On Death and Dying by Debbie Homewood

The following are the life and hands-on experiences of my work as a pastoral and palliative counsellor.

I find myself in the position of being able to say that death has been a pretty constant companion in my life. Before the age of six I had lost an uncle and a grandfather, but at 6 my father died, of lung cancer from exposure to asbestos. He was very ill for several years and died at home with all of us there. This had a huge impact on me, resulting in questions, to which I wanted truthful answers, and I asked and asked until I felt some truth. As an adolescent the father of my two closest friends was murdered. As a young teen one of our school friends died in a motorcycle accident. And on and on……..Death was part of life. It was painful, it changed things and people, but it was part of life.

I am the 5th of 6 children. The 6th was born on my first birthday. Ten years ago he died in my arms after a three year battle with multiple myeloma. It was such a privilege to journey with him through his illness and death. This experience resulted in a shift in the focus of my work. I had been involved in research and teaching at The Ontario Institute for Studies in Education, (part of the University of Toronto) for many years and in 1985 left to start a private counselling practice. I had done some palliative work over the years but it was not the primary focus of my practice. My brother’s death, and my inner journey precipitated by it, lead me to focus my work on palliative care.

I became the Pastoral Advisor for the York Region CCAC (part of the structure by which our Ministry of Health provides health care to those at home with serious illness), and worked primarily in palliative care.

Visiting clients and their families in their homes over a large geographic region, the services I provided included:

• Psychosocial and spiritual counselling
• Grief counselling and support
• End-of-Life planning
• Family support
• Counselling for fear
• Anxiety and depression around death and dying and suffering
• Support for prayer life during illness and dying
• Facilitating connections with the church or faith group and other community resources
• Liaising with members of the health care team
• Mediating family conflict
• Assisting in the expression of feelings and wishes
• Providing a safe environment for the exploration of theological issues around suffering and death
• Planning and conducting funerals or memorial services
• Facilitating ways to find peace, helping to re-establish or strengthen a connection to God

Spirituality has been a strong interest and big part of my life, from a young age, which lead to much seeking, studying and many wonderful experiences with teachers from all walks of life. I am certified for chaplaincy and spiritual care by the Ontario Multifaith Council, (with CAPPE equivalency), and I have been able to bring to my palliative care work my spiritual background, more than 20 years experience in counselling and my life long experience with death.

Working with patients at end-of-life is a deeply enriching, comfortable place for me. My life’s journey has necessitated learning to be able to deeply and authentically connect with my heart, understand my self well, and learn to communicate and share what I have learned about spirituality, the human condition, and life and death, whether in a one-on-one setting, a small group or teaching a larger group.

Let me share with you just a few of the things that empower me in dealing with death and dying:

• Strength comes from compassion
• Compassion comes from the heart (our deepest self, authentic self, soul…)
• We can all experience compassion from our own heart, and find the strength it brings
• Compassion transforms
• I absolutely believe in each person’s innate ability to connect with their heart, find compassion and enormous inner strength, to deal with death or whatever else life brings
• The strengths we can access include courage, acceptance, hope, faith, peace, connection
• I cannot save anyone but I can give the gifts of my own compassion, my own fearlessness, my presence, my open heart and acceptance, and through these gifts help others to find some peace
• I believe there is much more about life that we do not and cannot know. I have deep reverence for this mystery and I can help others become more comfortable with the “mystery”
• I can help others connect with their heart

In my work with palliative patients, I have been allowed into the deepest, most sacred places in people’s lives. I have held many people in my arms as they die, I have helped people plan their own funerals, and I have planned and presided at many, many funerals and memorial services. Some that were most traditional and many that were unique and wonderful in their own ways. My patients have ranged for a 4 year old with brain cancer, through teens, young mothers and fathers to the elderly.

Each life and journey is unique and yet we all share the incredible gift of the capacity for compassion and its many hidden treasures. Compassion is real, powerful, and at the end of the day is one of the greatest resources we have to meet the spiritual and psychosocial needs in our self and others. Compassion connects us with our deepest self and through that connection allows us the possibility to find meaning and peace in meeting death and the many great losses that come with death. For me, the beauty of compassion is that it allows me to work with everyone, regardless of their religious affiliation, faith, or lack of it. I was born into the United Church of Canada and am still an active member. My faith and my personal relationship with God sustain me and are the ultimate source of compassion and so much more.

Everything I have told you about is well substantiated in the research literature pertinent to this field, and, in every spiritual tradition. Our challenge is to make it real, where it really matters.

In palliative care we need to deal with the spiritual and psychosocial needs of the dying, their families and loved ones and how meeting these needs, changes the journey for everyone. This includes dealing with fear, grief, hopelessness, meaninglessness, guilt, despair, anger etc.

Compassion, made real and straightforward, becomes the key to addressing these needs. In learning to work in this way, we in palliative care have to do some work on ourselves. We need to be connected with our own heart and source of compassion. Compassion is not an intellectual attribute. We need to know how to deal with our own fears and emotions. We need to explore our own relationship with the unknowable.

If we work in palliative care and we don’t work with compassion, we contribute significantly to the suffering of our patients. If we work with compassion and through a deep and authentic connection to our own heart, we can do so much to alleviate suffering.

I have many moving, sometimes funny, interesting stories from the frontlines to share, to make these important ideas real and tangible.

Often when we are dealing with the dying, we feel powerless to help. Yet the truth is that we are anything but powerless. In learning to work with compassion, in concrete meaningful ways, we can help to bring about significant changes in a person’s experiences with illness, and ultimately death.