Compassionate Professionalism – End of Life Interpreting
by: Sandy Mahoney, CSC, MBA, BSBA - NIR Interpreter Coordinator
What is your client doing at this stage?
Your client is dying and probably knows it. They are experiencing a whole array of uncomfortable physical symptoms. They are drowsy and unresponsive some of the time and confused about time and place and even who is in the room with them. They have a decreased need for food and fluids. There may be a loss of bladder or bowel control. Their skin may be cool to the touch and their breathing is labored, shallow, irregular and noisy. They are confused about where they are and why they may be in a hospital. Their confusion leads to an inability to communicate at times.
What is your client feeling?
They may be experiencing feelings of remorse and worry about loss of control. They often feel they are losing their dignity and have become a burden. The may fear being abandoned or left alone as they approach death. Fear of dying and pain intensifies as their need for information about their situation increases. Your client may begin sharing practical concerns they have about their loved ones and what will happen to their family. Often this period is filled with a need for privacy countered by a need to connect and feel loved. Their thoughts race with fear of the unfinished work-legal, emotional and what they will leave behind for their legacy. All of this may be happening in a hospital room or client home where you are the only person in the room and your client desperately needs to process their feelings and thought
Hospice may become involved at home or at the hospital and provide some of the palliative care
This typically happens with 6 months or less to live. Their care shifts from cures to pain and symptom management and emotional support for the patient and the loved ones. This palliative care may take place in the home, the hospital; or in a hospice facility. The home becomes a mini hospital and a variety of Hospice staff and patient family members are on hand and may need interpreting services. At this stage, the family is providing most of the patient care with hospice supervision and emotional support. Planning for end of life intensifies and may include burial preparations, support for family members, friends and the patient himself who are grieving.
When are you ready to interpret these sacred situations?
You are being asked to interpret one of the most difficult situations your client and their family will face. It is a sacred moment for medical staff, clergy, family, friends and the patient. In a perfect world, everyone would know sign language and be able to participate directly in this process with difficult discussions and the emotional, religious and intellectual experiences happening to the client, however, that is almost never the situation even for family members. It is important to respect the boundaries which are very familiar in interpreting situations, but with a new perspective on how to navigate the hard moments. Death invites doubt, fear, anger, love, and unfinished work into this sacred space and because you’re able to bridge the communication barriers, you are invited….