7061204 Evolving Compassion in End of Life Care -- Jerral Sapienza ©2004 LLX Press Eugene, Oregon: Tel 541.343-1202 1 Evolving Compassion in End of Life.

7061204

Evolving Compassion in End of Life Care -- Jerral Sapienza©2004 LLX Press Eugene, Oregon: Tel 541.343-1202

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Evolving CompassionEvolving Compassionin End of Life Carein End of Life Care

Jerral SapienzaAuthor, URGENT WHISPERS: Care of the Dying

Chaplain, Unity of the Valley - Eugene, Oregon

7061204 Evolving Compassion in End of Life Care -- Jerral Sapienza

©2004 LLX Press Eugene, Oregon: Tel 541.343-1202

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Introduction Introduction 1 of 21 of 2

Brief biographical sketch

– Childhood hospital taught one side of compassion

– Childhood friendship with elders taught another.

– Family Cancer, Alz and AIDS of the 1980’s,

– Learning, Growing, Sharing in the process…



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Introduction Introduction 2 of 22 of 2

Birth of the book:URGENT WHISPERS: Care of the Dying

– Origins: AIDS hospice, family support.

– Vigil Sitters needed guidance, “Map & Compass.”

– Family Mentor and Guide in Elder Care facilities

– Volunteer Training for hospice volunteers



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Evolving Compassion Evolving Compassion How do the Puzzle Pieces of End of Life Care fit?How do the Puzzle Pieces of End of Life Care fit?

To start: You must be involved to start to evolve in caregiving.

Must be aware of variation and diversity of situations and cases

Must commit to help guide the inexperienced

Create and share a Vigil Record for your friend, yourself, others.

Now, to Urgent Whispers: Care of the Dying excerpts…

but first . . . an exercise …

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Workshop Hands-On ExerciseWorkshop Hands-On ExerciseLooking at the exercise page…

The phrases represent end-of-life caregiving roles / development.

Allocate the 20 points between each of twelve boxes shown on page 2.

~5 mins

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Discussion of ExerciseDiscussion of Exercise

Individual and Group responses to the allocation exercise…

~8 mins



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Urgent Whispers ExamplesUrgent Whispers Examples

Excerpts of 12 example “whispers” from the 52 in the book . . .

Some practical examples of Evolving Compassion

Urgent Whispers: Care of the DyingUrgent Whispers: Care of the Dying



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The Breath BudgetThe Breath Budget

Mindfulness of how we communicate at the bedside.

Respecting and Honoring Silence

Truly listening with an intent to hear

“Feel free to ask me what I want, what I feel, what I need. Then honor and respect my answer, or my silence.”

p39

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The GatekeeperThe Gatekeeper

The Symbolic Duties of the gatekeeper:– Sergeant at Arms– Appointment Secretary– Overseer / Manager

“Before I built a wall, I’d ask to know what I was walling in or walling out…” --Robert Frost’s Mending Wall

“I may have need of a gatekeeper now but I also need to have time with my family and friends”

p432



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Dignity in CareDignity in Care End of life progressions can significantly change a

person. Weakening, degeneration, dependence is hard. How you relate and are able to show your compassion

is important This whole and wonderful being has a body which is ill

and weakening.

“Treat my body with dignity. It is part, not all, of me.”p47

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Pity vs. CompassionPity vs. Compassion Pity is a closed contagion of Fear we have to shrink

in order to fit into, focusing attention on the self and worrying about everything.

Compassion is an open gift of commitment and awareness we agree to live in, an acceptance and willingness to try to understand.

“Do not bring me your pity. Bring me your honest compassion and expression of love, or bring me nothing.”

p51

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Seeing as EqualsSeeing as Equals Hearing is the last of the senses to let go.

Sight is often one of the first.

Being near, saving energy.

Sharing a special bond.

“Come sit down here with me instead of so far away. I can see and hear you better if you are at my level.”

p655



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Honoring BeliefsHonoring Beliefs Perhaps the single most sacred of respects we

can offer the dying is letting them determine their own spiritual practices and beliefs.

