We humans are three part beings. We are a combination of body, mind, and spirit and these parts are all connected. When there is a problem in one of these areas, usually the other two areas also experience problems.
The founder of the modern hospice movement, Dame Cicely Saunders, first used the term “Total Pain” to encompass into a whole the individual pain experienced by the body, mind, and spirit. FAIRHOPE Hospice and Palliative Care, Inc. understands this and approaches the plan of care of the individual on our service with all three areas included.
Second to fear, I think the root of most misconceptions about hospice is the belief that we are like most other medical organizations, that we are just a continuum of the same thing. We are not. We don’t just deal with the disease; we deal with the whole enchilada, so to speak. When a person signs on to FAIRHOPE’s compassion each of the three areas of body, mind and spirit is individually addressed.
To illustrate our commitment to the total being concept, three different people are involved in evaluating a person when they sign on to FAIRHOPE Hospice. Generally speaking the intake nurse is concerned with the disease, the social worker is focused on the patient’s emotional status, and the chaplain is concerned with their spiritual condition. Depending upon the situation these visits may be in short order or spread over several days.
Normally a social worker makes the initial visit in order to determine if the person is, indeed, eligible for our service. Sometimes a nurse will make the first visit if none of our social workers are available. If it is determined that the person is appropriate the social worker will then discuss any medical directives, learn about the family structure, and the emotional status of those most affected by the situation. Acceptance of the seriousness of the disease is of paramount importance for everyone involved.
Next, one of our nurses will arrive to talk specifically about the patient’s history with the ailment and to discuss in general their medical history. The nurse will contact the person’s doctor, or doctors, to discuss all of the medications the person is taking. Sometimes there may be medicines being taken that are addressing the side effects of other medicines being taken.
This is a common occurrence. Given the progress of the illness many of the prescriptions are no longer needed. We may recommend that some medicines be discontinued, but it is up to the person or their family to make the final decision. I need to emphasize that with FairHoPe Hospice we let the family make the final decision. Sometimes the best medicine is to teach someone how not to need it.
As a side bar, one of the many nice things about our nurses is that they are familiar with many of the area doctors. Often, they have direct access to your doctor and if they don’t they at least are able to make direct contact with your doctor’s assistant. This means that they usually get answers quickly.
Continuing with the admission process, after our social worker makes the initial assessment and our nurse has an understanding of the progress of the disease, the medicine being taken and has consulted with your doctor, the third person to make contact with you is one of our chaplains.
It is important to note that our chaplains are not calling to witness to anyone or shame anyone who has not gone to church in a while. The chaplain will call to simply inquire about the person’s spiritual condition and offer to visit.
Sometimes, when the person has a strong spiritual life, a good church family and a pastor who has been in contact with them, they may decline the visit. No hard feelings. The chaplains find it a comfort to know that the person is spiritually at peace.
But when discussing the fear of all humans, dying, the one question that seems to be on everyone’s mind is. “What happens next?” FAIRHOPE Hospice’s chaplains have the time to listen and to talk about what happens next in order to ease the patient’s fear of dying.
They have the time to help find meaning in the person’s life and to use biblical, or other sacred stories, to help the person find their spiritual path. They also have the time to just be there. A patient’s daughter once told me that the chaplain just seemed to silently “be” with her mother as if Jesus was sitting with her.
The end of life is not a medical experience; it is a spiritual experience that can be froth with fear. As the disease continues, the focus gradually shifts away from the disease until it is no longer in the conversation. The emotional status of the patient slowly lessens until it is also of no importance.
Spirituality gains prominence as the end of life approaches until it is the only area of focus. If the family desires we will have one of our staff present if the end appears to be imminent.
The nurse, social worker and chaplain are alert to the fact that each of their areas of expertise may overlap each other. Sometimes the person will tell the nurse that they are afraid of dying because they are worried about their children. Or they may tell the chaplain they feel physical pain, such as headaches, that are a result of emotional tension in the family.
The social worker may be told of spiritual pain felt because the physical pain is interpreted as punishment for wrong doing. Any of our staff will take the time to listen when these situations arise.
When you contact FAIRHOPE Hospice and Palliative Care, Inc. early enough after your diagnosis, you allow yourself time to experience a calmness and serenity rarely experienced in life. That is, the total comfort of body, mind, and spirit.
Rick Schneider, of FAIRHOPE Hospice, writes a bi-weekly column published in The Logan Daily News. The views of this column may not necessarily reflect that of the newspaper.