Church ministry for end-of-life care:

Lessons from a pandemic

Lori Ciccarelli Stotko, MPS, is a retired hospital spiritual care chaplain, Santa Maria, California, United States.

Never did I imagine at the outset of the COVID-19 lockdown its ramifications: to experience one of the most challenging times of my life, not only personally but also professionally, as a spiritual care chaplain and an end-of-life and grief recovery specialist. With my belief that no one should ever die alone, my heart still breaks because I could not be that calming presence for my mother at the end of her life. Not to be holding her hand and praying over her still brings me an overwhelming soul sadness.

My communication with Mom in the intensive care unit was restricted due to limited resources. Our talks on the phone or virtual visits over the last two weeks of her life were few and far between. And, as never before, I understood the challenges of end-of-life care.

Family advocates

“Providing support to families before and after the death of a patient can help mitigate a poor bereavement outcome. . . .

“. . . Communication skills and trusting relationships are core elements of palliative care; both are even more important now given the increased distress and social distancing associated with the pandemic.”1

With so many unknowns about the future, when loved ones come to the end of their lives, how can church members support one another, especially if restrictions are extended and resources remain limited? Church members can extend Christ to one another by being a compassionate presence and acting as family advocates to help those facing end-of-life challenges. Key members can help make arrangements for families to connect with their loved ones and help them prepare for that encounter.

The following are a few things that church members can do to assist families in preparing for a memorable visit with their loved one.

Reminisce about meaningful memories. Reminiscing is like show-and-tell in school. When Mom was first admitted and still coherent, my brother dropped off family photos at the hospital to place at Mom’s bedside and a special blanket to wrap around her with love. “Surrounding a loved one with pictures and mementos, . . . playing music, . . . and recalling life stories promote dignity and comfort all the way through life’s final moments.”2

During a phone call when Mom was still coherent, I played music from a Christmas ornament she gave me the year prior. It brought an abundance of joy as we reminisced together. On a later virtual call accompanied by my three siblings, I shared a photo book Mom created of Christmases past from our childhood memories. It sparked conversation and laughter. Even though Mom was now unresponsive, I knew she could still hear us because she stopped her restless moving and moaning and lay peacefully in her hospital bed. It helped turn a very sad situation into a joyous time of celebration. We ended each call with prayer, bringing a sense of peace and comfort to us all. Studies show reminiscing provides comfort and a sense of security for people facing severe loss and emotional distress.3

Talk about life accomplishments. On another call, it was inspiring to share how Mom made a difference in this world and in our lives, what she meant to us, and how she reflected Christ while raising us, grateful for the godly role model as a mother and woman after God’s own heart. Again, she was unresponsive, but I know she heard us. Research indicates that a life review process of reminiscing on the past can help patients face death more peacefully as it reaffirms a sense of identity, uniqueness, self-worth, and accomplishment.4

Restrictions allowing, churches can offer activities directly to end-of-life patients that will bring comfort by (1) supporting them in prayer; (2) helping them write letters to loved ones for significant life events they will miss such as birthdays, anniversaries, and holidays; (3) addressing areas of unforgiveness and areas to extend forgiveness and let go of past hurts; (4) reading a book or the Bible to them while they rest. The Word heals the heart by restoring joy, peace, and hope. And, (5) helping to create a memory book, scrapbook, or prayer book celebrating their life’s journey.

We all want to live well, but we need to finish well too. To celebrate Mom’s life with her while she was still with us was invaluable. It not only helped comfort Mom in the hospital but also helped us process our grief and left us with a beautiful memory at the end of her life, even when we could not physically be there with her.

Spiritual support

The death of a loved one is considered the most powerful stressor, with bereaved individuals at increased risk of adverse mental and physical health problems.5 Restricted access to a patient and not being able to say goodbye are associated with a prolonged grief disorder and PTSD in bereavement.6

I believe bereavement care is an integral component of quality end-of-life care. To continue walking alongside families during the aftermath is vital for the healing process so that grief does not become pathological. Here are ways in which churches can provide additional support to families.

