Living with Hope: A Hospice Spiritual Care Counselor’s Reflection

By Bette Birnbaum, SCC, Staten Island Region

Hospice is about dying with dignity. It is also about living with hope.

Some patients with cancer hope they will become strong enough to return to treatment. Spouses and children of cognitively impaired patients often hope these patients will recognize them. Some patients hope to attend a family wedding or make it to the next holiday. One woman I visit regularly is hoping for a cake with fancy icing for her 101st birthday. And almost everyone hopes to die peacefully and quietly in their sleep.

Steven* has been in VNSNY Hospice care for many months. He has lived a rough life but he is a sweet man. He speaks fondly of his mother, who he nursed until her death. Steven used to be an altar boy. His mom was so proud of him! His service in church nurtured his belief. Eventually, when he became his mother’s caregiver, they would sit together and watch mass on television. This was a sweet bonding experience that further strengthened Steven’s faith.

Even though his mother has died, Steven still never misses Sunday mass on TV. Recently, he asked me to bring him a rosary and a how-to rosary booklet. He was so excited to receive the sacred beads that he grabbed them out of my hands and looped them around his neck in one seamless motion.

On the first day I met Steven, he was very preoccupied—not with his illness, or with his feelings about starting on hospice, but with his beloved 19-year-old cat Jenny, who had recently escaped through a window in his apartment that had been left open by mistake. The loss distressed Steven and also triggered old grief for his mom and her deceased cat. For weeks after Jenny disappeared, the cat was all he wanted to talk about. He hoped his pet was still alive and that she would come back. He was so hopeful, he put away her toys and treats but didn’t throw them out. Although it was getting cold outside and he was too unwell to search the area around his apartment building, he vowed he would do so come spring.

Steven has been through a lot since our first encounter, from breathing difficulties to an inflamed elbow to a hospitalization. Nevertheless, he has maintained his hope of getting off his tube feeding, swallowing real food again, and reuniting with Jenny. Over the months we spent talking about the cat, I didn’t have the heart to say that I believed too much time had passed to expect her to return, but that’s what I was thinking to myself. There were so many times I wanted to gently burst Steven’s bubble, to protect him from further pain. I knew the same facts about his pet’s disappearance as Steven did, and I chose not to be hopeful. Steven chose otherwise. His hope sustained him.

You can imagine my absolute delight when Steven’s VNSNY Hospice nurse Elaine Gillard called me last week to say that Jenny had come back! She said that Jenny had appeared out of nowhere at the door of Steven’s building. The super thought he recognized the cat and brought her straight to Steven. Steven immediately unpacked Jenny’s toys and treats and picked up right where they had left off, even more certain of his faith.

Nurse Elaine was jubilant, as was I. But I also felt stunned. I couldn’t believe Jenny had survived the fall and winter in the elements, much less found her way home. I also couldn’t believe that the story turned out so well for Steven and that he hadn’t given up hope, even as he was coping with his physical condition.

I reached out to Steven the same day Elaine shared his good news. “Miracles happen!” I said.

“Thank you very much,” he responded. “I prayed, I believed, and she’s back.”

I am confident that Steven will continue to hope he can jettison his feeding tube and enjoy good things to eat. It’s something he can look forward to while Jenny curls up in bed with him and he strokes her head and feels her purr vibrate against him. Whether or not Steven achieves all of his goals, I am going to join him in hoping—and I will always be grateful to him for reminding me that where there is hope, there is life.

* The patient’s name has been changed for privacy.