hospice

Medical Assistance in Dying: A Complex Conversation in Hospice Care

/ scblair / Leave a comment

Hello (again) world! I know it’s been some time since my last post. The reasons are plentiful: word weariness after finishing my book, the breakneck pace of my caseload, and guitar lessons. Although, in all honesty, the guitar lessons and the following practice only account for probably 0.023% of my time. But given some prior conversations and a free afternoon, I thought I’d pick up the keyboard again.

The topic of physician-assisted suicide, more commonly referred to as medical assistance in dying (or simply MAiD), has been an interest of mine for some time. In 2014 I offered a presentation at the annual Association of Professional Chaplains conference regarding the debate regarding voluntary euthanasia, offering my own opinion on what I saw as the key underlying concerns of those for and against physician-assisted suicide, as well as how hospice and palliative care were uniquely situated to address those concerns.

Now, over ten years later, a lot has changed in this landscape. The number of states offering legal MAiD went from four in 2014 to twelve in 2024. Several states are considering legislation this year to offer MAiD, which, if they all pass, would make MAiD legal in over half of the states in the country.

Continue reading →

“Dying is very lonely”

/ scblair / 3 Comments

“Helen” is an elderly woman who lives in one of the nicer nursing homes in my area. She had an extremely difficult life growing up, which caused her to deal with addiction and its after-effects for many years. While she has remained a staunch Catholic, the “big book” of Alcoholics Anonymous holds a place in her heart as well. Helen is quite crippled and is in bed most of the time. While this leaves her rather isolated, whenever she is up she becomes quite anxious and often asks to be put back in bed. She is in almost constant pain from arthritis, which aggravates her anxiety, which in turn aggravates her pain. However, she is remarkably pleasant to visit. She treasures her Catholic faith, watching Mass every day and often talking about her faith with me.

On a recent visit, as I was leaving, she called out “thank you so much for coming, dying is very lonely.” This statement struck my heart, as it’s the most direct someone has ever been about their own dying experience.

Continue reading →

Beyond Certification: Looking At the Future of Chaplaincy

/ scblair / 10 Comments

From time to time I’ve been asked “so how do I become a Chaplain?”. While I usually answer with a laundry list of things to do to prepare, train and ultimately become certified, the real answer is – it depends. It depends not only on what you do to prepare to be a chaplain but also on what employers expect from a Chaplain. And sometimes these two areas are quite different from each other.

Continue reading →

Where We Are: COVID-19 Update

/ scblair / Leave a comment

So it’s been a while, hasn’t it? Many of us working in healthcare have been strained to say the least. Even if we aren’t dealing directly with patients with the coronavirus or their families, the rapidly changing and always dramatic day-to-day events in our country and around the world are more than enough for anyone to handle.

Rather than post an essay or some helpful “how-to-cope” stuff, I’m just going to write. Which is a way of coping in itself. Pardon any possible incoherence. Continue reading →

Chaplaincy Today Isn’t Chaplaincy Yesterday: Chaplaincy in COVID-19

/ scblair / Leave a comment

Dawn Malone, a lay chaplain for the archdiocese of Galveston-Houston, ministers to cancer patient Austin Bond, via video conference on Thursday, March 19, 2020 in Houston. Coronavirus has limited local chaplains the ability to minister to the sick or elderly. Chaplains have also been told not to minister to any group more than 10. Photo: Brett Coomer, Houston Chronicle / Staff photographer

Our CPSP chapter met by Zoom last evening and it was clear that we all needed to vent. The past few weeks have been quite tumultuous throughout the world, our country, our county and our workplaces. Where we would usually brought cases to discuss and receive feedback, we found ourselves becoming the cases to present. Many felt lost. One member who had just taken a new paid position was now told to stay home because she was in a high risk population. Another member was caring for an ill husband and struggled with the inability to do what he felt such a strong call to do. Another member was constantly bombarded with work calls during the meeting. One member, a Rabbi, spoke of trying to figure out how to have a Passover Seder via Zoom (which she called a “Zeder” – I laughed for about 5 minutes). Continue reading →

Choice, or Lack Thereof: Lenten Reflections in a Pandemic

/ scblair / Leave a comment

You have no idea how important this choice is (from The Stanley Parable)

I started a computer game last night that spoke to the times in an interesting way. No, not The Walking Dead or Plague, Inc.: it’s The Stanley Parable (and it’s free for a limited time as of this writing on Epic). Sure TWD and Plague, Inc. certainly share the paranoia and dread of today, but The Stanley Parable deals with something that has affected us all around the world, and that choice – and the lack thereof. Without giving too much away, TSP is game in which the isolated protagonist office worker Stanley discovers that he has suddenly stopped receiving directions from his boss. The parable that ensues makes you consider whether or not the choices you make are really your own and how much control do you have of the story being told – if there even is a story.

I’ve been very aware of choice over the past week, as have all of us I expect. We are all now much more limited in where we can go and what we can do. Some choices are made for us, like what stores are open, and others are made on our own. Others’ choices impact our own lives as well, from refusing to follow precautions to hoarding paper towels. The idea of choice and the lack thereof has impacted my life most significantly in my work as a hospice chaplain and bereavement counselor. Continue reading →

528 Hertz

/ scblair / 2 Comments

“You know that the universe vibrates at 528 Hz, right?”

This was only part of the first conversation I had with Neil*, who had just come on hospice and was living at home with with his mother. It was my initial assessment with him, and it was already off to an interesting start. When I arrived for our meeting time he wasn’t available. The neighbors in his apartment building who were sitting outside said that he had just gone out to the local Rite-Aid with his girlfriend. So I waited on the patio until he arrived.

Neil right off the bat struck me as an interesting guy. He was in his mid-50’s, and his long white hair, thin build, pale Hawaiian shirt and straw fedora made him look like a wandering beachcomber. He carried a portable oxygen concentrator, the only visible indicator of his end-stage lung cancer. “Hey man! Sorry I’m late. I had to go get my meds and some toothpaste.” He introduced me to his girlfriend who was with him and neighbors and then escorted me inside, chatting the whole time. Continue reading →

NPR Show Discusses Hospice and “Comfort Care”, Advance Directives

/ scblair / Leave a comment

Joshua Johnson, host of NPR’s 1A

The NPR show and podcast 1A recently held a discussion with former radio personality Diane Rehm and medical experts, prompted by the news that former First Lady Barbara Bush had chosen “comfort care” in the last days of her life. Continue reading →

Countering Hospice Myths: A Response to John Neihof and the American Family Association

/ scblair / 5 Comments

A recent article by Dr. John Neihof on the American Family Association website caught my attention recently. I find that I’m often at odds with the AFA, and try to counter some of their more off-base proclamations (the biblical mandate for border walls for example) in their comments section. It’s been a fool’s errand I think, and this fool has run his final errand with the AFA. Continue reading →

Why We Get Complicated Grief Wrong

/ scblair / 1 Comment

I recently switched positions in my company to help manage our bereavement services. Don’t worry – I’m still in the field as a chaplain as well (with a very limited caseload – something I asked for)! I had a great deal of experience working in bereavement in my prior company so this has been a good fit so far.

However this move has brought up something that has always bothered me. That is even though that the staff I work with on a daily basis has years of experience in hospice care we still struggle with measuring and even recognizing complicated grief and bereavement. Continue reading →