What is it Like to Work in Hospice? Part One: The Little Perks

So, what is it really like to work in hospice?  And, the ever popular follow-up question: Isn’t it depressing?

I get asked this a fair amount, so I thought I’d spend some time writing about it.  Of course, I can only speak for myself.  I should probably tell you that I’ve been doing it for a little over three years, part-time.   I think that’s important to know, because I write this from the perspective of someone who doesn’t do this all day, every day, year after year after year.  I’m not burned out.  And, as you might guess, I think this is a field in which it is quite possible to get burned out.  If any of you readers have a different perspective that you would like to share, I’m all ears!

So, in general, I will say that I really, really enjoy working in hospice.  And no, in general, it’s not overly depressing.  This week, I’ll write about some of the day-to-day aspects that make working in hospice enjoyable.  Next week, I’ll write about some of the bigger issues in end of life care that make hospice work satisfying.  And then,  I’ll focus on some of what we can euphemistically call “challenges.”
I’m part of the “home team,” so I visit people in their…homes.  I drive around the city and suburbs and go to houses, apartments, and nursing homes.  I love that aspect of my job.   I find it fascinating. Given that I’m a sociologist and always secretly wanted to be a real estate agent, I get a lot of pleasure from seeing people in their home environments (though I will admit that I don’t tend to get that excited about going to nursing homes).  And as I live in a very diverse city, I get to drop in on all sorts of folks.   As a white middle class gal from the ‘burbs, working in hospice has allowed me to intimately experience a wide swath of society that I would never have had access to otherwise.  And I love that, too.

Another logistic perk of being on the home team is that I get to spend a fair amount of time in the car, by myself.  This may not appeal to everybody, but I’ve become quite fond of it.  I’m very much an introvert–quite a friendly one, but an introvert just the same, and having down time in the car to recharge myself (and my phone) between visits has been life changing.  I listen to a lot of audiobooks–usually murder mysteries, actually.  (No, the irony is not lost on me.  Lately I’ve become enamored with the Inspector Gamache series by Louise Penny--I highly recommend it!)  For me, being able to stop at a coffee shop and get a cup of tea, and then drive around to my next visit, by myself, while listening to a good audiobook is pretty close to heavenly.

“Okay,” you might be saying to yourself.  “You get to look into people’s homes and unwind in the car.  Whatever.  What about hanging out with dying people?”

Yes, I’ll get to that, next week.  I like that part a lot.  But I can’t emphasize enough how important the flow of my day is.  While working in hospice is a very special, unique job, it’s still a job.  I happen to have stumbled on a job that really meshes well with my nature and needs.  I get to schedule my own day (usually), and am pretty autonomous, while still having the support of a team.  I can do my charting in my favorite coffee shops.  The ratio of social interaction to alone time is ideal for me.  If you have read the book Quiet, by Susan Cain, you’ll know what I’m talking about. I came into this work after staying at home with my children for several years.  I loved that time, too, but I had essentially no alone time in that gig.  When I don’t get enough alone time, I go a little crazy.  I would have done pretty much anything to get to drive around in the car by myself and listen to a story for grown-ups while drinking tea.

Even hanging out with the dead and the dying.

I had actually been nursing an interest in death and dying for a number of years, but had only read and researched it, not experienced it.  Looking to get more clinical experience, I shadowed a hospice social worker for a day, and discovered that I really enjoyed it.  I realized during that day that the whole purpose of hospice is to provide comfort.  There really isn’t any other ulterior motive.  And that’s a role I’m very comfortable with.  And so, in a nutshell, I drive around, drink tea, and drop in on people to see if I can make their lives a little bit better in some way.

That plays out in a number of ways.  My initial visits with families usually involve a fair amount of hospice education, and getting a sense of what their needs are and what they are going through.  Sometimes the people I meet are on the verge of death.  If that’s the case, I will try to prepare them for what’s coming, answer their questions, and provide what we call a “supportive presence.”  On subsequent visits, I work on building the relationship.  I check in to make sure that they have what they need on in instrumental, practical level: enough caregivers, equipment, etc.,  and spend time getting to know them.  I listen to their stories (which is fascinating), and also work with them on exploring their emotions and feelings at this stage in their lives.

I’m guessing that it’s that last part that makes people ask me if my work is depressing.  That, and that fact that pretty  much all of my patients die.

It’s not, though, at least not most of the time.  Why?  Well, I’ll tell you why.

Next week.

So, stay tuned.  In the mean time, go check out Still Life by Louise Penny.  The narrator on the audiobook is wonderful.  And I’ll bet you anything that by the end of it you’ll be craving a cafe au lait.  (At Starbucks, you have to call it a Misto, otherwise they won’t know what you’re talking about.)  And, as always, thanks for reading!