When individuals first come into a hospice program, they are frequently dealing with the initial shock regarding their poor prognosis. They have often just heard the words "there is nothing more that can be done" from their doctor, and they are reeling from a variety of mixed feelings - anger, sadness and fear are just a few on the spectrum of emotions that may be justifiably whirling through their mind.

Once the facts start to sink in, however, and they begin to accept their eventual outcome, many begin to ask some variation of the question "how do I die well?" In reality, there is no "one size fits all" answer to this question. More often than not, dying well means something different for each person. To attempt to provide a universal answer without taking into consideration the differences that encompass each person equates to disrespecting the individual as a human being.

Sometimes dying well simply means getting the technicalities out of the way. These details could include factors such as funeral arrangements, advance directives, and other mundane, but necessary, aspects that come with end of life decisions. There are times, unfortunately, when an attempt to perform even these routine tasks is disregarded, however. Thankfully, a straightforward explanation from the social worker is often all that is needed to redirect this thought process. In most cases, the dying person does not desire that the remaining family members be unnecessarily "stuck" figuring out these details, and when he or she realizes that this is exactly what will happen, they are, albeit sometimes begrudgingly, willing to put focus on this area.

Sadly, now and then the hospice social worker discovers there to be deeper issues that really need to be addressed (and hopefully resolved) in order to ensure not only that the individual dies well, but that the remaining family can live well after the person is gone. There may be some deep-seated family problems and resentments that have never been dealt with, and now, with the prognosis of death hanging over the family's head, it becomes more imperative to put the focus on these. There is little that is more distressing than when the individual passes before these issues can be worked out. The remaining members of the family are left with no closure and, instead, many unanswered questions.

Any hospice worker knows that they are working against time. Long-term counseling is, more often than not, an option that is extremely futile. It is crucial for a hospice social worker to swiftly recognize and aid in the family's attempts to address these issues before the clock runs out. The bereavement process after their loved one's death is already difficult enough, and to add unresolved family issues to the list of grievances after the fact brings about much more sorrow than is likely necessary. Despite the fact that addressing these problems can be an arduous process, the rewards, both for the family and the social worker, usually make these endeavors more than worth it.

About the Author

Angela Baker

Angela Baker, LCSW, works for a hospice as a Medical Social Worker.

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