I promised a post with recommendations for those working Hospice care. Hospice has to be hands-down one of the most difficult nursing care positions available. I hope I don’t come across overly critical, as I believe the service provided is invaluable, and people willing to do it are precious gems, every one. I hope that this post can be constructive, inasmuch as my tiny, sparsely populated little corner of cyberspace can be constructive. But there are some things that I have learned about birth, and now death, that relate.
1. Take your cues from the family. This is the most important piece of advice I could give anyone who is serving a family through a dramatic life event. Adapt your personality so that you become invisible. Completely invisible. We value your service, really we do, but we’d like to forget you are there. All the rest follow from this principal.
2. Watch the phone calls. Try to get as much into as few phone calls to the family as you can get. Once on continuous care, if you can take or make phone calls from outside or a completely separate area of the home, do so. If you cannot, limit your calls to those strictly necessary and no more than 5-10 minutes, and keep your voice down.
3. Be hyper-aware of the personal care issues related to the patient. The family should never have to point out that Dad has been sitting in wet clothing and soon-to-discover, his own filth for hours on end, before he gets changed. This is, after all, why you are there. If your immediate attention needs to be focused on other health issues, chart a note to yourself to remind you to change him ASAP.
4. Keep your personal life story to yourself. This one can be really awkward and difficult, since friends or family may ask you about yourself. But truthfully, these turn into long conversations focused on yourself, who, remember, is trying to be invisible. Try to curtail these conversations as kindly and quickly as possible.
5. Assume the family has normal intelligence and have not completely lost their mind in grief. Explain necessary procedures clearly, but don’t overly dumb down your instructions. It’s demeaning.
Our hospice providers were very nice ladies, and I am grateful that Pa was able to live out his time at home, able to receive visitors as desired and comfortable. But the experience could have gone even more smoothly had these things been kept to the fore of our interactions with the nurses.
