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'A good death'
Hospice volunteers, young and old, find growth in offering comfort
By Stephanie V. Siek
Globe Staff / May 8, 2008
Although Christina Kim and Pat Konkle are separated by a half century in age, they share a passionate belief in service to terminally ill patients and their families. Both are volunteers with Partners Hospice, a Waltham-based agency that provides palliative care to people with a fatal or life-limiting illness.
Kim began volunteering at Partners Hospice three years ago. She was 23, but already felt burned out by a sales job she hated. She had graduated from Boston College with a degree in biochemistry because she wanted to help people. But Kim didn't feel she could do that in her sales job. She had to find something meaningful in her life, if only in her spare time.
She said she's not sure why she felt so drawn to hospice care, although she had always been comfortable working with elderly people, and wasn't really bothered by the ideas of death and dying. But she also had a personal reason to be interested in working with people who have neared the end of their lives.
Soon after Kim began her training with Partners Hospice, her own father, ill with liver cancer, began receiving hospice care at the family's home in Silver Spring, Md.
In June 2006, he took his last breaths, surrounded by Kim, her two siblings, and their mother. Kim said the experience - the "good death" her father had - made her more able to empa thize with the families she works with at Partners.
Pat Konkle, 76, has been volunteering since 1990, a year after retiring from being a psychiatric nurse. She first heard about hospice care when she was working at Emerson Hospital, in Concord, which had a referral program. She guesses that she's since worked with more than 100 hospice patients and their families, providing respite care, giving families an outlet for their grief, guiding them through their bereavement.
"Hospice work isn't really about sadness, it's about growth; people overcoming adversity, courage, it's really tremendous work," Konkle said during an interview in her Bedford home.
Becky Wendler, the agency's volunteer coordinator, said she doesn't have to go looking for volunteers like Kim and Konkle. They find her. Often, they've been shaped by their own intimate knowledge of loss.
"It does take a very confident and very secure person, and it takes a very grounded person," said Wendler. "You kind of have to block out everything that you're about that day and just go to be with the person that needs you, and that you've committed to be with."
About 50 volunteers commit to a minimum of two hours a week for six months. Before being matched with a family, they undergo months of intensive training about the physical process of death, grieving and bereavement, and what might be expected of them as a volunteer. Their duties could include respite care, facilitating conversation between a reticent family member and the dying person, making coffee for a bedside vigil, or just sitting and listening to the patient and family. Hospice volunteers are part of a care team, along with a doctor, nurse, home health aide, nondenominational chaplain, and social worker.
Although not all of her friends understand it, Kim sees hospice work as uplifting, a way to help a patient die with dignity, and to soften the blow for the loved ones they leave behind.
"It sounds, really, kind of morbid, but I think I help people understand how death is really a natural process - that it's nothing to fear and that there is such a thing as a good death, and that hospice facilitates a good death," said Kim.
Volunteering has changed Kim's life. After her father's death, she decided to pursue a career change and become a nurse practitioner, specializing in gerontology. Despite her relative youth, witnessing the deaths of the roughly half-dozen patients she's worked with also has changed the way she looks at her own life, and eventual death.
"You're never too young to consider your own mortality," said Kim. "It's always good to consider your own mortality, because nothing is guaranteed."
In volunteering and nursing, she has found a long-sought sense of purpose. The confidence to change careers was her father's final gift.
"He knew I wanted to go to nursing school before he died. He was always asking me, 'Why haven't you applied yet?' " said Kim. "I was worried about how much it would cost. . . . But after he died, I realized that it was silly to let something like money keep me from pursuing what would make me happy and give me purpose in life. . . . My pursuing this career is definitely in his memory."
Konkle said it's not her age that is most helpful in relating to her patients and their families, although most of her patients have been in their 70s or older. She said that even though she doesn't usually discuss her personal history with patients, most can sense that the loss of a loved one has been part of her life experience.
"I've had losses in my life. I know what it's like to be devastated and come out of it. I tend to be patient with people because I know how hard that is," said Konkle.
Konkle's mother died when she was 5, killed in a car accident by a drunk driver. Her father had walked out on the family not long before. She and her only sibling, an older brother, were left to be raised by relatives. Her brother was killed in the Korean War when Konkle was 18.
Konkle became a psychiatric nurse and was raising five young children when her grandmother and a great aunt came to live with her family. She and her husband, Ken, had a sixth child while caring for her elderly relatives, and, she recalled, it was easy to feel overwhelmed. Hospice care was unheard of in those days, and as her grandmother and great aunt's health declined, it became more and more difficult to manage their needs. When Konkle's health began to suffer as well, the family made the difficult decision to put the two women in a nursing home, which is where they died.
After her mother died, "we never talked about it again. Now you'd never do that to a child," said Konkle. "I can see how things are done much better now."
Konkle's hospice work doesn't heal those wounds, but she said the sting is lessened by the knowledge that a 5-year-old with a parent under hospice care would not have to experience what she did. And when she offers support to a family overwhelmed by caring for a dying loved one, she does it knowing how isolating and frustrating that can be.
Konkle said she has a particu lar affinity for bereavement counseling, helping a grieving person through the transition after a death. Volunteers usually limit their participation to 13 months after the death.
"We represent a period in someone's life that is a crisis, and if after they are through it we hold on, it's saying they haven't quite made it," Konkle said.
That doesn't mean the goodbyes, to both patients and their families, are easy.
Konkle recalls one patient, Doris Rice, and the daughter, Elizabeth, with whom she is still in touch. Konkle and Doris would spend hours just sitting and talking. Doris was dying of abdominal cancer, and Konkle worked with her and her family for more than two years.
"When she died, I was there. She was a tough person, and didn't want to let go," said Konkle. "I told her it was OK, you can let go. And she did."
