“I slept and dreamt that life was joy I woke and saw that life was service. I acted and behold! Service was joy.”
-Rabindranath Tagore
A thousand years before the Common Era, there were healing sanctuaries in Greece, Egypt and Rome, sometimes attached to temples, for attending to the dying. The modern hospice movement developed in the 1950s, in England, to assist the terminally ill live the last part of their lives more harmoniously, free from impersonal institutional and technological dominance.
Dying can certainly be terrifying and frightening, and the individual is better served in a respectful atmosphere that eases the emotional, social, physical and spiritual stress. The most influential model of modern hospice care is St. Christopher’s Hospice in Sydenham, England, founded in 1967 by Dr. Cicely Saunders. She was its medical director from 1967 to 1985. The wards and rooms at St. Christopher’s are filled with photographs, personal items, flowers, and plants. Patients pursue familiar interests and pleasures. There’s an acceptance of the naturalness of dying, with the opportunity of families, including children and pets, to be with the patient. As the proverb says: “What comes from the heart touches the heart.” Cicely Saunders passed away at age eighty-seven in the hospice she founded. Hospices are now in more than ninety countries.
Elisabeth Kubler-Ross, M.D., a psychiatrist, came from Zurich to the United States in 1958. She passed away in 2004. Her writings are a great gift to those who work in hospice and to anyone interested in establishing one’s inner process of accepting and understanding a little about death, in oneself and in relationship to serving the dying.
When Elisabeth first worked in New York, she was appalled that dying patients were too often shunned and even, at times, abused. “Nobody was honest with them.”
She made it a point to sit with terminal patients, to listen. She wanted the patients to have the confidence to air their “inner-most concerns.” Many hospice workers have told me that listening with patience and interest is the basis of all the services. Elisabeth wrote twenty books; perhaps she is most famous for her five stages of the dying process (which can be hospice care near me applied to other losses as well): denial, anger, bargaining, depression and acceptance. I find this useful, if it’s not rigidly or dogmatically applied. I’ve found most helpful Elisabeth’s advice that the dying need unconditional love.
Elisabeth was very generous about giving lectures and answering questions. I learned so much from small contacts with her. I realize how controversial she became in her exploring. Sometimes we get “spiritual egg” on our faces; we may appear ridiculous to others. I’m sure she would admit to going up mistaken paths, becoming overly dogmatic and quirky perhaps. We all are just such complicated, paradoxical mixtures of so-called good and bad, humans. Why want it to be any other way?
The hospice movement is now fairly widespread in the United States. It’s a philosophy that enhances the quality of the dying person’s life-not just a medical facility. Hospice is holistic, offering service to both the patient and the family. Whether at home or in a hospice facility, the patient has reasonable control over pain control, treatments and environment. There’s respect of privacy, with a communicated feeling of personal goodness and dignity, open communication, an opening to the spiritual needs of the individual as he or she defines them. The caregivers review and revise-if necessary-advance directives, as well as address financial and practical concerns of the patient and family.