So, I’ve been working as a home hospice chaplain for about 6 months.\u00a0 I visit the homes of hospice patients and provide pastoral care to patients and families.\u00a0 I find the work very rewarding and a fulfillment of the call from God that I perceive.<\/p>\n
When I talk to people (friends, family, acquaintances, people from church, etc) I often get one of a small number of responses.\u00a0 Here they are in no particular order, with my answer for each.<\/p>\n
(A post for another day is “Things Patients and Families Say to Hospice Chaplains”)<\/p>\n
It is sometimes.\u00a0 Let’s face it – I have a near 100% death rate for my patients.\u00a0 By definition my hospice patients are not expected to get better.\u00a0 And I’m working with people who are emotional about the death of their loved one (or patient, for caregivers and our staff) whether they express it or not.\u00a0 It is certainly an emotional charged environment.<\/p>\n
On the other hand, one of my important roles is to help the patient and family and staff make meaning from the illness and death of their loved one (or self).\u00a0 Finding the personal meaning of the event is one key to integrating the event into your continuing life (yes, even for the patient).\u00a0 I have to do that every time, with every patient.\u00a0 And I have to do it for myself too.\u00a0 I have to be able to find the meaning for me, for my place in the system that includes the patient, their family, their caregivers, their own clergy, our staff.\u00a0 I have to have a sense of why I’m there and what it means for me.<\/p>\n
Beyond the individual patient, I have to find a meaning for doing the work in the first place.\u00a0 Why do I choose to visit a dying patient or four every day?\u00a0 Why do I walk into a room with strong emotions, varying dramatically from person to person?\u00a0 Why do I endure anger and grief and individual baggage that causes people to mistrust clergy?\u00a0 What keeps me going?\u00a0 Often the answer to this meta-question is the answer to the question for each patient for me.<\/p>\n
The answer is that this is what God has called me to and equipped me for.\u00a0 I’ve been working hard for the past 8-10 years to listen for God’s call on my life.\u00a0 Over and over and over I have received affirmation that chaplaincy is my call, and that hospice work and end-of-life work is my particular specialty.\u00a0 And God has given me what I need to do that work – personal emotional make-up, life history, skills and gifts, training and education.<\/p>\n
I believe that God has called me to stand in the place of shepherd for the journey to death for some of God’s sheep, and for their fellow flock members.\u00a0 It’s my place to listen to them, to hear the words they say and the words they do not say and the emotions that they feel, to let them know that what they are going through is real and usually a normal reaction to the final stage of life, to pray and read scripture sometimes to help people feel the presence of God.\u00a0 It’s my place to care for these people, and for them to feel that care.\u00a0 Sometimes it’s my place to serve as a stand-in for God or for others so that people can release the thoughts and feelings that have been stuck in their heart and soul.<\/p>\n
The meaning that I take from this is that they are being cared for (if not by me by someone, and always by God).\u00a0 They are being guided through a time that we will all experience – not directed but guided, in the hospice time and the death and the time after death and the grief that comes in each of those times.<\/p>\n
In my core I feel a strong need and call to help people.\u00a0 The primary reward that I get from this work is feeling that they are helped, by me or by someone else.<\/p>\n
Yes.\u00a0 I do.\u00a0 Not with every patient, and sometimes there’s no obvious explanation for why I get sad with one patient and not with others.<\/p>\n
With those patients who do not cause sadness for me, it’s usually because I feel a sense of joy.\u00a0 Joy that they are grieving as expected.\u00a0 Joy that they are not experiencing some of the dysfunctions that death can cause, or that they are receiving the help that they need.\u00a0 Joy that the patient is NOT experiencing a painful, neglectful, or premature\/delayed death.\u00a0 In essence, I am sometimes not sad because the death is going well. Sometimes I am sad.\u00a0 It comes in two flavors.\u00a0 One flavor is easy to understand – I come to feel some affection for my patients and their families.\u00a0 They have a big loss and I have a smaller loss that goes with it.\u00a0 I will mourn their death and their grief in my own time.\u00a0 The second flavor is more complicated.\u00a0 Sometimes a death just comes across as wrong.\u00a0 Perhaps the patient is too young (someone under 60 is a good rule of thumb, and it increases in intensity as the patient is younger.\u00a0 In my hospital residency, it happened with violent deaths.