Yep. I found Karl.

Hospice? That’s hard!

I have frequently heard that response to the vocational question – what do you do? Yeah, I suppose hospice is hard, if your definition of the word hard means not easy. Coming alongside people as they decline and die is not a day at the beach.  

But is that healthy – to skate through our years without effort, avoiding the difficult path and emotional pain?

In a more positive definition of the word, hospice is hard. Firm. Solid. Unyielding. The realities of life – which includes struggle, pain and death – are given full attention, but met with a compassionate presence and gentle touch.

I began vocational ministry in 1980, and am retiring as 2024 closes. I am so grateful that the final six years of my employment years have been devoted to this energizing and deeply rewarding work. Yes, energizing, although you may find that – here’s that word again – hard to accept.

Hospice is about dying, but it’s also about living. It’s about attempting to do both endeavors well, even if the curtain is closing on someone’s life drama. I’ve invited countless people into identifying what really matters in life, and nudging them to make that a reality by starting meaningful conversations with loved ones about forgiveness, love, and gratitude.

Hospice Chaplains are sometimes called midwives of the soul, gently assisting people transition from one life to the next. A few times I’ve been there for the final moment. More often I simply encourage the person to let the loving currents of the River of Life carry them around the final bend, which leads into the presence of God – a breathtaking vista of light and joy and beauty.

To prepare for that moment, I call them to put down the oars of the need to control and to negotiate with God, basking instead in the warmth of his loving presence.  

Shortly into my first year, I entered a memory care unit for a scheduled visit. But where was Karl? Not in his bedroom. Not in the activities room or the hall. One of the aides had an idea. Check the bathroom, she said. He likes to hang out in there.  

Yep. I found Karl – lying on a bench with the heat lamp on, keeping warm. Eighty-five degrees warm, I’m guessing. I brought a chair in to the bathroom and sat with him, wiping away the sweat on my brow with a paper towel.  

This is loving care. This is living out what Jesus did: The word (Jesus) became flesh and dwelt among us (John 1:14). Jesus seeks us out on the bench we have adopted as our own. And he calls all his disciples – not just chaplains – to do that too: sit with people. Listen to them. Bring a ray of God’s light and love into their existence, even if it’s not comfortable. I got paid to do it for six years, but it will still be my role in life when I retire.

Hospice work is about bringing comfort to the dying. The first time I met Duane he welcomed my visits on one condition: Don’t be talking religion with me!  So I didn’t. For some reason, that would have brought him discomfort.

Five times I visited with Duane, and five times he voiced the same restriction. I showed up for the sixth visit planning to ask him: how come you’re the one bringing up religion? Are there spiritual scars that still plague you?  I had been working to earn his trust so that he would thoughtfully accept my question rather than stiff-arm me.

I never got that chance. I entered his room to find his daughter by his side, who informed me that he had turned a corner and was no longer responsive. I’ve never felt bad about missing the opportunity to speak with him on a deeper level. As I was counseled in my first days of training: Duane had a visit with a far better Chaplain named Jesus.

Hospice is often about making connections, and especially through music for those whose minds have bolted ahead of their hearts in the race to decline.  Bonnie couldn’t remember whether she had been married or had kids, their names, where she lived or if she had a career. But when I sang familiar hymns, she stopped biting her lip. If it was Amazing Grace or In the Garden, she sang the words along with me.

Joy was in her early seventies when I met her, but for four years she had been bed-bound in a Memory Care Unit. Minimally responsive, and no longer talking, the tree outside her window held her gaze, as she didn’t have a TV in her room.

She had walked away from the Orthodox church of her childhood. Never married, she had no visitors. Her one brother had health issues, but his visits were restricted with the pandemic raging.

What’s a Chaplain to do? How do you make connections?

On my second visit, I remembered her brother said she loved the music of Willie Nelson. I pulled up YouTube on my phone, connected it to my Bluetooth speaker, and showed her a video of Willie singing Always on My Mind. Not far into the song, a tear rolled down her cheek. She was enthralled. I followed that up with Blue Eyes Crying in the Rain, bringing more tears.  

I asked if I could pray for her, and to my surprise, she reached out to take hold of my blue-gloved hand. As I prayed, she squeezed my hand and wouldn’t let go even as I concluded, so we sat quietly together for a few minutes. I finally told her I needed to leave, packed up my things, and waved to her. She waved back, and clearly said Thank you. In all my future visits, I never again heard her speak.

People often know they’re on the last bend of the river – despite the fact that their anxious adult children often instruct the care team to avoid using the “H” word during visits.

One day I entered Leona’s room, and she moaned please help me! The pain from weeping edema was overwhelming, and her legs needed to be re-wrapped. I told her that our nurse was coming soon; she was on daily visits for this issue.

I asked if I could pray for her, and she gladly accepted. I prayed these words: God, you know that Leona is in pain and needs relief! Have mercy on her, and give her your peace, both in body and in soul, so that she can rest. It felt inconsequential, but it was all I could do.

Leona died early the next morning. A couple days later I placed a condolence call to her son. I told him about my visit, and he said that her husband (his father) had died on the same day twenty-three years earlier - September 10. He said Leona was very conscious of that day, and he added a coincidental note: both his parents were born on the same day and the same year.

