Do you ever lie to a patient in pastoral care for the greater good?
The article, “Dementia sufferers told white lies to keep them happy: Nurses and psychiatrists admit ‘therapeutic lying’ to confused patients”, by Amanda Williams states
“Almost all nurses who treat dementia patients have admitted ‘telling white lies’ to avoid distressing them, it has today been revealed.”
American Institute Health Care Professionals‘s insight:
Is a white lie a good thing for a dementia patient? This is the question as many health professionals admit to this when dealing with dementia patients in regards to the overall good. This article looks at this pastoral care issue and examines what one should really do
So many times, Pastoral Care can lead to burnout for ministers and other caregivers who attend to the mind, body and spirit of others. Just like any field, stress can lead to burnout. In the pastoral thanatology field many depend on the counselor to help them. Try following this article to help you if you are feeling burnt out.
Paul Vitello of the NY Times writes about pastoral burnout and the importance of relaxation for pastoral care givers in his article “Taking a Break From the Lord’s Work”
Pastoral Care givers are thrilled that more options are becoming more available for dying patients to live their remaining lives at home and in decency. Federal laws are looming that may help families afford this option and give their loved ones some peace in their final days.
Irma Faith Pal of Inquirer News writes about the growing need of good and affordable Palliative Care in her article, “Palliative Care: Helping the Dying “To Live Until He Dies”
“For any family, it is devastating to hear doctors say there is nothing more they can do for the patient.
But with palliative care, patients and their families can face the prospect of death more courageously. It offers well-thought-out “goals of care” that ease suffering and give the patient the opportunity to die with dignity and in comfort.”
Pastoral and Spiritual Care for those in a coma is important because one cannot ascertain if the patient is totally unconscious or not. In this way, pastoral care givers should treat the coma patient as if conscious. Furthermore, the spiritual energy and presence can also communicate without any sensible connection. Albeit many deny the metaphysical realm, I would contend as a one of the faithful that such connection would exist.
Sara from the Institute of HeartMath writes in her article “The Effects of Compassionate Presence on People in Comas” about the sense of positive energy that can be transfered between loved one and patient. (Found in care2.com)
“Have you ever wondered if someone in a near death state could hear your words or feel your presence? Clues to the mystery of transition from earthly life are offered in accounts by individuals who have survived coma and unconscious states and from the experiences of people who care for the dying.”
Pastoral Help sometimes does not touch upon the needs of every family member or various feelings that identify the family as a whole. It is important to meet the needs of the patient’s family while the patient approaches death.
One of the first steps a pastoral caregiver can do is normalize any feelings within the family. Some family members may be experiencing secondary losses. They may feel angry at the dying person. It is important to let them know that this does not make them bad or that this does not mean they do not love their family. Instead, such emotions should be faced and dealt with in order to prevent guilt and other ambigious feelings when death does occur for their family member. There should also be care in preparing the family for death. The family should be prepared and taught what anticipatory grief is and how they may feel when the death does actually occur.
Second, it is imperative that the pastoral provider ensure that all family members are recognized in their grief. Too many times, other people and groups that are affected by a death are ignored and left disenfranchised in their grief.
Third, the family needs to have a healthy balance between denial and acceptance. The pastoral counselor must help certain family members who may experience denial and begin to slowly guide them to acceptance.
Fourth, a pastoral caregiver needs to guide the family into open dialogue with each other. Better communicating families experience better resilience after a loss than closed and quiet families. This open communication should also include children. Children should be told the truth but in accordance with their maturity and understanding of death.
Fifth, the family may need help learning and preparing to say good bye. Throughout the process of death, the family may be experiencing anticipatory grief. Through this, thoughts of the final good bye are already forming in their minds. As a counselor, one can help them better articulate how to express those feelings when the moment of death comes.
Finally, in some cases, the pastoral caregiver also assists with the after death rituals. It is important to ensure that the whole family has a chance to say farewell and commerorate the death of a loved one at the funeral. It is important to encourage the attendance of children.
If you are interested in Pastoral Care for families facing death, please review the program.
(Information for this article is from “Helping Grieving People-When Tears Are Not Enough” by J. Shep Jeffreys)
Mark Moran, MA, GC-C, SCC-C
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 Medicial 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 omnious 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
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
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.
