Embracing Hospice: Benefits of Optimizing Palliative Care

By: Hannah M. Burns
Tuesday, February 28, 2023

I have no idea what compels someone to become a funeral director, but I simply haven’t dreamt of being anything else. I choose every day to comfort the brokenhearted, to see others at their weakest and most vulnerable. I see the absolute worst life has to offer. A front row seat to the most horrible of all horrible, and for me, I feel indebted to those who sit before me. I see children, innocents, disease, accidents, heartache, fathers, mothers, and those so alone no one comes to cry for them. Yet, I’m not hardened like expected of me, I’m not cold, I’m not angry. In fact, my heart continues to grow in ways I never knew it could have. It is an honor to serve these families. 

Only a few things in life are guaranteed. One is that we are born into this earth, and the other is that we must die. Since a young age I have been fascinated and curious in regards to what happens when we die. Although I won’t ever get an answer, it has been my goal to share with others about my journey in death care. Some aren’t given enough time and that is the sadness in death, but optimizing your resources if you are able to plan at the end of life, whether for yourself or a loved one, is truly as beautiful as welcoming a new life. 

The stigma around the word, “hospice”, makes some people turn away. For me, it does the opposite. I love sharing the journey I had with them, their compassion and wholehearted love and care, and expressing the utmost gratitude for those who serve hospice patients. Hospice can be anywhere; now at home, at a facility, in a nursing home, even in hospitals. The past few years, I’ve established and maintained relationships with many local palliative care organizations. I’ve learned the complexity and beauty in the services that they provide to those patients experiencing that last stage of life and those loved ones who are by their side during this transition. I have also unfortunately had to work with palliative care services for two of my own family members, all within six months. The effect that they had on not only myself and my loved one, but the family left behind is remarkable. I never thought I would be sitting on the opposing side of the arrangement table so soon. I wanted to analyze and encompass data from families who use palliative care and the benefits it provides not only their loved one but those who are bereaved. 

In all studies I analyzed, families provide the most significant relationships, whether these be parent-child in the family of origin, or between spouses or siblings in nuclear families. The deeper the bonds of attachment are both beneficial to the family and the patient, and generally the more heartfelt are the emotions of grief. The process of sharing these emotions among family members initiates the potential for adaptive coping via mutual support. Active sharing of family grief is the norm during bereavement work. The construction of new meaning, fresh roles, and varied relations is sought. The number of sessions provided was not predetermined in this study, and averaged close to four per family. Participating family members completed measures of distress and family functioning at the baselines assessment and then subsequently at six months to one year post-loss. As it neared completion, promising trends showing prevention of distress in bereavement emerged in preliminary analyses. It was evident for individuals receiving therapy, compared to the families receiving standard, basic palliative care.

 Finally, families were asked to report on the level of communication perceived following each family session. Although perceptions of family functioning remain unchanged, Family Focused Grief Therapy was associated with a significant reduction in individual members’ distress after one year of bereavement. Much like anything else, there were trials that did face some issues. Therapists become involved with families at the end of life, when caregiving burden increases and patients are less ambulatory, keeping engagement in therapy can be challenging. Family Focused Grief Therapy has since evolved into a model of support that can be delivered in the outpatient setting, at the hospital bedside, or in the home. Although some therapists struggle to clarify and maintain the structure of therapy when it occurs outside of the consulting room. 

Family Focused Grief Therapy prioritizes the family as the natural context to individuals’ distress due to illness and loss is expressed. Research on families in palliative care over the last two decades has provided a strong basis signaling us to intervene and act early to accommodate these families. More importantly, working with the family as a whole is not only beneficial to the patient receiving care, but setting the family up for success after a loss occurs. The continuity of care prior to and following the adverse life event is a unique aspect of this therapy and presents an opportunity for families to change the course of how they adapt. I thought the research contributed significantly to defining the benefits of optimizing palliative care. 

From integrating traditions, rituals, or culture; I realized that is a very important piece, and truly worthwhile, to some families as their loved one is entering this last stage of life. In studying those coping methods and bereavement mechanisms used by those who have experienced a loss and continue to move forward, I have truthfully learned so much more about how I can better serve the families who come before me. Although there are thousands of ways to cope and grieve, and I will never know to the extent of which one brings one more comfort than the next. Taking note in my knowledge has not only made me a better person, but a better funeral service professional. To me, hospice care is about more than helping people die with dignity, but to live out the rest of their life with love.

In Memory of: Michael G. Myers & Charles Henry Regnier

I am a college student at Mid- America College of Funeral Service. I am halfway through my educational journey and just at the beginning of my career in funeral service. In October, I obtained my apprentice license in my home state of Maryland, where I work full time at Bounds Funeral Home (Dignity Memorial) alongside my sponsor. Each family that comes before me makes me realize why I am in this field, I love what I do. It can be so easy to lose yourself in the service of others, so in my free time I enjoy spending time with my family and my rescue dog, Tannah. Over the past year, I have lost two very special people in my life. Without hospice and optimizing palliative care options, I don’t know where we would be. I have worked collectively the past few months with a research journey on understanding that hospice is more about quality of life, rather than quality of death. Thank you for this opportunity to share this with you.

 

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