Abridged stories of hospice care service

The good life is not necessarily a long life — that seems obvious enough, and yet in the scope and focus of health care today, we find that longevity is often valued at the expense of quality. In that sense, hospice care represents a radical departure from traditional healthcare models, or at least comprises an altogether different category of it. Having relinquished the commitment to prolong a person’s life, hospice care seeks to ensure that it’s lived to the fullest extent.

Hospice care is therefore an excellent setting to understand those values which have somewhat ambiguously been termed ‘patient-centric’. With that goal in mind, I’ve been volunteering for a hospice care service which allows me to form relationships with terminally ill patients and provide companionship to them. Here are three patients whom I’ve had the pleasure of knowing.

Norma

My first hospice care patient was named Norma, and she lived in a large assisted living facility whose high-end accommodations made it look more like a hotel. As I walked through beautifully-decorated hallways, I considered it ironic that most of its occupants’ eyesight was probably too poor to fully appreciate these aesthetic features of their environment.

When the service pairs me with a patient, they provide me with a short summary which includes only rudimentary information: their age, place of birth, diagnoses, and some random personal facts that may facilitate conversation. I reminded myself that Norma was born to Italian immigrants, was devoutly Catholic, and was hard of hearing.

I knocked on the door and entered the room to find Norma lying very still on her back, looking peaceful in her quiet and low-lit surroundings. She was hardly moving, and only a steady but barely-perceptible motion of her chest told me that her current condition didn’t warrant a disconcerted call to the nurses.

I wondered whether the quality of my services, which I still hadn’t provided to anyone yet, was worth waking her up. After deciding it wasn’t, I took a seat in a chair just across the bed, and directed my attention to small details of the room. The walls were covered in Jesus iconography and romanticist pastoral scenes, and every available tabletop was stuffed with picture frames, knick-knacks, and greeting cards. On a nearby table, I spotted a visitation log which had been signed by family members and nurses.

About 10 minutes later I again approached Norma and introduced myself, only to find that her eyes had actually been open the whole time. Suspecting that she couldn’t hear me, I raised my voice, but she still looked straight ahead, with no apparent signs of having registered my words.

At this point, I figured there were two possibilities. Either her hearing and sight were so poor that she couldn’t sense my presence, or she could sense my presence but couldn’t communicate with me. The second possibility yielded two others: either she appreciated my visit, her silence notwithstanding, or I was something of a nuisance to her, but she couldn’t convey that to me.

In the end, I struck a middle ground by making some minor small-talk for just 10 minutes. I complimented her clothing, remarked on the family-centered values of Italians, and commented that her daughters seem to love her very much. I thanked her for allowing me to visit her, then left. By the end of the visit, I had no indication that she had even heard me, and yet I felt fulfilled all the same by the service I had provided. She passed away the next day.

Bill

Bill was a former salesman who spent the last few months of his life in a small nursing facility which he shared with five other people. The first time I visited him, his nurses told me that he sustained a minor fall. When I asked him about it, he denied the incident vehemently, and insisted with great pride in his voice that his caregivers like to exaggerate things for their reports.

Whenever I visited him, Bill was invariably lying supine, his large frame taking up most of the bed. Every once in a while, he asked for a piece of chocolate which was sitting in a bowl on his nightstand, and owing to his hazardous posture, I always watched him eat it with some worry.

During my time with Bill, I frequently asked him to share memories about his life, and he was eager to reminisce about Detroit’s golden age. Between stories of high-school dates at drive-in movie theaters, accounts of selling to major clients, and anecdotes involving his kids, I got the impression that Bill was highly satisfied with the life he was leaving behind, and was surprised at the level of detail with which he remembered it.

During the last few minutes of my second or third visit, Bill sat up a little straighter and donned a serious look, and adjusting his cufflinks slightly, told me that he would be seeing a major client after I left. I smiled and wished him luck, this brief moment the first glimpse of dementia which I had ever seen of him, and which had the effect of casting some doubts onto the recollections which he’d previously shared with me.

Wilma

My time with Wilma is something of an exceptional case, because I wasn’t formally paired with her as a volunteer. In fact she was already recieving regular visits by a volunteer, but a last-minute situation had developed where she would be home alone, and she needed someone to be with her during that time. Owing to a half-day at work, I was able to make a visit out there a few hours after it was requested.

Wilma first appeared as a quiet-spoken woman, and she lived in a modestly-sized house with her husband. Her diagnosis was renal cancer. We started with small-talk, but a portrait of Jesus provided an overture into a more serious discussion about a spiritual crisis among today’s youth. This quickly escalated, however, into a political monologue which featured tirades against the felonious acts of Hillary Clinton and severe chastisements against the “dumbocrats”, who she insisted had sided with the devil.

“What do you like about Trump?” I asked out of morbid curiosity. To this question she answered that Trump was putting America first, echoing a familiar sentiment among conservatives that liberal elites are trading domestic interests for profits, an idea encapsulated by the buzzword ‘globalist’, used in today’s political discourse almost exclusively as a slur.

I tried, despite our clear political differences, to establish some kind of a bond with Wilma, and resorted to my usual strategy of developing a vague notion of an ‘other’ against which we comprised a team. This placeholder was soon found in the nihilistic and irreligious tendencies of my generation, which, we supposed, were leading to social degradation.

During the last hour of my visit to Wilma, we watched a televised mass which was broadcast from some European country, and which she attended to with great excitement. She was sufficiently appreciate of my time to gift me a beautiful set of pink rosaries, which I still have on my desk.

There are other patients whom I could speak of, most notably the one I’m currently seeing, but in the interest of time I’ll leave them for another article.