"If you could have seen how his face changed," Rebecca Kaplin said of the hospice patient she was visiting. "He was having a very upsetting day. When I walked in and offered him a simple vase of flowers for his room, he went from a worried frown to the most wonderful smile."
Studies are showing what human nature has long known -- that flowers make us feel better. For patients recovering from abdominal surgery, having plants nearby has been associated with lower blood pressure and heart rate, reduced pain ratings, faster healing times and increased patient satisfaction, according to a recent study. Looking at the overall affect of a patient's environment on his or her health, healing and well-being, a study by the Cleveland Clinic says, "The environment of care has been shown to reduce the burden of disease and shorten healing time across multiple medical conditions."
The focus in hospice is not on cure but on relieving symptoms such as pain, nausea and fatigue, and on creating the best possible quality of life in one's final days. Flowers, along with attention to other details of environment, surely play a role. "For a patient nearing end of life, their world has very much shrunk," says Rebecca, who is a hospice volunteer and coordinator of a flowers program at the Visiting Nurse Service of New York Haven Hospice Specialty Care Unit. "Think about your world being your bed and the few things you have around you. Flowers add to that world."
Opening the Spigot of Conversation
Rebecca finds that when she delivers flowers door to door at Haven (which provides short-term, acute inpatient care for patients in home hospice), bouquets serve as conversation starters. Even if the patient is no longer able to talk, the exchange of flowers often unlocks an exchange of memories and interactions among family members and visitors, as well as with hospice staff.
"Oh, Dad, this reminds me of that huge sunflower you grew," went the beginnings of one family's reflection. "Do you remember that picture, with you standing under it?" Another daughter, whose mother was no longer conscious, told Rebecca all about her mother's lifelong passion for growing roses. "People get tearful," Rebecca recounts. "Flowers are a vehicle to opening people up on an emotional level and getting them talking about meaningful times."
Recently, with the help of flowers, Rebecca made a deep connection with a woman who flew in to New York from California to visit a beloved cousin in Haven. Arriving straight from the airport, the visitor had had no time to buy a gift but so wanted to offer her cousin a token of her love. She saw Rebecca's flower cart and was moved to learn that she could select an arrangement (not for a fee, but as a gesture). "She collapsed into my arms sobbing," Rebecca says. "She was so grateful that she could offer him these flowers. But what she also wanted was a chance to talk about this cousin, how important he was to her, how broken up she was that he was dying. We established this very human connection."
The California visitor stayed for about a week, until her cousin died, and Rebecca checked on them, and the flowers, each time she was in the unit. "We made this little connection in time and space," says Rebecca, who has just been named VNSNY's Hospice Volunteer of the Year. "Who knows what she might do with that experience, how it might change how she responds to another person. It's like dropping a rock in the pond -- you never know where the ripples will lead."
Do It Yourself
Rebecca offers some tips for offering flowers to loved ones, friends and patients in their final days:
1. If possible and if the patient is cognizant, offer a choice. There are, after all, very few choices hospice patients get to make at the end of life. If you are arriving with flowers in hand, you can still offer a choice: By the bedside or in the window?
2. Keep it simple. A few blooms should do it. The goal is more zen than extravaganza. The environment in the final weeks and days is about essential elements of beauty and serenity.
3. Refresh the flowers. They are there to uplift. Remove any aging blooms before wilt sets in. Change the water. Be content with plain greens, too, if they outlast the blossoms.
4. Get the conversation -- and memories -- started, whether prompting reflections of spring days spent gardening or the flowered wallpaper in a childhood home.
Not a Cure, But a Connection
"They're not going to cure anyone; they're a small thing," Rebecca says about the role flowers can play in end-of-life care. "But small acts of kindness change the feeling for people. Find what you love and give it to others."
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