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“The present moment, if you think about it, is the only time there is. No matter what time it is, it is always now.” – Marianne Williamson

The Importance of Being Present When Delivering Hospice Care

Delivering hospice care can be difficult. Clinicians spend their days (and nights) dealing with patients and families going through an intensely powerful and difficult experience. They have to be everything at all times, a health care provider, an educator, a counselor. Add in a heavy caseload, a slew of regulations, documentation needs, continuing education, as well as having family, kids, and personal needs and it is little wonder that burnout is a constant problem.

Even before getting to burnout though, there is a downward spiral of depreciating returns caused by stress and anxiety that impacts the care provider. No matter how hard someone tries to hide their internal monologue, that stress can be felt by patients and their loved ones. While it may not change the actual health care provided, such as how the clinician manages the patient’s pain, whether it shows up as being curt or as disinterest, the interpersonal relationship between caregiver and their patients and families can have far reaching affects.

Many of the CAHPS survey questions, such as:

  • Communication with family
  • Treating patient with respect
  • Emotional & spiritual support
  • Training family to care for patient
  • Rating of this hospice
  • Willing to recommend this hospice

are directly connected to how the care team interacts with patients and families

Working towards being present, increasing mindfulness, will help create better results for your patients and their families as well as being an important tool for the clinicians emotional and mental well-being. Practicing mindfulness will deliver positive returns for everything from referrals to testimonials, reviews, CAHPS scores as well as spilling over to increasing teams’ morale.

However, being present is often misunderstood and is counter-intuitive challenge for someone who is present physically but struggling to keep their schedules and tasks on track while juggling their internal stresses.

4 tips for developing mindfulness in hospice care

Tip #1. Hack Your Brain

Two simple physical actions before you walk through a patient’s door can trick, and train, your brain into mindfulness; breathing and smiling.

Take a beat before you meet and remind yourself to breath. It can sound funny, we breathe all the time. If we try not to breathe, our body will shut down, we’ll pass out, and unconsciously start breathing. What we’re talking about here though is mindful breathing. Develop the practice of taking a few consciously deep breaths before walking in to meet your patient.

Once you’ve taken a few deep breaths, take a moment to force a smile. The simple act of smiling creates an internal response that relieves stress and generates positive feelings.

These two simple acts, while only taking seconds, when done consciously will deliver outsized returns for reducing stress and developing mindfulness.

Tip #2. Go Slow

It can be tough to ‘go slow’ when you’re thinking about the patient you just left, the patients you still need to see, and everything else that just has to get done.

Start off with a check-in before starting tasks. Don’t meet a patient and jump right into telling them what you’re going to do let alone rushing to start delivering care. 1st, ask the patient and family members how they are doing and listen to their responses. Only after you’ve heard what they have to say and are engaged should you then turn to covering your agenda.

The key here is balance. The conversation shouldn’t drag on to the point that it increases stress because you have to perform your tasks. But taking two- or three-minutes right at the start to listen while not doing anything else will create the impression that what they have to say is important while grounding you in the moment.

You’ll find that if you start slow, performing the job of providing care will become more effective & efficient.

Tip #3. Stop, Ask, Listen

Many clinicians develop a habit of talking throughout the care process, delivering a monologue that includes asking questions. But the goal of this monologue is often about filling the silence while working rather than developing connections.

Don’t just talk mindlessly while performing tasks. Periodically stop and take a moment in between tasks to ask and listen while not doing anything else. Multi-tasking is not a real thing. Multi-tasking is a way of describing the ability to quickly switch from one thing to another.

If the entire conversation is taking place while actively delivering care, it isn’t a conversation.

Tip #4. Get Rid of Distractions

If, for example, you’re in a patient’s bedroom and the tv is on, ask if you can turn it down or even better, off.

Turn off your phone. Unless it’s an emergency, you’re not going to take most calls that come through when you’re with a patient. Despite the lack of urgency, when your phone rings or buzzes it’s hard to not stop and take it out and take a look at it. That distraction derails your ability to be present. Turn it off and give your attention to the patient and family in front of you.


Like any skill, mindfullness or being present, can be learned and improved upon with practice and effort. Incorporating these tips will help develop these skills and create better results for your patients, their families, and clinicians. Practicing mindfulness will deliver positive returns for everything from referrals to testimonials, reviews, CAHPS scores as well as spilling over to increasing teams’ morale.

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