Hospice Palliative and Psychosocial Spiritual Care for Living with the Pandemic

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May 10, 2022

Written by Diane Holmlund, RP, CASC certified Spiritual Care Practitioner
SCHC Hospice-Palliative Psychosocial Spiritual Care Coordinator

One of the most striking aspects of hospice and palliative care that is unique in the medical world is the expected clinical outcome of death, not wellness nor recovery. Hospice and palliative clients and their families do not get well in the traditional sense of getting back to their former selves or their sense of normality, though this is often the deepest wish of many in facing their human mortality. Instead, persons in palliative care have varying spans of time to face their impending death that victims of accidents or more sudden tragedies do not have. The shock and questions arising from this time also vary: Why me, why now, why is this happening, how did this start, how long do I have, how will it be, who will be with me, is there anything afterwards? How do I live with this until then? Who will care for my family?

A key support that I offer in end of life spiritual care and counselling is assisting in the opportunity to make, seek, find, create or recreate meaning that is true for the individual person, regardless of their age, gender, health condition, socio-economic status, personal beliefs or religious or cultural practices. Recently the CBC offered an in-depth look at the work of the late psychologist Dr. Viktor Frankl, a survivor of the German genocide and one of the leading teachers in the past century in care for the mind, heart and soul of suffering persons. His life’s work was founded on the need for “meaning making” that he felt to be essential for human life to succeed in spite of any obstacle, and in surpassing sheer survival.

The Coronavirus pandemic has thrown most of the world into the chaos of suddenly facing the utterly unknown. Though this is also true for many in the world living with war, famine, disease, poverty or persecution, many of us who have been previously unaffected are now in similar positions to the person facing a sudden diagnosis of “life-limiting” illness: Why us, why now, why is this happening, where did it come from, what will solve it? Will we and our loved ones survive, and what of those who don’t? How do we live with this now, individually and together?

​The Coronavirus pandemic has thrown most of the world into the chaos of suddenly facing the utterly unknown. Though this is also true for many in the world living with war, famine, disease, poverty or persecution, many of us who have been previously unaffected are now in similar positions to the person facing a sudden diagnosis of “life-limiting” illness: Why us, why now, why is this happening, where did it come from, what will solve it? Will we and our loved ones survive, and what of those who don’t? How do we live with this now, individually and together?

Many of us have now had more than one month of self-isolating and the prevention of our most basic human instincts to gather together for companionship, help, warmth and love. We don’t know when this will end so we can get back to our previous lives, a stable economy and our ability to plan for the future. Meanwhile front line and “essential workers” who never knew they were previously called that continue in daily putting their lives on the line for the rest of us. Guilt, resentment, panic, fear may abound in this separation of those who must stay home contrasted with those at the frontlines. It may feel like we are free-falling through space, or that all the formerly solid parts of our lives and of society are now in constant change, like the ever-moving parts of a mobile dancing over a baby’s crib.

In working with people and families facing terminal illness, I continue to face my own fears of death and loss. This has never been easy for me nor for colleagues in this field. But death is the ancient reality now before all of us, as we hear of doctors and nurses completing their wills and making their healthcare directives known to their family members. The “hard conversations” at which palliative teams excel in assisting people are now facing all of us, of any age. Yet when have we ever not been facing death as our human end? Some say the privilege of our developed world has made us “death phobic” in our daily distancing from the life and death struggles of so many regions globally, as well as that of the natural world, and most of human history.

We now have the chance to face the simple fact of our mortality, alone and together, whenever that will be for us or our loved ones. How can we do this? How are you doing this? How are you feeling about this new world into which we have been collectively thrown into? In the familiar greeting to her patients by the founder of the modern hospice movement, Dr. Cicely Saunders asked, “How are you within yourself today?”

While we all continue finding new ways to live and work through the pandemic and beyond it, perhaps we can learn to face our human fragility in this new time, alone and together. Let us remember that, as so many of the world’s religions teach, and as so much of Mindfulness, meditation, thoughtful prayer and trauma therapy teaches, the breath is our start and it will be our end. If all we can control at this time is the conscious managing of our in-breath and our out-breath a few times daily, we can have greater ability to face our realities, alone and together. I highly recommend doing this with plants in your home, even in your bedroom. Remember that the plant world exists in direct, symbiotic relationship to us – they feed us with their output of life-giving oxygen, while we feed them the carbon dioxide that is so poisonous to us, but life-sustaining for them.

And when we are able to breathe together again, let us remember what we are learning now and carry it forward, whatever the future holds for us, alone and together.