's loving hands were supporting him during his transition.

I am determined to find ways to help others experience their own version of this remarkable process of dying.  Along with the sorrow or pain, I wish for others to experience the death of their loved ones as an opening for peace, healing, and unexpected blessings.

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