Humor and hospice are words that you don’t necessarily think of as going together. When I began working in hospice, I never knew I would be laughing so much. It is said that there is a time and a place for everything. Most people believe that hospice is a time for sadness and grief and certainly there are times of great sadness. Usually when you tell someone you work in hospice, they get a solemn look on their face and say, “That is too depressing. I could never do that kind of work.” The truth is that hospice can also be a place for humor. A study done at Kent State and reported in the American Journal of Hospice and Palliative Care revealed that humor was present in 85 percent of 132 observed nurse based visits. Amazingly, they found that 70 percent of the humor was initiated by the patient. If humor is a part of living, than why should it not be a part of dying?
We all know the benefits of laughter in our lives and its role as a stress reducer. When we laugh, we feel better in the moment but there are also long range effects. Research has shown that laughter strengthens our immune system, improves alertness, increases endorphin levels, lowers blood pressure, increases the production of T-cells and helps the pituitary gland release its own pain suppressing opiates.
Sigmund Freud said that a high appreciation of death humor was a mark of maturity. Psychologists today consider a sense of humor an important strength for coping with life. Death itself is never funny but the situations before and after can be filled with opportunities for laughter. Humor buffers us from the negative effects of stress. It helps with pain and mental anguish and can make a serious situation less taxing as well as less threatening. Renowned psychiatrist Irvin Yalom states that we all have death anxiety but that for some, it is more overt than for others. How we cope with that anxiety determines how we live our lives. Laughing in the face of death is not to be confused with the Laughing Death (Kuru) that is an incurable degenerative disorder in which people literally laughs themselves to death. Of course, this disorder only seems to afflict cannibals.
Prior to a bone marrow transplant, a patient threw a “Bone Voyage” party in which everyone came with a hat or a scarf on their head. The recipient of the transplant wore a bald cap.
While in the hospital, her partner came in every morning with a new cheer, complete with moves to start her day with a laugh.
Humor is also important during the time of grieving. When we are in the depths of despair over the loss of our loved one, it is hard to think that we will ever smile again let alone laugh. One of the tasks of grieving is to learn to laugh again. A study from the University of Berkeley found that widows and widowers who could smile and laugh when remembering a loved one experienced less anxiety and depression at six, 12, and 24 months. Many successful bereavement groups incorporate laughter where members are encouraged to share humorous experiences associated with their loved one.
Laughter is essential for those who work with the dying. A 2009 dissertation by Ridley found that humor is important in the issue of employee attrition due to emotional exhaustion. Humor in a group provides opportunities to bond with colleagues and is a factor in longevity in hospice work. In my hospice, our texted morning update started with a joke. In team meetings, staff would share stories about funny things about themselves or situations. It seems as though the staff were able to laugh at themselves without their egos getting in the way. Every month there would be a Laugh Day where staff would bring in funny jokes to share with the group. If you are employed in a hospice and you feel your team is not laughing enough, you might consider starting a Laugh Day of your own. Laughter is good for the soul and is a lot cheaper than paying for psychotherapy.
November is National Hospice Month.