By Victoria Lucas, MA, BCC
I knock at the door of a new patient, Mrs. Fay. Her daughter answers, “Chaplain Victoria?” I show my badge to Mrs. Fay, letting her examine my name and title and face. She looks at me with a smile of welcome. She is a small woman with a halo of soft white curls, seated demurely in a wing back armchair.
Mrs. Fay lives in the assisted living wing of one of the continuing care communities I visit as a chaplain with Holy Cross Home Care and Hospice in Silver Spring, MD, a member of the Trinity Health System based in Michigan. Her apartment is small and beautifully appointed, with furniture, paintings and family pictures from her former home. She tells me about how she and her late husband acquired these artistic pieces while they traveled for his work with the government. She and her daughter describe their various homes across the country and globe, before settling down in this area. I enjoy hearing their family story, seeing these artifacts of her life. Those items she brought with her to this pared-down studio space illustrates how she sees herself, her life, and those values she holds dearest. Without a word, Mrs. Fay and her daughter are filling in the details of my initial assessment. Whenever possible, I try to meet with family members during this initial visit. I often minister to family as much or more than to the patient, and their presence usually puts my patient at ease.
Now, we turn to the events that led to her coming to hospice service. Mrs. Fay fell and was hospitalized for several days; she did not bounce back and her other medical issues were exacerbated. Mrs. Fay explained she fell while trying to get out of bed. “I did not want to bother anyone.”
This is a typical scenario, especially for persons living in assisted living apartments. Having recognized to a greater or lesser degree their need for extra assistance, they have given up their residences and moved to a place where their medications are monitored and distributed, meals are prepared and served in congregate dining rooms, group activities are planned. Mrs. Fay, and many others to whom I minister, wants to do for herself and preserve as much of her independence as possible.
Because Mrs. Fay is alert and oriented, I visit with her for a few minutes alone to talk about her fears, concerns and joys. She tells me she understands that her death is likely to come “sooner than later” and that she is content with that, unafraid, “because God will be with me then as he is now.” She tells me she finds solace in the Eucharist. She invites me to come again.
I then speak with Mrs. Fay’s daughter about her own concerns and fears. She and her siblings are saddened by this turn, but grateful they have the support of hospice. She explains their arrangement for visits and care. She and her siblings are clearly loving and supportive of their mother and each other. We discuss timing and details for my next visit, and the daughter expresses how pleased she is that spiritual care will be part of their hospice journey.
Just as I was about to offer prayer and Communion, the eucharistic minister from the nearby parish enters to take Mrs. Fay to the weekly eucharistic service. I introduce myself to her and collect information on the parish and details about the sacrament and Mass schedule at the facility.
She invites me to join the service and I readily accept. What a blessing to receive the ministry of another and feel the graces of Eucharist flow over me! This is an unexpected joy in the middle of my day.
Before departing, I head for the nurses’ room, make a note in Mrs. Fay’s chart, and outline my assessment and probable care plan and orders for our computerized charts. I greet the nurse for Mrs. Fay’s unit and introduce myself to the social worker for the assisted living unit who shares this office area.
While driving to see my next patient I smile as I think about Mrs. Fay’s gentleness¸ acceptance, innate politeness, and the obvious family love she enjoys.
Recently, I have been reflecting on Mrs. Fay and my other patients living in assisted living communities. I fell several weeks ago and shattered my arm. I am unable to drive, write, tie back my hair, and cut up my meat – so many little “activities of daily living.” A friend offered to drive me to a doctor’s appointment. I insisted that I could close the car door and fasten my seat belt. “Alright, Ms. Independence,” my friend chided. That struck a chord. I humbly recognized Mrs. Fay’s attempt to do for herself in my own “assisted living” situation.
It takes grace to recognize what we can and cannot do. It takes grace to let those who love us, help us. It is then that we become a conduit of grace to them. We have a model in Jesus, he who accepted the help of Simon and Veronica along his own final walk. So I have a broken arm, not a terminal diagnosis. Today, I have an opportunity to practice assisted living, and feel the graces of that life flow over me in the middle of my career as a chaplain.
Victoria Lucas works for Holy Cross Home Care and Hospice in Silver Spring, MD, ministering to patients in their own homes, in skilled nursing, assisted living and independent living facilities. She also ministers to hospital end-of-life patients.
