Lessons from Hospice Care

One patient I visited was named Sarah, and she liked to talk with her hands. She was usually in the dining room, so I would kneel next to her while she sat at one of the tables. This was one of the few patients I visited who could still speak and make eye contact, and it was very special to me to have gotten a chance to engage with her in this way. Sarah often started a sentence and drifted off by repeating a word or phrase over and over again. Then she would start up again and describe something about her son or ask me a question about myself. I couldn’t always catch what she was trying to say, but I could feel the intent of her words in the way she looked at me and the way her hands moved. I knew she also sometimes could not fully grasp what I was saying. I just wanted to keep her talking and engaged, so I would try to help her finish her sentences or continue her thoughts aloud. She was big on smiles as well, and even if we couldn’t quite follow each other’s words, we exchanged plenty of grins. I hope in some small way I helped validate her thoughts and gave her an outlet to socialize.

My experience with hospice has helped me better understand how health care evolves for older patients. I think we often assume medical care must be curative, and while this may be true for younger patients, it often leaves out care for the elderly. It has also made me think of medicine as not just pills or chemicals. I think a lot of geriatric patients in nursing homes need social interaction or some form of engagement, and this kind of activity can be equally beneficial as a pill that alleviates physical pain. Medicine or health care is not just about finding the best treatment for particular disease or ailment; it’s also about finding lifestyle changes or outside activities that can indirectly help our bodies heal. It sometimes makes me sad to see how many patients in a nursing home spend their day with virtually no active engagement. This experience has made me understand how important it is to try and bring more stimuli into these communities.

My experience this year has also taught me the value of nonverbal communication. I always rely on verbal communication in my daily life, and I forget how an exchange between two people does not always have to involve speaking. While visiting patients this year, I often spoke sparingly and instead relied more on sharing activities or just trying to provide a comforting presence. I think doctors often may encounter patients who either have a harder time vocalizing or may not understand a lot of the medical lingo, and it’s important to learn how to communicate better and more diversely. I have really appreciated being able to have such a one-on-one experience with patients, and it has widened my view on how a doctor should contribute to a person’s well being.