End Of Life Spiritual Care: A Pathway to Growth and Peace

In the following online post, Rev. Dr. Walter J. Smith presents a general overview as to the power and need for spiritual care for the dying.  As he describes, spiritual care can potentially be provided by any visitor.  This concept is one that transcends time.  It is a derivative of the famous rabbinic idea that a person improves by 1/60th after being visited.  As you will notice in reading his words, the questions being asked in the three vignettes all reflect the personal crisis that we go through when we are vulnerable.  The questions are not always asked to be answered, though there are times when a person is really looking to reflect on the specific questions relating to one’s relationship with G-d.  As you read, reflect on how these stories resonate in your own life’s narrative.   

Doug, 81, recently learned that he has end-stage cancer and probably only a few months to live. He’s devastated, frightened and feels alone. His wife died two years ago, and he has missed her greatly. He has outlived his siblings and closest friends. His only daughter lives 2,500 miles away; his three adult grandchildren are scattered around the country as well.

Doug finds himself thinking a lot about what he calls “The Big Questions”: “What’s the meaning of my life? When you add up them up, do my good memories outnumber the failed opportunities and disappointments? What’s going to happens after I die? Is there a God? How will I be judged? How will I be remembered by my daughter and grandchildren?”

Larry is 42 and a Wall Street analyst. Work is his life; it’s how he defines himself. Everything else has taken a back seat to his career: marriage, family, social relationships. Larry has just learned that he has prostate cancer, and question upon question swirl unanswered in his head. “Is cancer going to cut short or radically alter my life? Will I survive this? Will it destroy my career? I went to Harvard. I’ve been killing myself on Wall Street for the past 20 years. And for what, to be facing a radical prostatectomy?”

Doug has not been a religious person. Unlike people who are rooted in a faith tradition and community, he feels adrift. He can’t turn to and rely upon prayers and rituals, clergy and fellow congregants, all of which might help him find comfort and meaning. And he does not have much of a support network either, apart from some of his Wall Street co-workers.

Samantha is a 38 year old African-American single mother of two who has been diagnosed with Mitral valve prolapse, a heart valve disease that will require surgery. She has been treated for high blood pressure for several years, and suffers from shortness of breath and dizziness. She has chronic swelling in her ankles and has gained a considerable amount of weight since the birth of her second child. Although Samantha’s doctors are optimistic about the valve repair and her long-term prognosis, Samantha is pessimistic, believing in a very fundamentalist way that her condition is God’s punishment for her free-wheeling lifestyle, which she believes contributed to her first pregnancy that resulted in a still birth. “Am I a good mother? Did I smoke and drink too much when I was younger? Will God forgive me? How will my children get along if I’m no longer here?”

Although each of these people are worlds apart in terms of their life experiences and diagnoses, what’s common to them is that a serious or life-altering illness has triggered inner questioning and a search to make sense of life. “Who am I? What’s the purpose of my life? Why was I put on this earth?” At their root, each of their questions is spiritual in nature. Spirituality touches the essence of who we are, regardless of whether or not we embrace religious faith or practice.

Spirituality, according to the 2009 consensus conference sponsored by the Archstone Foundation, is “the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature and to the significant or sacred.”

Being unable to grapple successfully with these basic questions of existence can contribute to what may be called spiritual distress. Too often, health care professionals — appropriately focused on the diagnosis and proposed treatment plans — pay insufficient attention to the spiritual questions that arise and need to be addressed. People need “spiritual care” as much as they need “medical care.”

When our bodies are under assault from disease or illness and our minds are reeling from the threat of disability or death, our spirit is there to hold it all together. And many people can play the role of a spiritual care provider. Spiritual care might come from a spouse, a doctor or nurse, a priest, minister, rabbi or imam, a trusted friend or co-worker. What is required is presence, an ability to listen and understand, and an honest attempt to help a person find meaning — real meaning — in their life circumstances.

A person in spiritual distress is usually looking for meaning. A spiritual companion, whoever that may be, must understand this universal need to find meaning and commit to accompanying a patient to find and affirm their own answers from within their own life and experience.

That is what a good spiritual companion does. He or she commits to the journey and becomes a mirror held up to their friend’s life, inviting them to look in it deeply and to express truthfully what they see. They encourage their friends to reminisce about events and relationships that have occurred throughout their life and to rediscover legacies, meaning and spiritual strength.

Astute, sensitive spiritual care helps create gentle pathways through which a person might achieve inner growth and peace during critical steps along life’s journey until it is finally completed.

If you know a Doug or a Larry or a Samantha, don’t be afraid to reach out to them in a gentle way. Recognize that people cope with health crises and grief in their own way and at their own pace. Most importantly, offer to be there for them. Listen to what they say and what they don’t say. If your friend is in a hospital, ask if they’d like for a chaplain to visit. I’ve learned from many years of observation that professional chaplains are particularly able to help people — regardless of faith or beliefs — to find meaning and comfort.

Meaning and comfort is what we all need and what we all desire.

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