Recently a client of mine was transferred to a skilled nursing facility after a long hospital stay. Although her condition had improved in the hospital she was still quite weak and unable to talk much. Her recovery and rehabilitation period at the new facility was expected to be several weeks. After I made sure she was settled into the new place I emailed her adult children to let them know how she was doing. I told them I would be stopping by her home the next day to pick up some of her own toiletries, clothes and small comforts from home. I asked them if they could suggest a few specific decorations or special items at the house that I could bring to spruce up her room and make it feel more like home. The oldest son replied and suggested I pick up several framed photos of his sister, "since mom likes her best". He then immediately sent an apology message for making a joke with such a serious situation. I thanked him for the comment and encouraged him and his siblings to use humor to lighten things up as they dealt with all the issues of their mother's condition. I believe humor is an important coping mechanism.
If you are dealing with a major medical condition it's a given that you and your caretakers and family will be under a lot of stress. Finding ways to appropriately deal with the inevitable stress is important. And just like with all things in life, humor can be a useful tool for defusing stressful situations.
Obviously it is important to remember that there are going to be many times when humor is not appropriate. This has less to do with the specifics of what is happening and more to do with the people involved. My client's children obviously knew each other well and humor was a regular part of their relationship. Essentially, he knew his audience. When talking with people involved in the care of someone's serious condition before you say anything, humorous or not, think about the impact of your words. When you know people well you have a much better idea of how they handle stress and how a lighthearted joke will make them feel. If you aren't sure if a comment will be upsetting, err on the side of caution.
If you are the patient or caregiver and you appreciate humor make sure to let others know that lighthearted joking is fine. One of the best ways to do this is to make a joke yourself. There was a moment in the very end stages of my husband's hospice care when something happened that was funny. My friends that were sitting with me were quiet and somber (as you would expect) and I made a joke about what had happened. The tension in the room was lifted for a brief moment. One of my friends immediately said "I'm so glad you said that, I desperately wanted to say it but didn't want to upset you!" The joke didn't change the difficulty of what was happening but for a few minutes we smiled and felt a tiny bit better. My friends needed my permission to use humor at such a somber time and my own joking opened up that door.
Also, if you do inadvertently offend a patient or caregiver with humor apologize immediately. Don't explain or justify of defend your intention, just apologize and move on. The feelings of the patient or caregivers trump yours in this particular circumstance. Even if humor and jokes were acceptable with them before remember that things change constantly with illness and part of the way you can show support is to follow their lead as things change.
As with all things in medicine, every patient and situation is unique. Use your best judgment to find times to use appropriate humor. It can be incredibly helpful and healing for everyone involved.
Story shared with permission.