What happens inside a hospice?

“So what actually happens in this place?” Simon asked, his question caught me off guard.

 Trying to understand where he was coming from, I replied “What do you mean?”.

“Well I’ve been here for a week and I’m still not sure what actually happens in the hospice,” Simon said, still looking back at me, searching for an answer.

Simon had been admitted to the hospice a week earlier, as he was struggling at home with the symptoms from advanced liver cancer but was now able to move freely and sip cups of tea without pain and nausea.

He’d explored the well tended gardens, eaten meals of his choice cooked exclusively to his tastes and been nursed holistically, addressing not just his physical needs but his psychological and emotional distress too.

He continued, “I haven’t heard any screaming, I haven’t seen any dead people and this place just seems too quiet, peaceful and bright!”.

“Ah, I get it!” I thought and said ,“Well yes, that is Palliative Care to some degree”.

“Since your admission there have been a few people that have died and yes, there has been sadness and grief but we’ve tried to create a private atmosphere for families and patients, and for all our patients who die, they leave the same way that they arrived, through the front door.”

“The practice of palliative care is to help relieve suffering, be it physical, psychological, social or emotional and much of our care as you know, centres upon the family’.

As my supervisor and I reflected on this, we realised that there are many misconceptions around death, which is understandable because we have moved our dying from being visible and openly discussed, to largely being confined to hospitals and aged care facilities.

As Atul Gawande noted in his book “Being Mortal”, at the turn of the century, death was socially accepted to occur in a person own house, often in their own bed, tended and nursed by their own family.

In 2018, it is very common not to understand the processes involved in dying and seeing our days are numbered on this earth, it is very important to be aware, learn and be comfortable with death to a degree, as death will occur as naturally and regularly as birth!

Our Hospice

I often wonder as I walk through the glass doors of our Community Hospice, against the flow of hospital workers and patients, do they know what actually happens inside the Hospice?

The Albany Community Hospice isn’t tucked away behind thick bushes and trees or found at the end a winding stretch of road but situated in full open view as a seperate building, next to our staff carpark, accessed behind the main hospital.

I have to admit as a junior doctor, I feared being called to the hospice because I didn’t know what to expect.

I feared that I would find patients in their last moments before death, in agony, searching for meaning and resisting the mighty power of the end.

I was scared that I’d encounter what Simon was expecting, the sounds and sights of death.

But I was wrong.

Hospice is a place that I found a peaceful and calm atmosphere.

Hospice is a place that I saw compassion (mercy in action).

Hospice is a place that I saw eternal healing from devastating disease and earthly suffering.

Hospice is a place that induced deep self-reflection in some and brought what matters in life to the surface in many.

Hospice is a place where estranged families reunited, but also pushed others further apart.

Hospice is a place where I saw highly skilled nurses work in a rich blend of medical, psychological, social and spiritual care, a rare mix that I hadn’t encountered before.

Hospice is a place where symptoms were managed expertly and swiftly, helping to minimise suffering and alleviate distress in both patients and their families.

Hospice is a place where people came to finish their business here on earth, be it reconciliation and forgiveness, writing their will and testament and most importantly, saying good bye to the ones they love.

Palliative care is core business for everyone

Hospice and Palliative Care are words that we should learn not to fear because just as we all aim to live well, we should all also expect to live our last days surrounded by loved ones and cared for expertly with dignity and compassion.

It is my sincerest belief that palliative care will become core business for every person alive on this planet, as we can all reach a hand out in compassion to another who is suffering physically, emotionally, psychological or spiritually.

Palliative care is everyone’s business because it is a human right to receive good quality palliative care and to die free from unnecessary suffering, something that we are working towards providing to all Australians.

Call to action

This week is National Palliative Care week in Australia and there is no time like the present to consider “What matters most?” at the end of life.

Think about those in your immediate circle, your spouse, your parents, your neighbours or a good friend.

Do they have a chronic illness or life-threatening diagnosis which is irreversible?

Do they have an unmet need that would improve their quality of life?

Is there a conversation that they are dying to have? 

As I’ve experienced, talking about our last days can be very empowering and with great love and respect, I would encourage you to consider what matters most to you at the end of your life?

Thank you.

Live intentionally

Love relentlessly

Enjoy your days on earth in good health!

Dr. Jonathan Ramachenderan @thehealthygp