The Power of Presence
April 12, 2019 / Reid M. Jacobs, APHSW-C, MSW
Presence, or simply the act of being with someone, is a powerful tool when caring for someone with a life-limiting illness. It seems overly simplistic, but it can have a profound, lasting effect. I had been told that the first year I started working in hospice care. I wasn’t sure I believed it though. How can just being with someone, not doing anything, have any meaningful effect beyond feeling awkward. Because just being feels incredibly awkward.
Still, I had been told to do this because there are times when there is nothing more to be done. That’s what happens with life-limiting illness and near the end of life, making presence the best course of action. So, when I’d go see Mr. Smith, a widowed man with end-stage dementia who lived in a secure memory care unit, I would just sit with him. I felt so uncomfortable. Thoughts raced through my mind, trying to come up with something, anything to engage with him. Perhaps someone else could have come up with something brilliant. I could not. And I continued to sit.
Around that time, I was diagnosed with Non-Hodgkin’s Lymphoma. It was stage IV and had spread to lymph nodes throughout my body and had begun to invade my bone marrow. During treatment, I developed severe pain. The worst pain I’ve ever experienced. A friend, Joe, came by to check on me after work one day. He found me in bed, curled into a ball, clutching my ribs where the pain was most severe. I’d taken the opioid pain medications as prescribed, but after an hour, there was still no relief.
Joe called the doctor, but it was afterhours. All he could do was leave a message and wait for a call back. In the meantime, he pulled up a chair and sat next to the bed. He tried talking with me. I don’t remember the topic because I was in too much pain to hear much of anything he said, much less engage in conversation. He eventually just leaned back into the chair and sat as we both waited for the meds to work or the doctor to call back. There was nothing more to be said or done.
This could have been a horrible evening of suffering. The memory of severe pain could haunt me. But I happen to recall this as one of the most precious memories of my life. I don’t remember the pain. I remember that I was in pain. I remember the sensation of my ribs cracking, but I don’t actually remember the pain itself. I don’t recall a sense of suffering. Instead, I remember an immeasurable sense of compassion and comfort. I was no longer a cancer patient in a pain crisis. I was a person being honored, and I was not alone. Joe met with me and stayed with me in the midst of my horrible experience when there was nothing more to be done. He stayed with me through the storm and held the pain with me.
I don’t recall how the evening ended. Perhaps the doctor called back and gave new orders for the medication. Perhaps the pain went away on its own. Perhaps something else entirely happened. I truly don’t recall. All I remember is a compassionate presence and the fact that I was not alone.
Years later, after the chemo, after achieving remission, I asked Joe about that night. He told me how helpless, useless and awkward he felt. He had no meds to give and he couldn’t do anything to make the doctor call back any quicker. He couldn’t come up with anything to say that would make the situation any better. All he could do was sit and wait. As it turns out, that’s all he had to do. I explained how his presence relieved the pain in a way that no drug ever could, how his powerlessness had transformed into one of the most profound and meaningful moments of my life. Joe found this hard to believe, though he was glad to hear that his presence was not in vain.
Thinking back to Mr. Smith, my discomfort may have had a similar meaning for him, as Joe’s had for me, though Mr. Smith was never able to convey this to me. However, after several “unproductive” visits with Mr. Smith, he looked over to me and said, “you’re kinda nice.” It’s the most I ever heard him talk. It seemed like a nothing response at the time, but maybe, just maybe, my presence meant more than I knew.
Faith and Hope Hospice
We firmly believe that the internet should be available and accessible to anyone, and are committed to providing a website that is accessible to the widest possible audience, regardless of circumstance and ability.
To fulfill this, we aim to adhere as strictly as possible to the World Wide Web Consortium’s (W3C) Web Content Accessibility Guidelines 2.1 (WCAG 2.1) at the AA level. These guidelines explain how to make web content accessible to people with a wide array of disabilities. Complying with those guidelines helps us ensure that the website is accessible to all people: blind people, people with motor impairments, visual impairment, cognitive disabilities, and more.
This website utilizes various technologies that are meant to make it as accessible as possible at all times. We utilize an accessibility interface that allows persons with specific disabilities to adjust the website’s UI (user interface) and design it to their personal needs.
Additionally, the website utilizes an AI-based application that runs in the background and optimizes its accessibility level constantly. This application remediates the website’s HTML, adapts Its functionality and behavior for screen-readers used by the blind users, and for keyboard functions used by individuals with motor impairments.
If you’ve found a malfunction or have ideas for improvement, we’ll be happy to hear from you. You can reach out to the website’s operators by using the following email
Our website implements the ARIA attributes (Accessible Rich Internet Applications) technique, alongside various different behavioral changes, to ensure blind users visiting with screen-readers are able to read, comprehend, and enjoy the website’s functions. As soon as a user with a screen-reader enters your site, they immediately receive a prompt to enter the Screen-Reader Profile so they can browse and operate your site effectively. Here’s how our website covers some of the most important screen-reader requirements, alongside console screenshots of code examples:
Screen-reader optimization: we run a background process that learns the website’s components from top to bottom, to ensure ongoing compliance even when updating the website. In this process, we provide screen-readers with meaningful data using the ARIA set of attributes. For example, we provide accurate form labels; descriptions for actionable icons (social media icons, search icons, cart icons, etc.); validation guidance for form inputs; element roles such as buttons, menus, modal dialogues (popups), and others. Additionally, the background process scans all the website’s images and provides an accurate and meaningful image-object-recognition-based description as an ALT (alternate text) tag for images that are not described. It will also extract texts that are embedded within the image, using an OCR (optical character recognition) technology. To turn on screen-reader adjustments at any time, users need only to press the Alt+1 keyboard combination. Screen-reader users also get automatic announcements to turn the Screen-reader mode on as soon as they enter the website.
These adjustments are compatible with all popular screen readers, including JAWS and NVDA.
Keyboard navigation optimization: The background process also adjusts the website’s HTML, and adds various behaviors using JavaScript code to make the website operable by the keyboard. This includes the ability to navigate the website using the Tab and Shift+Tab keys, operate dropdowns with the arrow keys, close them with Esc, trigger buttons and links using the Enter key, navigate between radio and checkbox elements using the arrow keys, and fill them in with the Spacebar or Enter key.Additionally, keyboard users will find quick-navigation and content-skip menus, available at any time by clicking Alt+1, or as the first elements of the site while navigating with the keyboard. The background process also handles triggered popups by moving the keyboard focus towards them as soon as they appear, and not allow the focus drift outside it.
Users can also use shortcuts such as “M” (menus), “H” (headings), “F” (forms), “B” (buttons), and “G” (graphics) to jump to specific elements.
We aim to support the widest array of browsers and assistive technologies as possible, so our users can choose the best fitting tools for them, with as few limitations as possible. Therefore, we have worked very hard to be able to support all major systems that comprise over 95% of the user market share including Google Chrome, Mozilla Firefox, Apple Safari, Opera and Microsoft Edge, JAWS and NVDA (screen readers).
Despite our very best efforts to allow anybody to adjust the website to their needs. There may still be pages or sections that are not fully accessible, are in the process of becoming accessible, or are lacking an adequate technological solution to make them accessible. Still, we are continually improving our accessibility, adding, updating and improving its options and features, and developing and adopting new technologies. All this is meant to reach the optimal level of accessibility, following technological advancements. For any assistance, please reach out to