The role of the chaplain in end-of-life care is to be a calm spiritual presence to our patients and families and to help them find peace. Spiritual pain is real and can affect physical pain. The Hospice chaplain offers a safe place where patients and families can express their true feelings and not be judged. They can facilitate conversations between patients and families that are difficult to begin or have with each other. This includes denial of the terminal diagnosis and patients/families not being on the same page about hospice care. Sometimes a very religious person believes that prayer will bring healing, and if healing doesn’t happen, they believe they have failed because they did not have enough faith. There may also be forgiveness issues, relationship issues or other unresolved issues.
Chaplains help address patients’ fears about death, fear of the unknown, fear of leaving loved ones behind, guilt, and remorse. Chaplains help families say goodbye by giving their loved ones permission to go and telling them how they will cope after they are gone, letting the patient choose to pass with family present or not. This is the last gift of love the patient can give them.
Chaplains provide pastoral counseling and meet and accept people where they are – whether they have a belief system or not. Chaplains can connect people with their places of worship, provide prayer and spiritual counseling and support, and arrange for rituals. This includes arranging for a pastor to visit the patient for The Sacrament of the Anointing of the Sick, Holy Unction or Sacrament of Reconciliation, and inquiring about the rituals that need to be done with the person’s body after they pass.
Chaplains address anger with God, anger with the terminal disease, anger with life, anger with the medical system, loss of faith and loss of belief in a God who would let something like this happen to them. Some questions chaplains deal with include, “Wasn’t I good enough? Why is this happening to me? What have I done to deserve this? Am I being punished? Am I worthy to be forgiven? Can I forgive myself?”
Some patients do a life review at end-of-life. Traumatic experiences sometimes come up that have been suppressed in a person’s subconscious and now are being remembered. Allowing patients to express themselves brings much healing.
Chaplains provide grief support for families immediately after a patient dies, especially in the inpatient units, and are a supportive compassionate presence.
Finally, chaplains remind patients and families this is precious time they have been given with each other and to embrace this time to enjoy each other and say and do what needs to be said to hopefully bring some closure and peace.