My travels over the past two weeks have ultimately taken me to Florida where I’ll be staying for awhile to spend time with my dad. It’s the latest in many, many visits, which I mention only because that means I have gotten to know many of Dad’s friends over the years, too. In fact, I’ve gotten to know a handful of them very well, so that I actually seek them out once I get here to be sure I have the opportunity to spend some time with them.
One such friend is a gentleman I’ll call Jim, who lives next door to Dad. A retired lawyer, Jim has now become a Eucharistic Minister who calls on many sick people and leads services on Sunday mornings. He is well-respected and admired by so many, a man who balances his sense of fairness with his religion and spirituality. He puts a great deal of effort into making sure that anyone who would like to attend his services, regardless of their religious affiliation, is welcome to do so.
The three of us enjoyed brunch together today, and as it frequently does, the conversation turned to how life experiences were affected by our spirituality, the meshing (or repelling) of religion and politics, other people’s experiences as seen through a spiritual lens, and more…. Since Dad and Jim both live in a senior transitional-type community, where friends are often undergoing medical treatment, and where too many friends pass away, some of the discussion centered on healthcare and spirituality.
Midway through this morning’s conversation I realized (duh!) that perhaps spirituality is a topic advocates should be addressing with their clients. Considering the tendency of most human beings, whether or not they are religious (part of a specific religion), to turn to prayer and pastoral support when they are faced with a health crisis (their own, or a loved one’s), it seems that at least discussing spiritual needs with clients could be useful in at least three ways: First – marketing (yes – seriously!) Why do any of us call upon our pastor, rabbi or priest when we, or a loved one, is ill or injured? Because they offer a service and a point of view that we want and need support for. It’s not that we can’t pray ourselves – we most certainly can. But when the going gets tough, the tough call for help, and our pastors, priests and rabbis are there to respond to our calls.
We, as advocates, can use that metaphor as we explain how we can help our patients. Not necessarily that we will pray for or with them (although yes, there are some advocates who are also clergy), but rather, we provide them with support and assistance when they need more than they can do for themselves.
Second – breadth of services If for no other reason than to show how comprehensive your services are, it seems that religion and spirituality should be a part the initial conversations you have with some of your clients. Just by approaching the subject, perhaps as you discuss medical proxies, or even advance directives, you can ask if there is a member of the clergy who should be on a notification list. Or maybe ask if they have been in touch with their pastor, priest or rabbi – which can give you a sense of their fear levels. Ask them if they want assistance reaching out to a member of the clergy for support – you can offer to make the connection on their behalf. Or simply ask whether their spirituality or religious beliefs will affect the medical choices they make, and if so, is there any way you can assist them.
The very fact that you ask the question gives them the sense that you cover all their bases. It will instill some trust, and will show that you’ve thought of every angle. It’s at least as important as talking about their health insurance or coverage, and probably more important than many of the tangential conversations you’re already having as you get to know them. If they don’t want your involvement, they’ll tell you that, or you’ll see them avoid the conversation – and you’ll know.
Third – contracting I’m a believer that no advocate can be an expert at every service that a client might need, and that one approach to maximizing a list of services is to have trusted advisers who can provide those services – under your auspices. For example, if your primary service is medical navigation, you might have someone you collaborate with who can review medical bills for your clients. Or, if your client could truly benefit from a certain kind of clinical trial, you might consult with someone who is an expert in finding the ‘right’ clinical trial for your client.
To make that happen, you contract with the advocate adviser so that the client pays you for the service, your adviser provides the service, and you pay the advocate-adviser.
Spirituality and religion could be counted among the services you can provide – even if you don’t provide them directly yourself. Your best resource will be the clergy person your client trusts, and you can be the one to contact him or her on behalf of your client. You can also facilitate the outreach by providing as much background information to that person as your client is willing to share.
I suspect some of you have had experience with this point of view: spirituality and its interface with advocacy. Any advice, ideas or stories you can provide would be appreciated! Please share them with us here, or in the APHA Forum.
? ? ? ? ? ? LEARN MORE ? ? ? ? ? ?
FOR PATIENTS | FOR ADVOCATES | FOR POTENTIAL ADVOCATES
? ? ? ? ? ? ? ? ? ? ? ?
Hi Trisha,
That was a beautifully written post, thank you for sharing your thoughts.
Spiritual care is incorporated into my advocacy practice; and for what I am doing, can see no other way as I am bedside with the patient. This is of course only if my client requests it, but I am available for that if they wish. In my intake, I also request that they share with me their faith community/phone number so that is available at the outset of their hospitalization.
I spent 7 years as a Stephen Minister and then worked over 4 years as a volunteer in the Chaplains dept at our local hospital visiting with new patients; most often the “spiritual” is not saying a prayer, but rather just a listening ear.
Diana
Hello Trisha,
Thanks for the introduction of the discussion about spirituality and religion as an important component in advocacy practice. When trained as an RN, we all know the importance of treating our patients/clients holistically. Make no mistake, this is one of THE most important factors to take into account, especially as a person is transitioning into death.
I recently had the blessing of being able to help my mother-in-law transition into death after a lengthy illness with CKD, diabetes, heart diesease and a cachectic state. The most important thing for her was being right with her God. It was also important for her to be able to speak freely about an after life, and also what her life meant on this earth from a spiritual perspective. I would even argue to say that at this point, it had a higher priority than the physical realm.
Death and illness is a part of life, and spirituality is a part of both. In my opinion, it would be negligent of us to not attend to it.
I’m so glad that you brought this valuable subject up. I have long incorporated spiritual support into my nursing practice when appropriate and I find it is one of the most profound ways to help people through a grieving process. When my patient is actively dying, I gently ask is they would like to say a prayer (there is often not time to find a chaplain or priest) and they are so grateful to be able to pray as their loved one slips into eternity. It gives them such peace and brings closure. Sometimes, it is just as important to help people have a positive death experience as it is to help them live better. I am also a Stephen Minister at my church and prayer is one of the best tools we use to help support people through the trials they face. I am fortunate to have worked at hospitals who support and embrace prayer as a tool to help practice truly holistic medical care. It does not seem to matter what spiritual background people come from; they all appreciate having me offer prayer during a crisis or a death. My father in law remembers my prayer with him before a high risk interventional procedure more than anything during that hospital stay. Family members often come back and thank me for the offer of prayer, and I feel it is a huge blessing to ME when I am able to touch their spiritual pain as well.