Supporting a Hospice Patient During Their Life Review

Dear Barbara, I have a patient talking to me about all the mistakes he’s made in his life. Regrets for doing things that he isn’t proud of. He was noticing that very few people had visited him. What should I say?

As end of life approaches, people start looking at their life; what they’ve accomplished, not done, who they have touched, interacted with, and the relationships they have or have not built.

Added to this reminiscing are the judgements they put on themselves about what they are remembering. Also add that as they assess their life, as most do as death approaches, they will assess themselves and behavior according to their own perspective. Perspective is one sided, only showing what's on their side of the mirror.

So — what do we caregivers do? We listen. We aren’t going to have answers. We aren’t going to be able to fix things. We can only listen. And really listening is what a person wants. To be the reflection of their thoughts and words as they say them out loud. To hear their thoughts reflected back to them. Actually, this is true in most of life, not just when a person is dying. People generally aren’t interested in what we, the outsider, has to say about their situation. A listener is really what most people want.

For us fix-it personalities, keeping our mouths shut is a challenge. Our personality asks “How can I solve this situation? How can I bring relief? How can I fix this?”  Not our job! Our job is to be the sounding board, to let the person hear their words echo back so they can process them.

Now, all that said, if the situation is fixable, yes, consider fixing it. (My own personality wouldn’t let me not add this). In the situation above, ask the gentleman if there is anyone you can call for him and then invite them to visit.

Also, where else can you find listening ears? Have hospice volunteers visit on a regular basis. Chaplains are great listeners and can also come regularly. 

I think it is probably the time spent with a listening ear that will be the most healing for this gentleman, not necessarily who he wants to come and see him.

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