ABSTRACT
Working in end-of-life care is a privilege. As patients try to understand their
physical decline, deeply personal and intimate conversations between patients,
family, and hospice staff are common to all who do this work. Dying, however,
is not just about physical decline. Current relationships, past accomplishments,
regrets, hopes, disappointments, and cherished memories are all a part of an
ongoing end-of-life dialogue. The desire to tell another person one’s life history
constitutes much of what emerges as one approaches the end of life. Some
patients struggle with how to bring up a concern but ultimately never take the
risk to go beyond a superficial conversation. Other patients easily engage in a past
exploration of what their life has meant. Hospice chaplain Elizabeth Kaeton,
reflecting on her work, writes, “just below the surface of polite repartee lies what
author May Sarton calls ‘a crucial conversation’ about an important issue in
their life. . . . It is a frustrating, maddening dance unless one is skilled at listening
below the surface to the questions and their attendant issues” (1998, p. 285).
