Companioning:Companioning:A Hospice Essential

Rodney Bolejack, D.Min.

American Hospice, Denton TXRBolejack@American-Hospice.net

When one of his classmates died, an eight-year-old friend visited the boy’s home one day after school.

“What did you say?” asked the mother gently when the child returned.

“Nothing,” he replied. “I just sat on his mom’s lap and helped her cry.”

--Dan Zabra

Forever Remembered

Objectives

Value the need for companioning the hospice patient.

Relate the tenets of companioning to patient care.

A Few First Thoughts

Everyone must make this journey through life and death alone

No one should make this journey without a companion

Breakfast with Jo“What are your biggest fears for the future of hospice?”

NEEDED:A strong, deep person

wise enough to allow me to grieve in the depth of who I am, and strong enough to hear my pain

without turning away. I need someone who believes that the sun will rise

again, but who does not fear my darkness. Someone who can point out the rocks in my way

without making me a child by carrying them. Someone who can stand in thunder and watch the

lightning and believe in a rainbow. Fr. Joe Mahoney

This is companioning.

What is Companioning?Companioning is a willingness to be present with another, wherever they may be in their journey, and walk with them through their personal and often “unchartable territories” without having the need to say the right thing or to fix the unfixable.Companioning creates a safe place for those who are hurting to find their own answers.

Creating a Safe Place

Creating a free, empty space where a stranger may enter and become a friend instead of an enemy

It is the space in the relationship between me and thee

I have created that safe place when you are free to be you

-- Henri Nouwen

To love means not to impose your own powers on your fellow man but

offer him your help. And, if he refuses it, to be proud

that he can do it on his own strength.

--Elizabeth Kubler-Ross

Companioning Essentials

I want to be with you

PresenceNon-anxiousI will not abandon you Sue W

PhysicallySpirituallyEmotionally

You can tell me to stay away, but you cannot push me away

Joe H

I want to be with you

Creating relationship that allows the other to risk the courage to trust you.

How? Short time!Faithful presence and responsiveness

• I didn’t think God could find me

Promises fulfilled • Physical

• Spiritual

Kindness and care

Knowledge and skills

  I want you to teach me“Behold, I stand at the door and knock and say to myself, ‘I am about to meet my teacher.’”

CuriosityBeing teachableBelieving that this “other” knows how they wish to approach death & dying

They may not have words to describe itMay need a companion to explore values with them

  I want you to teach me

Believing that this “other” has life-gifts to give to anyone who would learn

What did you learn about life?What gives you peace? Meaning? Joy?

How do you wish to approach death & dying?

What do you fear most about the days ahead?What would a “good death” look like for you?

It was horrible. Noisy. Crowded. Not at all peaceful

I want to hear you

Its not that

we all have stories

that need to be told

…..rather….

We are stories

that need to be heard.

I want to hear youListening to empathize

To see the world through another person’s eyesListening’s primary purpose

Listening to reflect As a mirrorAllows them to hear their own storyRemembers that most of the answers are within them

Listening to learn each one’s uniquenessUnique storyUnique perspective on life, illness, & deathUnique coping

Being comfortable with just listening

The hardest part of listening is getting comfortable just listening

Being just a listener allows us to be a catalyst that helps them react to their feelings in a more comfortable way that allows them to establish significance with their loss

By-products of ListeningRemember: These are not the primary purpose of listening

InsightInsight happens when people talk and someone listensConnecting the dots for a full picture

Emerging solutions Validating and processing emotionsShowing acceptanceFinding meaningLearning

fears, struggles, joys, hopes, comfort

  I accept you

I am not here to judge or critiqueHe who gets labeled is he who gets dismissed

You will not be labeled as a good or bad patient

He who gets labeled is he who gets dismissed!

Non-compliance and other frustrationsNo blaming the patient (even when I return to the office)Creative caring

Arlon

Demonstrating Acceptance:

Acceptance of another person is a matter of “deep, empathic understanding,” as Carl Rogers terms it, which allows you to see the world the other person inhabits through his or her eyes. “It means a respect and liking for [the person] as a separate person….It means an acceptance of and regard for his [or her] attitudes of the moment, no matter how negative or positive.”

Demonstrating Acceptance:

Meet the person where he or she is.Trying to move your interaction with a hurting person to any other level is merely singing songs to a heavy heart.

Focus on here and now rather than there and then.

Meet with me in the moment not in the future: it’s a waste of time telling the hurting individual, “You’ll feel better as time goes on.”

Acknowledge the feelings.Respond to that hurting individual and their negative feelings in a feeling way rather than an intellectual way.

