Transcript Church of the Holy Spirit Pastoral Care Ministry

Church of the Holy Spirit
Pastoral Care Ministry
Friendly Visitor Training
Saturday, June 7, 2008
Welcome
• Welcome
• Introduction
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Housekeeping
Training Topics
Goals
Interactive Activities
Questions Anytime
• Opening Prayer
How A Person Gets Visited
• Church is Notified of Need
• Friendly Visitor Coordinator is Notified
• Coordinator Matches to Visitor Based on
Situation
• Visitor is Notified and Briefed
• Following Visit, Visitor de-briefs
Coordinator
Parish Nurse versus Friendly Visitor Roles
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Role of Parish Nurse
Represents the caring and praying
church community.
Cares about the patient’s spiritual needs
Professional Knowledge.
– Asks the right questions regarding
medications and treatments.
– Interprets a doctor’s diagnosis for
the patient.
– Assists the doctor in exploring
options for the recovery process.
– Follows up after hospital stay.
– Evaluates home resources.
– Interprets to the rest of the Pastoral
Care team about ongoing needs.
Patient Advocacy
– Voices concern to Hospital Staff
and physicians with knowledge
and credibility.
– Serves as liaison between patient
and health care community—e.g.,
hospice care.
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Role of Friendly Visitor
Represents the caring and praying
church community.
Cares about the spiritual needs of
patient.
Is more remedial than proactive
Walks along side the patient, not trying
to fix the situation, but to comfort
him/her.
Gives the message that the patient is
cared about, and is not alone.
Is present to the patient, that is, enters
into the patient’s world and responds
with feeling.
Alerts the Pastoral Care team about
changes in patient’s progress.
Be-Attitudes of Visiting
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Be Prepared – Take a moment to
collect your thoughts and pray that
your presence will show the patient
you are concerned.
Be Present – Be there 100%.
Be Open – Meet the patient where s/he
is. Listen without judgment.
Be Still – Listen and don’t feel that
you have to have the answers.
Be Sensitive – Be aware of the
patient’s needs and condition. Try to
pick up on an underlying theme of
what is being said.
Be Human – Admit you don’t have all
of the answers and identify with the
patient’s feelings whenever possible.
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Be Supportive – Leave the patient
feeling better than you found him/her;
give encouragement.
Be Silent – Don’t feel you have to fill
every moment with meaningless
chatter; just be there.
Be Empathetic – Convey the message
that you are here to “travel” with
them while maintaining your
objectivity.
Be Compassionate – Convey that you
care, not only through your words,
but non-verbally through touch and
willingness to sit close.
Be Yourself – Adapt who you are to
the situation.
Be-Attitudes of Visiting
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Be Selfless – Be there for the patient’s
needs not your needs, a lot of good
intentions flounder because the visitor
feels the need to do something rather
than be for the patient
Be Positive – Delete negative
thoughts and words. For example,
stop thinking cancer is a death
sentence.
Be willing to get involved – Give part
of yourself away by taking risks.
Be respectful of patient’s diverse
beliefs – Don’t cram your beliefs
down their throat. Trust there will be
an appropriate time to share your
beliefs in the future.
Be mindful of using Scripture
appropriately – Share verses of hope
and encouragement when appropriate.
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Be ready to pray when given
permission
– Recap with the patient what you
shared and ask if they have any
specifics about which they want you
to pray.
– Pray for the patient to have courage
to cope, for understanding and for
acceptance of God’s plan.
– Pray for strength for the family and
loved ones.
– Pray for the medical team to have
the knowledge and compassion
necessary.
– Pray for peace, calmness and
healing for the patient’s emotions,
spirit, and body.
– Give thanks.
Visiting in Hospitals
Mindset of person in hospital
Goals
• Make the patient feel s/he are still part of
the congregation.
• That the person is remembered.
What you can do – See book
• Call first.
• Provide reassurance; avoid offering false
hope.
• Touch.
• Bring sense of humor; be sensitive.
• Pray.
• Take cues on how long to stay.
• Observe notices on the patient’s door.
• Let the patient cry; affirm losses.
• Depend on the Lord to direct your visit.
Don’t, cont
• Let tubes, monitors, and/or machinery
become barriers to your visit.
• Sit on patient’s bed.
• Flatter the patient.
• Whisper when talking to the medical staff
or family.
• Take negativism personally.
• Tell the patient your troubles.
• Eat or drink in the patient’s room.
• Be judgmental..
• Criticize the staff or prescribed treatment.
• Make promises you cannot keep.
After the patient leaves the hospital
• Your support may be needed even more.
This is the time for you to notify the
Pastoral care team. Then they can
mobilize other pastoral care members’
abilities, as needed.
• Have the patient tell you what tasks and
activities s/he can do.
Rewards
Visiting Shut-ins
Mindset of Shut-in
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Feels like a prisoner.
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Feels alone and unloved.
