Navigating End-of-Life Conversations: Insights from Hospice Care
Discussing death is often challenging, yet inevitable. In a recent study, researchers delved into the realm of hospice care, aiming to uncover valuable lessons from the experts in end-of-life conversations. Daniel Menchik, an associate professor of sociology at the University of Arizona, dedicated eight months to understanding how hospice workers communicate with patients and their families about impending death.
Framing Death as a Process
Menchik’s findings, soon to be published in the journal Social Science & Medicine, emphasize the significance of framing death as a process rather than a mere outcome. This approach, he suggests, can offer valuable insights for anyone facing the daunting task of discussing loss.
The Perception of Death
“People aren’t dead until they’re dead,” Menchik asserts. Even after death, the connections individuals shared with the departed linger, especially if quality time was spent together. This perspective underscores the nuanced nature of how we perceive and experience the loss of a loved one.
Verbs in Hospice Conversations
Menchik observed hospice workers using three distinct types of verbs in their discussions with family members: predictive, subjunctive, and imperative. Predictive verbs, such as “will” and “going to,” focus on future assertions, while imperative verbs, like “should,” combine firmness with a call to action. Subjunctive verbs express personal stances regarding the future.
Minimizing Imperative Verbs in Hospice Care
Menchik’s study revealed that imperative verbs constituted only 17% of the verb phrases used by hospice professionals during meetings. This contrasts with medical fields like surgery, where imperative verbs are more prevalent, reflecting a need for quick and conclusive answers.
Emotional Management in Hospice
In hospice care, emotional management takes precedence. Dr. Maya Giaquinta, a pediatric resident at the Medical College of Wisconsin, highlights the role of hospice experts as guides rather than authorities. The use of predictive and subjunctive verbs allows them to tailor care to current emotional needs, prioritizing the present over future events.
Verbs of Uncertainty
While predictive verbs were predominant, Menchik observed that over half of the frequently used verbs conveyed uncertainty, such as “could,” “might,” and “may.” By avoiding definitive statements about the future, hospice professionals redirected conversations to the current moment, addressing anxieties and emotions effectively.
The Value of Grammatical Reflection
Dr. Robert Gramling, a physician and chair of palliative medicine at the University of Vermont, emphasizes the importance of thinking granularly about the words used in end-of-life conversations. Reflecting on language choices, such as referring to a person as “living” or “dying,” grounds the conversation in the present and fosters empathy and compassion.
Hospice care offers valuable lessons in navigating end-of-life conversations. Understanding the nuanced use of language, minimizing imperative verbs, and embracing uncertainty can guide us in approaching discussions about death with empathy and compassion. As we learn from hospice professionals, we gain valuable insights into enhancing our ability to discuss and cope with the inevitable aspect of life—death.