Pope John Paul the II, one of the most prominent Christian figures of the 20th century, was not just a leader of the Catholic Church but also a visible sign of unity for all Christians. During his lfietime, he spoke on a variety of topics and Pastoral Care was not an exception. Below is a document he wrote in commission of the Pastoral Care Commission of Health Care Professionals.
In the Papal Document, Dolentium Hominem, Pope John Paul II discussed the need for Pastoral Care of Health Care Professionals for the world’s suffering. He speaks of Christian dignity in dying and how pastoral counselors can help.
The deep interest which the Church has always demonstrated for the world of the suffering is well known. In this for that matter, she has done nothing more than follow the very eloquent example of her Founder and Master. In the Apostolic Letter Salvifici Dolorisof 11 February 1984, I emphasized that ”in his messianic activity in the midst of Israel, Christ drew increasingly closer to the world of human suffering. ‘He went about doing good’, and his actions concerned primarily those who were suffering and seeking help” (no. 16).
In fact, over the course of the centuries the Church has felt strongly that service to the sick and suffering is an integral part of her mission, and not only has she encouraged among Christians the blossoming of various works of mercy, but she has also established many religious institutions within her with the specific aim to fostering, organizing, improving and increasing help to the sick Missionaries, on their part, in carrying out the work of evangelization have constantly combined the preaching of the Good News with the help and care of the sick.
For the full document, please click this link http://www.vatican.va/holy_father/john_paul_ii/motu_proprio/documents/hf_jp-ii_motu-proprio_11021985_dolentium-hominum_en.html
As one can see, Pastoral Care is also a Christian endeavor that is not just merely a career but a vocational calling of all Christians.
For more information on Pastoral Thanatology Courses, please click here.
Pastoral care of the dying is a special type of counseling by chaplains, pastors or other religious leader to dying persons and also their friends, families and relatives. The pastor or the chaplain provides comfort, hope as well as assurance during a time of uncertainty. We all know that death is the ultimate conclusion to our earthly life and it is a phase that every living being has to go through some day or the other.
However embracing one’s own natural death or accepting the loss of a dear one is much difficult and so in such a situation we turn to religious teachings and religious leaders to find solace. The subject of death, both physical and theological has been the center of attention in the Bible. The main essence of pastoral care of the dying is showing spiritual love for fellow humans and forms an integral part of Christian teaching.
For a professional person who provides emotional and spiritual support to the dying it is very important to have a proper understanding and realization of thanatology. A person who is in his death bed looks to the chaplain or pastor for spiritual assurance and company to overcome loneliness and fear. The pastor or chaplain should help the dying person to communicate with his loved ones. The minister should also help the dying man to reflect on the quality of life that he has lived and at last prepare the person to face the final transaction of leaving the earthly body. The duty of the minister or pastor does not end here as he also needs to act as a pillar of support for the dear and near one of the dead person. The pastor can also help the bereaved family members to make various arrangements like burial, funeral planning etc.
The question of when to call for pastoral care of the dying may arise in our mind. There can be no single definite answer to this question. Pastoral care of the dying can be called for when a patient is informed of having some serious illness like cancer, AIDS etc. This type of help can be called for if a patient is in his death bed or is worried about some surgery that is going to take place in the near future. Pastoral care of the dying can be called for if the family member of a patient who is seriously ill wants spiritual guidance and support.
In the western countries pastoral care ministers constitute the health care departments of most hospitals so patients as well as their families can easily ask for their guidance. Different people have different point of view regarding death. Some view death as an unwanted intruder that hampers the natural process of life while some view death, suffering and pain as integral and unavoidable aspects of living life and a suitable ending to the journey of life. The view of a person regarding death is largely molded or shaped by different factors like social customs, religious faith or belief, cultural background, personal way of thinking etc. People who believe in the existence of God or are followers of Christianity generally call for pastoral care when they or some of their loved ones are nearing death.
For a dying man and his family a pastor or chaplain is not only a spiritual bridge with God and after-life but also a social supportive agent. When a man nears death his opinion of life can greatly change, all the materialistic things that seemed very important to him at one point of his life may then seem to be of no great importance. The person may feel a great desire to purge himself of all the sins that he has committed in his life time and so getting pastoral care for the dying can be of great help. In such critical situations friends and family of a dying man feel very close to the pastor. They start relying on the pastor for his guidance and help. The pastor may be requested to give his opinion regarding crucial matters like family, medical, moral and ethical issues. Many people believe that religious faith can work miracles where medical science fails and so they can call for pastoral care of the dying during such situations.