There is nothing wrong with holding hands in hospice. The problem is when that is the only treatment that you have to offer.
When modern hospice started there may have been less that could be done for patients thus holding hands may have had to be one of the only treatments available. If they couldn’t control your symptoms then at least you didn’t have to die alone and having someone hold your hand might provide some comfort.
Hospices may have started off as places where semi-retired doctors, nurses and others might go to work when they were wanting an easy job at the end of their careers but modern day hospice requires staff who are willing to continue learning, to grow their skills and knowledge as palliative care situations have become increasingly complex situations. Due to advances in medical treatments people are living longer than they ever have before. The silver tsunami is the greatest achievement of modern medicine, people are able to live to old ages.
Prior to the advent of antibiotics and modern surgical techniques death was all around us, and now people survive things that they never would have years ago. Even in my own practising career I have seen such changes. For example 22 years ago, someone with metastatic bowel cancer would be dead within six months, and now with modern treatment techniques their life span may be extended by years or many years in some cases.
People are living longer with their diseases and even some cancers can be considered to be chronic diseases which is great progress. Some of the pain syndromes that our patients may face can now be considered as chronic pain syndromes, and require a different approach compared with what we were used to dealing with in the past.
Thus those working in modern palliative care and hospice need to be able to deal with complex physical symptom control situations. That though is only part of the story, as the other components of health have also become increasingly complex, and higher levels of psycho-social-spiritual-cultural care is required. Thus hand holding alone is no longer enough.
That being said at times it is more than appropriate to hold someone’s hand at times. It depends on the situation and the patient. Human contact may be a very humane and compassionate response to someone else’s suffering, to tell them that they are not alone at the end. In some situations the treatments that we have are still limited. If someone is bleeding to death, it may all be over within minutes, and even the medications that we administer might not work at all. At those times, being there with the person, holding their hand and speaking calmly to them may be the most comforting thing that you can do.
The modern day palliative care worker needs to negotiate a balancing act. Providing state of the art physical symptom control and holistic psycho-social-spiritual-cultural of patient and family members. Walking the wire is not for the faint-hearted, and those looking for a cushy easy job may need to look elsewhere. If you are looking for a challenging job where you can make a difference in the lives of people and their families in what may be some of their most distressing times, then please give us a call. Bring your best compassionate and professional self – let’s make the world a better place for dying people.