spirituality

Pastoral Care and Advanced Dementia

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***update 5/7/20: I was recently forwarded an article noting how certain natural remedies, including tumeric, may have positive benefits for those suffering from Alzheimer’s disease and Parkinson’s disease. If you’re interested you can find it here. This is not an endorsement, just a passing along of information some may find beneficial.***

When I first started chaplaincy, I would walk out the door with bible in hand and a planned reading for the day for all my patients.

That lasted about two days.

The reason was not that I gave up or got lazy, but rather that I quickly found that the majority of the patients I saw didn’t benefit from it because they simply couldn’t understand what I was doing due to advanced dementia of some kind. Even if end-stage dementia was not their primary diagnosis, I’d say at least 2/3rds of the people I saw suffered from this. Many could communicate and talk with me, but lived in a world of their own. They would often misinterpret their environment, and in many cases couldn’t remember what I had just said to them a few minutes ago. Some were truly end stage, confined to a chair or to bed, nonverbal or nonsensical, and having no apparent understanding of what was going on around them. Organically, their brains were slowly dying, leaving them trapped in a world that I didn’t know how to enter.

That’s what makes dementia and Alzheimer’s Disease so tragic. A person can otherwise be relatively healthy, but as their brain deteriorates it can seem as if they are lost to us already. Continue reading →

Self care is part of your work

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As important as self care is for Chaplains and other caregivers, it’s probably one of the most neglected parts of our job. And self care is part of our job, because if we don’t care for ourselves we will be unable to do our job.

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Jesus loves you, but you’re still going to die

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Every so often in hospice you get asked a baffling question, one that you don’t have a ready answer for. Sometimes it’s because the answer is simply beyond fathoming or beyond a simple explanation: “why is this happening to me?” or “why does God allow so much evil in the world?” Other times I’m baffled because the answer seems so obvious that I’m trying to understand why it’s asked at all. Such was the question I had posed to me a while back:

“Why does God have to take my mom? She never did anything wrong!”

Continue reading →

Keep your friends close, and your “-ism”s closer

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yes, that's Geneva in the background

I’m trying to work on a new post on Calvinism and having a bit of a hard time, so I thought I’d take a break.

I grew up Calvinist but only because that was the only pool I could swim in at the time. During and after seminary I questioned things more but still held on to a lot of it. Now I’m investigating the other side of the fence – that would be the more Arminian traditions including the Anabaptists – and even the contemplative Catholics like Thomas Merton. All of this has been great, and disturbing at the same time. Continue reading →

On Donald Miller and Christ outside the church

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image: Amy Corron Power

Donald Miller recently wrote in his blog, “I don’t connect with God by singing to Him.” Well Don, I don’t either.

That doesn’t mean that I don’t sing to God. But I find that the only time I do is in church on Sunday for about 20 minutes. At times I find myself being drawn closer to God by music, including Christian music, but those songs somehow never make their way into the worship center.

Plus I don’t sing well. While I knew this all along, it became glaringly obvious to me when I attended a Reformed Presbyterian church in college. At RP services no hymns are sung, and there is no musical accompaniment. The congregants sing the Psalms a-capella, often breaking into multiple lush harmonies as the verses change. I just stood and listened. It was beautiful, but I was a spectator, not a participant.

Continue reading →

Hospice Chaplain Interview: Reblog

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I picked this up of the Web and wanted to repost it; the original is here.

A reverend’s rounds: Hospice chaplain ministers to the terminally ill

October 30, 2013  6:30AM ET
Demand for hospice chaplains grows as more Americans seek deathbed spiritual counseling
NEW YORK — Sunlight permeates the Upper East Side apartment of hospice patient Kam Hi Tse, 78, as he arranges himself in a half lotus position on the sofa and places his hands, facing upward, on his thighs in what’s known as open-palm mudra. The former chef explains in Cantonese to the Rev. Mary Chang, an ordained Lutheran minister sitting next to him, that this pose makes him open to receive blessings from the Buddha. Chang, 70, nods and opens her palms upward, too.

A hospice chaplain for MJHS, the largest hospice and palliative-care program in the Greater New York City area, Chang makes daily visits to the terminally ill and dying, offering conversation and prayer to patients and grieving loved ones. She typically sees at least four patients a day, in hospitals, nursing homes, hospice centers and private homes. Unlike clergy of the past who usually only served people of their own faith, hospice chaplains take a multifaith and sometimes even secular approach. Chang meditates with Buddhists and sings hymns with the Russian Orthodox. She prays with atheists and speaks with people uncertain of their faith.

“I am here to listen, to be present, not to convert or judge,” says Chang, a sprightly Chinese-American woman who on Sundays leads a congregation at the Lutheran Church of the Incarnation in Cedarhurst, NY. Favoring brightly colored clothes when she visits patients, she usually eschews the formal collar and title of her Protestant calling.

Continue reading →

Joshua 4: Message for a facility memorial service

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I thought I’d pass this recent message from a memorial service our hospice hosted at a personal care facility. They had started a rock garden and we donated a tree to serve as a memorial marker.

