Anger, in general, comes from believing things are unfair. There’s plenty of unfair in hospice.
The medical establishment is a complicated and poorly operating machine that depends on countless interlocked gears moving smoothly. The system frequently breaks down when we most need it to function. The breakdown results in people not getting what they believe they should get.
Families are also complicated and not always harmonious. Many harbor long-term and deep-seated resentments towards our relatives. Many people respond to learning that an estranged family member is dying with unconscious guilt that they deal with by projecting it onto other family members or showing up with an inflated need to take over and advocate for the relative.
Hospice itself is complicated and difficult to manage. As an example: Hospice team members–nurses and home health aides in particular–have full caseloads that they need to adjust frequently in order to accommodate emerging situations. It’s common for the timing of visits to be unpredictable, causing inconvenience to patients and family members.
And then, of course, there’s the anger that emerges as part of the grieving process. It seldom feels fair when someone we love is no longer with us.
Step 1 of resolving angry situations: Recognize the anger is valid
The first step to supporting angry people is to recognize the anger is valid. This doesn’t require you to agree that they were mistreated, but you can understand that their situation truly feels unfair to them, and there’s no point in trying to make them see there’s nothing to be angry about.
Step 2: Gently match intensity
The second step is to remain gentle and unthreatening while matching their intensity. You don’t yell if they’re yelling. You don’t slam a door. But stand up straight. You widen your eyes. You nod your head decisively. You are as intensely steady as they are intensely angry.
Step 3: Show you are on their side
Third, reassure that even you are on their side and will do everything you can to make things right. This is true. You can’t guarantee that you’ll get them the result they want. You might not even believe that the result they want is best or realistic. Don’t worry about that now. You’re on their side. You’ll do what you can to help make things right.
Step 4: Verbally encourage action; nonverbally encourage calm
With your words, urge them to take action with you. With your own physiology, guide them to a calmer state. Take deep breaths that end in a crash of a sigh, as if you are buckling down to finish a term paper you had been procrastinating on. If they’re standing, invite them to sit with you. Turn the focus away from the unfairness to the action which will make things better. Pull out a pad of paper and start outlining a plan.
Verbally urging someone to calm down often backfires. People can find it invalidating. You want them to calm down because you want them to be well, and because you know that calm states of mind get better results. But if you tell them to calm down, they may take it as an attack on how they’re perceiving the issue.
Instead, use your words to encourage them to work with you for a solution. What does that do? It expresses agreement that there is a problem that must be solved. It is an expression of support. It’s an invitation to get into the trenches together. It is an opportunity to channel the energy instead of merely shutting it up.
When they’ve sat down with you, the immediate crisis is averted. You likely have a better rapport now than you did when before this interaction. And doing your part to follow through with the action plan will further build trust.
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