Dr Michael Barbato spoke last week at the Experiences around Dying forum from his wealth of experience in end of life care, discussing a range of topics including being present and available to people at end of life.
He pointed to research highlighting that a person in their last years of life might see as many as 28 doctors, a subset of the total number of clinicians that the person is likely to interact with during that time.
Consequently the experience of a person around end of life is likely to be determined by the ability of those clinicians to set aside their busy-ness and take the time to be present and listen.
Michael spoke about his own experience as a pastoral care worker in end of life care, at times his experience of feeling vulnerable and helpless, and the realisation that the most valuable skill he could bring into that setting was his ability to listen.
His message to clinicians and volunteers was simple:
“You don’t need any particular skills or talents – you have got everything you need to listen and let people talk.”
In particular he encouraged clinicians and volunteers to value silence and to avoid ‘rescuing’.
Silence on the part of the patient might mean that they are going deeper into their experience and given enough time they might come up with something more profound about their experience.
Interrupting this silence, perhaps by a well-meaning attempt to ‘rescue’ them, might exacerbate their existential suffering.
“The danger with reflective listening is that it might ‘rescue’ a person just at the moment when they were hoping to go deeper.”
He pointed out that the ability to refrain from rescuing is critical to hearing, and why workers in palliative care should be mindful of what they bring into their roles – their mindset, attitudes, frame of reference and agenda each influence their interactions with patients and families.
“What gets in the way of listening and hearing is the baggage that you bring into the room. Look inside, your agenda, your bias – because these will influence your ability to be present.”
He reminded us that curing is something that is directed at a physical level, whereas healing is directed at a psycho-spiritual level.
“Hearing can lead to healing, so the right response is to listen and help with understanding. What’s important is understanding at a heart level.”
He also discussed end of life dreams and visions, the importance of symbolic language and consciousness around end of life.
Michael was speaking at the Experiences around Dying forum held in Tamworth on the 25th of October 2018 that was hosted by the Volunteer Support Services Programme.
Michael is a plenary speaker at the 2018 Biennial Palliative Care NSW Conference to be held in Kiama in 2 weeks. He will also be holding an extended workshop on the 3rd of June as part of the 2019 NSW Palliative Care Volunteer Conference in Blacktown.
Pic: Michael Barbato speaking at the forum in Tamworth