What It's Like to Work for Hospice

November is National Hospice Month!!! In honor of it being national hospice month…I want to write a blog post about what it’s like to work in hospice.

I’m fairly certain that I have received only TWO types of responses when I tell people what I do for a living.

“I work in hospice- I’m a chaplain doing bereavement care.”

Response 1:
“Hospice? Yuck. Now, why would you want to do that? Don’t you get depressed?”

Response 2:
“Hospice? Oh my goodness. You must be an angel. It takes a SPECIAL person to do what you do.”

One of the reasons I’m writing this blog post is because I want to describe what it’s actually like working in hospice. For those of you that may not know, hospice is a form of health care that takes care of people at the end of their life. To qualify for hospice, you need to have a life prognosis of six months or less. So yeah- my job evolves around death. Wah wah.

My specific ministry within hospice is bereavement care. This means that I provide support to people after their loved ones are dead- I facilitate support groups, I offer one-on-one counseling, I provide grief education to the Des Moines community, and I coordinate large scale events.

What is this like?
1)     It’s Meaningful. 
I honestly never doubt the necessity or the value of the work I do. Oh sure, I doubt my
own effectiveness at times, but I never doubt the need for bereavement support.

2)     It IS Sad.
I can’t tell you how hard it is to hear someone intensely grieve for their loved one- to cry over and over again how much they miss this person. To say that they would give anything to be with him or her again. And there is nothing I can say or do that will come remotely close to fixing their problem for them- they have lost something that they will never have back again.

Someone once told me that the best grief gets for them- as good as their life will get after their loved one is dead- is that they figure out how to “mark time.” They find ways to keep active and engaged in their life, but ultimately, they are still marking time until they die and join their loved one. It’s incredibly…heart wrenching to think about all of the people we lose in life and the toll this takes on us. It’s devastating to think that sometimes the best life can get is to tolerate it until it’s over.

3 )    It’s Fun. (WHAT? Working with death is fun!?!?)
Yes! Actually, I have a really fun job. The people I work with are awesome- they really care about the work we do, but they also know how to have fun. (One of my coworkers just hosted a Halloween party this weekend that resulted in me painting my entire body green for a witch costume). Additionally, my job is fun because I have a LOT of variety in what I do. I lead support groups…I give educational presentations….and I’m always traveling all over the city of Des Moines. Moreover, some of our events are quite engaging and enjoyable. We have a yoga workshop coming up….we have an annual movie night…and we have a social wine and canvas painting event every spring. Additionally, one of our support groups is at a different restaurant every month, and another one of our support groups gives me the opportunity to color. (It’s a crafting support group). I get
paid to do some pretty awesome things!!!

4)     It’s Surprising.
I am continually surprised by the variety of people, lives, relationships, family dynamics, and lifestyles that I encounter. You know the nuclear family? Well, statistics have debunked that mythical notion, but my experience in hospice has definitely deconstructed it as well. I’ve met people that are divorced but still living together. I’ve met people that have never married but live with their mother. I’ve met people who have no one that care about them and so their body ends up unclaimed. And I’ve met people who have touched so many lives that their funeral is bursting at the seams. I’ve met rich people, and I’ve met people who live with insects in their homes. It’s a little bit of everything.

5)     It’s Connecting.
I listen to people when they are at their most raw and when they are at their most vulnerable. Do you want to experience some real intimacy? Hold someone’s hand while they are bawling hysterically and sobbing that they are not sure if they can go on living. Look into their eyes as they tell you that the only thing they want is their loved one back, even though they know that it will never happen. That level of connection is one of the most profound and personal ways that I have ever been close to another human being. It’s as close to touching someone’s spirit as you can get.

Additionally, I’m strangely connected with my coworkers. I think that professional boundaries are more porous when you work in hospice because you are dealing with such an emotional subject. I never thought I would be someone that had good friends at work, and somehow, some of my very best friends are the people I work with. My coworkers have seen me laugh hysterically and sob uncontrollably. They’ve seen me on my ‘A’ game when I just nail bereavement support, and they’ve also seen me completely miss the boat. They really have seen me in all of my complexity and sides of my identity. In any field, shared experience is significant. Hospice is no different- my coworkers are the only ones that know what it’s like to have your entire career evolve around death.

6)     It’s Disconnecting.
It’s hard for me to type this (because I think it can sound a bit condescending), but sometimes I feel disconnected from some of my friends and peers because I’ve had to confront many intense questions and issues that they have not. Many of my peers are in a stage of life where everything is still new and exciting. They finally have a worthwhile career, they are in serious relationships/marriage, and they may have even had a kid or two. I’m not saying their lives are perfect or without difficult issues, but I don’t think many of them know what it’s like to have your entire world completely blown up. They don’t know what it’s like to question everything you have ever known because you have experienced a loss that shook you to the core.

