There are a lot of articles written about the hospice philosophy, hospice care, who is eligible for hospice care, etc. But not many a...

Laughing Matters

 

two happy elderly women spending time with each other at home


     There are a lot of articles written about the hospice philosophy, hospice care, who is eligible for hospice care, etc. But not many articles are written about humor, or laughter, in the hospice setting.  Having been a hospice patient care volunteer for over 20 years and a paid employee for over 11 years, I know that hospice is serious business. I also know that hospice, especially the one where I volunteer, celebrates life. And life may involve laughter, but hospice is no laughing matter, is it?

     Of course, we’ve all heard the overworked phrase, “Laughter is the best medicine.” It may be an overworked phrase, but it is also a well documented truth. Laughter is just as necessary in life as are tears. A friend of mine told me that laughter may be the best medicine, but if you are really sick, maybe you should call a doctor. Good advice.

     It is important to know that used correctly, humor does not disrespect the situation nor diminish its gravity. It can allow what is happening to begin to be discussed. Humor may open the door to acceptance and healing. It is up to those involved to find the humor is any given situation.

    Humor may be in the form of a funny situation or a joke. In my case I can never remember a joke so years ago I began writing them down after I heard one that I liked. I’ve kept those jokes in a binder. After I get to know a patient and it seems like the right thing to do (sometimes it is not), I will bring that binder with me when I visit them. I’ll ask the patient and family if they’d mind if I read from my binder. It has never failed when I bring the joke binder we all have a great time. They invariably tell me that they haven’t had a good laugh like that in quite a while.

     There was a particular family I visited as a patient care volunteer who requested what they called, a “groaner-type” joke when I arrived for my weekly visit. A groaner-type joke would be for example, “Why did the cowboy buy a Dachshund?” Answer, “Because he wanted to get a ‘long little doggy’” (groan). 

     When I would arrive to visit, his wife would answer the door and ask,” Do you know any groaners?” I would answer, “Yes. Did you hear about the man who was reading a book on antigravity? He just couldn’t put it down.” She’d laugh and ask me, ”Did you hear about the Siamese twins who moved to England…so the other one could drive?” Then we’d go back to the patient’s room and he couldn’t wait to hear the jokes. He’d always have one ready. For example, “The waiter asked the teddy bear, after his dinner, if he wanted dessert. ‘No thanks, I’m stuffed.’ The teddy bear replied.” The whole situation was fun to me. I remember thinking that I never thought that I would have so much fun visiting a patient. 

     Exchanging bad jokes was fun and it made the patient, his wife, and I think of a silly joke before my weekly visit. There is no doubt that he and his wife were having fun too. Yes, the patient and spouse knew he was terminally ill but we had fun in spite of it. 

     One of my hospice chaplains, Karl, tells the story of a terminally ill patient who is lying in his bed at home and smells the aroma of cookies wafting through the house.

     “Honey,” he calls out, “Those cookies smell so good, may I have one?”
     “Certainly not,” she replies, “Those are for your wake!”

     In one study of humor in the hospice setting it was determined that humor helped to maintain a sense of belonging. It helped patients to relax. It offered a feeling of warmth, lightheartedness, and delight. Humor was a life-enricher and a life enhancer. 

          A study done on nurse-based home visits found that humor was present in 85% of 132 observed home hospice visits. Of these visits, hospice patients initiated humor 70% of the time. In this study, and others as well, humor was spontaneous and frequent.

     A while back, I was accompanying one of my hospice’s nurses while she visited a patient in their home. The family pet was a cockatiel (a bird similar to a parrot). The family would leave the bird cage door open so that the bird could get out and stretch if it wanted to. While our nurse was sitting next to the patient the bird flew over and landed on the nurse’s shoulder. Without hesitation the nurse put her hand over her eye and said, “Aye, matey.” as if she were a pirate. Everyone had a good laugh.

     Instances of humorous interactions between hospice personnel and patients can be a prevalent part of everyday care giving work. According to the researcher in the study mentioned above, “Our research suggests that nurses and other healthcare professionals don’t need to suppress humor. They should trust their instincts about when it is appropriate.” 

     Humor shows the human side of hospice’s staff. It is also an important aspect of communication. Patients will observe the nurse or aide for a response to humor. An open accepting response to humor signals understanding. While a negative or no response may serve to isolate the patient.

     The hospice where I volunteer helps people to celebrate life. One way to celebrate life is to enjoy the moment, regardless of the circumstance. Laughter is a very effective way to do that. I’m often asked, “How can you work in hospice? Isn’t it sad?” It’s hard to believe that not only is it very rewarding to volunteer with hospice, but sometimes it can also be fun. Yes, laughing matters.