Don’t Sing Songs to a Heavy Heart - Kenneth Haugk, Ph.D

Acceptance doesn’t need to:

Judge

Advise

Rescue

“Preach To”

I want to know you

So I can be with you on your journeyNot so I can analyze and label you in IDTIf I find words to describe you it is so I can better walk with you; never to dismiss you

Your storyPast, present, and future

Your struggles, fears, hopes, grief, anger, joys , comfort, peace, values

Because you are dying and not someone else

  I want to walk alongside you

I will go where you goInto the struggles of your bodyInto the mix of emotions that comeInto the wilderness of your soulInto the sanctuaries of your heartInto the celebrations of your lifeInto the time of your good-byesInto the reverent silence of letting this world go

  I want to walk alongside you

Together we will discover and learnWhat works for your body

How to bring creation from chaos

Meaning for this journey

Finding a path in the wilderness

Sacredness in the stillness

The joy of a shared journey

The Ultimate

Stages/Phases/Tasks/Touchstones of Grief/Mourning

Stages: Elisabeth Kubler-RossPhases: Colin Murray-Parkes Tasks: J. William WordenTouchstones: Alan D. Wolfelt Don’t memorize and then use them to try to analyze people into a categoryYou don’t need to be a counselor to be a companion to the dying

I believe you

You can believe me

Its about trust

Mutual trust

Open

Truthful

Physical needs

Emotional- Spiritual needs

I see you as a fellow-pilgrim

We travel the same road, you and I….. …..the difference is that, today, you’re just a bit further down the road than I.

Brothers and sisters in the human condition

EqualsNot healthy and unhealthy

Not expert and apprentice

I see you as a whole person

Body and soul

One with a past, present, and future

One with relationships and a self

Not broken because you are dying

I want to honor your spirit

I am your advocateI will be your voice (at IDT)

I will honor your spirit to your family and friends

This is about you.

I want to bring all my skills & all of my self to comfort you

Medical training

Hospice training

Life experiences

My self

The more you are able to understand a suffering individual and value him or her as a unique person with a unique life history, a unique set of circumstances,

and a unique set of resources to draw on, the more likely you will be able to relate

effectively with that person.Come as a guest to the suffering person’s house

of pain—without assumptions, without judgment.

Come with a heart open to understanding.“Don’t Sing Songs to a Heavy Heart”

Kenneth Haugk, Ph.D.

Don’t try to be too wise; don’t always try to search for something profound to say. You don’t have to do or say anything to make things better. Just be there as fully as you can. And if you are feeling a lot of anxiety and fear and don’t know what to do, admit that openly to the person you are with and ask for their help.

--Sogyal Rinpoche The Tibetan Book of Living and Dying

CONCLUSIONCONCLUSION

Pain

Fear

Abandonment

AngerFrustration

Helplessness Hopelessnes

s

Their buckets are full!

What’s in their bucket ?What’s in their bucket ?

CelebrationHope

GriefQuestionsLove

THE NEED TO:

Fix Cheer

Make them feel better

Say Somethin

g

Be Needed Be Liked Be Smart

Be Profound Be Right

What’s in your bucket ?What’s in your bucket ?

Who’s Bucket Needs Carrying?Who’s Bucket Needs Carrying?

Can we fit our needs into their already filled buckets ????

We need to empty our bucket to be able to get into theirs—then we can help them as a companion – carrying

some of their load.

HEAL-ing People

Here. Present for you when you need themEmpathetic. No one else can truly understand what you’re feeling, but with empathy they’ll do their best to understand and let some of your pain touch them.Accepting. They don’t judge you, try to change you, or tell you what you should do or how you should think or feel.Listening. They really focus on what you have to say. They let you share your feelings and know how important it is for you to tell your story again and again.

From a Prayer ofFrom a Prayer ofSt. Francis of AssisiSt. Francis of Assisi

Grant that I may not so much seek to be consoled as to console,

To be understood as to understand,

To be loved as to love,

For it is in giving that we receive…

Hail guest! Not only the Hail guest! Not only the door, but the heart of my door, but the heart of my owner lies open to you.owner lies open to you.

AVE HOSPES!AVE HOSPES!

NONSOLUM IANUA SEDET NONSOLUM IANUA SEDET CORDOMNIMEO PATET TIBICORDOMNIMEO PATET TIBI

From a stone wall in Assisi, Italy

Questions???

Tenets of CompanioningAlan Wolfelt

Being Present

Going to the wilderness of the soul with another human being

Its not about finding a way out of the wilderness

Honoring the spiritNot focusing on the intellect

Tenets of CompanioningAlan Wolfelt

Listening with the heartNot analyzing with the head

Bearing witness to the struggles of othersNot judging or directing the struggles

Walking alongsideNot leading or being led

Discovering the gifts of sacred silenceNot filling the moments with words

Tenets of CompanioningAlan Wolfelt

Being stillNot constant busy-ness

Respecting disorder and confusionNot imposing order and logic

Learning from othersNot always being the teacher

CuriosityNot expertise

ResourcesWolfelt, Alan D. Companioning the Bereaved: A Soulful Guide for Caregivers. Companion Press. 2006.

Nouwen, Henri J.M. Our Greatest Gift: A Meditation on Dying and Caring. Harper Collins Publishers. 1994.

Nouwen, Henri J.M. Reaching Out: The Three Movements of the Spiritual Life. Image Doubleday. 1975.