CFLE in Context: Hospice Care — Guiding Families Through Grief and Loss

by Kathleen Helgeson, M.A., CFLE
CFLE Network
Content Area
Counseling and Therapy
Human Growth and Development Across the Lifespan
Internal Dynamics of Families

When I stand before God at the end of my life, I would hope that I would have not a single bit of talent left, and could say: "I used everything you gave me." Erma Bombeck

Amen, Ms. Bombeck, amen. These words have inspired me many times over the years to never give up on personal development and never stop sharing what I have to give toward making the world a healthier, happier place to live. Every season of life and stage of development offers opportunities for amazing quality of life, and I don't want to miss a thing. I am proud to be a woman, wife, mother, and grandmother who chose to complete a BS in Psychology with an emphasis in Marriage and Family Therapy and earn an MA in Human Services with Family Life Education emphasis after turning fifty.

My journey toward degree completion was long and wound through years that were busy with building marriage, growing family, making a home, and finding my place in this world by feeling my way one day at a time. Jumping into adult responsibilities as a teen wife and mom in 1974 with one semester of a marketing degree under my belt, I didn't always know where I was headed but was purposeful about making the most of each day and thinking of possibilities as adventure. Thirty-two years later, life experience helped guide my path back to higher education – older for sure, but with a half-century of whole-hearted intentionality lighting the way.

Deeply affected by the loss of both my parents through illness when I was a young mom, I became increasingly interested in hospice care and the powerful effectiveness of this comprehensive approach for assisting dying patients and their families during irreplaceable, precious last days together on earth. I was taught as a child that God helps those who help themselves; through engagement as a patient family member, I have experienced hospice care as a beautiful expression of the help of God to those who cannot help themselves.

My growing interest led to several years of work as Community Education Coordinator for a local hospice and home health agency and also raising funds to supplement the cost of care for their acutely, chronically, and terminally ill patients. Eventually, circumstances came together opening doors of educational opportunity that unlocked my long held desire to achieve academic goals. Along with FLE certification, my studies in Spiritual Health and Wellness, Certified Funeral Celebrant services, Grief Support Group Facilitation, Biblical Peacemaking, and Discipleship Leadership broaden the range of families with whom I may provide educational intervention including specialized assistance for spiritual wellness, funeral service planning and observances, and grief support.

I am convinced that attention to each identified FLE content area is critical for comprehensive professional service to families and individuals throughout the lifespan. Dying is the final stage of human growth and development and presents opportunities for psychosocial and spiritual growth not experienced in any other season of life.

In my practice I am privileged to serve families suffering the recent death of a family member by designing individualized funeral services and integrating into the memorializing unique stories, meaningful songs, and fondly cherished experiences of the one who died. Often, the families with whom I work do not have a pastor or church home and prefer less traditional ways of publically remembering their loved one. The process of creating personalized funeral services includes special times of meeting with grieving families to hear their stories, memories, and anecdotes as they introduce me to the one they love and to whom they must say good-bye. Funeral services are created from these remembrances, and family and friends are encouraged to participate in the memorial observances. Family meetings, funeral planning, and funeral participation promote feelings of understanding and connectedness as family members begin to accept the reality of death, and they positively support personal re-identification and role reorganization.

Another aspect of my professional involvement with families focuses on bereavement needs through group grief support. Death of a family member interrupts established patterns of family relating and can affect levels of health in family functioning. Family grief support that is founded on solid academic research and utilizes a systems perspective honors the affect of loss on individual family members and families as a whole. Guidance and support that is focused on validating emotions and healthy mourning practices strengthen skills for grieving together; throughout the family journey of grief, these practices assist in creating what is the "new normal" and new traditions that bring families closer together.

Loss is inseparable from the human experience, and grief is an essential response to loss in hope for healing. In all of the ways one may begin to understand grief of another's loss, none fully encompasses every facet of its impact on an individual or a family. If a professional cannot fully "walk a mile in another's moccasins," he or she can approach compassionate professional caring with recognition of another's individuality and respectfully honor another's pain.

