“Spiritual care was offered and declined. The chaplain will remain available at the request of patient/family” This is the usual verbiage I use to document the fact that the patient or family has declined to see the chaplain. The reasons are many and are often understandable. This situation was a little different though, the relationship with the family and the patient was at a boiling point. They were on the edge of crisis due to the illness progression and increased care needs with a pinch of Mother-in-law/ Daughter-in-law tension sprinkled in for some added flair!
A few days after the initial hospice admission was complete the crisis hit. Her family that was providing her day to day care could no longer care for her and all the telltale signs of caregiver burnout were present. We provided respite for the family and she was moved to a facility so that our team and the family could formulate a plan to move forward. I thought I would drop by to check on her and to say hello since I was already at the facility. I knocked and was invited in to introduce myself. I noticed the curtains were drawn closed, the lighting was dim and since she was only going to be staying there for a few days the room seemed sterile as it was void of any personal belongings. One exception of significance was the 8×10 picture of her and her spouse. It was vibrant and colorful against the backdrop of her greyed shadow-filled room. Fresh skin tones, full smiles and a posed embraced in the photo told a story of a loving relationship between her and her spouse. He was gone, he passed away a few years earlier and since then her own health challenges had taken over. Every time he was mentioned in our conversation she would brighten. She happily shared all of their favorite things to do together. They would dance with one another in the living room of their home to the music played on their extensive vinyl record collection. A Ginger Rodgers, Fred Astaire like image came to mind for me but she quickly erased it by sharing that their dances together were less about well time choreography and more about being close to one another. She would glow as she recounted the summer evenings on the back porch of their home in their working-class neighborhood where they shared glasses of wine together. We even learned that we had at one time lived in the same community and frequented the same greasy spoon diner for breakfast. It was one of their favorite spots on Saturday mornings. Something about that cheap diner coffee! In reviewing her life, a central theme became obvious, they were madly in love and he left a huge void in her heart that no one else could fill.
At the end of our time together that day, I asked If I could come back? She agreed and said that she enjoyed our conversation. As our time together was closing, I asked, “Could I pray for you?” She kindly declined and said that she had her, “own people” to pray with her. I felt bad about assuming that she would want prayer because I failed to learn her background. This made me feel insensitive to her spiritual care needs. I apologized and told her that I meant no disrespect to her and she was gracious and invited me back.
Our visits would move from her temporary place of respite to a long term care facility. Over the next several weeks we had great conversations about life and love. She seemed to blossom under the care of the facility paired with the team of hospice workers. Her life seemed less dull and more vibrant like the smiles and colors captured in the photo that now held a prominent position on her bedside table. A recent trip to the stylist even left her with the wildest streak of purple hair that matched her personality well. Since my initial visit, I was more mindful of her faith tradition and never fell into the minefield of imposing my traditions again. As a chaplain, I am not an evangelist, not in this setting. I consider myself more like a spiritual guide in a “Choose your own Adventure” book, like the ones that would engross me in elementary school. Each conversation that we had would lead to a new place of discovery and no two discoveries were the same. It was always a beautiful new outcome of her story, not mine. One thing I observed was that I had not seen any support from her faith group. No record in the facility sign-in sheet, no bulletins left behind, no trace of any other visitors except the team of hospice workers. I asked her about it and she sadly said they have lost touch over the years. One thing I am learning is that in many cases death moves in slowly and is present long before the last breath is breathed. It arrives in our lives and begins to march along, bringing a slow rhythm of change. Death seems to start with subtle changes like no longer being able to drive or the inability to attend weekly services. These changes compound until everything is finally taken in the. I asked her, “would you like me to get in touch with them for you?” She excitedly said, “Yes”. She gave me a name and a location. After weeks of messages and unreturned calls, I was driving by her place of worship and noticed a crowd of people exiting the building. I slammed on the brakes and with squealing tires, I turned into the building’s parking lot, scaring the new employee orientee with me that day. I asked for the person I needed to reach and they knew exactly who he was and provided me with his cell number. Mission accomplished!
On my next visit, I learned that her church did get in touch with her. She couldn’t wait to tell me that a bunch of “her people” came on a Saturday afternoon and brought her favorite home-cooked meal paired with her favorite wine and prayed together according to the traditions of her faith. I considered this a major win in spiritual care for her.
As things always do, they change. Much like the season we were in was shifting from Autumn to Winter, she too was in transition. The warmer Fall days faded into cooler nights and just as the daylight grew scarcer, so was her time with us. She was sleeping more and growing lethargic. This had all the sights and sounds that I have grown to recognize, death was near. I spent some time with her at the bedside, talking and just offering a compassionate presence. As we entered the weekend I braced for the likely report of her passing by Monday. On that Monday morning report, I learned she was now alert and oriented. A strong rally that rivaled the strength of my Monday morning coffee, she was back! She was up, talking and living with the same vibrance as the Purple streak she wore in her hair.
Our relationship was now at a place that allowed for frank conversation. She was not naive to the reality that death was near. I said, “I thought you were gone” and told her that I had spent some time with her while she rested. She smiled and expressed appreciation. She thanked me for all my visits and we found ourselves in a sacred space where she was able to share some very real feelings and emotions. There was a sense of finality in the room that conveyed a feeling that whatever needs to be said should be said because there would likely not be another opportunity. We laughed together about our first encounter and my offer to pray with her. She must have read me like a book and noticed my embarrassment. When she brought it up again, I apologized quickly one more time. She said, “Oh, it was not an issue and it did not offend me. I’m used to well-meaning people offering prayer.” Her last words to me were ones that gave me a great sense of purpose as a Chaplain. “Besides”, she said, “you did something better, you became my friend.” Just a few days later, my friend was gone…