By Maggie Finley
During a recent visit, friend and former colleague Rev. Charlotte Keyes of Providence Hospice of Seattle and I talked about ministry to families as the rule rather than the exception in hospice care. Charlotte agrees with me that when someone is sick, in a manner of speaking, the whole family is sick. Illness is a crucible experience for families, making members vulnerable, bringing out the best and the worst in everyone. Charlotte remarked, “When it comes down to it, hospice chaplaincy is being present and aware of family dynamics.”
Charlotte makes no assumptions about whom she is actually there to support in any given visit. During one initial assessment, although the patient’s daughter had requested a chaplain referral for her father, she was the one who ultimately needed support. Meanwhile, the patient slept soundly throughout. The daughter led with the belief that her father “is having trouble letting go.” Charlotte listened intently while the daughter shared a family history fraught with verbal and physical abuse, the scope of which included her mom and two sisters. She still wanted to care for dad, convinced he loved them as much as he could. Since coming to grips with his powerlessness to control his temper, she found it in her heart to forgive him because he was a good provider. Near the end of the visit, the daughter was surprised to feel “a burden had been lifted.” Charlotte remains open and accessible to her as well as anyone else who might enter into the patient’s narrative.
Our conversation also reminded me that hospice ministry is about kinship, since we may begin to see part of a patient’s legacy in its multi-generational dimension. One family with whom I grew into a genuinely pastoral relationship over the course of about 2 1/2 years, spanned four generations. Initially, my bimonthly visits were divided between the nonagenarian patient, Greta, and her caregiver son, Dale (all names have been changed). Protestant and Canadian, they were without formal faith affiliation in Washington. I became something of a pastor figure. Having built a trusting relationship, Dale approached me about the funeral when his eldest son died unexpectedly. It gave me an opportunity to meet other family members of whom I’d previously only heard. My follow-up bereavement visit included Dale as well as his adult children, along with their spouses and children.
Only six months later, Dale disclosed his wife’s newly diagnosed cancer. Since Dana was admitted to a Providence-aligned hospital for surgery, at the couple’s request, I made a post-op visit, on a day otherwise dedicated to hospice admits. Dale, along with extended family from both sides of the border, arranged their visit to coincide with my time on the floor. A good number were assembled, so I chose to introduce myself via ritual, in response to Dana’s request for shared prayer while incorporating the loved ones’ healing touch and storytelling into our time together.
I don’t know how long it was after Dana’s discharge that Greta, my matriarchal patient, died. I kept my promise to her and her family to preside at her funeral. I was honored to be the one to help these people whom I’d come to know begin the process of mourning the loss of beloved Mum.
During Greta’s last few months, Dale expressed his own health concerns. Neither of us anticipated that merely a month after his mother’s death, during what was simultaneously my last and only bereavement visit, he would discover that his own cancer, in remission for years, had returned. This wasn’t an easy context to end our formal relationship.
But there’s a postscript to the story. Dale stayed in touch by mail, so we exchanged occasional notes and holiday cards. Once I retired, he said he’d welcome a visit, so I did. He processed feelings about the outcome of cancer treatment and said, “I’m not sure I’ll make it.”
I didn’t hear anything for a while. Then a chaplain acquaintance in another healthcare system tracked me down: Dale wanted to reconnect if possible. In a phone call, his son and daughter let me know that he was only expected to live another 72 hours. “Dad would want to see you before he dies,” they said. “Your presence would mean a lot to the whole family.” Acting on my intuition, I visited immediately. On arrival, Dale was fairly unresponsive, although he’d been awake and oriented less than an hour before. His breaths were barely perceptible, some far apart. I called his name, held his hand and talked to him. He knew I was there. He managed to open his eyes momentarily and drew a few more breaths — then tranquilly, his last. I was moved to silence.
Finally, I said, “What more can I do?” Dale’s children asked for bedside prayer, and I began with lines from Greta’s favorite childhood prayer. I moved us into spontaneous prayers and storytelling. I encouraged the family to bless him in their own words or with loving gestures, to “prepare Dale for the next chapter in his journey.”
I’m forever humbled by what seemed his willingness to wait for me (see the book “Final Gifts”) before making his transition: dying peacefully, surrounded by many loved ones. His parting gift to me was not only the privilege of midwifing his death, but a sense of having come full circle in my hospice ministry to four generations of the same family. I won’t forget.
Maggie Finley, BCC, is a retired chaplain from Providence Hospice of Seattle.