Walking With Families Through End-of-Life Care and Grief

My grandfather received hospice care for the last month of his life. My grandfather, grandmother, and other family members hesitated about involving hospice right away when he was diagnosed with cancer and told he had six months to live. However, after my grandfather was cared for by the hospice team in his own home and experienced the many benefits of the program, they wished they had involved hospice sooner to take full advantage of the services offered. Ten years later, I felt a strong call from God to serve as a Social Worker in the Sioux Center Health Hospice and Home Care program, where I worked for two years before coming to Dordt University as an Instructor of Social Work. 

To some, a career spent with those who are dying or grieving sounds challenging and sad. In reality, it is a great privilege to walk alongside patients and their families as they experience end-of-life care. 

Hospice, by definition, is “a specialized type of medical and emotional support that focuses on comfort, dignity, and quality of life for people with a terminal illness who are approaching the end of life” (National Institute on Aging, nia.nih.gov/health/hospice-and-palliative-care, retrieved 9/30/26). To be eligible, the patient’s physician must believe the person is likely to die within six months, and the patient is no longer pursuing curative treatment. Hospice is patient-centered, with a care plan focused on the patient’s needs and goals. 

As Christians, we cannot simply ignore the spiritual element of hospice care. Death is inevitable. It is a consequence of sin and the Fall. As a hospice social worker, my desire was to provide support, care, comfort, honesty, love, and encouragement—allowing family to experience treasured time where memories were made, relationships restored and celebrated, and hope was found or strengthened. I believe this is what distinguishes end of life care for Christians.

Involving hospice early greatly benefits the patient and family. Many hesitate or do not feel comfortable with hospice because they are afraid it means they are “giving up.” Or, as Christians, choosing hospice indicates they are no longer trusting in the power of God and the hope for a miracle. They may see it as a lack of faith. Therefore, moving forward in the patient's best interests demands a shift in perspective. Loved ones are not giving up; they are choosing to support the patient in living their best life, focusing on quality, dignity, and comfort rather than continuing treatments. They are focused on making the most of their time together.

Hospice providers are an interdisciplinary team of physicians, nurses, home health aides, social workers, chaplains, music therapists, massage therapists, art therapists, pharmacists, and volunteers. The team provides medical, emotional, psychosocial, and spiritual support as needed. Hospice staff provide in-person visits and are available by phone 24/7. Services are often covered through Medicare, Medicaid, or private insurance.

Services include symptom management, pain control, medical equipment (hospital bed, walker, wheelchair, oxygen, etc.), giving patients choices, and developing a care plan that meets their individual needs and supports their health and life goals. The care plan reflects how patients want to live the rest of their lives, no matter how long that may be. 

While we typically view hospice care as serving the patients who are ill, it also supports caregivers and family members who are often overwhelmed with the daily care of their loved one. Those close to the patient are likely to experience anticipatory grief as they prepare for the loss of their loved one. They may feel distress and sadness. There are losses to grieve throughout the journey as their loved one declines in health, gives up independence and past enjoyed activities, and realizes their future is limited. 

For the family, hospice can provide short-term respite care, grief and loss support, education and instruction on how to provide care, address concerns, and offer tips and strategies to help caregivers manage their role and prevent burnout. The social worker is highly involved in these aspects of care. Caregivers are supported as they face the challenges of guilt, anger, anxiety, exhaustion, loneliness, and sadness. A social worker connects the patient and family to needed services, such as financial assistance, funeral planning, and grief support groups. 

A social worker’s role also involves helping the patient and family have difficult but necessary end-of-life conversations. Families are advised to start these conversations early and make them a natural part of life. Ask about the aging person’s wishes: what are their values, and what brings meaning to their life? Even before an illness crisis, everyone should have an advance directive—a legal document that states their choices for medical care before they can no longer make decisions for themselves. A social worker can provide this document and help complete it. It is important to stay focused on dignity and the aging person’s desires. A social worker can mediate conflicts and disagreements among family members (focusing on what the patient wants), explain and provide options, and provide emotional support. 

Having these conversations ahead of time will decrease anxiety, stress, and confusion in the future when tough decisions need to be made. Clarity and peace will be more evident. Patients will also be more likely to receive the care they want and planned for. 

Ultimately, faith heavily influences how we approach aging and end-of-life care. For believers, fear of the unknown may exist, but belief in eternal life through Jesus’ death and resurrection grants hope and a peace that passes all understanding – “When the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” (Philippians 4:7). 

For believers, the sanctity of life takes precedence. God created all in His image. Faith guides end-of-life decisions and helps people make sense of suffering and death. Prayer and scripture reading can lower anxiety and depression and lead to internal peace. Additionally, when pastoral and spiritual care are involved during the end-of-life journey, patients can better connect their religious values with medical goals. 

As Christians, we receive comfort and solace because Jesus overcame death through his sacrifice on the cross. Praise the Lord!