The Center for Loss and Life Transition says, “Grief is what you think and feel on the inside after someone you love dies. Mourning is the outward expression of those thoughts and feelings. To mourn is to be an active participant in our grief journeys. We all grieve when someone we love dies, but if we are to heal, we must also mourn.”7 Scripture says: “ ‘Blessed are those who mourn, for they will be comforted’ ” (Matt. 5:4, NIV).

Mourning is the action following grief that brings comfort, connecting us to others who are also mourning and bridging our past to the present. We can mourn through written, verbal, or physical activities, expressing ideas, thoughts, and beliefs that help us transition from pain and chaos to wholeness and healing. We have daily rituals or routines to help us process life. We need rituals, or actions during our time of loss, to help us process our pain.8

Making space to listen provides a safe place to vent, which helps those grieving with their emotions and pain. To be an empathetic listener reflects Christ. Listen with your entire body, giving your undivided attention; turn off any distractions. Reflecting back what you heard without judgment or unsolicited advice will validate feelings. Save advice for those who ask; most often, people just want to be heard and affirmed. This is healing to the soul.

When in pain, we crave connectedness. Those experiencing grief seek comfort from community. Churches can offer community through grief- support groups or help to find local support resources. Many organizations, such as hospitals and churches, offer this kind of group support. Encourage families not to isolate, as it leads to depression and anxiety. Help surround them with those who love and support them, ensuring that they are not alone.

Encourage with practical application of spiritual truths because they will carry families to victory through the deepest loss. “Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen since what is seen is temporary, but what is unseen is eternal” (2 Cor. 4:16–18, NIV).

Access to spiritual support at the end of life is important for many patients and families, whether or not they are religious; but this is an aspect of care somewhat neglected in acute hospitals.9 Research studies indicate religious and spiritual beliefs are an important factor and predictor of outcomes during a time of grieving. Those who profess stronger spiritual beliefs seem to resolve their grief more quickly and completely after the death of a person close to them than do those with none of these beliefs.10

Compassionate presence

God’s mission for each of us is to advance the kingdom by reflecting Him, to be His heart and hands. What a wonderful opportunity to extend Christ as a compassionate presence through end-of-life ministry, bringing the kingdom forward on earth as it is in heaven. After the death of Mom—in less than perfect circumstances—I know just how important that care really is.

  1. Sue E. Morris, Amanda Moment, and Jane deLima Thomas, “Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient,” Journal of Pain and Symptom Management 60, no. 2, (August 2020): e70–e74,
  2. Melissa Wayne, Jeanne Segal, Lawrence Robinson, Late Stage and End-of-Life Care,, last updated September 2020,
  3. Dorothy Wholihan, “The Value of Reminiscence in Hospice Care,” The American Journal of Hospice and Palliative Care 9, no. 2 (March/April 1992): 33–35.
  4. Wholihan, 33–35.
  5. Morris, Moment, and Thomas, “Caring for Bereaved Family Members,“ e70–e74.
  6. Lucy E. Selman et al., “Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians,” Journal of Pain and Symptom Management 60, no. 2 (August 2020): e81–e86,
  7. Alan D. Wolfelt, “The Journey Through Grief: The Six Needs of Mourning,” Center for Loss and Life Transition, December 14, 2016,
  8. Lori Ciccarello Stotko, “Mourning Through the Holidays,” Transforming Lives Advocacy (blog), 2017,
  9. Selman et al., “Bereavement Support,” e81–e86.
  10. Kiri Walsh et al., “Spiritual Beliefs May Affect Outcome of Bereavement: Prospective Study,” BMJ 324 (June 2002): 1551.

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Lori Ciccarelli Stotko, MPS, is a retired hospital spiritual care chaplain, Santa Maria, California, United States.

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