REVIEWED BY DIANE KRESLINS, BCC
The Art of Conversation Through Serious Illness: Lessons for Caregivers
By Richard P. McQuellon and Michael A. Cowan
Oxford University Press, 2010
Paperback, 160 pages, $15.95
This book is a must-read for caregivers who companion people living with a serious illness. The approach offered is an empathetic and honest method of conversation that focuses on the patient/person and supports them as they search to find meaning and purpose in their diagnosis, as they discern their treatment options and as they grieve their losses. The authors write, "[Our] hope is that people facing mortality, those who love them, and those who care for them will find in these pages compassion for their suffering, the consolation of meaning, and practical guidance for the challenging journey through mortal time, which awaits us all."
They point out that "when someone enters mortal time directly, their caregivers enter the same 'time zone' vicariously. How they speak and what they do in mortal time together affect the quality and meaning of life for all involved, in the moment and beyond."
"The critical underlying challenge for patients and caregivers in mortal time is maintaining a sense of hope," the authors say. "Conversation creates bridges between professional and family caregivers and people in mortal time." In my experience as a health care chaplain, patients and families want someone who will listen to them through serious illness. The conversational method recommended in this book has the capability to provide a therapeutic intervention that can offer health and well-being emotionally, socially and spiritually for people living with serious illness.
The authors suggest that "the fundamental task for anyone who would accompany a person in mortal time is becoming a companion," adding that it is through conversation that human beings become companions. They give guidance and education on the cost and risk to companionship and the challenges of being a companion to those who are seriously ill. In my opinion, this part of the book is too short. It left me wanting more information and conversational stories about companioning and the self-care of the caregiver. However, the guidelines offered were minimally informative and formative.
From my perspective, the approach the authors recommend is a compassionate style of communication that addresses the emotional and spiritual suffering patients may experience when living with both serious illness and the reality that life could end because of that illness. I have come to learn that through companioning conversations in mortal time with patients, they have the time to share personal beliefs about the meaning and purpose of their lives. This sharing is healing and provides quality of life for both patient and caregiver.
The book is short and a fast read. I recommend it for professional health care providers, para-professional caregivers, medical student interns, religious and spiritual leaders and other caregivers who provide support to those living with serious illness.
DIANE KRESLINS is spiritual care coordinator at the Lacks Cancer Center at Saint Mary's, Grand Rapids, Mich.
Excerpt from The Art of Conversation
The training and vocation of the professional caregiver allow for openness to talking about death as one way of sustaining hope, but without forcing the issue. A possible conversation opener initiated by a professional caregiver in this spirit is as follows: "Most people who are diagnosed with your illness have some worries about death and dying. We can talk about it whenever you want and leave it alone when you don't." Such a simple invitation is often met with relief since patients and caregivers alike can vacillate between being reluctant to speak of the possibility of death and being unable to speak of anything else. These are hard, necessary healing conversations that require courage and hope.
Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.