The Words

Words hold great power. What we speak carries such weight. This holds especially true when dealing with difficult subject matter. Hospice caregivers are enveloped in that very thin tight rope of sensitive subject matter and profound human emotion. How can we communicate the magnitude of the situation without causing deep emotional upheaval?

Die, dying, death… these words are often the least chosen. I am guilty of using words like passing on in their place? But, why do we do that? Will avoiding those barbed words prevent the inevitable from happening? The answer, as we all know, is sadly no.

It is our place as hospice workers to prepare the families and loved ones for where the road will lead. Saying the words won’t make it happen any faster. There are times when using undercover phrases may backfire and cause confusion and more pain. Be open, be honest, be direct and most of all, be kind.

Communication and education are the cornerstone from which hospice is built. Most people do not understand the dying process and all that might take place. It is complicated and messy. It is emotional and exhausting. It is fulfilling yet can leave one feeling empty.

We educate and communicate with every single interaction. Selecting our words carefully so as not to potentially increase the pain of the situation, but some words cannot be avoided. They should not be avoided. The patient is dying.

They have been dying, not from the moment they entered hospice, but, long before that. Each day, every one of us is dying – individually at different rates. Those with terminal disease are obviously doing so at a much quicker pace. Disguising the inevitability in a different costume does not make the truth any easier to accept.

“But, where did he pass to?” , she asked me with big brown eyes glistening with tears. Her husband, so young and full of life, had died moments earlier. She had just run to take a quick shower and he chose that very moment to make his exit. I tried explaining again that he had passed on, but, her face reflected such confusion. The nights awake and overwhelming emotion all came to a climax. I took a deep breath and placed a hand on her shoulder, “I am sorry, but, your husband has just died”. This, she understood. This, she processed. This, was what she needed to hear.

My mom used to say that the tongue doesn’t have bones, but can break bones. Meaning that what you say to someone can cut deep. Personally, dealing with such incredibly emotional subjects, such as end of life, I don’t believe this saying holds true. Our communication has to be simple, kind and yet direct and pointed. Dressing up the situation with pretty words won’t fix anything but might cause confusion and misunderstandings. Communicate with families the way you would want to be communicated with.

The patient has died.

The patient is dying.

Being completely transparent and clear may help those supporting the patient to take the first micro steps to understanding, acceptance and healing. After all, isn’t that what we hospice workers are supposed help do?