Professional work with the bereaved may begin by simply walking beside them as they take their first wobbly steps toward wholeness; as trust is established, one may offer very real, effective strategies through education to assist the grieving stabilize their emotions and strengthen their efforts as they journey through the valley of the shadow of death. I regularly observe that a focus on strengths-based educational intervention and program development can strengthen struggling families on the road to achieving healthier levels of functioning; this focus can also facilitate families' self-repair of broken hearts and relationships.

In addition to care of the bereaved, my role in hospice volunteering Spiritual Care and facilitating a Life Review process is close to my heart. Life-cycle achievements in dying include completing tasks related to career, societal, and community obligations, but usually the more imperative issues are linked to quality of relationships with loved ones, self, and God. The terminally ill typically question what gives their lives meaning, who is God, and wonder about spiritual destiny after death. Answering these questions can lead to personal growth and strengthening of spirit.

This work can be achieved through a Life Review process. I employ a form of written, collaborative review that utilizes a question and answer format to inspire remembrance of specific experiences and their significance. This results in a type of guided autobiography. The process assists in completion of important end-of-life tasks by providing fresh opportunity and broader perspective for assigning meaning to past joys and challenges within whole-of-life context. It very simply yet effectively helps the hospice patient to tell surviving family members and generations to come how he or she wishes to be remembered and what values he or she holds most dear.

FLE can play a significant role in professional work with dying individuals and their loved ones. The dying process can become especially meaningful by putting emphasis on connections and cohesiveness and by drawing on love and common experience. This period provides a significant opportunity to say what should be said with open hearts and to give and receive forgiveness and understanding.

Families who suffer great loss can heal; suffering the loss of a loved one can become impetus for determining what brings significance to life for survivors. One of the most positive aspects of my work relates to application of meaning-making coping that involves drawing on personal beliefs, values, and goals for identifying ways that good can come out of suffering. Since I believe that a positive approach is empowering for families working through changes and challenges, I mindfully employ strengths-based strategies for promoting and reinforcing families' resiliency skills related to issues of death, grief, and bereavement.

Admittedly, at times, providing compassionate care for individuals and families during very difficult life-cycle transitions can weigh heavy on the heart. It is important for me to consistently utilize intentional personal and professional reflective practices in order to process thoughts and emotions related to my work, and I would advise other CFLE's serving such a vulnerable population to take seriously the self-healing qualities of these practices. It is also helpful for me to work collaboratively and regularly with other professionals who utilize similar constructive academic and adaptive approaches for assisting families throughout the dying and bereavement processes.

I consider it great privilege to serve hurting families at very painful times in their lives; I am deeply honored by my calling as well as equipping for companioning, educating, and caring as a CFLE. I am amazed by how educational opportunities inspired me to reach beyond self-perceived capabilities to strengthen skills of my callings. Although academic achievement does not define who I am, in the field, it does redefine what doors of leadership are open to me and the level of skill I have to invest in my passion for strengthening healthy individual and family functioning.

It is my fervent hope that developing and giving my gifts helps others in fully giving theirs - no one need ever give up on dreams of becoming all one was meant to be. Every individual and each family is precious in uniqueness and potential; rich in gifts to be given until last breath – and beyond. Believing in those gifts bestows legacy affecting positive and transformative change for loved ones left behind and has the power to inspire future generations long after one's work on earth is complete.

Kathleen Helgeson, M.A., CFLE, lives in Baldwin, Wisconsin, with her husband and chubby little dachshund. Their three adult children are married, and Kathleen and her husband thoroughly enjoy hanging out with four amazing grandkids. Kathleen owns CrossBridge Family Solutions, LLC, and serves families in the St. Croix Valley area of Western Wisconsin-Eastern Minnesota. Her practice includes Certified Funeral Celebrant services, Grief Support Group Facilitation, Grief and Loss Coaching, and Family Life Coaching. Kathleen also serves in Spiritual Care and Life Review as a hospice volunteer.