Johnathan Thomas, MBA, PhD. D.DIV
Emotional stability and good mental health are important for all of us. When we add the experience of hospice care, finding a sense of balance, calm and general understanding comes into play as an essential piece for everyone involved – the patient, their family and friends, and healthcare providers. It is important to understand how hospice addresses mental health when working with patients who may be struggling to find peace and balance.
First, let us talk about the term mental health. There are levels of need, in terms of services, based on the psychological profile of a patient even before the need for palliative care becomes an issue. If clinical mental health concerns are at play, meaning the patient is managing with a clinically diagnosed mental illness, then any special needs or attention regarding that illness will be addressed and incorporated into their hospice care plan. This blog is less about clinically diagnosed illnesses like schizophrenia or bipolar disorder. Instead, we are looking more closely at the general need for mental wellness and emotional wellbeing. And in that case, everyone has needs. We are, as humans, better able to handle the stresses of illness when our personal mental state is in check.
Mental health services in the context of hospice care are not really about things like group therapy or psychological analysis. Hospice care is not about addressing mental illness, but it does very specifically deal with helping to foster a positive mental state for the patient and for family and caregivers. The overall goal, after all, of hospice care is to provide peace and a sense of calm for everyone involved.
Good hospice care provides that calm by setting an example, especially when caregivers are there in person, in your home or at a healthcare facility. For all families, knowing that the patient is coming to the end of their life can generate anxiety, discourse, and drama. Trained hospice caregivers are able to manage these situations and help everyone involved to keep a positive outlook. One of the best things trained hospice teams do to foster mental wellness is help reduce fear. They bring real and reliable knowledge to the process and are able to answer difficult questions from the patient and from family members, with direct, honest information. They are also typically very kind. They are trained and encouraged to take the time to talk with family members.
Very often, conversations with a patient include conversations about their faith and religious beliefs. Religion often plays an important role for patients and their families, so good hospice care will bend around science and medicine to also incorporate faith-based practices, like inviting a priest or community leader to visit, if that is what the family wants. Remember, the goal of hospice care is to ensure the patient’s good quality of life.
One part of hospice care that many people do not expect is moments of joy. Good hospice workers are adept at talking with people, asking them about the patient, encouraging them to share happy memories or stories. In many cases, old photo albums come out, stories are told and there is a sense of real happiness because of the shared life experience and love for the patient. This may not be part of the official job description for a hospice caregiver, but it is more often than not a very real part of the role they play in families across America.
The sum of all of these aspects of hospice care provides very real, hands-on training for everyone involved. In the best of circumstances, it is a master class in coping skills. For all of us, coping skills are earned, more than learned. We go through things in life, including illness and death, and the quality of our experience is defined by our ability to cope. By providing reliable information, demonstrating calm, sharing memories, laughing, and caring, everyone involved in the hospice experience is made stronger and more ready for their next challenge. Especially the patient. Facing our own mortality is not for the faint of heart. Good hospice care can build up our coping skills, help us approach challenges with grace and dignity, makqe peace with our life, our loved ones, and our own end.