Dame Cicely Saunders is one of the great spiritual benefactors of the modern era. At least that is how I rate the white-haired, kindly looking British physician who, in 1967, began the hospice approach to helping people at the time of their dying.
This quietly dynamic Londoner, now 85, thought it important to move the place where people prepared for death away from hospitals to a home-like setting. She also placed emphasis upon making people comfortable rather than trying to cure them when that was no longer possible.
Thus she brought to the care of the dying not only physicians and nurses but also chaplains and others who could provide for their spiritual needs. She recognized that the soul needed support as much as did the body.
Dr. Saunders has taught people to express five sentiments as they approach death:
- I forgive you
- Please forgive me
- Thank you
- I love you
- Good-bye
She herself is a person of great spiritual stature. She once told an interviewer that, rather than dying suddenly, she would prefer to die of cancer. Dying a slow death would give her time to make the statements noted above.
Dr. Saunders draws inspiration from writers both ancient and modern. She finds hope expressed by Julian (or Juliana) of Norwich, a 14th century English mystic who, living at the time of the black plague that ravaged Europe, nevertheless wrote the famous words “all shall be well.”
She also takes inspiration from J. R. R. Tolkien, author of “Lord of the Rings” with its promise of overcoming evil, and from J.K. Rowling who has written the wildly successful Harry Potter series.
Dr. Saunders has brought about a revolution in end-of-life care. Many Americans have found in hospice care crucial support in their time of passage. However 50 percent of those who die each year do so in hospitals despite the desire of the overwhelming majority to be in their own homes when they die.
If all American hospitals offered hospice or palliative care services, then the situation would not be so bad. But, despite the advances in such care, fewer than 60 percent of our hospitals do offer such.
Emily Chandler, a Boston-area resident who is both a nurse and an ordained minister, explains the benefits of the hospice approach as follows: “Experience with hospice has taught us that rather than being a fearful, dreadful experience, dying can be healing, peaceful, even spiritually fulfilling for patients and their loved ones.”
As to what caregivers can do, she writes: “Attuned to the possibilities of sensory spirituality, we can enhance a peaceful, even joyful participation in the encounter with mystery that dying entails. In the process, we can learn something of our own spiritual journeys ourselves.”
The reference to “sensory spirituality” refers to Emily Chandler’s confidence in experiences that engage more than one sense at the same time. As an example, she says that combining sights and sounds or sounds and aromas can be effective in supporting healing memories.
Rev. Chandler also thinks that the great need of people when they come to die is to remember hope. It is a time for them to look back on their lives, if possible, and recall the images they have had of the transcendent, of what goes beyond the seen.
It can help them spiritually to think back to the familiar symbols that put them in touch with God, the beyond, the mystery of life. This is also the time when well-loved stories can be retold with the help of family members, friends, or others in attendance. These tales can stir the heart as they bring back the people and the events that figured large in the person’s life.
In this way, hope remembered can provide comfort and perhaps inspiration at this time of such crucial importance. Dying can thus become an event that summarizes life’s value, making it a supreme human experience.
The approaches to end-of-life care indicated here give expression to a strong movement toward favoring care over cure when the latter is no longer feasible. More and more people in later life want their time of dying to be one in which their bodies are made as comfortable as possible and their souls receive the attention they need.
Richard Griffin