Pastoral Care Counselors and Dealing with Denial of Patients
Elizabeth Kubler Ross identifies denial as the first response to grief. She considers it to be a natural reaction to sudden and horrible news. In her seminar on the dying, she hoped to share with pastoral care counselors, health care professionals and ministers the necessity of denial in the progress through grief.
While not everyone follows the same pattern of grieving, pastoral care givers can be assured to witness many cases of denial. The looming question, however, is when can denial become dangerous, if it ever even can be?
Kubler Ross experienced one case of a woman who was diagnosed with cancer. She attended a faith healing service and proclaimed she was healed despite everything medical science proved otherwise. Her behavior was consistent till the very end insisting she was healed. Nevertheless, she continued her treaments, medications and visits to the hospital. During that time, she would joke of the foolishness of these treatments only till her body finally broke down and she had to come to the heart breaking conclusion of her dire situation.
Kubler Ross never contradicted her denial explicitly. Instead, she would never confront the woman on the issue of the supposed healing or say otherwise. Her primary concern was that the woman continued to take the prescribed medications necessary. Through simple requests to continue to take one’s medication, Kubler Ross implicitly resisted the denial.
This type of denial was far from dangerous but critical to the woman’s coping of her physical situation. It allowed her to carry on day by day. As long as the woman did not resist the medications or therapies, then the denial was not dangerous.
Cases where denial become dangerous are when the person refuses treatment or carries on doing activities that are harmful to their health. Some people and their denial will even lead them to insane adventures and spending sprees.
The primary lesson for pastoral care givers to learn from Kubler Ross is to react to most denial in an implicit way that does not damage a person’s coping. Merely ensure the denial does not damage them health wise.
If you are interested in Pastoral Care Certifications, please review the program.
Mark Moran, MA
Pastoral Care Givers and Assisted Suicide in Massachusetts
The issue of Patient Assisted Suicide became a national controversy when Oregon first passed a bill that allowed it in the late 90s. Now Massachusetts is proposing a similar bill. Many people may support this idea but there are many Pastoral Care Givers who oppose it. In the article below from Lifenews.com, the concerns regarding this bill are analyzed.
Dr. Jacqueline Harvery writes on Patient Assisted Suicide in her article “Massachusetts’ Assisted Suicide Proposal: Concerns on Question 2” and how it may not be beneficial to those of the state.
“The 2012 “Act Relative to Death with Dignity” goes before Massachusetts voters on November 6. Question 2 asks voters directly whether to legalize physician-assisted suicide (PAS) or uphold existing state statutes. “
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Mark Moran, MA
Caring for the Dying and Their Rights
It is so common to speak about the dying and the rights of the dying instead of to them. They almost become the giant elephant in the room. However, from a spiritual and ethical prism, the dying have rights that must be preserved and respected. As people they have human rights and their needs, concerns and issues need to be met with compassion and professionalism. In caring for the dying, we must remember these five rights.
The first rights of the dying is that they have a right to know as much of the truth that they can handle. To purposely leave the dying patient out of the light of what is happening to their body is unethical and wrong. Only when such knowledge can cause harm to a patient should some information be disclosed with discretion and in possible dosages. In some cases, as with children, every single detail is sometimes not needed in one’s discourse with the dying, while in other cases, the dying patient may well need or be able to handle the information.
The second right of the dying is they have a right to be free from suffering, pain and have hope for the future. It is the duty of providers to provide the maximum comfort for the sick and dying as possible. The dignity and spiritual nature of the person must be preserved in this final stages, even if for a simple hour. Whatever can be done to alleviate suffering and provide comfort should be offered to the dying patient.
The third right of the dying that must be adhered to by pastoral care givers is the autonomy of the patient. The patient has a right within his or her capabilities to participate in decisions. This is even more helpful when one has a Advance Medical Directive, but even without, the patient’s right to engage in dialogue regarding procedures is imperative to his or her dignity as a human person.
The fourth right is a patient can talk about death when ready. Many families like to ignore the ominous signs of death but if a dying patient wishes to discuss this important event in his/her life, then the family and providers should take the time to hear the concerns of the dying.
The final right of the dying patient is the right to express emotional feelings, complete unfinished business and the presence of any religious figures. A dying patient may want to express regret, or forgive a friend, or call upon a priest. These are imperative to the spiritual and emotional well being of the person and his/her journey to the next phase of human existence. To deny these things is a gross case of spiritual neglect.
If you are interested in pastoral care, please review the program.
