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Finding Answers
29 October 2021

There are no straightforward answers to the difficult questions that arise in the course of journeying with our patients, but by unpacking the emotions behind these questions, we often arrive at our own understanding and closure. (Above) HCA Spiritual Care Counsellor Irene Lee on a home visit.

By Paul Bashyam, HCA Medical Social Worker

World Hospice and Palliative Care Day fell on the 9th of October 2021; the day celebrated and honoured the importance of hospice and palliative care around the world, including Singapore. The aim is to raise awareness and understanding about the needs of critically ill patients and their loved ones.

Hospice and palliative care do not just focus on relieving physical pain and symptoms, but also address the psychological, social and spiritual needs of the patient and the family. Therefore, multidisciplinary hospice and palliative care teams usually comprise not just of doctors and nurses, but also of social workers, spiritual care counsellors and art therapists.

Do you always have the answers to the questions?

In the course of our work, there are times when patients ask us difficult questions, such as “why me?” or “why do bad things happen to my mother, even though she is such a good person?”

Often these questions need to be unpacked further, to understand what the patient or their loved one is really asking and what the emotions behind the questions are. It could come from a place of anger, frustration, shame and guilt.

In such cases, we will usually also involve our Spiritual Care Counsellor, to follow up and help the patient navigate this labyrinth of emotions. As our Spiritual Care Counsellor, Irene, honestly states: “The truth is, most times we don’t have the answer – the main thing is to be present, to be in the here and now with the patient asking the question.”

“To further understand their understanding of suffering. To create a safe space to help them find their identity at this stage of their life. To let them know that they are not alone in their journey.”

Case of Mr Rob

Take for instance, the case of Mr Rob*, an elderly man suffering from a terminal illness. Mr Rob was referred to the psychosocial team as he often lashed out at our medical team and his own family. He would often scold everyone, because he felt they were not listening to him and he would lament about why he had to fall ill.

After multiple home visits by Irene and I, we managed to build a therapeutic alliance with Mr Rob – only then was he able to calm down and share with us his thoughts and emotions. During this time, Irene was also able to conduct an FDI (Family Dignity Intervention) with him – a form of legacy work that encourages expression of emotions between the patient and family – and this allowed Mr Rob to find closure and help his family make positive meaning of the caregiving journey.

Why Me?

Ultimately, the difficult questions our patients ask, also enable us to reflect on our own lives. “It makes us reflect on our own mortality and what we hold dear, as well as the transience and transcendence of life,” Irene says.

Irene always reminds us, that sometimes it is important to slow down and let the emotions settle; we have to let go of our own guilt and resentment before we can attend to these difficult questions. When we let the emotions settle, we become aware that these questions are difficult, not because of their enquiry but because we too, are pondering the meaning of our own mortality and also yearn to know: “Why me?”

*not his real name