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Monday, June 19, 2017

Hospice Staff, Volunteers Cope with Death, Burnout (Death Ritual, Research)



Sometimes patients die without family and friends available to handle any death rituals that recognize, honor, and bring closure to death. Such was the case with my hospice patient named Lelia, whose memorial service at the nursing home was planned by the hospice chaplain. This informal ritual of only 12 participants included staff, residents, one relative, one personal friend, and myself. 

Death Ritual Excerpt from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes


A small group gathered in the recreation room at the nursing home. Most people present were other patients who knew Lelia. Essie, Lelia’s sister, came with a friend named Nola. The hospice chaplain opened the memorial ceremony with a prayer and a reading. Taking turns, we shared our memories of Lelia. Some comments were hilarious, while others revealed Lelia’s demons. We all discovered new layers of Lelia that came together in a mental mural of colorful qualities.

Essie spoke last, “I’m sitting here in shock listening to what you all said about my sister. I can’t believe we knew the same person. The Lelia I knew hardly ever said anything funny, and she sure wasn’t thoughtful, at least not to me. Even when I helped her get into this nursing home, she still acted like she hated me. She was grouchy and liked to criticize people all the time. Nobody was really close to her. To tell you the truth, nobody in our family was close to anybody else in the family. There was just too much drama going on all the time. That’s why I’m the only one here. I started not to come myself, but now I’m glad I did. I learned something new today. I feel better about Lelia after hearing your stories.”

Although the chaplain hadn’t known in advance how many would attend the ceremony, she had brought twelve helium balloons, the exact number needed for each person present to have a balloon to release later. Like colorful hula dancers swaying from strings tied to a chair, the balloons added a festive energy to Lelia’s homegoing. Riding down with the group on the elevator, Nola mentioned that she and Essie were both singers. We all agreed they should lead us in song when the balloons were released during our tribute to Lelia.

Our humble circle stood in the front yard of a Detroit nursing home to perform our final death ritual for Lelia. People riding by in cars on a busy street observed a lively group of ecstatic mourners looking upward, enthusiastically singing “Going to Shout All Over God’s Heaven.” Passionate voices resonated like rockets. We released our buoyant balls of bliss floating in a hurry to get somewhere. I imagined Lelia looking on, bobbing her head to the gospel beat. She grinned her toothless rainbow smile that colored our hearts with joy from the Other Side of Through when we all yelled, “Bye, Lelia! Have yourself a good time!”


Research on Death Rituals

This research on hospice staff and volunteers examines the role of personal death rituals in increasing compassion and decreasing burnout. Members of the National Hospice and Palliative Care Organization (NHPCO) completed an online survey which inquired about personal death ritual practices. Responses came from 340 participants, mostly Caucasian females, from 38 states.

Results indicated that 71% did use personally meaningful rituals after the death of their patients to help them cope. In addition, those who used rituals demonstrated significantly higher compassion satisfaction and significantly lower burnout with professional support, social support, and age playing significant roles.


Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

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