Listening to patients at their end of life can be mentally, physically, and spiritually exhausting. Although often highlighted in books about hospice and palliative care, listening rarely takes the spotlight. Robert Mundle’s new book, ‘How to Be an Even Better Listener,’ is an accessible companion for hospice and palliative care volunteers. We talked to Robert about how anyone can become a better listener.

 

In your opinion, what makes a good listener?

I think that really good listeners demonstrate a particular kind of attention and care for others that is revealed through subtle gestures of body language and stillness, and also through the kinds of “quality” questions they ask that invite further conversation and that allow for deeper reflection, without ever losing focus on the person speaking. That’s easier said than done, but I think it’s something we can all learn to do better. Listening is so important, and it makes a deep impression on others. I think it’s important to remember that.

In my research for the book I was delighted to come across the following description of how St. Francis de Sales listened in his role of providing care to others:

He received all comers with the same expression of quiet friendliness, and never turned anyone away, whatever his station in life; he always listened with unhurried calmness and for as long as people felt they needed to talk. He was so patient and attentive that you would have thought this was all he had to do.

I’m not sure how he learned to listen like that. But I think we can learn from his style. Even more directly, I think we can learn from how we have experienced good listening from others in our lives.

You mention in the book that it is not unusual for humour to arise in palliative care scenarios. Why do you think this is, and is it ever appropriate to initiate a humorous exchange with someone at the end of life?

I think humour arises in palliative care scenarios because in whatever stage we’re at in life, it helps us to communicate and connect with each other. I’ve found that oftentimes patients will initiate humour with me, with a pun or a joke, as a way to begin a conversation, including even so-called “black humour” sometimes that can make “taboo” subjects life dying and grief easier to talk about. It creates a safe and comforting space, and can help ease tension during very stressful times. On our part, I think it can be appropriate to initiate humour gently with our patients in hospice or palliative care, but it requires careful listening and sensitivity of us to take our lead from their cues and to be mindful of boundaries, which will be different for each one of them.

Emotional burn-out is a risk for palliative care workers, as they take on the emotional burden of listening to their patients’ worries and traumas. Do you have any advice for readers who may be experiencing burn-out?

In healthcare, we learn how to be with others in their pain. But it’s more difficult, I think, to learn about our own strong feelings that are roused within us in the face of suffering—our own pain, and what to do with it. Not knowing what to do with the pain we experience can lead to feeling overwhelmed and burnt out. Therefore, it’s so important, I think, for all of us to take the time to reflect on our own feelings, needs, and boundaries. Sometimes we can become so focussed on tending to the needs of others that we forget to tend to our own, or even to recognize and admit that we have our own needs! So, it’s vital, I think, for each of us to find our own listeners—to have others in our lives to talk to who can really understand what we’re dealing with in hospice and palliative care on a regular basis, including its steady drumbeat of dying, death, loss, and grief, and the emotional and spiritual burden it imposes on us personally while we’re trying to provide quality care for patients and their loved ones professionally in very difficult circumstances. In this way, it might be helpful to confide in a manager, peer, or small supportive group of peers who meet regularly to debrief and help each other recognize and acknowledge the feelings and responses we have to dying and grief, to de-stigmatize grief in the workplace. Seeking this kind of listening care might be a good first step to receiving additional kinds of help and support we may need.

Death is still very much a taboo subject in Western society. In the course of your career as a chaplain, have you encountered any surprising or memorable attitudes towards death from patients?

I’m always struck by the extraordinary potential for new experiences of creativity and creative expression in others, even near the very end of life. My most memorable moments with patients in palliative care have to do with how they have expressed themselves in the stories they tell, or in poetry, art, photography, and in music, and how, while talking about their lives with me, they’ve reached back through their memories, sometimes over many decades to childhood experiences, to express something vital about themselves that was true for them then, and still is. In my work as a palliative care chaplain I’ve learned from my patients that listening can be life-giving, in that it can open-up new possibilities for creativity in healing relationships, even when it might look, on the surface, like narratives and creativity must inevitably shut down and come to an end. In the end, those meaningful stories continue to live on in me as a caregiver and resonate with my own stories. This kind of reflective experience enhances the kind of care I can offer to others.

The book is primarily for hospice care workers, but could the learnings be applied to other professions?

Absolutely! Listening is paramount to providing quality healthcare at all levels, and I believe it is vital to enhancing the quality of all of our relationships, professional and personal. Lawyers, bankers, teachers, anyone at all, really, could provide better service to their clients, and better attention to family members and friends, with better listening. We all want to feel heard and understood, don’t we? I think people are really longing for that kind of deeper communication and connection in the world today, perhaps especially in this digital virtual world of ours. The curious thing about listening, I find, is that it seems so darn obvious, yet good listeners can be so hard to find. Why is that? Listening is such a rare gift to receive. It’s powerful. I think we could all share it much more abundantly with each other in all of our relationships, in our various roles and responsibilities.

For more information and to buy a copy of the book, please click here.

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