Hope at the End of Life: An Interview with Mona Hanford (From the Hope Initiative)

Mona Hanford is an end-of-life-care activist, teacher and writer. She chaired the conference “Journey of the Soul–Peace at Last,” which was held at the Washington National Cathedral. In this interview, she explains her work with the Hope Initiative, a program designed to offer support to those facing end-of-life decisions. Mona currently serves on the board of the Collegeville Institute.

What is the Hope Initiative, and what does it seek to do?

It’s a course we designed to provide a spiritual lifeline for caregivers and patients who are dealing with serious medical issues. It was my belief that people needed this kind of support as they were caring for family members during that long last chapter, so the Reverend Jamie Haith created a five-part series that includes talks on love, hope, peace, joy, and faith. People can freely access the course at our website, and while the talks do have a Christian focus, the material will help people from all faiths, because it’s really about God.

If they can think there’s peace at last, then there’s hope.

What do you do when the worst thing has happened to the family, when they are losing a loved one? Your aging father fell and broke his hip, and he’s 92. The doctors might want to put in a feeding tube, but he’s had dementia for the last five years and doesn’t even know who anybody is in the family. How do people make decisions in these kinds of situations? We urge people to focus on the next chapter. If they can think there’s peace at last, then there’s hope. That’s why we call this the Hope Initiative. Having God in our lives and having spiritual lifelines that attach us to God’s care are so important, because otherwise we are left with the grim reality of looking at the furnace or the dirt. I strongly believe that having a hope that extends beyond death has a significant impact on end-of-life decisions we face either for ourselves or our loved ones.

Why is it important to have this kind of support for people?

People are afraid to face the reality that we all have an expiration date.

So many people are in hospitals doing everything for family members, and by “everything,” I mean every procedure, every device, every medication, every test. People are afraid to face the reality that we all have an expiration date. But we do, and so the question then becomes, do we want a graceful exit or a prolonged and possibly painful one? We at Hope Initiative try to offer a big picture and a toolkit to help people make these difficult decisions—to support them and offer them a perspective on the importance of hope. We want to tell them, “Do not be afraid,” and give them confidence that they aren’t killing their father because they aren’t putting a feeding tube in when he’s 92 and very sick. What people of hope can admit is that his body is shutting down, and it might be better to let him depart life in a peaceful way. Medical technology frequently ends up being a hinderance rather than a help: people put hope in technology and medications rather than in God.

Do you think most people fear death?

hope initiativeYes. The bad news is that we all have to face the fact that death is here for each and every one of us. The Hope Initiative is built on the idea that one way to have a graceful exit is to trust God. We can try and block God’s time schedule by hooking our loved ones up to lots of machines, but once a person gets tied up to those machines and they are old, they rarely get untied. The person becomes a prisoner. But it doesn’t have to be like that. I remember reading an article by a doctor who works in an intensive care unit, and he said something like, “You know, if Martians landed and read what we did to patients in Intensive Care, they would say, ‘What did those patients do that was so horrible that you are torturing them?’”

I am also reminded of another story. A neighbor’s brother was a great surgeon and he got Stage IV cancer, and they tried a few things, but it was very serious. He decided that he wasn’t going to go through any more painful treatments. All of the doctors huddled around him as he was leaving the hospital, and they said, “What are you going to do?” He said, “I’m going home to drink champagne. Come visit me.”

Sometimes, it’s more important to make the most of our time here rather than get burned with radiation or poisoned with chemo. There are certainly times for that, but there also comes a time when people have had enough. I want them to feel that God is with them in that moment and will help guide them.

So one of the things that is very important to you is letting go gracefully?

We want to offer them spiritual lifelines and support as they make these difficult decisions

Yes. At times, what we try to do in hospitals and at the end of life is not appropriate, because of what it’s costing financially, and because of what it’s doing to the person and their loved ones. But navigating that reality can be difficult for many people. That’s why our work at Hope Initiative is so important—we want to offer them spiritual lifelines and support as they make these difficult decisions. We invite those who are facing this reality to be open to the possibility of a graceful exit, which means closing the loop with everybody you love and care about.

What does “closing the loop” look like?

Sharing memories, telling everyone you care about how important they were, saying, “I love you,” and “I’ll always be with you.” I personally want my exit line to be: “I’ll be fine, and you’ll be fine. We’re in God’s hands.”

Death is so much better with God’s love and mercy.

We have to trust that God will bring us to the other side, and we have to trust that those we leave behind will find their way with God’s help. Death is so much better with God’s love and mercy. Death need not be feared. That is what peace at last means.