\u00a0 It also happens with deaths where the family is unable to reconcile their conflicts long enough to get through the patient’s death, and to make that death as peaceful and painless as possible.\u00a0 I remember one hospital patient who was estranged from his children for decades because of his abuse of them as children.\u00a0 His family ultimately chose not to provide comfort care, leaving him as a “Full Code” with full resuscitation required, and then left the building not to return.\u00a0 That certainly looked like an intentional infliction of pain.\u00a0 And the one that shook me soundly after the fact was a hospital Emergency Room death of a two-month old child.\u00a0 Nobody was to blame; it was a crib death.\u00a0 But it’s hard to understand why that would happen.\u00a0 In all of these cases, there was something wrong with the situation, something that could be fixed but wasn’t.<\/p>\n So yes, it does make me sad sometimes.\u00a0 And please don’t take any lack of sorrow or even signs of being pleased as a lack of care for the patient.\u00a0 In hospice circles there is a sometimes-spoken concept of a “good death”.\u00a0 Those I celebrate rather than mourn.<\/p>\n You might be right.\u00a0 There is a very unusual set of skills and attributes necessary to do this and do it well.\u00a0 (Short version: chaplains are weird, hospice chaplains exceptionally so.)\u00a0 Or maybe you could do it.\u00a0 If you want to talk about chaplaincy careers or training let me know.\u00a0 (And if it’s still early April 2016, and you want to do this in Ocean County NJ, my company has an opening.)<\/p>\n You might also be in that role in your own life.\u00a0 We often hear stories of people who have capabilities that they did not know about until they were called on to use them.\u00a0 You may be the person who reconciles people in your family or job, or you might be that middle-kid glue that holds the family together.<\/p>\n Chaplains aren’t hatched.\u00a0 We aren’t born with special chaplain powers.\u00a0 We develop them over time.\u00a0 Our birth and formation do need to include and foster certain traits and attributes.\u00a0 Chaplains do need some religious connection.\u00a0 But beyond that we train.\u00a0 Certification as a clinical chaplain in my organization (CPSP) requires at least two units of CPE and many go for the certification that requires four units.\u00a0 Some certifications require a Masters degree in something relevant (the MDiv is used as the template).\u00a0 That CPE training includes experience.\u00a0 So no – we aren’t born doing this.<\/p>\n There is a real need to be able to keep your feet and your wits and your focus in the face of strong emotions – theirs or yours.\u00a0 That can be learned too.\u00a0 But beyond that, maybe you could do it.\u00a0 Maybe you don’t want to, and that’s fine too.\u00a0 We don’t need a world full of chaplains.\u00a0 We just need enough of us.<\/p>\n Thank you.<\/p>\n No, really.\u00a0 This is one of those jobs where compliments come less often.\u00a0 Where we often are unable to see the effects of our work in people because it only shows after we’re gone.\u00a0 Where an angry family member or patient is actually expressing emotions rather than suppressing them and that’s a victory, but we’ll never hear a thank you.\u00a0 Rejection is a constant.\u00a0 Some people feel funny about their lack of church attendance, or never grew up with religion, or had a bad experience in the church or with clergy – those people tell us to go away, politely or not so politely.<\/p>\n I’m glad that someone is doing this too.\u00a0 I’m going to need it someday.\u00a0 Either for myself, or for my parents, or for someone else in my life.\u00a0 And I will have to resist the temptation to fix my own family and myself.\u00a0 Just as a lawyer should never represent themself, and a doctor should never self-diagnose, we should not self-chaplain.\u00a0 We have to be able to feel what we are experiencing when the situation comes home, and we need other chaplains for that.<\/p>\n There are many guides in life.\u00a0 Teachers, pastors, police officers, therapists, mentors.\u00a0 Hospice chaplains are a specific kind of guide in a specific situation.\u00a0 All are needed.
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\nWe as chaplains (and this is also true of clergy) are expected to feel some detachment from their flock.\u00a0 We are expected to suppress our emotions about a situation in order to help others with theirs.\u00a0 Our own questions about death and why it comes and why God permits certain things to happen to people – we are expected to deal with our stuff on our own time so that the patients, family, etc. can deal with their experience of these same issues.\u00a0 My therapist once said to me that I have a strong ability to put my emotions on the shelf (we actually talked of Tupperware in a virtual refrigerator) and get through a situation and then deal with my emotions later.\u00a0 That is true, and helpful.\u00a0 It works that way for my theodicy<\/a> too.<\/p>\nI Don’t Think I Could Do It<\/h2>\n
I’m Glad That Someone Is Doing This<\/h2>\n