Personal reflections on compassionate practice toward relatives

Showing compassion to patients and their relatives is a fundamental component of the palliative and endof-life care provided by multidisciplinary teams. Patients can clearly describe when compassion was present in or absent from their care (Bramley & Matiti, 2014), and patients and their families say that how they are listened to and cared for matters just as much as the quality of the healthcare they receive (Bray et al., 2014; Lown et al., 2011; Schout et al., 2009). “Compassion” has been defined as “a virtuous response that seeks to address the suffering and needs of a person through relational understanding and action” (Sinclair et al., 2016, p. 193). The focus on taking action is what differentiates compassion from empathy, sympathy, and other virtues (Papadopoulos & Ali, 2016; Sinclair et al., 2016). As practitioners of palliative care, we understand that compassion is not just about caring; it is also about acting to relieve the suffering of others. In this essay, we reflect on the skills needed to show more compassion to relatives. We draw on our personal experiences and offer insights into our clinical practice. We describe our experience of caring compassionately and with intention for family members who seek meaning at the time of their relative’s death. We have a responsibility to listen and understand that families’ personal beliefs and practices shape and form their search for meaning at such times (Saunders, 1988). Palliative care revolves around nonjudgmental, compassionate care. Recently, I (SL) delivered endof-life care that focused on a grieving family’s comfort and concern. I first met Mary, an elderly AfricanAmerican woman, and her family as the weekend hospice triage nurse. Shortly after I arrived, I stood with her family as Mary took her last breath. Tears, as an expected reaction to passing, expressed the family’s intense grief. Initially, it seemed they didn’t even notice my presence. After some time, I encouraged them to share some cherished memories about Mary. They were quiet at first, but I said that I was interested, and then they smiled and began to tell stories, laughing through their tears. This seemed to give them comfort, and they seemed more accepting of Mary’s death. Then they handed me about a dozen cell phones and asked if I would take pictures of each of them with Mary. In turn, each family member posed on the bed with Mary, placing their arms around her while smiling and/or waving at the camera. Some of the children were also included in the photos. For me, this was an unusual request, and I was initially unsure as to how to respond, but I realized it was not my place to judge family traditions or customs. No one explained the desire to take photos, but it seemed natural to the family. Compassionate care required me to respond to their needs at the time and do whatever they needed to assist with their grieving process, so I accepted the role as photographer. I felt honored that they asked me to be the photographer, as they could have taken the snapshots themselves and dismissed me as an outsider. Including me affirmed that my actions had contributed to a valued relationship—I was no longer merely a professional but someone who shared their grief. After seeing how important the photos were to the family as they recorded the last time they would see their loved one, it was obvious this was an integral part of their grieving. By taking photos for each family member, I supported how they needed to say goodbye to their Address correspondence to: Anne Hofmeyer, School of Nursing and Midwifery, Faculty of Health Sciences, University of South Australia, GPO Box 2471, Adelaide 5001, Australia. E-mail: anne.hofmeyer@unisa.edu. au. Palliative and Supportive Care (2017), 15, 506–508. # Cambridge University Press, 2016 1478-9515/16 doi:10.1017/S1478951516000766