Bob lived in an Assisted Living Facility. On a Friday, one of the nurses said to him: I’ll see you Monday. He responded I don’t think so, and had already told his daughters he didn’t think he would make it through the weekend. Sunday evening, just a couple of hours after his daughters had left him for the night, he took his last breath.

Jane lived down the hall, just a few doors from Bob. I walked into her room one day to find her singing, which brought an embarrassed flush to her cheeks. I assured her that I thought it was wonderful, and asked what she was singing. It was her favorite hymn, All the Way My Savior Leads Me. We sang the song together.  Here’s verse three:

All the way my Savior leads me

Oh, the fullness of His love

Perfect rest in me is promised

In my Father's house above.

When my spirit clothed immortal

Wings it's flight through the realms of the day

This my song through endless ages Jesus led me all the way.

This my song through endless ages Jesus led me all the way. *

She died a couple of weeks after this visit. I figure I had visited Jane during one of her regular rehearsals for the heavenly choir.

On earth as it is in heaven. There are many dimensions to this portion of the Lord’s prayer. Sometimes heaven breaks through into our daily affairs and beckons us forward.

Early in my hospice tenure I was assigned to Erwin, who lived in Scappoose, Oregon. (I love the name of that town!) His wife and I sat in the family room to begin the visit, and I asked her how he was doing. She said that during the wee hours she woke up, hearing noises in the house. She got up and found Erwin in the garage, listening to music and drinking a beer. She pleasantly asked him: what are you doing, honey?  

His response: Oh, I’m just having a beer with my friends. Wisely, instead of just guiding him back to bed, she asked:  that’s great! Who is here with you?  Erwin mentioned the names of three friends, all of whom had preceded him in death. She headed alone back to bed after saying: have a great time! **

One month ago I went to visit Mary, an eighty-five year old with a failing heart and a joyful spirit. Singing was a crucial component of her faith; she would close her eyes and meditate whenever I would sing a hymn. On this latest visit, instead of me selecting a song, I asked her a question: Is there a song you’d like me to sing today?

Her eyes lit up, and immediately said: I’ve been hoping you would be visiting soon. I've been thinking about a song for a week. Can you please sing “Because He Lives”?

I know the song, but don’t have the lyrics memorized, so I pulled them up on my phone. She sang along with me on the chorus. Here’s a portion of what I sang for her:

And then one day, I'll cross the river,

I'll fight life's final war with pain;

And then, as death gives way to victory,I

'll see the lights of glory and I'll know He lives!

(chorus) Because He lives, I can face tomorrow,

Because He lives, all fear is gone;

Because I know He holds the future,

And life is worth the living,

Just because He lives!

Because he lives, I can face tomorrow. Mary’s song was prophetic, as she died tomorrow, about twenty-six hours after we finished singing. Alone in a corner bed at a skilled nursing facility, she crossed the river – but she was not at all alone.

Hospice is primarily about people and relationships, those who have opted for comfort care in the last chapter of life and those who love and support them.  When a person is admitted to hospice, they are assigned a care team of workers – nurses, home health aide, social worker and chaplain – who drive to wherever the patient resides.    

I drive alone to those visits, but I also represent a staff of medical and administrative professionals – local, regional, and national - who provide a 24/7 network of care and assistance. 

I feel so privileged to be part of that larger team. I am so grateful for those who have trained me and entrusted me to do the work well. And I want to express my gratitude for some of them.

Side note: If this sounds like a Thanksgiving post, that’s because it is. The last two weeks have been full of too-much-good-stuff – holiday family time, traveling, preaching at our church, training the replacement chaplain – so the time to write has been scarce.  Thanks for being patient with me with a very tardy release of the Blue Spigot.

• Erin – you took a risk hiring me in 2018. I had passion, but not much else. I will always be grateful you had confidence in me. 

• Kathy, Nick, and Nicole – your outstanding supervision of my work has been such a gift. 

• Mike – Thank you for your executive skills, and for entrusting me to lead the Bristol Hospice Sacramento chaplain team.

• Spring & Tessa, Lindsay & Angela, Jayson & Raman & Holly – watching each of you as nurses has been an incredible honor. If I ever need go on hospice care, I hope I have someone like you serving me.*** 

• Peggy – you are an incredibly wise and gifted Nurse Practitioner, and now a dear friend for life.

• Joel and Jeff, Lydia and Father Cormac – Chaplains extraordinaire! I’m delighted to have served with you, and have treasured the way you follow in Jesus’ footsteps.

• Lyndsie, Mary, Yana, Nikki and Valencia – from your office desk you covered a multitude of my mistakes and oversights.  Thank you for your assistance and patience!

Benediction of Blessing:

• May you remember the words of CS Lewis, who said that we are souls who have a body, and not the other way around. And so may you nurture your soul!

• May you slowly grow in your ability to accept your mortality, thus living and dying well.

• May you see your time in this life as a time of learning to live with God, on earth as it will be in heaven.

* Words by Fanny Crosby. Public Domain

** Want to read more stories like this? 

*** I discovered a wonderful book written by a hospice nurse about her work. It’s outstanding, and Linda loved it also.  The In-Between by Nurse Hadley 

Credits:

Man on Bench: Shutterstock

Holding Hands: Advent Health University

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All Scripture quotations, unless otherwise indicated, are taken from the Holy Bible, New International Version, NIV. Copyright 1973, 1978, 1984, 2011 by Biblica, Inc. TM