Steve Thomas, DMin, is a senior pastor and healthcare chaplain residing in Wellingborough, United Kingdom.

Research has shown that professional chaplain visits during hospitalization increase patient satisfaction. A survey of patients found that a chaplain’s care correlated highly with their belief that their spiritual needs had been met. Chaplain visits contributed to the patients having a sense of hope and mental strength. It helped them realize that God does care for them.1

Spiritual pain

While pain is the hard reality of disease, old age, and dying, our response to pain—called suffering—is highly subjective. Pain in life is inevitable, but suffering is optional. When body, mind, and spirit are cared for, most fears—suffering—about the crisis or the end of life will then vanish.2

We can define pain as any unpleasant sensation occurring in varying degrees of severity because of injury, disease, or emotional trauma. Rarely do people choose pain. Instead, an involuntary instinct seeks to do whatever it takes to stop it.

To determine whether a person’s hospitalization triggered an emotional and spiritual crisis, the ancients spoke about “taking a spiritual pulse” by asking the person in crisis, “How are you within?” The response to such a simple question can provide valuable insight into the inner struggle and what will be needed to restore the person’s emotional, spiritual, and religious balance.3

One of the most powerful images of hope appears in Isaiah 41:13, where God says that His people do not need to fear because He is the one “ ‘who takes hold of your right hand’ ” (NIV). It is comforting to know that God is close to us during our time of need.

In every healthcare intervention, a sense of hope is central to alleviating or mitigating pain and removing suffering. We should remember that some people will find hope in the smile of a friend, holding a loved one’s hand, seeing their pet, or knowing that their loved ones, including their beloved pet, will be taken care of post-death.4 A pastor’s reassuring interventions, whether by facilitating one’s wishes to have a loved one or pet at their bedside or via a video call, can make a difference whether they rest in Christ with peace (a good death) or struggle with the dying process because of unfinished business (a bad death). For others, hope grows out of financial security or a stable marriage, grandchildren, and a sense of meaning and purpose in life.5

People in extreme physical anguish can experience challenges that affect their religious faith. Some appear to have sources of strength that enable them to continue living after their expected time has expired. They refuse to die until some unfinished business is resolved, even though their doctor predicted their death months earlier. Finally, the closure takes place with acts like a separated loved one’s visit at the bedside, family forgiveness given, the arrival of a long-awaited relative, or the disclosure of a long-held secret. Then, the person dies. How do we know when such a critical issue may be keeping someone from a peaceful death?

Courageous questions

Regardless of who may visit the hospitalized person, courageous questions take both intuition and courage to inquire about what is happening inside the individual, emotionally and spiritually. Diagnosing pain involves listening rather than compulsively talking and trying to fix it. The pastoral caregiver’s job is to help the person articulate what may be happening in them. Their role is to become a mirror reflecting compassion back to the person.

I experienced this with patient Beth,6 a 34-year-old African-Caribbean lawyer and Christian mother of three adult children. Despite her ovarian cancer and leukemia, Beth remained actively involved in church and life. Because she appeared emotionally distanced from her husband, some felt concerned that her busyness was a distraction, keeping her from facing “ghosts” from the past and preparing for a good death.

An in-depth spiritual assessment7 revealed that Beth was spiritually struggling with a crisis of faith because of her image of God and her lack of forgiveness. I asked her, “Share with me what your thoughts are when you read, ‘Forgive me my sins as much as I forgive those who sinned against me?’ ” The interventions that provided spiritual healing for Beth were forgiveness exercises, confession (James 5:16), journaling (writing down how she was feeling and what triggered or led to her feelings), and a personal life review.

Keeping a journal can be a powerful op­portunity for self-reflection during any crisis, especially at the end of life. Through writing, Beth looked at the pattern of disappointments in her life and found a path to forgiveness. Her willingness to keep a journal created a life review process. Survivors of near-death experiences unanimously speak about some form of life review as an integral part of recovery.

As Beth gained the courage to express herself more candidly and restore relationships, God heard her prayers and granted her time. She left the hospital with great joy and hope.

What helped me, as her pastoral caregiver, to be present and nonjudgmental was being fully aware of my own fear of cancer as a result of caring for my wife during her encounter with the disease. From that faith journey, I learned a lot, especially from the strength of her faith in God and how she persevered even in her pain. My wife’s willingness to lean into the pain authentically revealed its reality and nature, and her faithfulness to God helped her pastor husband learn so much about peace and a willingness to take the good and the bad that came from the disease.

The experience reinforced the reality that God is good and that He walks and talks with His children. It helped both of us encounter God and see who He is. He then chose me, another wounded human being, to be that instrument who would listen and answer questions and thereby provide hope for another. I became God’s agent of hope8 for Beth. Her faith journey also strengthened my relationship with God.

Member-centered

The following principles will help you through the process of being member-centered in supporting suffering parishioners:

Build a relationship of care and support. Beyond building rapport, as a pastoral caregiver, lay a foundation of trust and care that your member can draw upon.

Convey a calming presence. Convey a calming presence through a non-anxious manner while demonstrating acceptance. Your peaceful presence will hopefully calm them as well.

Demonstrate caring and concern. We can express caring and concern in numerous ways, depending on the circumstances of the situation. Be sensitive to what God might be indicating for you to do for the person, such as encouraging self-care.

Affirm faith. Affirm faith as part of bolstering a sense of connection to the person’s closely held spiritual and religious beliefs by assisting with spiritual/religious practices (e.g., Communion, morning devotions, and evening prayers) and through exploring issues of faith and values.

Lessen anxiety. One important ministry activity that lessens anxiety is exploring the divine promise of hope, what God promises for our future.

Supportive love

Death is not something that everyone wants to think about, but when the time comes, we need to ensure that those in our care face their ending with love and support. It is often the last thing we can do for them.

  1. George Fitchett, Peter M. Meyer, and Laurel Arthur Burton, “Spiritual Care in the Hospital: Who Requests It? Who Needs It?” Journal of Pastoral Care 54, no. 2 (June 2000): 173–186, https://doi.org/10.1177/002234090005400207.
  2. Richard F. Groves and Henriette Anne Klauser, The American Book of Living and Dying (Berkeley, CA: Celestial Arts, 2015).
  3. Stephen Roberts, Professional Spiritual and Pastoral Care: A Practical Clergy and Chaplain’s Handbook (Woodstock, VT: Skylight Paths, 2012).
  4. Andrew D. Lester, Hope in Pastoral Care and Counseling (Louisville, KY: Westminster John Knox, 1995).
  5. Howard Clinebell and Bridget Clare McKeever, Basic Types of Pastoral Care and Counseling: Resources for the Ministry of Healing and Growth (Nashville, TN: Abingdon, 2011).
  6. Pseudonym.
  7. George Fitchett, Assessing Spiritual Needs: A Guide for Caregivers (Lima, OH: Academic Renewal, 2002).
  8. Gerald R. Niklas, The Making of a Pastoral Person (New York, NY: Alba House, 1996).

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Steve Thomas, DMin, is a senior pastor and healthcare chaplain residing in Wellingborough, United Kingdom.

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