By Connie McGregor, RSM
“One size fits all?” Anyone who has been involved in chaplaincy quickly learns that that is not the case. I believe that this is particularly true in home care, where ministry to patients and families demands a constantly shifting focus.
As a home care chaplain, I travel regularly throughout Erie and Niagara counties in western New York. My mileage reimbursements are significant, but the drive time between patients offers the opportunity to reflect on the visit and to think about the next encounter.
My travels may take me to a patient who is trying to cope with bad news, or to someone who is recovering from a stroke and is aphasic or has lost her/his independence. The spouse or family may be caring for a loved one who suffers from dementia. Perhaps the patient does not desire spiritual care services and it is the spouse or family who requests it.
In family meetings, we offer the patient and family the forum to share their concerns and their hopes, and we share our thoughts regarding possible options, such as an adult day program for the patient or supportive counseling for patient and/or family members.
Our challenges include those patients who, after a hospital stay, have had to relocate to the home of an adult child or another relative. Many times, families are unaware of the challenges they may face in meeting the various needs of their loved one. Their routines are altered. If they are members of the “sandwich generation,” they are also caring for younger family members. Although they are well-intentioned, their efforts to care for their parent or relative may result in a lack of opportunities for socialization by the patient.
As a chaplain, I try to familiarize families with the ramifications for the patient and for themselves of a decision to bring a patient into their home. This calls for not only our expertise but also for bringing in other members of the healthcare team, in a case conference, a family meeting, or both.
Patients and family members also struggle with treatment. Perhaps the patient decides to forego treatment and opts for palliative care. If the family does not agree with this decision, that is obviously a challenge. As chaplains or healthcare personnel, we cannot make that decision. All we can do is try to help those involved to understand the pros and cons and to help them see each other’s point of view. The decision rests with them. We can and do assure them of our prayers that their decisions about the future will be decisions that benefit the patient.
My bottom-line question for caregivers trying to reach decisions about their loved one is, “Whose needs are you meeting”? As always, I offer continuing support for all involved.
I have met numerous family members who share feelings of guilt that they do not do enough for their loved one. Sometimes they are inclined to literally relinquish their lives. I see the necessity of affirming them in their efforts but also helping them recognize their own needs (self care) and making provisions to meet those needs.
Many times, patients and families state that their faith is helping them to cope. I encourage them to reflect on how their faith has seen them through those stressful times in their lives. I encourage them to continue to access their faith for strength and comfort during their current challenges.
Family members are involved to varying degrees and in some cases, live great distances away. Again, our ministry is one of listening presence and support. We acquaint the patient and family with possible resources in the community that would offer opportunities to interact with others. If a patient is connected to a particular church, with the patient’s consent, we contact the church. Our patients are appreciative when their parish sends a Eucharistic minister or when their pastor and/or church members visit.
Regardless of the great diversity we encounter, our ministry is always one of presence, support and encouragement for our patients and their families. They are asking, “Why me?” which we can’t answer. But we can help them identify their strengths and what helps them to cope during their difficult days. We can assure them of our prayers and continuing visits.
Above all, we can assure them of God’s presence and unconditional love for them.
Often, those who are seriously ill and have lost so much independence question their own value. They ask, “Why doesn’t God take me?” And I reply, “You still have work to do.” I attempt to relate to them what they and others teach me as I carry out my ministry — how to deal with illness, faithfulness, perseverance. I make them aware that in their illness, they are teaching those around them — their families and friends and others with whom they come in contact. That is their ministry.
Our visits with patients may be only with the particular individual or they may include a family member/caregiver. At other times, there may be grandchildren in the home. I leave it to the patient to make the determination about their presence during the visit.
The four-legged creatures who are my patients’ faithful companions bring them comfort and demonstrate an undying loyalty. Some of these furry companions are protective and initially eye me with suspicion. Later, they may find their way onto my lap (no problem for someone who loves animals).
Each day, as I set out, I ask God, “What opportunities will you offer me today?” Each day, as I return home, I reflect on what I learned from those with whom I ministered. Did I learn about perseverance? Faith? Devotion to a spouse? I offer gratitude to God for the many ways my patients have ministered to me. Countless.
Sr. Connie McGregor, RSM, BCC, is a chaplain for Catholic Health Home and Community Based Care in Buffalo, NY.