Paying attention to the details is critical-- knowing the history, the story, the people.

“Please respect my own religious beliefs, whether they are consistent with yours or not”

“Please do not demean nor mock nor cry out against my own views and practices of Spirit. They are mine.”

p75-776



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Tuning In to the ProcessTuning In to the Process Dying is a very difficult process in some

ways, and an extremely simple process in others.

Not everyone dies the same. Be present now.

Breathing in unison can help tune in / reflect.

“Tune into what I’m going through here. Be present with me here and now.”

p877



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What Time is it?What Time is it? Semi-conscious states at the end of life.

Discussions of desired plans and process.

Be mindful of the Breath Budget when discerning when… Day? Night? Early? Late?

“I may like to choose the day and hour of my death… What time is it now?”

p998



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Importance of TouchImportance of Touch Human connectedness touches.

Respecting “Giving vs. Taking” in touch.

Appropriate loving touch is self-worth, value, love, kindness.

“Touch me gently (but not distractingly) as I die. Be with me but do not demand that I be with you.”

p1019



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Cathedral of the SoulCathedral of the Soul Must we go see Aunt Millie?

Each person has a history, beingness, unique and everlasting. But only one body.

Encourage the visit by children. They need to say their goodbyes, too.

“Please remember me as a Personal Being with history and not just as the fragment you may find me to be now.”

p10710



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Death as TeacherDeath as Teacher If Death is a teacher, many of us in the West

are always trying to skip that class! Yin Yang says that in all darkness there is light

and in all light, darkness. As we are present to support, so they are

present with their torch.

“Realize that I go before you now, at least in part, as Teacher and Reflector for where you one day will follow.”

p113

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Letting Go Isn’t Letting Go Isn’t Saying “Goodbye” Saying “Goodbye”

The call to Death is a strong one.

The call to Life is a strong one, too.

Giving permission to go is a gift you give.

Let go of attachments, fears, worries.

“Don’t try to hold onto me beyond my time. Don’t keep my physical body here beyond its will.”

p11712



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Once you Understand about Evolving Compassion…Once you Understand about Evolving Compassion… Share Your Wisdom With OthersShare Your Wisdom With Others

Sharing your Stories and Wisdom goes a long way to helping others discover the loving gift of Evolving Compassion in their lives.

End of Life Care is a gift we give ourselves and others. Lessons abound . . .

Where from here? Other ways to share?



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Sharing Your WisdomSharing Your Wisdom 2 of 2 2 of 2

Developing outreach projects around End of Life care to assist in community awareness for evolving compassion:

Help setup CodPod groups in your area (Care of Dying Public Outreach Discussion) groups. You can download Participant and Facilitator manuals from LLX Press web.

Activate Church Groups, Civic Organizations, Hospices.

Start Library / Book Discussions around EOL issues.

Other ideas YOU have? How will YOU reach out?



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Training Materials to assist with classes: Training Materials to assist with classes:

Available online from LLX Press: http:// WWW.LLX.COM / UW / Train /

– This PowerPoint presentation and handout available.

– 7-Week extended Discussion / Training materials

– Downloadable manuals for facilitator and participants.

– 12-Powers of End of Life Care based on Charles Fillmore’s “The Twelve Powers of Man.”

– Short story, poetry, writings on End of Life topics.



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URGENT WHISPERS: Care of the Dyingby Jerral Sapienza © 2002 LLX Press, Eugene, Oregon USA

ISBN 0971710708:Paper / 0971710759:Spiral / $14.95 152 pg

Available here today for purchase / autograph; also available online, at booksellers everywhere, and direct from LLX Press.



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Thank You for ComingThank You for Coming

I am Jerral Sapienzaand I approved this message.

7061204 Evolving Compassion in End of Life Care -- Jerral Sapienza ©2004 LLX Press Eugene, Oregon: Tel 541.343-1202 1 Evolving Compassion in End of Life.

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