…Joshua said to them: “Cross over before the ark of the Lord your God into the midst of the Jordan, and each one of you take up a stone on his shoulder, according to the number of the tribes of the children of Israel, that this may be a sign among you when your children ask in time to come, saying, ‘What do these stones mean to you?’ Then you shall answer them that the waters of the Jordan were cut off before the ark of the covenant of the Lord; when it crossed over the Jordan, the waters of the Jordan were cut off. And these stones shall be for a memorial to the children of Israel forever.” Joshua 4:4b-7

This scene marks a pivotal point in the history of Israel. This nation of former slaves has survived forty years in the wilderness, scraping by only at times by means of miraculous intervention, to arrive at the land promised to them several generations before. Nobody who heard that promise is alive to see it fulfilled. Even Moses, who lead the bedraggled group for those 40 years and who was for all that time their closest connection to God, died before this scene. This nation of nomads has finally arrived at the end of their journey from slavery to freedom.

Continue reading →

1 Corinthians 13:1-7, for a funeral

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1 Cor 13:1-7 If I speak in the tonguesof men and of angels, but have not love, I am only a resounding gong or a clanging cymbal.2If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but have not love, I am nothing.3If I give all I possess to the poor and surrender my body to the flames, but have not love, I gain nothing. 4Love is patient, love is kind. It does not envy, it does not boast, it is not proud.5It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs.6Love does not delight in evil but rejoices with the truth.7It always protects, always trusts, always hopes, always perseveres.

These words are often heard at weddings, not at funerals. But they are just as appropriate. In marriage we see the romantic side of love, the love of one for another. But in reflecting back over an entire life we can see how that love flowed out to others, to see the hard work that it did in tough times, and to see that love is not merely something that is felt but something that one does.

When Paul wrote to the Corinthian church, he was writing to a church divided. There were rival groups fighting for attention and power while more serious issues were being ignored. They were boasting about their wisdom and knowledge, but Paul was pointing out that their wisdom was futile. The church was “majoring in the minors” to borrow a phrase. Paul responds to a number of their questions about the order of the service and so on, points out where he sees them in error. And then it’s at this point that he points them to the “why” behind the “what to do”. Continue reading →

Faith and Dying Well

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I recently came across an article on a Christian site discussing why it is that Christians seem to have so much difficulty with end of life choices such as hospice care (unfortunately I can’t link to the article right now as I can’t find it again).

As a hospice chaplain for seven years I can say the following:

  1. most of my patients and families have some kind of faith background, and I would guess that it is about 90% Christian
  2. about half of my Christian patients are Roman Catholic
  3. of those that can tell me, most of my patients are not afraid of dying and neither are their families.

That said, I would say that obviously not all Christians die poorly, and a good number are quite accepting of God’s plan and, even when there is a very real fear of the dying process, that fear is tempered by the hope of Heaven.

However this is only a sample of those who have already chosen hospice. It would stand to reason that patients and families that are in some way afraid of dying or the dying process don’t consider hospice at all. One would think that this group is mostly atheist/agnostic and so on, but I don’t think that’s the case. I’ve had atheists on service before, and they look at death as a release from their pain and struggle and accept it as part of life. On the flip side of the coin, there are many Christians who struggle with decisions at the end of life and hang on even when recovery is impossible. The “why”s in these cases are plentiful I’m sure, but faith itself itself can be one. Continue reading →

When Prayer is Trivial

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While driving out to my first visit today I ran through the presets on my radio as I usually do. Not finding anything of interest music-wise I jumped to the Christian talk station to see what was on there. The speaker (don’t remember who, but he’s well known and I think nationwide) was talking about the need for us to pray in order to maintain our connection to God. He laid out several other benefits as well, but then made a bit of a quizzical move. God apparently wants us to pray, but God doesn’t want to be bothered with “trivial prayers”.

Prayers for mundane things – he used the example of picking out his clothes – are trivial in that they aren’t about important matters, or about things we can take care of ourselves. He got a laugh about his comment about his clothes-picking skills, but I was a bit perturbed.

I did a quick little search for “trivial prayers” on Google and got an interesting list of results: nonbelievers who said that any prayer was trivial or that prayers for personal gain were trivial, as well as people who called their own prayers trivial because they didn’t seem to be about important things. I even ran across a video of a minister teaching that God doesn’t want our “help me! help me!” prayers or petitions at all.

I brought this up to my client that I saw today, an elderly man with heart failure who prays the Rosary daily every day he can. He too was surprised and not very happy with the comment. He said, “Any prayer is important to God! Something that seems trivial to someone else can be very important to me. Say I cut my finger and I pray that it gets better. You could say ‘just put a band-aid on it, don’t bother God!’ But if that cut gets infected I could lose that finger. Prayer is all the more important to me!”

I replied, “I think the only kind of prayer that is trivial is one that isn’t said.”

And it was probably the smartest thing I said all day.