I once attended a seminar on death and dying given by Barbara Karnes, RN, who was then the Director of Hospice and Home Health agencies at Olathe Medical Center in Kansas. Her presentation was compassionate and insightful, based on her years of experience working with the dying, and her eloquence moved me. As I listened to her speak, she said something that raised the hairs on the back of my neck, a profound statement of truth I have never forgotten. She said, “People don’t just die.” She went on to explain that there are only two ways people die: suddenly, as in the case of a tragic accident, or when they decide to let go. For the majority of us, we will decide when to die.

It was so simple, as all such truths are. Most of us fear death, a harsh, looming specter waiting to grab us or our loved ones with no warning. It is something we will all inevitably experience, something that feels completely out of our control. But when we look deeper at death, we see this is not the case. It is no coincidence that death rates fall immediately preceding and during major holidays. It is no coincidence that the dying, despite their pain, hang on until a loved one arrives from out of town to say goodbye. We cannot avoid death, but we do have control over that final moment, a brief window of time to resolve unfinished issues.

According to the Hospice Foundation of America, “Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. Hospice care neither prolongs life, nor hastens death.” Hospice workers provide palliative care, alleviating physical suffering to the greatest extent allowable. However, I would say the primary mission of hospice workers is to assist in the transition process, to act as spiritual and emotional guides during an individual’s final journey. They counsel the dying and their loved ones, helping them work through the stages of grief so they may reach acceptance and peace.

This can be a difficult process. Loved ones don’t want to let go, and the dying hang on, waiting for a sign that it is okay to pass. What the dying fear most is neither pain, nor death itself; they fear their loved ones will not be okay. They worry about who will take care of their family once they are gone. The hospice worker reaches out with compassion, helping families find a path to acceptance, and helping the dying find the comfort, dignity and peace they so deeply need at the end of life.

Hospice workers form an uncommon niche in the medical field. All of their patients die. It is hard work, taking an exhausting toll on care givers physically, emotionally and spiritually. But for those truly called to hospice, the work is both an honor and a privilege. When the body cannot be healed, hospice workers set about healing the heart and soul. Knowing that “people don’t just die,” hospice workers help the dying and their families walk together through one of life’s most deeply meaningful and moving experiences—the end of life.

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