(800) 237-4629   

The Importance of Storytelling for a Hospice Chaplain

Tom HolteyBy Pastor Tom Holtey

“Humans are essentially storytellers.”- William Fischer

Children love to tell as well as listen to stories. When people are at the end of their lives, they also need to tell and hear stories. Dr. Stanley Hauerwas wrote, “Our existence makes sense only insofar as we are able to place it in a narrative.” The search for discovering our purpose in life starts when we are very young and continues throughout our lives.

As a Hospice chaplain, I have seen many people struggling with their purpose in life when death is imminent. Encouraging patients to tell their “life story” seems to help them in this struggle. By listening closely to these stories, a connection can be made and this seems to help with their existential questions. Telling their “life story” also appears to create a change in their attitude.

After telling their “life story,” often patients will address their concerns about their illness or family. This frequently leads to prayer or triggers stories that may relate to their illness and how they or their families are coping. Dr. Eric Cassell believes “Each of us gets to our illness our own way, it becomes part of our story, and we individualize it by its place in the narrative of our lives.”

It is tempting for the listener to put the words of the patient within his or her own paradigm or agenda, but it’s crucial that the listener pay close attention to understand more fully the context and its implications. Sometimes it is appropriate for the listener to share a little of his or her own story to coax stories from the patient. It is important to keep the focus on the patients and their needs, and to quickly direct conversations back to patients, even if it means not being able to complete your own story or thought.

Another form of stories comes from scripture, holy texts or devotionals. Picking an appropriate verse or story that relates to what a person feels or thinks can add a depth to the visit that wouldn’t be achieved otherwise. Hearing stories from hymns or scripture may trigger comforting memories that may induce conversations that wouldn’t otherwise come up. Singing or reading hymns, particularly those from a person’s religious tradition or childhood, can be particularly fruitful for comfort and reflection.  Even humming the tune of a hymn or song can remind the patient of the words and “ring” in a person’s mind and heart long after a visit is over.

Stories can also be stimulated through pictures of vacations, former homes, farms, churches and religious images. Dementia patients often like to tell the same stories over and over, sometimes as if the memory is currently occurring. It is important that the listener give these stories the same respect as if they had heard them for the first time.

The gift of the story lasts long after a person has died. These stories are often shared at prayer services, funerals and other gatherings. This is one way patients can have a “purpose” in their last days, even when they feel like they are no longer able to “do something.” Humans are essentially storytellers, and it is “holy ground” when people are telling their life stories. It is a privilege to be a witness to these stories and the storytellers who have lived them.

Pastor Tom Holtey is a chaplain at Hospice of the Red River Valley

The Gracious Gift of Acceptance at the End of Life

By Karin Moberg

 “To refrain from giving advice, to refrain from the affairs of others, to refrain, even though the motives be the highest, from tampering with another’s way of life – so simple, yet so difficult for an active spirit.”      – Henry Miller                                   

I consider myself an “active spirit.” As a hospice chaplain, I am trained to be involved in people’s lives. I am also a mother, daughter, sister and friend. A “hands off” approach just doesn’t fit my understanding of what it means to love.

It was difficult to sit by and watch both my parents die from a cigarette addiction.  Periodically, I encouraged and even pleaded with them to quit smoking. When my Mom was diagnosed with end-stage, COPD—a lung disease, my family’s intervention allowed her (and us) to receive the benefit of hospice care.

My Mom wanted to die at home, and we wanted to make that happen. However, due to her decline and our inability to provide enough home care, we had to intervene in her life once more. The hospice staff assisted us in finding an appropriate placement.

While Mom watched from her wheelchair, my brother and I prepared for her final move to a nursing home. We went through drawers, closets and cupboards packing up her things. We stopped to tell stories, look at pictures, and marvel over our findings. Given my Mom’s cigarette addiction, it wasn’t surprising that we also found cartons of cigarettes tucked away in the oddest places.

Everything smelled like smoke. We took the pictures off the walls of her one-room apartment. A yellowish smoke stain created a frame around the empty spaces where the pictures once hung. The smoke of her addiction colored not only her walls and her lungs but also so much of her life.

That night, my Mom grabbed my hand and said, “Karin, I am done.” I asked, “Done with what, Mom?” She said, “I am done smoking.”

How many times over the years had she said those words? “This time,” she said, “I am done for sure.”

Later that night, she had me turn off her oxygen and roll her out to the balcony as she held two cigarettes and a lighter in her shaking hands.

I was mesmerized by the peace that settled over her as she gazed out over the city of San Diego from fifteen stories up—breathing in the night air, the remarkable view of the city lights and the last few puffs of pain and pleasure. It was almost as if her heart turned toward thoughts of home … past, present and future.

