Interview with Phil Carpenter, MDiv
Phil Carpenter, MDiv, Program Officer & Bereavement Specialist, HFA
Q. Tell us about your background, and how you ended up working in hospice?
A. I received a degree in music education, and my intention was to pursue an advanced degree in music. But I had been exploring theology at the same time through parish-based work experience, and realized that I was searching in another direction. So I switched my master studies to theology, with an emphasis on pastoral care and counseling. This was a great decision for me—I gravitated to a profession that I felt had meaning and where I knew I could help people.
I worked eight years in a church-based setting—education, youth ministry, hospital visits-- with the common thread being pastoral care and counseling. One great influence on me was my studies with Dr. Wayne Oates, a well-known theologian who also had a medical degree. His work and guidance were key in helping me understand the connection between pastoral care and research. Additional work with Andy Lester and Wade Rowatt rounded out a solid background in this field of study.
While in seminary, my wife was involved with the development of a new, state-of-the-art continuing care retirement community. Because of her work I spent a lot of time with the elderly population, and found that I truly enjoyed the work. And of course end-of-life issues were always there; many of the residents declined and eventually died in the facility. I also worked on some projects with a local hospice while I was working at a church in Winston-Salem, NC. So throughout my career, this thread continued.
As many people do, I took a “detour” in my professional life for a while and worked in corporate administration at Pepsi-Cola! This job eventually took me to Washington, DC, but I realized that it was ultimately not the right match. I knew I was not ready to go back to parish-based ministry, but someone I knew put me in touch with what was then Hospice of Prince George’s County, and I began work with them as a Bereavement Counselor.
Eventually this hospice became part of Capital Hospice (now Capital Caring). I continued to do bereavement work with them, but I also expanded to supervising the Social Workers, Bereavement Counselors, Chaplains, and Volunteers.
Q. What did you enjoy most about your work at Capital?
A. I loved being an advocate for the hospice staff. My work gave me a great opportunity to help ensure that all of the team members’ voices were heard. Of course, the medical issues facing a hospice patient and their loved ones are always paramount. But often, it became clear that the main concerns that needed to be addressed were spiritual ones, or even financial—the house was too cold for the patient to be comfortable, because the family couldn’t afford the gas bill. I really enjoyed supporting and representing the full range of hospice team members, and working together to see how that team could support the patient and family.
Q. What challenges did you find in this work with hospice team members?
A. I learned a great deal about hospice from an administrative standpoint. While the main focus is always the patient, there are still administrative tasks that are essential for the staff—screening and hiring, budget management, evaluations, etc. Without good administrative support, the potential for burn-out is enormous—and it’s critical to avoid that situation before it happens. Sometimes we would bring in outside support services; other times we would creatively utilize the expertise of our own staff.
Another interesting challenge for me was moving from a small, independent hospice program to a larger program covering a wider geographic area. Capital provides services in Washington D.C., Maryland and Virginia—so that’s three different jurisdictions, three different sets of statutes and laws. More importantly, there is a great deal of diversity among the communities and neighborhoods we served. So the challenge was always balancing consistency in terms of how the teams were treated, yet giving the teams the ability to respond appropriately to the specific needs of their own community.
Q. You bring an interesting perspective to this work, having served in parish-based ministry for a number of years. How did that work prepare you to work with those who are dying?
A. Actually, I was startled to find how many pastors I encountered, both during my time in ministry and my time in hospice, who were so uncomfortable with death and dying! There is just not enough emphasis given to end-of-life issues in ministry training, even at the Master’s degree level, especially given that pastors are following certain academic “tracks.” I understand why people focus on certain areas of the ministry—but what a mistake, to turn out well-trained preachers or researchers who are still so profoundly inexperienced and uncomfortable visiting hospitals, going to patients’ bedsides, and offering that comforting presence to those who are facing death.
Q. After your work at Capital, you moved into another field that makes many people uncomfortable—pediatric palliative care. Tell us more about that transition.
A. I really enjoyed my work at Capital, but after about 9 years was ready for some new challenges. Two of my colleagues, Dr. Carlos Gomez and Susan Rogers, had a keen interest in how to provide better care and make the dying experience better for children, based in part on some experiences at Capital. Their commitment and passion around this issue propelled them to start a new organization—the District of Columbia Pediatric Palliative Care Collaboration (DCPPCC). They developed a new collaborative model and invited me to join the staff.
It was a fun, challenging – and sometimes overwhelming - place to work! We did not provide direct services, but did offer education, advocacy, curriculum development and training; it was a very new model. Working there provided me the opportunity not only to learn but also to speak at both national and international conferences on the subject of pediatric palliative care. I continued to be active in grief-related issues, training area healthcare professionals on the needs of grieving families, especially as those needs related to the decline and death of children.
While it was a wonderful experience, I ultimately realized I was ready to go back into the hospice field, and was so pleased to be able to join the staff of HFA in April of this year.
