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 Excerpt from Chapter 2 Even though dying is about the patient, their final legacy may be how they've helped us learn more about dealing with the dying process, while contributing to our own preparation for death. What practical steps can we take to deal with our own mortality and to accompany others with their mortality? Be in touch with your own mortality and issues about death
~Earl Grollman Death matters! Everyone will die but most people do not want to die. Thoughts and beliefs about eternity, life after death, God, heaven, leaving loved ones behind, regrets, rewards and punishment are just some of the thoughts that race though the minds of the dying. Dying is a process that allows a time of preparation, and dying people need and want to prepare. As the once it may have been dormant. Unexpected instantaneous death does not allow for preparation and is often described as a tragic death. Much of the time a dying person is preparing for death and eternity, at the same time the caregivers may be fighting death and interfering with the dying person's preparation. Sometimes it is the health care professional, the chaplain, and the politician who interfere with the patients dying preparations. Since everyone will die, there is a need to face death, in order to be able to walk with others who are in the dying process and preparing to die. It's helpful to set aside some time to contemplate on some questions.
Asking questions like these helps to process our own feelings of death. Wrestling with these feelings now, helps us to rest peacefully when we accompany others who are wrestling with death. Be sincere A patient needs to know that I want be with them through their journey. They also understand that I can't stop what is happening to them, any more than I will be able to prevent my own death. Love your patient Love is seeking God's highest good or the highest moral good for the other person. It is giving of self to help others. It's important to make the patient my priority and to set my agenda aside to pick up the patient's agenda. Love means choosing to do the right thing in the situation. If the patient is fearful and wants to end the dying process I cannot, but I can help them find peace in the midst of spiritual suffering. Meet the professional and ethical expectations of the patient Organizations and agencies that care for the dying have ethical and professional standards. And often patients have stereotypical ideals of chaplains. It's not necessary for me to dress in a shirt and tie, but to a Baptist church lady in her eighties, my tie is a visible credential that gives her immediate comfort. Also, a priest who enters a patient room in an Aloha shirt may not command the same presence as one wearing the traditional collar. Time is short and presentation is important. It can open or close doors with patients, families and other staff. Be friendly and calm Dying is often accompanied by fear, anxiety, agitation, anger and helplessness. The atmosphere is usually unstable and fuses are often very short. Families frequently fight with each other and patients are not always nice to their families. Years of coping systems are being tested and come up wanting. It's not unusual for a chaplain who enters this chaos feeling helpless in the situation, thinking he/she has nothing to offer. On the other hand, one who enters calm and stable understands when a patient or family vents that it's not about him. A chaplain's presence can be calming during times of pain, hurt, despair and hopelessness. Dying is not a time for judgment or mystery, but of support for the patient and family. It is not uncommon for a room full of family members to disperse when a chaplain enters. Whoever remains acknowledges and talks. And those who left earlier usually talk separately later to make sure the whole story is told. It's important to be available, approachable, not take sides, and work toward bringing reconciliation peace to the family and patient. Don't be offended Offense causes the focus to shift from the patient to self. It is the product of fear and a sense of being treated fairly. Right and wrong do exist and seeing something wrong can offend and inflate our own sense of rightness. It is nice to be respected, but evil will always battle against good and respect will not always be there. Assuming Chaplaincy is the fruit of love, the biblical passage "love does not keep an account of wrongs suffered" keeps us from being offended and from seeking to right a wrong suffered, empowering us to forgive offense and set judgment aside. Be helpful where the patient is helpless Imagine walking into a patient's room, exchanging introductions, and beginning a conversation. The patient is polite but looks in pain. After a few moments of uncomfortable conversation the patient asks for help in removing the bedpan they have been sitting on during the visit. It's okay to call the nurse or the aide for assistance. It's also okay to offer a very dry mouth not in danger of aspiration, a drink or swab of water. Don't be afraid to push a wheelchair, assist in eating, or readjusting a pillow or blanket. When in doubt, call their nurse or check with their family. However, let the patient hold onto what little control they have left and allow them the freedom to give you direction in their care and do what they can still do for themselves. Ask open ended questions Don't let people off the hook with "yes" and "no" answers. Chaplains sometimes make the mistake of putting words into patient's mouth, many times answering their own questions so the patient doesn't have to deal with reality. Patients will often test the chaplain to see if they are really being heard. A patient may talk about golf for 10 minutes, and during it toss in the line, "I taught my son to play golf, but we haven't talked for 15 years." Then, continue talking as if they never interjected the phrase. A chaplain needs to recognize the statement and ask something like, "Why haven't you spoke to your son for 15 years?" to see if they are estranged, or if the son died 15 years ago and the patient is just now grieving his death. Listen and pay attention The world is full of listening experts. But who wants to listen to another expert on listening? But listening is not just hearing words but also hearing the person's heart, revealing both expressed and unexpressed needs. Active listening enhances communication with the patient and helps to understand what the patient wants us to know. Often a patient will say they're telling us a secret, but in reality, they've also told others and are trying to manipulate us. Listen and pay attention to the ploys of the patient. |