Caregiver tells how Willingness to listen is the most important quality that anyone can bring to the bedside of a dying person, says a man who has made a career of doing just that.
to be ‘compassionate
companion’
The hospice expert will give a
workshop here on WednesdayBy Mary Adamski
madamski@starbulletin.comInstead of the feeling of dread when visiting terminally ill family or friends, or a perception that caregiving is a burden, "at its best this is a mutually beneficial relationship, and that is what I want to encourage," said Frank Ostaseski, founder of the Zen Hospice Project in San Francisco.
"In telling their stories, they uncover the meaning of their lives," he said of the patients to whom he has listened.
Modern society tries to "keep death at arm's length. We do our best to keep it hidden away -- we shut our elders away so we don't bear witness to their pain and our destiny -- so we fail to learn the lesson it teaches us. We are caught by surprise when someone around us is dying."
Ostaseski, who works to help the terminally ill and their caregivers accept death as part of life, was invited to the Oprah Winfrey show after the Sept. 11 attack to discuss "what do we know for sure about death and what do we believe." His work was featured in the Bill Moyers television series "On Our Own Terms."
The hospice professional will conduct a Honolulu workshop Wednesday on "Being a Compassionate Companion." It is open to the public and may be of particular interest to health-care and religious professionals and those anticipating being a caregiver, according to the sponsoring Hospice Hawaii and Borthwick Mortuary. The $25 fee includes lunch. Call 924-9255 for registration information.
"It can also be for people who want to explore their relationship with dying before they get to their own deathbed," said Ostaseski.
The San Francisco project is the first Buddhist hospice in America. He now directs its educational arm, the Institute on Dying. He serves as a consultant to health-care agencies and as co-chairman of the Robert Wood Johnson Foundation's Last Acts Spirituality Committee, and, he said, "I still find myself at the bedside."
The art of listening is one way that Buddhist belief and practice come into play in providing care to the dying, said Ostaseski, who was raised Catholic and is now a Buddhist teacher.
"One way to describe meditative practice is very deep listening. To get to know ourselves, we listen to ourselves and what our responses are. In order to remain present with people, we need to cultivate our ability to listen.
"Another Buddhist approach is recognizing all things are impermanent; every thought, every relationship comes and goes. At first, when we start to see this, we feel some panic. We come to see that to resist this truth, to hang on to things too tightly, causes suffering.
"We come in contact with the preciousness of this life. The acceptance of this truth brings forth in us a kindness. A deep-rootedness in this truth enables caregivers to be with people in their dying and not regard it just as tragedy."
On the Winfrey show, Ostaseski was asked to discuss what is known about dying. His response was based on what patients have told him.
"Illness is not a punishment, dying is not a failure," said the longtime hospice counselor.
"In this culture we think of death as a medical event, but dying is much more than that. It is about our relationships to others, to God. So working with the dying is helping to develop those relationships. There is an opportunity for growth at the end of life.
"The first question I ask is what matters most to people at end of their life. My dying patients tell me it is, 'Am I loved and did I love well.' Everything else is kind of extra."
His message to the family members or friends in a caregiver role is to not lose themselves.
"What can happen around the dying is a lot of martyrdom -- I am taking care of Grandma, and that's all there is. We have to care for ourselves. Go ahead and enjoy a movie. We have to live our lives fully.
"If there is one message, tell them you love them. Don't wait."
Ostaseski said that a person who questions himself makes a good caregiver. Besides listening to a patient tell his stories about life, "We have to be willing to do some exploration of our own issues, to listen to our own heart and mind. Through that we can form a bridge to the other person's experience."
Sometimes a person's religious beliefs are not the consolation they may expect in their dying time, such as harking back to fear of a punishing God.
"I can't say what happens to us after we die," he said. "I do know that everyone has an image of what happens, and that image can change the way they die. The image may be based on culture or religion. Adult images, child images show themselves.
"These beliefs have a stranglehold on us because we keep them inside. I find when these beliefs are brought into the light of day, they lose some of their power. So it is helpful for people to explore. It shapes how they face the way they die."
Exploring their lives does not happen in deep philosophical deathbed debates about the meaning of it all, but in telling little stories about their lives.
"We do that by going through photo albums. Most likely we find it in events that had meaning for them, ways they encountered mystery," he said.
"I find that when someone tells their story, something happens. The experience of their dying changes."
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