(Some of the information found in this article was from “Helping Grieving People-When Tears Are Not Enough” by J. Shep Jeffreys)
Mark Moran, MA, GC-C, SCC-C
Pastoral Care and Euthanasia
Many in pastoral care are faced with the dilemma of euthanasia. Although banned in many states, the right to die movement is a powerful one. This movement, however, is far from pastoral. It may paint images of taking someone out of their misery with compassion or ironically tying the words “mercy” and “killing” together, but if one looks beyond this, one will find nothing pastoral regarding euthanasia.
Euthansia is murder. It is that simple and those who seek to bring Christ to the dying and wish to represent a pastoral element can never condone it. Euthanais is suicide of despair. It is the rejection of Christ’s will and cross he has given someone. Furthermore it is the attempt to make oneself the author of life instead of God. As a sin of suicide, it shows the active act and the direct willing of death by the agent and requires the assistance of an outside agent to conspire in this taking of life. With this, it contradicts the laws of life and mocks the oath of all doctors to preserve life.
From a pastoral element,however, one is stricken with the images of such pain and suffering. Obviously a person in such condition does not deserve harsh criticism for seeking death but to the one thats duty is to preserve and protect is a different story. While some may be acting out of ignorance in such affairs, it is imperative that care givers realize that true pastoral care is not about ending life but comforting the final phase of it.
In such ways, hospice takes those who cannot survive via ordinary measures into its fold. These patients do not wish to end their life, but wish to spend the remainder of it as God wills. Of course, God does not forbid one to find comfort in sickness and sorrow. In this way, one who seeks death willingly or actively but merely accepts the natural reality of life does not contradicts the laws of God. From another extreme, as care givers, we cannot forget also that while some piously champion the value of life, they sometimes forget that unnatural prolongation of life or the use of extraordinary measures to preserve life are unneeded and sometimes more burdensome and painful to the dying and his/her family.
It is for these reasons that when one accepts the fact of death, one can with good conscience deny extraordinary measures and know they have not given in to the despair of euthanasia but instead have carried their cross to their own calvary with Christian dignity and heroism.
Pastoral care givers need to focus on making the journey of the dying to their personal Calvary a spiritually and emotionally healthy experience where comfort, love, and support are given instead of despair.
If you are interested in Pastoral Thanatology Education, please review the program.
Mark Moran, MA, GC-C, SCC-C
Hospice and Pastoral Care Giving
For many the choice of hospice is a painful one. Intrinsic to hospice is the idea that one has given up and medicine can no longer save one’s loved one. One feels defeat and dismay but the reality is one is freeing him or herself from the bondage of self and accepting the will of Christ. Pastoral Care Givers have an opportunity to help others accept the final leg of their journey. They can also help families learn acceptance and find some joy in the final days. Furthermore, once prolongation of life is no longer the goal, then comfort becomes primary. This is the essence of hospice. It accepts the end but allows the person to die with dignity, comfort and consolation. It is not defeat but victory over denial. In many ways it is heroic decision for a person to submit his or her will to Christ and prepare for the next world.
Hospice should actually be seen as a pasture for the dying. The word actually comes from the Latin word, meaning hospitality. With such a warm meaning, it points to a better ending for the dying. In fact, 88 percent of the dying wish to die in their own home. Hospice in most cases can make this happen, unless certain critical conditions prevent this. It was a great joy personally to allow my grandfather to pass away in the comfort of his home. Fortunately, my grandmother was a retired nurse, but this is not the case for many and hospice gives individuals a chance to die comfort with dignity.
Hospice as a care giving service focuses on the whole human person instead of just the medical condition of a person. It has professionals who specialize in physical comfort for those dying of particular diseases but also professionals in counseling and ministry that help one find solace in their final moments. Although hospice service is only for those diagnosed with six months to live, there are many people who are re-diagnosed and have received care longer.
Hospice offers four types of care. The first type of care is routine home care. Standard services and visits are conducted in this first type of care. Registered nurses, chaplains, social workers and other care givers can come to the home and check on the patient. The second type of care is Respite Care. Within this care, a patient can spend five days with the hospice unit giving the primary care giver the much needed time to relax and refocus. The third type of care is General Inpatient Care. This type of care is a continuing care for someone who requires special treatment and care before death. The final type of care is Continuous Care. This type of care service allows the patient who is near death to stay home but is cared for by a mobile unit.
These services are critical in fitting a certain person’s needs but also giving the person the spiritual and emotional comfort before death.
If you are interested in Pastoral Care and care for the dying, please review the program.
Mark Moran, MA, GC-C, SCC-C