Saul Ebema, DMin.

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Setting the Scene

• Mrs. Hernandez’s three adult children are confronted by the nursing home’s no visit policy, shortly after her health turned for the worse and seeming imminent.
• Hospice nurse, Josh*, isn’t struggling to manage his own fear around his work with COVID-19 hospice patients; he is experiencing distress because his mother, who is terrified for him, is distressed.
• Deborah, who lost her husband in 2005, can’t stop wondering whether this scary virus will be the cause of her losing another man she loves.
• Aretha feels guilty; she believes that attending a church service resulted in her bringing the coronavirus home to her husband of 48 years, Frank is now on Hospice Care due to COVID-19.
• Hospice leadership is growing increasingly anxious about their care roles as they contemplate how to best support COVID-19 patients and front-line RNs.
• Eighty-year-old, Sarah, has been wanting to see her great grandchildren since the stay at home orders were put in place and her nursing home has refused access to all visitors and sometimes hospice staff, she doesn’t see how she will be able to do that.

Right now with most hospice chaplains around the country working remotely from home, who cares for these people and their souls? Who stands ready to meet the unique challenges they face? Who stands poised to help them spiritually and psychologically, along with their families, and other health care professionals who are safely trying to navigate the nightmare that is COVID-19? 

This moment calls for Hospice Chaplains. The role of the hospice chaplain is not only to stand in solidarity with people as they wrestle with this very serious threat to their existence; but also to maintain a commitment to core values that demonstrate what it means to care.

What Postures should Hospice Chaplains Embody in order to Help?

Hospice chaplains can embody four major postures in order to provide support for patients, families, and other health care professionals during the COVID-19 pandemic.

1) The Hospice Chaplain as a facilitator of meaningful connections

In these times of uncertainty, there is tremendous value in helping people become comfortable enough to share their feelings. To feel safe in a time of vulnerability. Hospice chaplains should be committed to creating connections with people to make them feel comfortable, and have a desire to reveal any issues that are troubling them. By facilitating connection, hospice chaplains can help people like Josh and Aretha to express, process, and possibly re-frame the distress they are experiencing.

2) The Hospice Chaplain as an Advocate

Sometimes, health systems (large or small) and their corresponding policies can limit an individual’s rights and values. But often, these rights and values are foundational to a person’s ability to cope with major traumatic events. By advocating to protect basic human rights in times of great pain, hospice chaplains can help people like the Hernandez children (who are denied access to the nursing home) secure the ability to be with their mother, so they can support her, as well as grieve her impending loss with honor and dignity.

The Hospice Chaplain as a facilitator of Meaningful Reflection

This COVID-19 pandemic is a major crisis for everyone around the world. In order to navigate it, people may choose to engage in course charting, to figure out what they want to do independently – and hospice chaplains can help with this.

Reflecting helps people access memories of successful journeys from their past so that they are encouraged by knowing that this journey, too, is chartable.

By opening space for hospice leadership and other staff to speak their truths (and fears), and then reflecting back to them what was said (and even praying with them about it), the hospice chaplain can help them to feel heard and embrace their own personal agency.

The Hospice Chaplain as a Supportive Presence

Two key tools that hospice chaplains use are conversation and presence. These are engagement tools, which help open people up emotionally, so they feel comfortable talking about how they are being affected by the circumstances in which they find themselves. The information gleaned from engagement is invaluable, in that it helps unearth issues that generally lie beneath the surface.

Once [emotional issues are] uncovered, especially in times of crisis, we can ensure that people receive care that is personal, communal, and comprehensive.

These tools help Deborah talk through her deepest fears, and help Sarah by offering use of technology to see her great grandchildren, despite the fact that they cannot come to the nursing home to see her.

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While we seek to effectively care for people with terminal illness in the era of COVID-19, it is important that we do not forget time-honored methods of caring for the human spirit and psyche. As important as it is for hospice care to treat symptoms that affect the body, it is just as essential to care for the soul. Hospice chaplains across the country need to stand ready to answer the call to care for the human spirit and psyche in this COVID-19 era. We need to stand ready to make our contribution.

*Names were changed in an attempt to protect personal privacy.

By facilitating connection, hospice chaplains can help people to express, process, and possibly re-frame the distress they are experiencing.

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The process of reflecting on the past experiences helps people access memories of successful journeys from their past so that they are encouraged by knowing that this journey, too, is chartable.

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