Q. What are you doing with HFA, and how does your work differ from your time in hospice setting?
A. While I’m not, of course, providing any direct care, I do still feel lucky to work with hospice professionals each day by designing educational programs, developing resources, and offering support in their daily work. HFA’s type of programs allow a certain freedom that I appreciate—a freedom to develop new resources or ideas based on a need from a professional, or a question from a family member that reminds us of a need for a certain type of information. For instance, based on both my work at Capital and some research I’ve been doing, I realize what resources might be lacking for hospice volunteer training, especially for those volunteers who work with bereavement counselors or spiritual care professionals. I’m learning more about the materials that are – and are not – available, and how HFA can help fill in some of those gaps.
Part of my role is to answer phone and email questions from both professionals and consumers; we generally answer more than 30 questions/ month. When you pick up the phone or click on that email, you never know who is calling or what their question will be. It has been reassuring to remember that it’s okay to say, “That’s a great question—and I don’t know the answer to that right now!” To listen and to be honest about what I do or do not know; and then, of course, to always ensure the person that I will find answers and resources and get back to them as soon as possible.
Q. You spent a lot of time in your previous positions working in the communities you serve. What opportunities will you have to do that with HFA?
A. I’m excited that I have opportunities to help HFA become more visible within the local communities of DC, Maryland and Virginia. Whether it is participation in local end-of-life oriented consortiums or committees, service on boards, or presentations at various governmental or other business agencies, I welcome the chance to talk about the innovative work that HFA does, and how we support and complement the work of local hospices all across the country. And, returning to my roots in pastoral care and counseling, I am privileged to collaborate with hospices and other organizations in regards to providing the needed bereavement services in times of local, regional or national disasters. In this role I get to pull together much of my training and experience and use it to be of service and support for those in need during a difficult time of grief and loss. It is truly an honor to work in this capacity.
And, on a broader scale, I am pleased to represent HFA at conferences where I not only share our products and materials but also engage conference attendees one-on-one in discussions about the work they are doing and brainstorm about how HFA might complement their professional interaction with the public. For example, I recently represented HFA at the ADEC (Association for Death Education and Counseling) meeting in Miami. That provided an great way to connect with an international audience (at the first session I sat between groups from Canada and Australia) and learn a bit from them about their end-of-life care needs, thus giving me (and HFA) a fresh perspective on what we are doing and why it matters – and ideally what we can learn from folks from all parts of the country and world to improve our services. It was also uplifting and encouraging to hear ideas discussed in the sessions, and learn the outcomes of the newest research being conducted.
Q. Are you working on HFA’s newest fall educational program, the “New Perspectives” series?
A. Yes, I am! The cutting-edge work that HFA is doing in grief and bereavement was always of great interest to me when I was working in hospice and palliative care, so I am pleased to be involved in the new fall program, “Beyond Kubler-Ross: New Perspectives on Death, Dying and Grief.” There is so much information out there on grief—and so much misinformation! The program is a great opportunity to explore some of the pioneering thinking around grief and bereavement, as well as a chance for professionals to examine some of the newest thinking and models, and how to apply that to their everyday work. Having had hands-on experience in hospice care, I know how important it is to bridge that gap between research and practice, and think this program will be a great way to do that.
In this fashion, and in others that we are continuing to discuss and research, we are seeking to create those services and products that will meet needs that have previously been unaddressed.
Q. What advice do you remember as being important for hospice professionals in their daily challenge to “bridge that gap”—to serve patients and families, keep up with the latest thinking in the field, and somehow still have time to care for themselves?
I always used the image of a worn-out sponge—if you squeeze it too much without replenishing, it will eventually dry up! And once you have gotten to that point professionally, you cannot be effective as a caregiver. But you always want to be sure that you are “filling up” with the best information out there.
In my own work, I always remind myself about the lessons I learned from “Miss Mary.” When I was working at a small church in Kentucky, I heard again and again about Miss Mary—how she’d visit someone who was sick or in need, and after she came by how it all somehow seemed better. I sought her out to learn more about her “secret.” She had no idea, she said, why she had this reputation. “This is what I do,” she said. “I go to the home, I walk in, and I sit there.” I pursued my questioning—“but what is it that you say that is so meaningful, so helpful?” She looked at me, surprised, and just said, “Oh I wouldn’t know what to say. I just sit there. And I leave when it seems right to leave.”
That presence, that genuine concern and ability to listen when people are in need—that had an impact in a way that an academic “model” or “theory” might never have. Hospice professionals and others who work with the dying should always challenge themselves to really look at what they say, what they do—challenge themselves to think about what is offered to patients and families every day, and be open to new ideas and new possibilities that can bring both the newest information and the most compassionate presence possible. That will make this work meaningful and purposeful, and will keep that sponge from going dry.
