Hospice Care of the LowCountry

Being a Friend ‘Til the End Through Compassion

Caring is a natural extension of our humanity. When faced with a family member or loved one’s terminal diagnosis, we may feel helpless—at a loss for words to comfort or actions to help. What’s important to remember is that we have reached out to help countless times in our lives in meaningful and loving ways without thinking twice about it.

Frank Ostaseski, a Buddhist teacher and a leader in the field of end-of-life care and the Guiding Teacher and Founding Director of Zen Hospice Project in San Francisco, likens offering care to meditation—there’s no one right way, but some basic guidelines and practice can help.

In an article for the Buddhist magazine, Lion’s Roar, Ostaseski, who was also the former Spiritual Teacher-in-Residence at the Esalen Institute, offers guidelines and practices on how we can focus on being supportive, mindful, and offer compassionate care when we are dealing with the life-threatening illness of a loved one or companion and on how we can be a friend until the end.

Embrace Impermanence

The Japanese term, mono no aware, expresses an aesthetic sensibility that’s challenging to translate. It speaks to a gentle sadness—to being deeply moved by the transient, finite nature of things. It doesn’t deny loss or bypass grief but reminds us that the beauty of things and our appreciation of those dear to us is heightened by our awareness of their ephemeral nature.

Recognition of the transience of life is a central tenet of Buddhism. Impermanence is an essential truth woven into the very fabric of existence. It’s inescapable and perfectly natural and how we meet that truly makes a world of difference.

Enter Mindfully

In the Zen tradition, we have the practice of “dokusan”, a face-to-face meeting with the teacher. The student is instructed to wait outside the teacher’s door and gather herself. She has no idea what’s waiting for her on the other side of the door. She has no idea what the teacher will ask, or perhaps even what she most needs. She does her best to be ready, flexible, and open.

Going into the room of someone who’s ill or dying is like going for dokusan. Empty your mind, open your heart, and enter with fresh eyes. Once in the room, sit down, talk less, and listen more. Touch when appropriate.

Be a Calm Presence

When we’re caring for someone who’s sick, we lend them our body. We use the strength of our backs and arms to move them from the bed to the commode. In the same way, we can also lend them the strength of our mind. We can help to create a calm and accepting environment. We can be a reminder of stability and concentration. We can expand our heart in such a way that it can inspire the individual who’s dying to expand theirs. One calm person in the room can ease the entire experience for everybody.

You Are Enough

We’re always telling ourselves what we should be experiencing, trying hard to be someone special, hoping we’re doing it all in the right way. Often in spiritual practice and in caregiving, we set some goal of where we think we ought to be and then use that to not be where we are.

Carl Rogers, a humanistic psychologist said it best:

“Before every session, I take a moment to remember my humanity. There is no experience that this man, this woman has that I cannot share with him, no fear that I cannot understand, no suffering that I cannot care about, because I too am human. No matter how deep his wound, he does not need to be ashamed in front of me. I too am vulnerable. And because of this, I am enough. Whatever his story, he no longer needs to be alone with it. This is what will allow his healing to begin.”

No Advice

While our intentions may be genuine in offering advice, sometimes it can be done too quickly, is unsolicited, and we may not be aware of the impact this has on others. The attachment to the role of helper runs deep for most of us. If we’re not careful, it will imprison us and those we serve. Let’s face it: if I am going to be a helper, then somebody has to be helpless.

Is what you want to say true? Is it helpful? Is it the right time?

Wise speech is a mindfulness practice. Words can heal or harm. Before speaking, pause. Silence has the benefit of slowing things down. Ask yourself, is what you want to say true? Is it helpful? Is it the right time? And, maybe most important, is it wanted? If the other person doesn’t want to hear it, you may not need to say it. But at times we do need to speak whether the other person likes it or not. In such situations, it’s more likely to go well if you follow the other guidelines covered in this article.

Turn Toward Suffering

An integral part of healing is letting go. But there’s no letting go until there’s letting in. As James Baldwin once wrote, “Not everything that can be faced can be changed. But nothing can be changed that is not faced.”

Suffering is exacerbated by avoidance. We cling to what’s familiar in order to reassert control, thinking we can fend off what we fear will be intolerable. When we push back, hoping to get rid of a difficult experience, we’re actually encapsulating it. In short, what we resist persists.

Suffering will only be removed by wisdom cultivated through inquiry, not by drenching it in sunshine or attempting to bury it in a dark basement. Compassion manifests through the medium of fearless receptivity.

Love Heals

At birth and death, love can melt division, allowing us to move beyond what we thought possible. When someone is sick, when their body is ravaged by illness, when they can no longer function in their familiar roles, when their identity is shifting daily, many people feel unloveable. When someone believes they’re beyond love, you cannot convince them to love themselves. But you can show them that they’re loved.

When someone is sick or suffering, love them. Just love them. Love them until they can remember to love themselves again.

Click here to learn more about what it means to be a caregiver.

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