On the other hand, I’ve had…some pretty intense experiences. I’ve had a bereaved client die from suicide….after he sent me the final suicide note. I’ve held a baby that was born after only 20 weeks gestation, and I still remember the precious, tiny features that were only half-formed. I’ve talked to people who lost their spouse after being married for over 60 years. I’ve witnessed people in their 30’s die from cancer, even though they had so many dreams that they still wanted to accomplish. And overall, I’ve seen more dead bodies, blood, and excretions than I really care to remember.  I’ve witnessed and experienced the darker side of life, and most of my peers have not. Their naivety about life- that it's mostly sunshine with a few clouds- feels really disconnecting to me.

Additionally, I also feel disconnected from my peers because they don’t get that this is my daily life. That death, pain, love- the intensity of what makes us human- is my EVERY day. And so sometimes, I get impatient when someone complains to me about the fact that the office mixed up their dental appointment. Yup, that’s annoying, but I just don’t have much energy to listen to you complain about that. You see, a couple of hours earlier, I had to hear someone talk about how they would give anything to have one more hug from their mother. And so not only am I drained from listening to that person, but it’s also hard for me to not look at your problem and trivialize it.

HOWEVER. I’m also chastising myself while writing this because I think it is SUCH a dick move to trivialize someone else’s pain and irritations (that’s like pastoral care 101, yo!) I mean, it’s completely ineffective and patronizing to tell someone that their concerns aren’t valid because they don’t deal with death and dying on a routine basis. And the fact is, I know I personally still complain about trivial things (remember how I broke my foot this summer and it was like the only thing I could talk about for 2 straight months?) Everyone complains...and it’s a part of being human…and it’s one of the ways that we connect with one another in our relationships. And so I recognize it in myself and I recognize it in others. But sometimes…it’s still just hard. It’s hard for me to have the energy to listen to someone bitch about a mundane problem when I listen to people who are struggling with the most difficult questions of human existence. It’s hard to go from exploring questions like, “Why do we die” and “How can I live knowing that I will never see my loved one on this earth again?”…to questions like, “OMG, how could they mix up my dental appointment?!?!”

It’s definitely a balancing act for me, one that I need to continually renegotiate and navigate every day. It’s a balancing act for how much energy I can give to others after working all day…how much I can validate my other people’s concerns and empathize with them…etc. One of the (many) reasons that TGR –my gym- has been a godsend is because it allows me to be social, but I don’t have to actively listen to people in order to connect with them.

7)     It's Not very Anxiety-Producing.
For those of you that know me at all, you know that I have high levels of anxiety. I’ve learned to manage it quite well, and I can often use my anxiety to work for me as a form of energy (definitely a topic for another blog post!!!) Regardless, it’s still a part of me that I have to constantly navigate. A lot of my anxiety stems from a desire to be perfect and be in control. However, hospice actually makes me feel less anxious because I’m working with grief and death. Even I have the wherewithal to know that I cannot be perfect. This knowledge- that I'm working with problems that cannot be fixed or solved- melts away much of my anxiety.

8)     It's Boring. There ARE some boring parts.
It’s easy to wax poetics about how meaningful and beautiful it is to work for hospice. Well, there ARE definitely some boring parts. Anything involving charting and documentation is extremely mind numbing. Sometimes phone calls are boring- either the person really didn’t give a shit about the deceased, or the person simply isn’t open to talking. Or sometimes the person has NO self-awareness whatsoever and he or she talks my ear off- usually in rambling circles. Additionally, there are still meetings that I have to attend that I find unproductive or uninspiring. There are still definitely those mundane components to the job.   

9)     It Restores My Faith in Humanity.
People talk about how terrible the world is now…how everyone does awful things…and how scary it is. I can understand that…AND…I also see the most beautiful side of humanity. I see people grow in ways they never thought was possible after their loved one dies; for example, one woman may join a barbershop chorus after wanting to sing her whole life. She only was able to do it after she was forced to challenge herself to find new ways of connecting with others after the death of her spouse. I see people support one another in the most incredible ways. For example, someone may drive patients to chemo as a means of honoring their loved one’s legacy and assisting with others that suffer from a similar disease. One of my other favorite experiences is when I see people make new friends in support group. I LOVE that something as beautiful as a new connection can come from the darkness of death.

10)   …I Love It.
I really do love my job. From the time that I was in grade school until I finished graduate school, I was VERY worried that I would never find a job that I liked. I had SUCH a negative connotation with the word “job” itself. The word “job” meant boredom, stifled, and trapped. And now? I don’t even think about my job as a job. Yes, I’m one of those super annoying people that thinks of her job more as her “calling” or her “vocation.” It’s…honestly kind of a natural extension of who I am. I’ve always been compassionate and enjoyed hearing people stories- I’ve been doing that since I was a child. And now…I’m doing what I’ve always done in a more intentional way. Again, I don’t mean to say that I don’t EVER get bored, irritated, or frustrated. BELIEVE me, I DEFINITELY have those moments. But overall…I genuinely love my job.

So, there you go, folks! That’s my experience of working in hospice as a chaplain providing bereavement support. I’m not some weird goth person obsessed with darkness…nor am I an angel sent from God. I’m Anne. I’m Anne, and I’m doing what I feel I am called to do. And I hope that you are too.


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