Category Archives: Chaplain Training

Missing the Mark: Are the suffering ones really being served?


Are we hearing the cries for help? Are we really relieving the suffering caused by our “care”? This is a question I have been asking myself for several years now, after having done an elective 400 hour intensive clinical pastoral education unit at Albany Medical Center (AMC), a 600+ bed regional acute, primary, secondary, tertiary care teaching hospital in Albany, New York. For about four years now I have been tracking the Pastoral Care department there and,  over that period, have been able to make some on-site, personal observations of the “pastoral care” being provided at AMC, and must report that, at best, the overall care was very disappointing.


Are we hearing the cry for help?

Are we hearing the cry for help?

If AMC is representative of the state of “pastoral care” in the Northeast or in the United States as a whole, what does that say about all those words and ink spilled in the scientific, clinical, and professional journals about “relief of suffering?” Is it all pablum-puking palaver from the top of the ivory towers? Wishful thinking? Are the chaplaincy organizations and “certifying bodies” simply self-serving special interest (their own) groups providing certificates for cash, and satisfying the paper-mill appetites of both consumers and human resources dullards? We want certificates not skills or competence? It would seem so from our observation point.

As an informal survey, we looked at the AMC pastoral care staff page on the AMC web site and reviewed the credentials of the people working in pastoral care at that hospital. Here’s what we found:

The travesty and biggest joke that healthcare facilities — I mean hospitals offering primary, secondary, tertiary, and the rarer quaternary care — and skilled nursing facilities, including those offering rehabilitation,  are foisting on the paying pubic is that they offer what is commonly called “pastoral care,” a term eschewed by those of us who are really professional chaplains because “pastoral” is a hugely Christian term and serves to alienate non-Christian traditions. Fancy that! Far from appreciating what a real chaplain is, most of our healthcare organizations use a discriminatory term to describe the paltry spiritual support they think they provide, but in fact are not providing.

Most facilities rely on volunteer pastoral care, that is, local “visiting clergy” who drop in and wander around cold-calling (dropping in on patients or residents) or visiting their own church members. As for those that actually have a paid— and reimbursed chaplaincy program — the composition of that staff raises concerns about competency and bias. Seriously.

Really? We don't think so!

Really? We don’t think so!

One regional medical center in Albany, New York, Albany Medical Center — the institution does a great deal of public relations and advertising and is more in the real estate business than healthcare — shows a staff of 14, including chaplain interns, chaplain residents, full- and part-time/on-call “chaplains”: Pastoral Care Manager Jake Marvel (personal acquaintance), is a Reformed Church of America (RCA) clergyperson. The RCA is a minor denomination, an offshoot of the Dutch Reformed Church, and Calvinist in its doctrines, rightist liberal Christianity in its leanings; Harlan Ratmeyer (persoanl acquaintance), is director of a chaplain training program, a RCA minister, in his late 70’s and beyond retirement; biased and distracted. Staff Chaplain Yervant Kutchukian, is an Armenian Orthodox, with apparently various contemplative interests. Pastoral Care department secretary, Elizabeth Hall, is Roman Catholic, but doesn’t work as a pastoral care provider despite having several units of chaplain training — most of which was apparently acquired by sitting behind her desk. Aloysius Kabunga is a native of Uganda, Black African, with some seminary training and an eclectic educational background but no stated faith tradition (do we assume he’s some sort of Christian adherent?). Valerie Cox, female, another African American on staff, is an “ordained” Baptist minister with a degree from a “bible institute,” whatever that means. Kabanga BoswamiNO! I didn’t make that up — is yet another Black African on staff, from the Democratic Republic of Congo, has degrees in business admin, computer science and divinity. Marjorie S McCoy, female, Buddhist adherent to an American Buddhist tradition, has a B.A. in comparative religions, worked as attorney for 23 years, was a hospice volunteer for six years, and is now an intern in chaplaincy — this means she’s out there on the floors at AMC with little or no training. YA is a staff chaplain but I can’t make out his actual credentials from his blurb. Mary C. Craven, white female, has some credentials and 9 units of clinical pastoral education at AMC (she’s Roman Catholic by tradition). Two Roman Catholic priests serve as chaplains at AMC Kenneth Gregory and Robert DeLeon, enough said. A rabbi and an imam serve the Jewish and Muslim traditions at AMC but are not “staff” in that they are on-call, for their own people. At AMC, the Roman Catholic chaplains serve on an alternating day schedule; I have experienced situations at AMC when neither RC chaplain was available. Naturally, the on-call rabbi and imam restrict their care to their faith tradition. So that’s 4 chaplains out of the total of 14 that serve their specific faith groups: Roman Catholicism, Judaism, Islam. Two part-time chaplains, one cultural Pakistani male, Younas Azad (personal knowledge) and one elderly white female, M. Craven (personal knowledge). That leaves 4 “chaplain residents” who are still in training, under the supervision of HR, and four “full-time” staff. Of the four “chaplain residents” 2 are black African males, unknown traditions, and one is an African American female, Baptist tradition. The remaining chaplain-in-training is a white female, Buddhist, with a law background who served as a hospice volunteer. The remainder of the AMC pastoral care “full-time” staff includes two RCA ministers who are PC manager and director, and a secretary.

