By Kelly Evans-Hullinger
MD
For the last five years, I have had the great privilege of serving my local health system as Medical Director for Home Hospice. Every week I sit in a meeting with the multidisciplinary caretakers on this team – the nurses who provide the great majority of the hands-on care, social worker, pharmacist, dietician, and pastor. We discuss all the patients currently under our care and discuss how we can improve each patient’s suffering and maximize their quality of life.
The patients we care for on home hospice are those we believe to be at the end of life. Some are actively in the dying process; others are stable, still going about their lives, but have a terminal disease with a high likelihood of death in the next six months. On home hospice, most patients either stay in their own home with help from a caretaker, often a family member; or they might choose to reside in a care facility where they can get more extensive needs met.
Our nurses and other staff get to know these patients and their families extremely well, and I truly enjoy hearing our patients’ stories relayed. I don’t always get to meet the patients cared for by our team, as most continue to stay under the care of their primary care providers while on hospice. But even when I am hearing their stories second hand, a theme stands out as a common sentiment of our patients – the desire to reflect on their lives.
Patients facing their own deaths want to talk about their lives. Our staff frequently tries to facilitate what they call a “life review” in which a patient can openly talk about their childhood, family, career, service, and sometimes their regrets. This is therapeutic for the dying patient and their loved ones. Even some patients with dementia, with no memory of recent years, can delight in recalling a story from their childhood, looking through old photographs, or listening to music they once loved.
I have recently thought about this particular human need – to reflect and remember one’s life. I take this as a reminder to both seek those stories from my own loved ones (gosh, I wish I had asked my grandmother more questions about her life) and, perhaps, to tell and write about the things in my own life I would want to be remembered after I am gone. For if there is another thing I’ve learned serving patients on hospice, it is that my death is also inevitable; but, I think, life’s finality is what gives it beauty and meaning.