It was probably the only time I watched her smoke that I didn’t want to tamper with her way of life—the only time I didn’t think of her as indulging in a deadly habit. In fact, that night it reminded me of the Ojibwa belief that the rise and the fall of the smoke is a reminder of where we come from and where we are going; the act itself a sacred prayer. (Kent Nerburn, Small Graces)

I didn’t want to interrupt her as I watched from a distance … one still shot of the beauty and the brokenness of life.

It took my breath away.

The grace of acceptance filled those moments.

Mom was right. Those were her last two cigarettes. She was done smoking. As she said, “this time for sure.”

She died two days later.

I have witnessed variations of “my story” many times over as a hospice chaplain; the spiritual work attributed to the end of life is as simple and complex as we are. We aren’t always sure when to intervene and when acceptance will enter some moment to offer a gracious gift.

Our role as hospice chaplains is not to impose a particular religious or spiritual agenda. Rather, we can give witness and support to the amazing, and unique, spiritual journeys of our patients and families.

Karin Moberg is a chaplain with Hospice of the Red River Valley based out of the Detroit Lakes, Minn. office. She feels her job is sacred, and feels honored to encourage the spiritual strengths that already exist in the patients she serves.

Fulfilling Spiritual Wishes at the End of Life

By Karin Moberg

As a chaplain with Hospice of the Red River Valley, I have the privilege of providing spiritual support to many of our patients and their families. My passion and interest in the spiritual dimension of hospice care emerged from my own experience.

When I was twenty-eight years old (thirty-two years ago), my dad died from lung cancer. He was able to remain in his home due to the support and care of his children and an area hospice program.  In a formative way, my dad’s death and my early experience with hospice care significantly shaped my understanding of the spiritual journey, particularly during this season called “end of life.”

The hospice staff encouraged us to talk openly with each other and to take notice of what Dr. Ira Byock has come to call the “four things that matter most”: expressing love, saying thank-you, forgiving others and asking for forgiveness. Generally, these four practices are not only at the heart of what sustains healthy relationships in this life, but are also essential for meaningful and grace-filled goodbyes.  I have found this to be true regardless of whether one has a strong spiritual tradition or religious affiliation—or none at all.

In my dad’s case, he had long been alienated from the church of his childhood, which was Catholic. He also had some significant relationship issues. Accepting that the end of life was in sight became an opportunity to consider our spiritual needs in a new light. The question we were looking into was, “What might bring healing and reconciliation to our family relationships and also to the relationship between my Dad and his higher power?”  

After some conversation with my dad, he acknowledged that he would like to see a priest, even though he felt guilty and undeserving. I made the call. The priest came as quickly as he was able. I can honestly say that in the many calls I have made on behalf of our hospice patients, rarely have I noted anything but eagerness on the part of spiritual leaders in response to the spiritual needs of those who are “turning toward home.”

The priest’s visit, confession, communion, the baptism of a new grandchild and the extended family praying around my dad’s bed—all profoundly changed the spirit of those last days. It didn’t matter that each of us, my dad’s five children, were following very different spiritual paths. When my Aunt initiated prayer with her rosary, we all joined in. The words of the Hail Mary were particularly poignant in those final hours…“Pray for us now and at the hour of our death…” What I had previously judged to be an “empty ritual” seemed to come alive in those moments.

When one Aunt handed my Dad a broken rosary blessed by the Pope, he hung it on his bed and said, “It is broken, just like I am.”

From a Dad who lived most of his life spiritually troubled, came these humble and beautiful words. In his dying we were able to receive some of the most healing gifts of his life…

And my life has never been the same…

Karin Moberg is a chaplain with Hospice of the Red River Valley based out of the Detroit Lakes, Minn. office. She feels her job is sacred, and feels honored to encourage the spiritual strengths that already exist in the patients she serves.

Experiencing a Hospice Chaplain Visit (Part Two)

By Amy DuBois

Elizabeth
On another visit, I went along as James*, a Hospice chaplain, met with Elizabeth*, a cheerful patient living in a nursing home. I followed James as he navigates the maze of hallways in the nursing home with remarkable proficiency, stopping to greet each of the patients that he recognizes along the way. When we came to Elizabeth’s room, her door was wide open and she rested comfortably in her chair.

“Hi, Elizabeth, it’s James from Hospice of the Red River Valley,” he said. “Would it be okay if we visited with you for a little bit?”

Elizabeth’s crystal blue eyes sparkled and she replied back “Oh, that would be lovely.” Then with a mischievous grin she says, “Aren’t you handsome?”

James blushes and he quickly turns the conversation back to her.

“How have you been doing?”

She tells him she has been doing fine, and that she is working on moving around with her walker. She makes us laugh with her tales of the nursing home, her family and the very direct and honest answers she gives us to our questions.  

After visiting for awhile, Elizabeth becomes thoughtful and tells James she has always wondered something about God. James gently urges her to continue. “I want to know why a loving God would sacrifice his own son. I just don’t understand it.”

 James remains quiet for a moment and asks her, “Can I share with you what I believe?”

