‘Welcome to Hospice’: Working as a Chaplain at the End of Life

CW: Frank discussion about death, palliative care, and hospice work.

Just over one year ago I started a journey that totally changed my life. A friend encouraged me to apply for a job at a hospice as a chaplain/spiritual care practitioner. To my surprise I was offered the job and started my orientation into palliative care. Conceptually, I knew a little bit about what was involved with palliative care in that it was working with dying people, but I had little experience with actually walking with a person during their dying journey.  

Each day as a chaplain started in a similar way. I would log into the computer and check if any new referrals had come through overnight. Each referral had a tag for how urgently contact was needed (the majority of patients were primarily located in their homes in the community). I was given a two-week orientation where I went on visits with the locum chaplain (locum is on an as-needed basis) and it was expected that I would not do any solo visits during this period as I was acclimatising to end-of-life care. Of course, during this period, the one day that the locum chaplain wasn’t there an urgent referral came through. When an urgent referral comes in it literally means, “Get there as soon as you possibly can.” It’s hard to describe how out of my depth I suddenly felt. With little other choice, I made contact with the patient’s family and headed out for my first solo visit. 

It was a strange experience driving to the house of a person who I knew was dying. I really didn’t know what to expect or what I would say. A panic set in as I wondered how I might mess up this person’s life by saying something stupid or inappropriate. After taking some breaths to calm down and desperately pleading with Jesus for any sense of peace, I knocked on the door. A man invited me into the house and showed me to the room of his father, Ben.*

"When an urgent referral comes in it literally means, “Get there as soon as you possibly can.” It’s hard to describe how out of my depth I suddenly felt."

Seeing Ben for the first time was a really confronting experience because I was looking at this guy knowing, for a fact, that he would be dead in the next couple of months. His disease had progressed to the point where he was deteriorating at a rate where his body would shut down and all curative options had been explored and tried. With all of this swirling through my head, I found a place to sit and introduced myself, “Hi, my name is Graeme, I heard you wanted to talk with me. What would you like to talk about?” I felt something which I guess was confidence because I had asked a great open-ended question that allowed Ben to take the conversation in whatever direction he wanted. I would sit there, listen, respond, and ask questions to help him process what he needed to. His response was the last thing I expected him to say. He looked me in the eye and said, “Well, I’m not sure. What do people usually talk to you about?” This was my “welcome to hospice” moment. 

I don’t know whether it was dumb luck or divine intervention, but Ben and I had a good conversation. He shared things about his life that were important to him, and he was able to vocalise things that he hadn’t felt safe sharing with the medical professionals. By the end Ben was tired and wanted to sleep. As I got back in my car, I felt like something special had happened in that time with Ben because as we had talked, I was so consciously aware of Jesus’ presence with us. 

The second time I met Ben was in the hospital. He had been rushed there because his pain was becoming unmanageable and required urgent care. His son had reached out asking if I would come visit Ben because he had found our first meeting to be a very calming experience. Of course, I agreed and made my way to the hospital. When I found Ben and saw him he looked noticeably more frail. Only two weeks had passed but his appearance had changed drastically. It was a difficult experience to process in the moment. 

Just as Ben’s son was leaving the room he mentioned that the doctors had just given Ben a big dose of morphine to manage his pain. This made our conversation one of the most interesting I’ve ever had in my life. Ben said hi and acknowledged that he felt a “bit loopy.” I asked what he meant by that. In slow and slurred speech, he began describing it and halfway through his second sentence he just fell asleep. Now I really had no idea what to do so I just sat there in silence waiting to see what would happen, and what did happen was not something I could’ve predicted. After about 3 minutes, Ben woke up a bit startled and just carried on his explanation of feeling a “bit loopy” right from the word that he ended on before falling asleep. This happened about three more times. I’d ask a question, Ben would begin to answer, fall asleep mid-sentence, wake up after a couple of minutes and carry on like nothing happened. 

Eventually, the morphine really kicked in for Ben and he wasn’t able to stay awake anymore. He was now in a deep sleep, and I sat quietly with him. And just like our first meeting I was keenly aware of Jesus being with us too. After about ten minutes of us sitting with Ben I silently prayed for him and left knowing that he was in the best care possible with Jesus. 

About a week later one of the nurses who had been to see Ben said in a team meeting that he had entered into his last days of life. Ben was now actively dying. I made contact with Ben’s son and asked if he thought I should come by and see Ben. He agreed and I made my way over to their house. I had known him for less than a month but when I got to Ben’s room it was difficult to recognise him. He was now days away from walking through the gates of death and was peacefully sleeping. I gently said to Ben that I was there with him. He opened his eyes, looked at me, smiled, and he went back to sleep. Ben slept and I sat next to him. 

This would be the last time I saw Ben before he died. Out of the three times I had seen Ben this was the most impactful for me. When he opened his eyes, looked at me and smiled, I knew that I had done what I was there for. Why did Ben smile when he saw me? I can only guess. Whatever Ben’s reason, he and that moment stay with me. 

~

Graeme Chamberlain is a theology graduate from the Bay of Plenty.

*All names have been changed for privacy.