'Working in the hospice at Christmas just feels right'

Karen, Chaplain and Spiritual Lead at Weston Hospicecare in North Somerset, is one of those people. She’s worked at the hospice every Christmas Day for the past 18 years, giving her time to be with patients and their families, and making their last Christmas together as special as possible. 

While many of us are enjoying quality time with our own families, Karen describes what it’s like for families at a hospice, where caring doesn’t stop for the holidays. 

“I currently work in Weston-super-Mare, in Somerset. It's not a particularly diverse community, unlike Leicester and Bedford where I’ve worked before. 

“It would be a joy to celebrate the different festivals together and mark these occasions as a community. When people are facing these major festivals in their tradition, and facing the death of a loved one, it’s obviously a difficult and emotional time.

"Where that person would usually be in the heart of a family celebration, now they are either very ill – or it will be the first celebration without a loved one.”

“In the lead up to Christmas, we offer remembrance services to families who've been bereaved, and that's a big part of the emotional build up to Christmas itself. We try and support people who are facing that big holiday for the first time without somebody they've loved.  

“As early as October, we’ll start getting responses back from people who are attending these services. Some of them will come to the hospice on Christmas Day to look at the Book of Remembrance or to sit in our chapel. There is also the possibility of people being able to put a message on the Christmas tree as well. Or they’ll come to put a message on the tree in the in the reception area.  

“So it's more than about just that particular day. It's the lead up to it that we're really conscious of trying to support people, particularly those who have been bereaved.  

“It sounds strange, but from October I hear patients say that they’d like it all to be over and done with because they don't want to spoil Christmas. 

“And actually, that's transferable across different faith groups and people without a faith. It's that sense of, ‘oh gosh, the celebration is looming, and I'm not going to ruin it all by dying the day before.’ 

“I think as a hospice chaplain, I'm really tuned into that sort of emotional aspect and the pressure that builds around the specific time itself.” 

“On Christmas Eve, we've got a tradition here of inviting people to come in and sing some carols. Our in-patient unit is decorated. But we’re always mindful that it has to be done thoughtfully.  

“It's not about going over the top, but just gently showing that Christmas is happening, it's going on out there in a big way. In the hospice we recognise it as well as we would if we were a hospice with different faith representation. We do that as well for other celebrations too. 

“I think for me the key thing is that there has to be a subtlety and an awareness that this is a tough time, that people are in a hospice. We've had deaths on Christmas Day, and on Christmas Eve. 

“But death doesn't really take much account of what day it is.  

“So from that the week leading up to Christmas, there's that tension. Will people who are patients in the unit make it through? They're talking to us about it: will they get home for a few hours? They'd like to welcome the family for Christmas dinner in the hospice; or they’d like to just kind of forget about it altogether. 

“So there's a lot of emotion, and a lot of questions.”

“I always work on the day itself. As a minister, I've done it all my life – it goes with the territory! It's always felt like the right thing to do. 

“I go in for at least a couple of hours, just to support the staff as much as anything. I’ll just spend time, either with patients, if they want that, or certainly to sit with the staff and just be there for support.  

“My family have always been used to me disappearing off to do services. They're all grown up now. It's just about making a difference.  

“Working on the day brings that layer of my own thoughts of people. My parents have died and I tend to think and reflect very much on my own life as well.  

“But it's a very emotionally charged time of year. I have to be careful around this myself, because it would be very easy to stay and get stuck in that bit. When I go home, on my 20 minute journey, I have to say, ‘OK, I've done that, I've got to put that off now and be present with my own family.’  

“It’s a tricky one, so I have to be wary of it, because sometimes emotions can catch you off guard.

“This is a difficult time as well for myself and the staff. We have all experienced bereavement at some time so we bring our own feelings and emotions with us to work at Christmas too.”

“On Christmas Day itself, I'm aware that I’m not sure what will be happening. I've had phone calls early on Christmas Day to say that somebody's died – the family are coming in and they'd like to see me, and they'd like to spend some time in in the Chapel. 

“It’s a day of nuances and subtlety…and very mixed emotions. 

“I usually arrive here at about 10:30am. The nurses of course have been on shift all through the night and from the early morning. They'll dress up a bit, they'll put fancy earrings in and maybe wear Christmas hats.  

“But it's about being subtle here, and mindful that we're in a hospice. And so we are careful not to go over the top – whilst trying to make it as joyful a day as possible.

"Our kitchen staff work incredibly hard to provide a lovely basket of goodies for every room...just little touches of special things which make such a difference and are really appreciated.

“They'll provide Christmas dinner for the families if that’s helpful, and if the patient is well enough, they can join their family meal. Other times there are patients who just want to be quietly left alone, and we respect that.

“There will be Christmas music playing gently in the background, but again, it's not too much.  

“A patient and their family may wish to have Holy Communion together or some prayers said to acknowledge Christmas, if they are people of faith. It’s always a joy to facilitate these requests.” 

“One of my most outstanding memories is of an elderly lady. This was on Christmas Eve, and we had carol singers in. I was going round the rooms and asked if anybody had any carols that they'd like to hear. This lady said she'd like Away in a Manger. She had no family at all.

“So I sat with her while they played it. She just gently sobbed her way through the carol, and I found myself shedding a few tears as well.

“At the end of it she said, ‘that was so wonderful. It reminded me of when I was a little girl.’

“She'd gone right back to those days, transported away from what was happening. She died overnight. I've always remembered that because it was just one of those moments that was beyond words."

“Important holidays, like Christmas, are mixed emotional times that I think a lot of people wrestle with – the staff as well as patients.  

“For staff, we all have our own thoughts and memories that may or may not be going on at Christmas…and then we also find ourselves supporting people through this particularly difficult point of their lives.  

“I think it will be true of people with faith and for those who don't. It's one of those times of year that just triggers a lot of emotion whether or not somebody acknowledges the Christian aspect of Christmas or not – it’s a time with a lot of emotional resonances for many people. 

“As social media puts so much pressure on us to have the ‘perfect’ Christmas, whatever that is, many people are experiencing a lot of suffering as they face loss and sadness. Hospices provide safe havens for patients and families to meet this emotional time. 

“As hospice staff we are able to support people through this and it continues to be a great privilege to do this work.”

Thank you to Karen for sharing her story.