“Yes,” she says, “please do.”

James explains it this way, “I imagine that sacrificing my child, would be far harder than sacrificing my own life. Would you agree with that?”

Elizabeth nods her head in agreement so James continues, “His sacrifice goes to show us just how deep his love is for us.”

Elizabeth pauses and then looks James directly in the eye, “Thank you; that helps me understand it.”

As James prepares to leave he asks if he can come back and visit with her again sometime.

She responds, “Oh, I would like that,” and I can see that she means it. James has been a bright spot in her day and Elizabeth has been a bright spot in ours.

*Names have been changed to protect privacy

Amy DuBois is a communications manager for Hospice of the Red River Valley. What she enjoys most about her job is meeting patients, family members, volunteers and donors and having the opportunity to share their hospice stories with others on www.hrrv.org

ZFAGV3XKB65V

Experiencing a Hospice Chaplain Visit (Part One)

By Amy DuBois

Editor’s Note: An important aspect of hospice care is the spiritual support provided to patients. Hospice chaplains are professional clergy who are well-versed in the spiritual needs of both patients and families going through the end-of-life experience. If desired by the patient, they provide support based on the patient’s personal beliefs, no matter what religion, and can serve as a link to a faith community.

****

When tagging along with a Hospice chaplain, James*, on patient visits, I learned the simple truth—no two visits are the same.

Ruth
The chaplain and I arrive at our first visit to find Ruth*, the patient, lying in her bed. She is waiting for the pain medication to begin working. Ruth scoots herself up in bed to visit with us.

When the chaplain, James, asks how she is doing, her face falls as she fights back tears. She slowly composes herself, while James remains by her side silently waiting for her to go on. A minute later she responds, “I’m okay.” Ruth doesn’t seem okay, she seems deeply sad. She tries to focus on the positive; “My daughter is taking ‘maternity leave’ to care for me” she jokes, “I guess it’s only fair, I took six weeks off to care for her, now she’s taking time off to care for me.”

James agrees with her, and lets her know that her daughter wants to do this for her after all she has done for her. Ruth contemplates this, but she’s not convinced. This is not how she had planned to spend her retirement and this is not what she wanted for her daughter.

Head bent down, Ruth tells James, “I don’t want to go down; I want to go up.” She goes on to tell him that she doesn’t think she is worthy of heaven.

James listens intently and doesn’t interrupt. After a brief pause, he asks her, “Do you remember the last time we visited, we talked about Romans 8?” Ruth looks up at him and acknowledges that she does. “Would it be alright if I read it again?”

She slowly nods her head. James takes out his bible, turns to Romans 8 and begins to read.

As he reads, Ruth’s expression begins to change; the tension starts to ease from her face. When James is done reading, he closes the Bible and asks “Would you like me to share a prayer with you?”

Again she nods her head and he reaches out to her, lightly placing his hand on her shoulder, he begins to pray for her. He prays for her comfort, for her peace and for her caregivers. When the prayer is over, Ruth relaxes into her pillow. She is comforted and ready for the peaceful rest her body needs. James quietly says his good bye with a promise to return.

After leaving the visit, I couldn’t help but feel humbled and impressed by the quiet, spiritual guidance James offered Ruth. My instinct—to wrap Ruth in a big hug and tell her it was all going to be okay—would have added to her physical and mental anguish. In contrast, James listened to Ruth first, acknowledged her feelings and comforted her with his simple reading and prayer.

*Names have been changed to protect privacy

Amy DuBois is a communications manager for Hospice of the Red River Valley. What she enjoys most about her job is meeting patients, family members, volunteers and donors and having the opportunity to share their hospice stories with others on www.hrrv.org. 

The Role of the Hospice Chaplain

By Jane Millikan

Anytime you’re dealing with a limited prognosis, spiritual issues are in the background. Everybody deals with this in their own way. A hospice chaplain can help because we’re good listeners; someone to talk to when it’s hard to find answers.

We may not know all the answers, but we know that asking the hard questions is an important part of moving toward peace. We help figure out the particular things that help you, as an individual.

If you are sustained by your connection to a congregation, we make sure your clergyperson is kept up-to-date (if you give permission for this). If you draw spiritual strength from nature, or a network of family and friends, we find ways for you to have more of that, even if your life changes due to an illness.

Chaplains are trained to give support to people of all faith backgrounds, including those who do not identify with any spiritual group. All people have things that are of ultimate importance to them, those things that we focus on because they make life worthwhile. There may be times when someone wants to talk about the meaning of life and death. There will be other people who don’t like to talk much at all. There is no “one size fits all” to spiritual support. It should be as individual as you are. Spiritual support can make all the difference as you face the challenges of this part of your life.

Jane Millikan is the chaplain coordinator for Hospice of the Red River Valley. What she enjoys most about her work at Hospice is the great variety of people it allows her to meet.