Wisdom for Dealing with End of Life Issues from a Hospice Nurse's Perspective

Sunsets Cover

Interview with Deborah Howard

Deborah Howard's book, Sunsets: Reflections for Life’s Final Journey, is for anyone with family or friends facing end of life issues or terminal diagnoses. She offers insight that will help you walk through the challenging times that are ahead. She was kind enough to take the time to answer a handful of questions for the blog. Here's part one (of two):

1. You didn't start your career off as a hospice nurse. How and why did you decide to go into this specific field?

Like a lot of people, I suffered under the misguided conclusion that hospice was all gloom and doom, and death and dying, and I thought it would be really depressing. A friend of mine who was an oncology nurse went to work with hospice and immediately started bugging me about it. She’d say, “I know you, Deborah. You have such a heart for hospice and you don’t even know it. You’d be so perfect working here. Please, come interview.” Twice, I refused. The third time she called, I agreed to come talk. Once I found out what hospice really was all about, I was sold! I traveled around with her one day and saw what she did in all these homes, how she touched people’s lives. I wanted to make that kind of a difference, too. So I signed up with hospice and never looked back. Not only did I NOT find it depressing, but extremely rewarding. There was not a day that went by that I didn’t know, without a doubt, that I had made a significant difference in someone’s life. I often pray for God to use me as a vessel. Hospice gave me the opportunity to be used by Him, and through my experience I was able to write Sunsets.

2. You mention the importance of believers preparing for and being preoccupied with heavenly things even when death does not yet seem imminent. Why is this so important? What does this practically look like?

Like the apostle Paul, I encourage people to keep their minds on eternal, heavenly things. “If then you have been raised with Christ, seek the things that are above, where Christ is, seated at the right hand of God. Set your minds on things that are above, not on things that are on earth,” Colossians 3:1-2. This is more about the way we LIVE than the way we die. Not only is this attitude of faith honoring to our Lord, but keeping this godly, spiritual perspective in mind sifts through our day to day concerns. If we are right with God, we can “live and move and have our being” in Him, and in so doing, can have joy-filled lives—even in the midst of trials. If we constantly worry about death or sickness or losing our money or possessions, we will live stress-filled lives. What I’ve found is that when we are prepared to join Christ in eternity, we are then able to view the temporal with less of a tendency to cling to the world. We can then hold the things and the people we love with an open hand, trusting God in all things.

3. What are some practical things family and friends can do to comfort those who are dying?

Do them the honor of not pretending this isn’t happening to them, that they’re going to get better if they just keep a positive attitude. Friends and family who persist in this attitude actually lose the opportunity to share in their loved one’s burdens. Instead, let them know how much you love them, that they have made a difference in your life and that you’ll never forget them. Offer to take them for a drive (which is often the only thing they have the energy to do), or bring them a milkshake, or mow their yard, or sweep off the porch, or bring a meal to their family, or pray with them, or read from the Bible to them. Even people who have never been interested in spiritual things may suddenly become more receptive when they realize their “hereafter” is nearer and more relevant than they had previously thought.

4. How can friends and family best serve those who are grieving?

Galatians 6:2 says, “Bear one another’s burdens, and so fulfill the law of Christ.” So my advice would be to come alongside those who are grieving. We should become a splint to add strength and mobility to their lives as they struggle through. There are times when caregivers feel they can’t go through this. Remind them that God will give them the strength to go through it, and that you want to be there to uphold them when they feel they can’t go on. Instead of saying a blanket, “If you need anything, call me,” be specific in your offer to help. “I’m going to the store to get a few things. What can I pick up for you?” Or, “why don’t I come by tomorrow morning about 10:30? I’ll sit with __ while you go out to lunch or run a few errands.” Or, “Since I’m here, why don’t you go upstairs and take a long, leisurely bath, or a nice, quiet nap or whatever you want to do? I’d be happy to sit and visit with ____.” Or, “why don’t I take your kids home with me for the weekend?” Keep your eyes open. What needs to be done? Flowerbeds need weeding? House need dusting? Laundry or dishes stacking up? Do them! Don’t wait to be asked. Bills piling up? Sometimes a wife who has never paid a bill in her life is left with that responsibility and doesn’t have a clue how to do it. Ask her if you could help pay some bills, teaching her as you go. Be creative with the ways you choose to help others. Even if you don’t do it exactly as someone else would, the effort and the intention will mean the world to someone who is struggling to keep their world from spinning out of control. Being on call 24/7 with a sick, and/or dying person is exhausting and complicated. Doing that and keeping house and cooking meals and doing laundry and . . . well, most caregivers would welcome a little relief, even if they’d never ask for help.

5. You say that denial is at worst destructive, and at best procrastination. How can grieving people move beyond denial or optimistic wishful thinking? What's the difference between denial and hope?

I believe the biggest difference is that denial hinders the constructive progression through a serious illness; hope propels you forward. We are told, in Philippians 4:8, to think about “whatever is true.” When we deny the reality of an illness, we focus on what is false, not what is true. We think things like, “That can’t be,” “The doctor’s got to be wrong,” or “He’s been through worse than this before and come out of it every time. I’m sure he can do it again.” When we do that in the face of facts that say otherwise, we not only deny reality, but we reject God’s providence. The initial step in moving beyond denial is the recognition of it in the first place. Once you recognize you’ve been in denial, you must confess it to the Lord and ask Him to equip you with the strength, knowledge and hope that will make you an asset to your loved one instead of a hindrance. Many people pray for a miracle. But our hope is not in the miracle; it is in the Lord, Who holds our future. Yes, by all means, pray for the miracle, but faithfully trust God to work His will in your loved one’s life—whatever that will is, knowing that God’s will is perfect and that our suffering will result in two things – ultimate good for us and ultimate glory for Him.

Learn more about Sunsets | Check out part 2.

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