Table of Contents

Introducing hospices. The work of hospices. Helping dying people. Activities and therapies. Hospice compared to hospital care. What is special about a hospice. The nature of the work. The rhythm of a day. Particular roles. Day patients. The hospice at night. Patients at home. Managing the hospice. Responding to patients and relatives. Welcoming and reassuring. Physical and practical needs. Emotional help. Spiritual support. Discussions about returning home. The needs of relatives and friends. Children. Working with dying people. Helping people to come to terms with dying. Returning home to die. Recognising the terminal phase. The actual death. After a death. Giving time to families. Preparing the body. The next days. Attending funerals. Bereavement work. Subsequent contact with relatives. Sources of stress: difficult patients and families. Difficult patients and relatives. Anger and aggression. Patients and families in denial. Family neglect. Other sources of stress and their impact. Emotional involvement. Particular frustrations. General pressures of work. The impact on staff and their families. Ways of coping. Keeping work out of the home. Support from family and friends. Finding ways to relax. Support from the hospice. Own spirituality. Initial motivation. A sense of vocation. Prior experience of death. Other formative experiences. The accidental route. What makes the work worthwhile. Feeling involved. Responding to challenges. The variety of people. Feeling valued by patients and families. Working with other staff. A sense of fun. Working in a hospice. Qualities needed. Training. Telling people what you do. Reflections on living and dying. A good death. Choosing the timing of death. What happens after death? A sense of mortality. Learning what is important. Extending the learning from hospice care.