How can you joke at a time like this? Making light of dying
by Patty Ayers
Laughter is the shortest distance between two people – Victor Borge
It’s never easy when you’re in the middle of a visit with a patient and their family and the patient makes a joke about their illness or about dying. The part that’s not so easy is when the family member or caregiver doesn’t seem to find it as funny as the patient. Has this ever happened to you? How did you react?
Even though it may seem like joking and laughter is in bad taste or insensitive, sometimes it provides some surprising benefits. As we all know, laughter can provide a welcome break from the stress of the situation and may help bring people together. Sometimes it can even provide a new perspective on what’s happening. In the late 1970s Norman Cousins studied the physiological effects of laughter and believed that a person’s circulatory, sympathetic nervous system and respiratory system could be improved. Since Cousin’s research, many still study the effects of laughter and believe that it may have the ability to lower blood pressure, boost immunity and raise pain tolerance (Borod, 2006).
It’s been my experience that playful teasing and joking can sometimes help me make a connection with the patient and family, but you need to read the situation and the personalities involved first to see if they are receptive to it. The one thing about working in hospice and doing this job is that we try to see the patient as a person first and not define them by their disease. I think many appreciate this because patients say that family and friends often treat them differently when they are put on hospice, but with members of the hospice team they can be themselves. About two years ago I had one patient, “Mary”, with whom I was having a very difficult time because she was incredibly fearful and very particular about who she would let in. It wasn’t until we starting joking around about “my perfect boyfriend” that she felt comfortable enough to let me in.
The other day I was facilitating a cancer support group and I asked the members if a sense of humor or laughter helped them through the rough times. One member said that while she was having chemotherapy she formed a friendship with another woman who had her chemotherapy at the same time. The two would laugh and joke with each other during that three hours which made the time go by much quicker. She also pointed out that this made her husband feel comforted by knowing that she could laugh while going through her treatments. Another member pointed out that the use of humor during those embarrassing situations or issues made it not so serious or embarrassing.
Caregivers—both family and professional hospice caregivers—can and should use humor as a coping tool. I think it’s imperative that we do. I remember when I first started working in hospice, the one thing I loved and still love is the sense of humor among the team. Some weeks we may have a caseload of very difficult cases and the ability to let off some stress by joking around or finding humor in some situations is so very helpful for not only us but the patient and their family members as well. Family caregivers may benefit from sharing humor with their loved one, if that’s a good fit, or by releasing stress through humor when they are taking a break from caregiving. Joke with a friend, watch a funny movie, read some Dave Barry essays, and let yourself lighten the load.
Borad, M.,(2006). SMILES – Toward a Better Laughter Life: A Model for Introducing Humor in the Palliative Care Setting, Journal of Cancer Education, 21, 1, 31-33.