Who Cares About the Pastoral Caregivers?

Pastoral Care for the One Who Cares the Most

The vocation and task of care usually falls to the spouse who then becomes the primary caregiver
The vocation and task of care usually falls to the spouse who then becomes the primary caregiver
My grandmother cared tirelessly for my grandfather and as his health gradually deterioated he became more needy in his everyday activities.  Fortunately for my grandfather, my grandmother was a nurse and knew how to care for someone who was gradually becoming less and less physically capable.  Her energy level was amazing and my grandfather through the final two surgeries received top notch care and affection.  After my grandfather’s eventual death, my grandmother finally slowed down some herself, almost as if her body knew she no longer was needed everyday.   Still alive, still moving, but now with a cane, my grandmother showed her own pastoral and emotional care for my grandfather through the fulfillment of her vow-“in sickness and health”.
Many primary caregivers are not as energetic or well trained in end of life care as my grandmother, however, even my grandmother showed the tired face and burnout that accompanies caring for a loved one.  This can be twice as draining on someone with little knowledge or training to care for the sick.  The constant pressure and beat of the drum that pushes the primary care giver to doctor visits, prescription and medication study, dosage delivery, feeding, cleaning and the emotional realization that the one you love is going to die soon is overbearing.
Professionals recognize this as caregiver grief.  This type of grief not only affects the primary caregiver emotionally over the loss but it also strips from them the loss of a future and loss of freedom.  The vacation that was once planned by a couple is now forever gone as a faithful wife tends to a crippling disease that is killing her husband.  Or, that special 50th wedding anniversary will not become a reality because one’s wife will not live to experience the 49th one.  In addition, the loss of freedom strips the primary caregiver of the ability to go to the movies, or visit others at a picnic.   Gradually, the vocation of caregiving for their loved one, forces these people to give up on extra curricular activities because the demand of care is so overwhelming.  This was not only the case with my grandmother, but also my other grandmother who also gives up much of her time and energy for care of her husband.  How many times do we see our loved ones becoming burnt out because we will not take that simple step to offer an hour or two of our day?
Pastoral counselors need to let the primary caregivers know that it is alright to be tired and it is alright to take time off.  Pastoral counselors need to emphasize occasional relief through other family members or respite care.  Respite care is available within hospice and can help the primary caregiver have a few days to him or herself.  The National Family Caregivers Association sometimes helps charitablly with the fees for hospice in this service.
Who holds the hand of the primary caregiver?
Who holds the hand of the primary caregiver?
Most importantly, pastoral caregivers need to let the primary caregiver know that is alright to feel emotions of guilt, resentment and anxiety at times towards the dying loved one.  These are natural emotions and do not mean that one does not love or wish to not care for one’s dying partner or parent.
In fact, after the death of a terminally or chronically ill person, sometimes the primary caregiver is known to have some relief.  Not in a relief that the one they love has died but a relief that they have performed their duty with courage and devotion and that their loved one is now free from suffering.
With these things in mind, who cares about the primary caregiver?–everyone should.
If you are interested in Pastoral Care Education, please review the program.
Mark Moran, MA, GC-C, SCC-C

Pastoral Care and Use of Advance Directives

Pastoral Care Giving and Advance Directives

An Advance Medicial Directive from Germany
An Advance Medicial Directive from Germany
It is important in Pastoral Care to also ensure that the needs of the dying patient are met in full.  This not only involves physical and spiritual support but also helping one fulfill their end desires for themselves or family.  Advance Directives are essential elements in knowing exactly what the dying patient would want or wish if he/she is unconscious or unresponsive in his/her final hours.
An Advance Medicial Directive can solve many problems in regards to who takes charger in an event if the person loses consciousness.  It also lays out groundwork for care givers and medicial providers to follow in regards to medical treatment with regard to extra-ordinary life sustaining measures and whether to pursue prolongtation of life or pursue comfort measures.
These questions can become very confusing if there is no Advance Medicial Directive to follow and the care givers, medical providers and family members can enter into a guessing game that can lead to numerous debates.  If there is a Advance Medicial Directive, the proper authorities should receive it and utilize it when the path becomes murky regarding ethical or medicial decisions.
The Directive itself lists who the patient wishes to be his/her health care represenative with alternate choices following if the primary represenative is unable to perform his/her duties.  Following this is a list of situations that involve pain and suffering, mental incapacity, physical immobility, physical helplessness, interest of loved ones and potential living situations.
Ultimately the autonomy of the patient is a critical concern in pastoral care.  As long as the requests are within reason, a patient’s rights must be met and listened to.
If you are interested in Pastoral Care Education, please review the program.
Mark Moran, MA, GC-C, SCC-C