During the second half of my year-long Chaplain Residency at the Hampton Veterans Administration Medical Center, I served in a hospice care unit.  Three months into my assignment, the air-conditioner in the Hospice facility broke down, and residents (patients) were relocated to a long-term care unit.  This transition came with challenges, while highlighting some of the extraordinary qualities I witnessed in interdisciplinary team members as they offered the best possible care.

For informational purposes, allow me to define hospice care.  Generally speaking, hospice is a course of care for those nearing the end of life.  Instead of focusing on life-saving measures, it seeks to provide comfort and quality-of-life.   Hospice care might involve, 1) Routine home care, where loved ones care for the patient at home and hospice providers visit on a regular basis, 2) General inpatient care in a facility for those whose symptoms cannot be managed at home, 3) Continuous home care, which includes a more intense and short-term engagement of the team in the home of the patient and 4) Respite care in a facility for the purpose of providing caregivers at home a rest. 

The hospice residents I cared for had been admitted to the VA facility after a terminal diagnosis, or when their loved ones were no longer able to care for them at home.  A few survived in excess of a year, but many lived only days, and in some instances hours before their deaths.  I also met a couple of residents who were reevaluated after much improvement and removed from hospice care.

I learned many valuable lessons during this season of ministry.  I hope to share the most meaningful of these in the reflections that follow.

My most profound discoveries came in the form of personal gifts from the residents themselves.  These were not material gifts, but rather perspectives and truths they embraced in their circumstances.  I am forever changed by the courage I witnessed in those who were forced to come to terms with their diagnosis and accept the realities of the days ahead.  I do not mean to suggest this was an easy process.  The pathway to acceptance often passed through anger, resentment, regret and denial.  Even after acceptance, these feelings occasionally resurfaced along with discouragement and depression in light of emerging realities.  Yet, I can confirm the human spirit is amazingly resilient among the dying.  In the past I have wondered what it is like to face death, and now I am comforted in knowing God has designed us with abilities which, along with our faith and community, give us the strength to persevere.

A rewarding aspect of providing hospice care, which I had not expected, was the way residents used humor to cope with their frustrations.  One high-spirited 79-year-old woman with pancreatic cancer told me, “They say they can’t give me what I want because I am under treatment.  How can they say I am under treatment when I’m not being treated?”  Another man in his late 60s who was dying of cancer always started my visits with a joke.  I believe God gave us humor to help us cope with pain and disappointment when we have nothing else to say.

As you might expect, I had numerous conversations with residents about faith and eternity.  According to my directives from the VA, I was not to proselyte or convert those I cared for.  However, I could answer questions, and if I listened carefully and responded to the material presented, it usually wasn’t long before I had an opportunity to share what my faith tells me.  One memorable encounter involved a believer in Christ who repeatedly asked me, “Am I saved?”  Straining to speak, he had concerns about eternity because of imperfections in his life.  Together, we recalled scriptures which remind us we are saved by faith, not works, and the resident was finally able to come to a place of comfort and resolution that God’s grace was sufficient. 

I would be remiss if I didn’t praise other members of the interdisciplinary team for their loving spirit and countless acts of mercy.  These aspects of their work were most evident when residents transitioned to the long-term care facility because of the air conditioning malfunction.  This situation continued for three months, leaving residents with less privacy in their last days, considerably more noise and distractions from long-term residents.  This caused no small unrest among family members who were disappointed in their loved ones’ circumstances.  If I might borrow from a basketball phrase, in response to this trial, members of the care team went “man-to-man”.  In other words, they stayed with their residents constantly, traveling with them everywhere they went in the facility, and congregating them in a common area during daytime hours to give them a sense of normalcy and community.  My admiration for the hospice care team grew immensely when I saw how willing they were to make personal sacrifices for the sake of those in need.

There are many aspects of hospice care I am not addressing here, as my service was confined to a facility.  My mother was in home hospice care, and I am aware there is much to be said for family members who put their lives on hold to care for their loved ones.  Still, many lessons are transferable.

On a personal level, caring for those in hospice care led me to reflect deeply on the subjects of life, faith, love and eternity.  I came away with a greater desire to use the time I have left on earth in meaningful pursuits, and to spend as much time as possible with the people I love.  I believe I have always tried to be productive, but now I reflect more on “why” I do what I do.  As my life gets shorter, I have less time to waste doing things that don’t matter.  Please understand, I don’t mean everything I do has to be serious or laborious.  In my book, a day of fishing without a single catch is meaningful; perhaps not desired, but meaningful.  But if I do spend a day this way, I need to make certain it is something that brings me joy. 

In regards to my faith and eternity, while I have thought about going to heaven and seeing Jesus face-to-face throughout my life, I haven’t always involved the Lord in these reflections.  Hospice patients taught me to be more intentional in having these talks with God, as I ask Him to help me age gracefully, and when the day comes, to die with hope in my heart.  There are also many practical points I want to address to prepare my family for this eventuality.  I will add, as my mother always did, “unless Jesus comes back first.” 

This is my last devotion as I look back on my Chaplain Residency experience.  I am now serving in my first job as a trained chaplain, and I know there is still much to learn.  I hope the things I have shared in these reflections have provided some food for thought as you journey through seasons in your own life.