In a small house in Portsmouth, Virginia, we sat next to her as she lay in a hospital bed in her dining room. Without any air conditioning in the house, I could feel the sweat running down my back as I watched him hold her hand as she slipped in and out of consciousness. Throughout most of our visit, she hadn’t been able to say much and her daughter had told us she wouldn’t even know we were present. Yet as he prayed, I watched her hand clench his letting him know she was there.
This summer as I find myself coming to the end of my Clinical Pastoral Education residency through Bon Secours Health System in Southeastern Virginia, I’ve been assigned to shadow our outpatient hospice chaplain a few days during the week. While I have spent the past 10 months working primarily in a hospital setting, working in outpatient hospice has been an eye-opening experience for me.
While I’ve had a lot of experience providing pastoral care to families who lost loved ones this past year, I haven’t had as many interactions with patients who were in the final stages of their lives. A large reason for this is due to the growth in hospice and palliative care services, more patients are receiving care in their final days at home surrounded by family and friends than at the hospital. And while this is the most comfortable place for these patients to be, it’s harder for them to receive the same amount of spiritual support because there are fewer chaplains doing outpatient hospice care than those serving at inpatient hospitals.
In 2008, the New York Times published an article about the great demand for clergy to provide hospice and palliative care for patients. With fewer individuals associating themselves with religious communities and churches than ever before, most patients still have a great unmet need for spiritual support in the final days of their lives. And with Medicare and private insurers now providing support for spiritual caregivers, there is a need to find those who can provide spiritual care to hospice and palliative patients.
I would be lying if I said that hospice chaplaincy has not been difficult for me. While I have a sense of confidence in my ability to provide spiritual care to grieving family members (especially since I lost a lot of loved ones in my life such as my mother when I was 23), it can be difficult being present with someone in the final days while not reflecting on my own morality and those in my life who have died.
“It’s not the type of ministry churches want to advertise on their church signs as being a ministry they offer,” Charles, our hospice chaplain, said to me recently. “But it’s an important step in life and an important ministry that needs to be provided by churches and faith communities.”
Despite its difficulty, I’m also learning that hospice ministry is a rewarding ministry. I’ve watched our hospice chaplain provide prayer, help patients explore their imagery of God, define their life legacy, and travel with them in their emotional valleys when they discuss their life regrets. These are affirming moments not just for the patients, but also for him as the chaplain.
Like other mainline denominations, as the Presbyterian Church (U.S.A.) seeks to expand and grow by developing new worshipping communities for youth, teenagers, college students and non-churched individuals. It is my hope that we as a denomination will be able to grow our ministry and our service providing spiritual care to those who are in their final stages of life just as we want to provide spiritual care to those at other stages in life. Not only is it my hope that our churches and clergy can provide support to those who are dying by giving them proper training, but I hope as a denomination we can to create ministries in our churches that specifically serve the terminally ill and their family members. This type of ministry would be especially valuable to those individuals not connected to a church who are looking for spiritual support as they travel the final miles of a loved one’s life – or even possibly their own life. I believe individuals would be more willing to accept end-of-life spiritual support if we as a church offered it rather than as a church looking for individuals to come to us requesting a need for it.
Just as it’s important to provide spiritual support at the beginning of life, I think there is a great need for us as a church to learn ways we can also provide care for those at the end-of-life. Because, in a way, that can also be considered the beginning of life, too.
Christopher Schilling is a resident chaplain at Bon Secours Maryview Hospital in Portsmouth, Virginia. He is originally from Hookstown, Pennsylvania, and is a 2013 graduate of San Francisco Theological Seminary. Currently, he is a candidate for ministry in the Presbytery of the Redwoods in Northern California. Christopher is also a freelance journalist, creative writer, and has a passion for the outdoors, running, radio broadcasting and cars.