Spiritual Care for Non-Communicative Patients

A Guidebook

Linda S. Golding, Walter Dixon

• Publisher: Jessica Kingsley Publishers
• Year: 2019
• ISBN:
  9781784504793
• Topic: Theologie & Religion
• Subtopic: Christlicher Dienst

Research shows that non-responsive patients benefit significantly from spiritual and pastoral care. This book equips chaplains with the confidence and skills to deliver excellent care in this challenging context. With exercises, worksheets, small group activities and case studies, it sets out how best to use words and body language, foster trust and respect, and involve patients' loved ones. It provides practical ways to recognise and affirm the humanity of the patient, and how to engage with the patient by employing skills of listening and presence.

1	In the Hallway
	The Long Walk

In the middle of the journey of our life I came to myself within a dark wood where the straight way was lost.

Dante Alighieri, The Divine Comedy,
Inferno Canto 1 (trans. Charles Lyell)

On any given day, a hospital chaplain may attend interdisciplinary rounds and speak with social workers, nurses, doctors, nursing attendants, physical and occupational therapists, speech and swallow specialists, unit assistants, food service staff, and members of the housekeeping and security teams. In each case, the chaplain both provides and receives information about patients and families.

Referrals can come to the chaplain from any member of the hospital team. In the case of the non-responsive patient, a referral for spiritual support is often given for the family or friends. Although there is a general agreement that such a patient can hear, the referral is rarely for the patient. Given this general agreement, and supporting literature (see Resources), this guidebook is based on the premise that the patient can hear something—but just what that is must wait until the patient can tell us.

ChapTime 1

Recall a conversation when you were told you did not need to visit a comatose patient because he or she would not be able to engage with you. How did you feel?

 

 

 

 

 

Let’s go onto the intensive care unit (ICU). The first stop is the hallway—a nurse looks at you and wonders who you are coming to see. A family turns away from you. Or towards you. There is the usual soundscape made up of beeps and bells from the life-sustaining machines, the ringing of phones and pagers, the buzz of talk among the medical team and floor staff, and the one-sided cell phone conversations of family members or friends. These sounds and unspoken emotions surround a patient without directly including him or her. Depending on the time of day, the patient may be alone in the room or surrounded by family or friends who are talking among themselves or staring at the bedside monitors. Perhaps the patient is being examined by the medical team or being cared for by the nurse.

 

 

 

ChapTime 2

Stand still. Which sounds go with which piece of medical machinery?

 

 

 

 

 

ChapTime 3

What is the story being told by bedside monitors? What is the tone of the conversations around you? Any smells? What do you think? How do you feel?

 

 

 

 

 

The hallway is a metaphor for aspects of chaplaincy—journey, transition, connection, entry, leaving. It can also be an obstacle. There are many opportunities to provide meaningful pastoral care in the hallway of any hospital, but these do necessarily lead to the patient.

Voice of the Chaplain:

Are there responsive patients who need me more?

ChapTime 4

What concerns do you have about visiting a non-communicative patient?

 

 

 

 

 

If you are responding to a referral, you know which room to enter. But if you are visiting the unit on your rounds, you will need to make choices. A few questions to open the process:

How do you decide which room to enter?

 

 

 

 

 

What draws you into a room, but keeps you from entering?

 

 

 

 

 

Do you walk through the unit inquiring of needs?

 

 

 

 

 

Do you look into each room before returning to enter a room?

2	Entering the Room
	The Patient Is Alone

No act of kindness, no matter how small, is ever wasted.

Aesop, The Lion and the Mouse

Preparing to cross the threshold

Crossing the threshold into a patient’s room can be a challenge for any chaplain. We hold the expectations of those who see us entering and thos...