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Feels guilty.
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Sees chores going undone.
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Not likely to ask for what is needed.
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May not know where to turn.
Goals
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Help the person to be as active and
as independent as possible.
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Make the person feel part of the
congregation.
What you can do
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Run errands/perform some
chores—don’t say, “Call me if you
need anything.”
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Encourage them to grow—Art,
music, writing, taking courses.
What you can do, cont.
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Choose to care.
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Encourage participation in
Church via prayer chain, prayer
shawl, other ways.
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Send cards; call on phone.
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Schedule time with the shut-in—
short visits, set boundaries.
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Promote laughter.
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Bring something with you-child’s
picture, flower, etc.
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Bring catalogs for shopping at
home.
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Smile, give hugs, and pray.
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Avoid getting involved in family
disputes; can be a sounding
board.
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Parish nurses: Provide info on
resources.
Rewards
Visiting in Nursing Homes
Mindset of resident in a nursing home
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Wants to go home.
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Feels loss of independence—has to
depend on others for basic needs—
humiliating and frustrating.
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Feels treated like a child.
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Doesn’t feel remembered.
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Nothing can be done about the
situation.
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Is most at risk for suicide.
Goals: Make the person feel:
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Remembered.
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Important.
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Loved.
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Still part of the congregation.
Challenges:
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Depressing to see a person who
is waiting to die.
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Don’t know what to say.
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Difficult to talk to someone who
cannot hear.
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Hard to listen to the same old
stories over and over and over
again.
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Reminds the visitor that growing
old can be difficult.
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Person may not recognize you.
Visiting in Nursing Homes
What you can do:
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Remember whose needs you are
serving.
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Pray before you go.
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Schedule short visits—10-15
minutes.
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Visit during non-holiday times.
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Talk about mutual friends, church
members.
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Share letter or picture you received
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Ask for advice.
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Offer a friendly touch—hugs,
holding hands.
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Take children.
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Take something—not flowers in
Alzheimer’s unit.
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Speak to those in hallways.
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Write letters/cards for the person.
Rewards (The resident)
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Gains so much joy when visited.
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Are able to share their
knowledge, experiences.
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Feel loved.
Visiting Children—Developmental Stages
Under Age 5
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Take things literally.
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Have a hard time with the concept of
time. They live in the present and the
future is a hard concept.
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They think in magical terms.
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Concept of Death is best understood as
it relates to physical body—the
cessation of bodily functions.
Ages 6-9
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Have a penchant for details and facts.
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Begin to ask how and why questions.
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Are more social, while still selfcentered.
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They start to come up with conclusions
on their own rather than relying on what
adults tell them to be true.
Ages 10-12
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Prefer doing things with best
friend/group.
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May/not be starting to mix with other
sexes due to insecurity surrounding
changing body image and developing
sexual identity.
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Trapped between being too old and
too young.
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Can be a confusing time as self
confidence diminishes and as they
begin to exercise independence.
Ages 13-17
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Influence is moved from the parent to
peers.
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Adolescents need each other; to be
accepted—this is what drives
behavior and self-esteem.
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Boys and girls discover each other
first in groups and then singling each
other out.
Visiting Children
Mindset of a Child who is sick
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Hospitals are scary places.
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Doesn’t understand what is going on
(esp. younger child).
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Has fears of abandonment and loss.
Goals
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Recognize the characteristics of the
child’s age and maturity
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Meet the child where s/he is
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Affirm child’s feelings
Challenges
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Understanding the different
developmental stages.
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Child may regress to earlier stage.
What you can do
Visit the child—Not the adults
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Don’t whisper around the child
What you can do, cont.
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Keep the information about
developmental levels in mind.
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Don’t overwhelm child with
information; explain in terms
appropriate to the child’s level.
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Be honest—otherwise you can lose
the child’s trust.
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Do not provide prognosis to the
child, that is the responsibility of
the parent(s).
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Do not make child feel responsible
for the illness.
Listen to the child
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Tune into what s/he is saying.
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Let child talk about fears and
frustrations.
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Affirm feelings and loss, esp.
adolescent’s feelings of self-image.
Visiting Children
What you can do, cont.
Bring something.
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Cards and/or letters from peers.
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Bring small age or developmental
appropriate gifts—puppets/paper
crayons, CDs, etc.
Do something.
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Keep visit interactive.
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Tell stories; draw pictures.
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Help with homework.
End visit on a high note.
Rewards
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So much to learn from the child.
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Helps to make time pass.
Helping the parents of a sick child
Listen
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Let them talk about their fears and
frustrations.
Support
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Validate and empower them.
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Don’t tell them they shouldn’t feel
guilty, because they probably do.
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Offer respite, but don’t feel hurt if
they do not accept it.
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Parish nurses can provide referral
info.
Pray
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Pray for and with them.
