Hospice Chaplaincy

There is a good article about Hospice Chaplaincy in the NYTimes today. It reminded me a lot of my very rewarding service as a Hospital Chaplain in NJ and then CT.

Apparently, the demand for Pastoral Care for patients is on the rise:

In the quarter-century since Medicare and some private insurers began picking up the bill for hospice care, it has become a common recourse for the terminally ill. With doctors, nurses, social workers and ample supplies of pain medication dispatched to their homes or nursing facilities in the final weeks and months, about 1.3 million Americans died last year in hospice care.

Spiritual counseling has always been an optional part of the service. But recently, the proportion of patients choosing to receive it, and the number of new chaplains entering the field to meet the need, have risen sharply.

Chaplain services in New York City have nearly doubled since 2004: About 65 percent of the city’s 4,000 hospice patients accept visits from chaplains today, compared with about 35 percent four years ago, according to the two major hospice providers, the Visiting Nurse Service of New York and Continuum Hospice Care.

Nationwide, a study released two weeks ago by the National Center for Health Statistics of the Centers for Disease Control set the proportion of patients accepting a chaplain’s care at 72 percent in one sampling, as compared with the 59 percent another group found in 2000. (source)

I think the author of the article was somewhat surprised how "non-religious" chaplaincy looks. Perhaps he was expecting more talk about "saving your soul" and Jesus around the bed sides of the dying. Perhaps he assumed this was a modern phenomenon, part of the secularization of North American culture. But actually this is just the result of one of the first rules of chaplaincy, learn the patient's language! In a parish setting you teach people to use a religious vocabulary, but at the bed side you just have to use what is at hand. Thus talk about a tree that needs to be cut down in the back yard becomes the way to talk about the patient's upcoming death.

Two things really struck me. One was this excellent example of pastoral care...

The chaplains listen, mainly; and sometimes, like jazz musicians, pick up themes and try to bring them to new levels.

“I talked to my mother yesterday,” said Robert, an 83-year-old man with Alzheimer’s, whose mother died in the 1960s.

“How was she?” said the chaplain, Tom Grannell. “You haven’t talked to her in a while.”

“Pretty good,” said Robert. “She agrees with my father: I’m laying here too long. Time to get back to work.”

“Your mother always believed in you,” said the chaplain.

“Yes, she did,” said Robert.

Just a text book example of good Pastoral Care. Showing someone something that they always knew to be true, but they just didn't know it.

I was also impressed with the end:

As he hurried along, checking phone messages, scanning a subway map, he was asked if the daily encounter with other people’s deaths was ever too much. He paused, and said a chaplain’s own distress and sense of vulnerability to death were, in a way, part of the job. “It is my first bond with my patient,” he said.

In the best of worlds, he said, a relationship based on that helps a patient make peace.

“But many times, this never happens,” he said. “We are there to be there. That is the point. It is my job to stay when there is no answer.”

Yep, this particular Chaplain is definitely the Real Deal! God Bless the Chaplains!

-t