It needs to be said that the information provided above is publicly available at Meet the Staff and is not provided as a statement of competence or as an assessment of effectiveness of the individuals or of the department as a whole. I’m presenting it as an example of what a 600-bed regional acute, primary, secondary and tertiary care, trauma center, teaching hospital provides by way of spriritual care. Now, I have to ask my readers, given the composition of the PC staff — excluding the secretary, the part-timers, and the rabbi, imam and Catholic priests, who obviously see their own people, What do you think of the composition of the Albany Medical Center “pastoral care” staff? Presuming Albany Medical Center is a fair representation of the state of pastoral care in most similar institutions, What do you think of the likely cultural competency of the staff? Think of it this way, if you were an 84-year old white female, How open or vulnerable would you feel if one of the resident chaplains paid you a visit? How well served do you think the mainline traditions are served by the composition of the AMC pastoral care staff? Finally, do what I did and visit the site and ask yourself the question, “How well served are the some 600+ patients of AMC by this handful of questionably trained pastoral care providers?”

Treating the Parts while Indifferent to the Whole

Treating the Parts while Indifferent to the Whole

We chose Albany Medical Center because of its size, the extent of its services, its PR/advertising claims, and because we have personal knowledge about and experience with that institution. A simple online investigation of most of the other major hospitals in the Albany,  New York, area, including Schenectady and Rensselaer counties, doesn’t provide much satisfaction. Most simply describe a vague “spiritual care” or “pastoral care” entity but not much more. None provide a staff page, which indicates quite clearly to us that they have none and that all of their pastoral care activity is provided by volunteer (= untrained, non-professionals), ancient RC nuns (that’s all that’s left), or “visiting clergy.” Point made. How is it that these so-called healthcare providers get away with not providing total healthcare?

Our conclusion is obvious: Our healthcare institutions — and we include here most hospitals, nursing homes, rehabilitation facilities, etc. — do not provide competent spiritual care for patients, residents and clients. These institutions donot provide “care” but provide only “procedures.” They operate almost exclusively on the biomedical model which has been around for more than 100 years unchanged, and is based on the body-mind duality espoused by Descartes, the so-called Cartesian duality, in which healthcare treats physical complaints, everything else is in the “spiritual” realm.  In other words, our healthcare institutions treat the disease (the physical manifestations) not the illness, not the person. The treatment received in our healthcare institutions is procedural in nature and the very procedures done as treatment are the source of significant suffering, to which our “care” providers are either indifferent or of which they are ignorant.

Considering that the region we are considering, the Capital District in New York State, a region comprising the counties of Albany, Rensselaer, Schenectady, parts of Greene County, and other areas, we are talking about at least 28 hospitals and 56 nursing homes/rehabilitation facilities. The question we should be asking ourselves is not what kind of care is, rather what procedures are done, but how much suffering those environments and  procedures are causing, and what is being done to relive the total suffering of the patients, residents, and clients?

Please leave us a comment but please be specific and focus on the questions we’ve posed above. We’ve tried to be non-judgmental in presenting the facts; all we ask is for your honest opinion about the pastoral care situation at this regional 600+ bed teaching hospital.

The True Story of Our Healthcare System

The True Story of Our Healthcare System and
Relief of Suffering

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Forming a Church-based Bereavement Group

A couple of days ago a reader, Kathy T., wrote to me asking for recommendations on starting a church bereavement program. After having reflected on Kathy’s request and her plan, I responded with the following counsel. I hope it’s helpful to those of you contemplating a response to such a calling or who are already involved in such a program. Please share your thoughts and insights on what I wrote.

Bereavement_Ministry

“A place to listen, yet be heard.”—”A place to cry, yet also laugh.”—”A place to find peace, yet never be over your loss.”—”A place to create lifelong friendships.” 

A bereavement ministry seeks to provide a safe place where the bereaved can gain an understanding of the grief process, have the opportunity to talk through their experiences, and explore their thoughts and feelings with others who are also grieving the loss of a loved one. Doing so will assist the bereaved in working through their grief on their journey to healing so that they, once again, will be able to enjoy a happy and productive life with memories of their loved one.


Good evening, Kathy:

Once again, thank you for your inquiry. It’s my pleasure to provide some assistance to you for your plan to create a bereavement ministry in your church community.