Visiting the Terminally Ill
Mindset of the Terminally Ill
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Passes through the same emotional
grief stages as survivors do after
someone has died. (See Stages of
Grief on right)
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Unfortunately, some patients never
reach the last stage before they die.
Attitudes of loved ones/family may
have contribute to this.
Sees loved ones going through their
own anticipatory grief.
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May feel guilty for making others
grieve.
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Often is ministering to those who
visit. May hide fears and appear
cheerful.
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Feels alone.
Goals
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Meet the patient where s/he is.
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Allow the patient to speak freely.
Stages of Grief
By Elisabeth Kubler-Ross
“On Death and Dying”
Denial—“There must have been a
mistake.” “The doctor misread the
reports.”
Anger—“Why does this have to happen to
me?” “I don’t deserve this.”
“Where’s God when you need Him?”
“ I worked hard all my life—for
this!”
Bargaining— “I’ll stop smoking if you heal
me.” “I’ll become active in church…
“Just let me have enough time to …”
Depression— “I’ll never feel good again.”
“What’s next?”, “I’ll never see my
grandchildren again.”
Acceptance —“I’m not enjoying this, but I
am at peace.” “I’m ready.”
Visiting the Terminally Ill
Challenges
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Loved ones may be out of synch
with the terminally ill person’s stage
of grief.
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The person may be in a different
place each time you meet with
her/him.
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Need to recognize and address
feelings of inadequacy/hurt on our
part.
What you can do
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Become somewhat knowledgeable
about the patient’s illness.
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Ascertain where the person is in the
grief cycle.
Keep Visiting
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Help lessen the patient’s feelings of
being alone.
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Let your foremost message be, “I am
on this journey with you.”
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Keep visiting even when you feel
inadequate/unwanted.
What you can do, cont.
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Listen!
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Touch!
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Be honest.
Relationships
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Help the patient to communicate by
writing notes/cards.
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Encourage the patient to mend
broken relationships.
Make Everyday Count
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Encourage them in attainable hopes.
Don’t give them false hopes.
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Note: Hopes in a dying patient may
change from visit to visit.
Pray for and support the patient’s
hopes.
Journey with the person by allowing
her/him to stay in, or move on to the
next hope.
Visiting the Terminally Ill
What you can do, cont
Make Everyday Count, cont
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Ask questions to find out what you can
do to make each day count for the
patient and how you can support
her/him.
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What you can do, cont.
Practical Needs – Friendly Visitor
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Help to take care of practical issues
not provided by external resources,
e.g., cut the grass.
Notify Pastoral Care Team if
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“What have you always wanted to do?” •
uncertain, you should be doing
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“How do you want to leave this earthly
home?”
what patient is asking.
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“How do you want to be remembered?” Practical Needs – Person assigned by
Work together with the patient to come
Vicar.
up with a plan. Encourage the patient
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Alert family/others to available
to follow through on its
resources.
implementation.
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Ensure the patient’s affairs are in
Help the patient to reflect on her/his
order. For example, are her/his wills
uniqueness, and special qualities to
in place?—living and testamentary.
ease loss of dignity.
Be open to hear her/his feelings of fear, •
Seek out professionals.
helplessness, love, and concern, and
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If asked, help gather documentation
share yours.
together.
Visiting the Terminally Ill
What you can do, cont
Spiritual Needs
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Allow the patient to share feelings
and hopes in the present and future.
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Allow the patient to verbalize areas
of her/his life that are unsettled.
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Be available when s/he wants to
discuss God, salvation, etc. Look
for overt and subtle cues.
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Offer scripture verses that speak of
God’s forgiveness, love, mercy, and
salvation.
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Pray openly when it is agreeable
with the patient.
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Tell the patient that loved ones will
be okay, and that they will look out
for each other.
What you can do, cont
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If unconscious, continue to talk to
the person; hold her/his hands.
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Allow her/him to let go and say
good-bye.
Rewards
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Deepening friendship.
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Knowledge that you helped her/him
to die well.
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Knowledge that something holy has
happened.
A Bit About Boundaries
Know Thyself….
Important To Know….
• Scope of your mission and guidelines for visits
• Your own personal strengths and challenges
• Some details of the situation prior to your visit –
what are you walking into
• Other limitations on your time and talents
• You can say “NO” and how to say it
• You can refer back to Friendly Visitor leadership
• You can listen to your “gut” feelings
Role Playing Exercise
Chose a partner and practice an exchange
that might prove a challenge to your
boundary for that visit
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Role play as both the visitor and “patient”
Share with your partner after each role experience
Share your experience with the group
There is no right or wrong response
How This Ministry is Built
• A Vision for this Ministry
• Recruitment and Training of Friendly Visitors
– Practical Aspects
– Setting Boundaries
• Communicating about this Ministry to Church
Leadership and Congregation
• Ongoing Training
• Support of Volunteers
• Evaluation
Summary & Wrap Up