What value is spiritual care at the end of physical life?

Thanks for the question. It is a question often asked, either silently or out loud, when one is involved in end of physical life care. People have many pre-conceptions of what a chaplain’s business is and most of them are incorrect, and some of the more incorrect opinions are voiced by veteran end-of-physical-life caregivers!

No spiritual care is not about religion and not just about getting people saved. A chaplain isn’t going to preach to you, condemn you, call you you to reckoning or the like. In fact in most organizations chaplains cannot prostyle although they can give an account of their faith if asked, and they most certainly are able. End of life spiritual care may involve someone’s assurance of salvation but there are a whole lot of other concerns such as the meaning of one’s life, loss of purpose, a sense of diminishment due to disease progression, dignity, dealing with paranormal phenomenon, having a sense of normalcy, having a sense of identity separate from one’s disease, alternative methods of pain control, resolving anxiety about the dying process, forgiving and being forgiven, affirming basic humanity, resolving ethical dilemmas, healing relationship wounds or church wounds or anger at God, developing a positive sense of one’s life, dealing with choices, resolution of ethical concerns, feeling valued by having someone listen, and this is just the short list!

I have prepared a list of twenty questions that generally cover areas of spiritual concern at the end of physical life. It is a pretty good self-evaluation of what might or might not be a concern as someone goes through the dying process. I have found that even very faithful people can have issues that afflict them and cause distress. For example a spirit-filled Christian who believed God has told her she will be healed but she is not and as a result has trouble with her faith.

Or consider the woman who simply needed to make a confession and to hear the words of forgiveness from another human person reiterating the words of Jesus. She was an absolute bear of a patient to her caregivers and friends. She was angry, temperamental, ungracious, unthankful, and inclined to find fault. Each and every physical pain was a major episode. Each and every way her body deviated from accustomed expectations was a crisis. Her disease was a personal affliction sent upon her, although she always stopped short of exact explanation. I got to know her and had several visits that were, to be kind, uncomfortable for me and I was sure uncomfortable for her.

But then  one day she bade me enter her house and seeing me looked at me with an absolutely serious look that was not unkind and blurted out, ” I never told my husband that our second child was not his!”

Needless to say I was stunned and tried not to show it. Sometimes the listener’s reactions can make a persons sin more serious than it is.

We discussed what had happened and at last got to the topic of forgiveness. She wanted her husband to forgive her but since he was long since departed knew that was impossible, although it bothered her. She wanted forgiveness from God but was certain God could not forgive her and especially since it was a sin that had festered for decades. Clearly we had a bit of exploration to do and we did it, and not over the course of weeks but right there in hours of exploration of the Bible because she was a Christian. At last she was assured of God’s forgiveness, but not quite so convinced of her deceased husband’s forgiveness! We discussed the idea of a Great Cloud of Witnesses and discussed the fact that in Heaven there would nothing but forgiveness and at long last she felt that perhaps her husband had, or would certainly forgive her.

The result was miraculous. Overnight she became a wonderful, caring, and loving person. Her physical discomfort greatly diminished and she seldom complained about pain even as her disease progressed. When she died the care staff did genuinely weep.

What accounted for the change? She needed forgiveness. That was it. She needed to hear it from a fellow human person and needed to know the full extent of it in her heart and above all needed to know God forgiveness her. There is one example of the value of spiritual care and for this one woman it meant the difference between dying awash with guilt and feeling acute physical pain and dying with a sense of well-being and with greatly reduced physical pain. There are many such examples. Many such nuances.