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Sheila Armstrong—Helping hospice patients and their loved ones say good-bye

Sheila Armstrong of the X Theoretical Design Division began her Laboratory career in 1972 but in the 1990s took a break and trained to become a hospice volunteer.
October 7, 2014
Sheila Armstrong

Sheila Armstrong takes a well-deserved break among the trees.

“At the end, everyone wants to feel that they made a difference, so my visits with patients often include tape-recording stories about their life. If they have dementia, I try to not make judgments about what they understand or don’t understand and to find different ways to be with and listen to them. Everyone needs to be heard.”

Sheila Armstrong of the X Theoretical Design Division began her Laboratory career in October 1972 but took a break for two years during the 1990s to attend the Elisabeth Kübler-Ross Hospice Training Institute in El Rito, which was part of the Northern New Mexico College from about 1987 to 1996.

"Elisabeth Kübler-Ross was a Swiss-born American psychiatrist," Armstrong says, "whose 1969 book On Death and Dying is seen by many as the starting point of today's hospice movement. Dr. Kübler-Ross was appalled by the hospital treatment of patients who were dying."

After leaving the Hospice Training Institute, Armstrong returned to her full-time work at the Lab but began to volunteer for the hospice program of a local visiting nurses service in her spare time.

"I'm part of a larger hospice team," Armstrong explains, "that provides compassionate medical, psychological and spiritual end-of-life support to patients and their loved ones, usually in the dying person’s home. The team may consist of a doctor, nurses, nurses' aides, a social worker, a massage therapist, a music therapist and volunteers like me. I provide much-needed respites for family members or other personal caregivers, and I offer pre-death grief support to the patients and those close to them, because the process of saying good-bye—and celebrating the patient’s life—starts long before the final parting minutes."

Armstrong believes that savoring each moment of shared experience and maintaining a sense of joy are key to not only honoring patients’ continued presence but to helping them and their loved ones look back on the richness of the person’s life.

"At the end, everyone wants to feel that they made a difference," Armstrong says, "so my visits with patients often include tape-recording stories about their life. If they have dementia, I try to not make judgments about what they understand or don't understand and to find different ways to be with and listen to them. Everyone needs to be heard."

Graduating from the planet

Each patient and each situation is different for Armstrong, and the needs of the patient and the needs of the patient's loved ones are different as well. "In addition to the five stages of grief that Kübler-Ross proposed—denial, anger, bargaining, depression and acceptance—she believed that we all go through developmental stages during the course of our lives," Armstrong notes. "But people do so in different ways and at different speeds, with some not completing their evolution until their deathbed. The patient's loved ones also may experience sudden developmental spurts as they face the patient's changes, their own lives and the upcoming loss."

Armstrong has worked with some patients for as long as two years. "Patients can have a diagnosis that suggests that they'll be with us for only another three or six months, but they may be able to work through personal issues or issues that they have with people close to them and then are so relieved and at peace that they are in no rush to graduate from the planet. In any case, we always recommend that a hospice team is brought in quite early so that the patient and the patient's loved ones can benefit from the team's full support."

Armstrong is grateful to have been part of a team of teachers and graduates from the Elisabeth Kübler-Ross Hospice Training Institute, who helped Kübler-Ross before her death in 2004. "I had never met Dr. Kübler-Ross in person," Armstrong recalls, "but we attempted to 'work' with her by telephone during the last months of her life to give back to her the love she had shown in creating and developing the hospice program in El Rito."

blue butterfly To Armstrong, every person deserves to live fully until they die, and often times it is laughter and beauty that provide the most effective encouragements."The balance is where the joy is," Armstrong says. "Even in the midst of the worst moments, there are still things to feel good about. Funny things still happen, flowers still bloom and butterflies, which Kübler-Ross considered to symbolize the transformation that occurs at death, still delight us."


Armstrong works for the X Theoretical Design Division's Division Office.


Disclaimer: The views and opinions expressed in the Employee Spotlight articles are solely those of the featured employees and do not necessarily reflect the official policy or position of Los Alamos National Laboratory.

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