Psalm 90 encourages “us to number our days carefully so that we may develop wisdom in our hearts.”[1] While we may not know when we will die, we do know that we will die one day if the Lord does not return first. Here, in this liminal space, at the end of life, hospice care might step in to help.
Few people think about their wishes regarding end-of-life treatment, much less communicate it. Yet our Christian faith is central to our approach to death and, consequently, we must think about it. One ministry we might consider is that of hospice. As a result, this article, instead of focusing on discussions surrounding life-prolonging technologies, will focus on what hospice care provides for those with a terminal illness. This particular circumstance requires acknowledgement that death is near, which we are rarely comfortable with.
Death is certainly not the end for those that have placed their faith in the resurrected Lord. Faith in Christ reassures us of the promise that our bodies will be renewed (Rev. 21:4). With this promise in mind, we should seek richness and meaning in our last days.
History of Hospice
We can trace the origins of hospice care back to Malta in 1065, where the Knights Hospitallers of the Order of St. John of Jerusalem cared for sick and dying pilgrims to the Holy Land.[2] Records from these caregivers show an attitude of caring for those at the end of their lives. This holistic approach reflects what we understand hospice care to be today.
Roughly eight hundred years later in 1840, the Irish woman, Mary Aikenhead, established a similar sort of work in a shelter in Dublin that focused primarily on caring for the dying.[3] She had no direct connection with the Knights Hospitallers; even so, her work focused primarily on caring for the sick and dying. A few years later, a similar place of shelter was opened in 1905 in London, where it has continued until present day, known as St. Joseph’s Hospice.[4] Much like the Knights Hospitallers and Aikenhead, their work provided care for those at the end of their lives.
A significant development came during the 1950s with the development of the Marie Curie Foundation. The leaders of this organization aimed to provide comfort for patients dying from cancer. Their priorities focused on “establishing special residential homes to care for cancer patients, provide home nursing, provide help with practical needs such as bed linen, furniture and medical equipment, and give the public advice about cancer and the help available for patients.”[5] While these hospice shelters were opening in Europe, a similar focus on end-of-life care started taking place in the United States.
Rose Hawthorne, and her work through a Dominican order of Sisters, opened their first hospice in New York in 1899.[6] Seventy-five years later, Connecticut Hospice was founded in 1974 in Branford, Connecticut. After studying various hospice care companies throughout the United States and their viability for caring for terminally ill patients, President Reagan signed into law the Medicare Hospice Benefit, covering care for 80–85% of hospice beneficiaries. Today, Medicare, Medicaid, and most private insurance plans completely cover the cost of hospice care for those who meet eligibility requirements. Not only is the care provided by hospice staff covered by this benefit, but so are medical supplies and prescriptions related to pain and comfort management.
Purpose of Hospice
The early work of hospice care focused on the symptoms at the end of life, rather than aggressive or life-prolonging treatments. Furthermore, it focused on treating the person holistically (spiritually, emotionally, and physically). An early form of this type of care came by way of the Marie Curie Foundation, which established residential homes for patients. This approach extends even to this day, opposing the misconception that hospice care is provided only in an institution. The support of hospice care allows the people to spend their final days at home, if that is their wish.
History shows how hospice care is not just a place where you give up hope. Care can be provided anywhere that the patient is residing. This philosophy of care truly focuses on quality of life, with emphasis on spiritual and physical well-being. Studies have shown longer patient survival with hospice care. Todd Eichelberger writes that a person’s “receiving at least one day of hospice care may increase life expectancy by up to three months.”[7]
With hospice care, the person is holistically cared for with added attention to pain management and other symptoms related to life-ending illness. Their care will also be monitored by an interdisciplinary team comprised of nurses, physicians, home health aides, volunteers, spiritual support, bereavement counselors, and social workers.
How Can Christians Be Involved?
I often get asked how Christians can help those in the medical field, specifically in hospice care. A simple yet easy way to help is through volunteering. Nearly every hospice company will have some type of volunteer program through which people can help provide companionship to hospice patients and their family members. Volunteers can help in a variety of ways—whether through reading or storytelling, office and administrative work, veteran recognition ceremonies, or arts and crafts. The core of hospice care is friendship and hospitality, and Christians have a unique opportunity to fill this need.
Most hospice teams will have bereavement or grief support counselors. Their work often includes support groups where people can share memories and stories of their loved ones who have passed away. Churches could co-sponsor with hospice companies and help provide the shelter space for these support groups to operate. Furthermore, churches could sponsor community education events with hospice teams focusing on death, dying, and grieving.
Sadly, death is a normal process in our world today. Christians have the unique opportunity to provide witness in this area, reminding people in the truth of life after death. The promise of the resurrection reassures our hope that death has been defeated by the risen Lord. In the here and now, Christians can help in those moments of death and dying. Not only can we provide help to those who are sick, but also I think that people can learn about themselves introspectively and growth can ensue. If you want to add perspective to your life, spend some time with a hospice patient. Hear their story. Ask them questions. Learn from them.
I am grateful for the focus and care that hospice gives to people in their last days. For those involved in ministry, we can see the effects of modern medical advances on the people for whom we care. However, certain medical technologies may not always be ethically appropriate. We must listen to the Psalmist who encourages us to “number our days carefully” with the promise that our God is present, even unto death.
[1] All Scriptural quotations come from the Christian Standard Bible.
[2] Janet Moscrop and Joy Robbins, eds., Caring for the Dying Patient and the Family (Germany: Springer US, 2013), 246.
[3] Ibid.
[4] Ibid.
[5] See “Our History,” Marie Curie, https://www.mariecurie.org.uk/who/our-history.
[6] Moscrop and Robbins, 246.
[7] See Todd Eichelberger and Anthony Shadiack, “Life Expectancy with Hospice Care,” American Family Physician 97, no. 5 (March 1, 2018), https://www.aafp.org/afp/2018/0301/od2.html.
Recent Comments