Inspirational Stories

Christmas a Bittersweet Time for the Terminally Ill and their Families

Christmas. It evokes images of goodwill, family time, sharing and giving, but even for the average family it can also be a stressful time. It is even more difficult when a family member is terminally ill. Lucy Meldrum is a Hospice Community nurse. She shares the highs and lows of working with patients who are terminally ill during the festive season.

'It is a bittersweet time,' says Lucy. 'There is normally a lot of storytelling on Christmas day - and even more so when people have the knowledge this is the last Christmas. I think families put in a huge effort on Christmas day to make it work, but to also accept the bitter sweetness of the last Christmas with their loved one.'

'They make the best day they can for the person, but as you can imagine the build up is extremely stressful. You are expected to do those normal Christmassy things. You are expected to put your decorations up. You are expected to socialise with people. You are expected to do normal things under completely abnormal circumstances. Part of my job at this time of the year is going in and saying that it is okay.'

Like other Hospice nurses, Lucy works over the Christmas break to make families feel supported. She describes their role as making the day as 'mellow as we can make it.'

'We keep things patted down a wee bit. Even the most anxious and most stressed out families will attempt to do that on Christmas day as well. If I see people on Christmas Day, I give them more time than I normally would. I acknowledge that Christmas Day is not the easiest day and I encourage families to do as few big things as possible. I will also tell them on the lead up to Christmas to keep it simple. You might not want to have the big flash Christmas dinner at home. You might want to go somewhere else. Families might split up and go out and then go back to the patient's house. Or the whole bunch of them might choose to share this last Christmas at home. And each different situation will have its own stresses.'

Inside the In Patient Unit at Hospice, Lucy joins the In Patient team who go all out to create a festive atmosphere. Lucy enjoys sharing Christmas lunch with patients and their families when she works Christmas Day.

'Working Christmas Day is not as bad as people would think. When you go to work the other staff try to make your day as easy as possible. We often have lunch in the In Patient Unit - and they put on the most incredibly beautiful Christmas lunch. It is quite lovely. We create a festive atmosphere in the Unit.'

'If we are on the road, we go out and see our patients and it is a different ball game. If someone is really sick the day is tinged with sadness, but the family will do their very best to make it a good day.'

'There is something about Christmas. There is an enormous build up in society and then there is that falling off. In my experience the closer you get to Christmas the more stressful it becomes because you have people saying is he or she going to make it? What is going to happen if they don't make it? How is it going to make me feel? What will we do? And then you have people having their first Christmas ever without a relative. It is so sad. And then there are patients who get through Christmas but then die in late December or over January. And I think it is because the patient has been hanging on to get through Christmas. I think if there are any reserves left, people use every bit up to get through.

'You can't ignore that powerful psychological component, or spiritual component that keeps people going at a time like Christmas. Physically these patients should be dying or dead, but spiritually and psychologically they drag themselves through. It is extremely powerful.'

Hospice nurses provide crucial support for terminally ill patients and their families every day of the year, but Christmas is a time when patients and families need even more support.

'What we try to do for patients, especially for the people in the Unit, is making Christmas Day special for them. For a dying patient it is a day of reflection. They will be thinking this is my last Christmas Day. I won't be here next year and they acknowledge that. How does it make me feel? Families usually cry. I think what we work for is not having people on their own, and we support the families and stop them from tipping over. We get more call outs and we spend much of our time helping people with emotional support over Christmas.

'It is a bittersweet time.'

Karen McMillan