A church community is a very appropriate place to create such a ministry, and in most traditions it is a no-brainer to have one, at least in past generations. Today, it seems, even church communities avoid supporting the dying and the bereaved, and those that do continue that tradition have a very myopic view of how it is to be done.

Research done over the past 20 or so years has shed quite a bit of light on the real needs of the dying and of the bereaved, and healthcare research has shown hands down that a holistic approach is required when dealing effectively and sensitively with the dying person and his or her survivors. In fact, back in the 90s, Charles Corr published an eye-opening article (see details below) on a task-based approach to coping with dying, which was a very novel notion and gained quite a good deal of acceptance in the field of thanatology.

What-Does-our-Church-BelieveBut back to your plan for a church-based bereavement program. One point that is extremely important for anyone starting a bereavement ministry in any faith or belief community is that the persons practicing that ministry must be absolutely familiar with their faith or belief tradition’s teachings on life, dying, death, and any afterlife. While a bereavement ministry is not the place for evangelizing or catechizing, it is a place where the focus is on hope and hope, in contrast to wishing, is reality oriented. Far too many faith community bereavement groups focus too much on past sins, an afterlife, and a promised resurrection. While the past sins part is OK, the last thing a dying person needs is an 11th-hour guilt trip or an anxiety attack! As for the other two, well, they’re still to be proven. Faith goes a long way but it has to be administered with compassion and good sense.

bereavement support hopeIf a bereavement ministry is to companion the person actively dying that person even while dying is still a living person and not dead yet. As a living person, he or she still has meaning, purpose, a legacy, hope. And yes, the dying person is also a bereaved person, since she or he has lost a great deal that was once valued by him or her, and may also be grieving! The bereavement minister can help the dying person find her or his hope, meaning, and assist in a good death and that should, in my opinion, be your focus.

Then there are the survivors, who are bereaved because they are anticipating losing or have already lost a loved one. While it would be naïve to try to persuade you that everyone who dies is a “loved” one we have to frequently admit that not everyone who dies is especially loved, or if loved, perhaps not very liked. This happens and you’ll find yourself in the middle of a lot of unfinished business and you’ll have to deal with it effectively.

While I’m not trying to dissuade or discourage you from responding to a calling, I do want to impress upon you that dying, death, grief, bereavement, mourning can be very, very complicated and you’ll have to do a lot of work learning about the subject matter. Dying, death, grief and bereavement may be as old as humankind itself and one of the most natural things that there is but it’s incredibly complex. Because of the complexity it can be intimidating, which is why it’s so easy to avoid thinking or talking about and so easy to deny.

The saying, “The path to hell is paved with good intentions” applies very precisely to many persons, with the best intentions, embark on a course of action for which they are ill-prepared, and consequently do a lot of damage. This is no place for doing damage and all the good intentions in the world cannot substitute for an ounce of good planning. As a bereavement minister you’ll have to learn all about yourself and your intentions before you step up to the plate, and attempt to provide support to others in crisis. You need to give some thought to what is motivating you to provide bereavement support and if that motivation is really more for you or for your helpees. It’s not uncommon for people to think they are responding to an altruistic calling, when in fact they are the unconscious focus of their efforts. That’s not to say that they don’t do a hell of a lot of good work despite that fact, but some can really cause problems. That’s why it’s so important to be honest with yourself and seek a couple hours of counseling, psychological or competent pastoral counseling, avoiding any sectarian or denominational emphasis, to ensure that you can be authentic and not self-serving.

So, for starters, I’d recommend you get your hands on a very helpful book published by the Association for Death Education and Counseling (ADEC), Handbook of Thanatology: The Essential Body of Knowledge for the Study of Death, Dying, and Bereavement (link: Handbook), by David K. Meagher (Editor), David E. Balk (Editor). The book is a superb overview of death, dying and bereavement and should be on every bereavement minister’s desk. It covers just about all the essentials and has an extensive bibliography. Once you dive into the Handbook, you’ll initially have a sense of being overwhelmed with the scope of bereavement and its myriad manifestations and complications but as you acquire some experience, you’ll find it’s all quite natural.

In Clinical Pastoral Education we teach that the intentional ministry of presence is the essential activity of the bereavement minister. Just being present to hold a hand, give a hug, silent but there. That’s harder than you might think because most of us go through every phase of our lives making some sort of commotion, talking, not listening. But as a bereavement minister, silence, listening will be your greatest challenge.

Boundaries are something you need to explore and I can send you a good bibliography on boundaries in bereavement and crisis facilitation. One of the essential boundaries is that unless you have the credentials, you are not a therapist or a counselor, and as a bereavement minister you are not there to “fix” anything but rather to be an authentic and compassionate companion to the person doing the dying and the survivors.

Again, I’d refer you to ADEC’s professional Code of Ethics (link: Code of Ethics) for some idea of how to manage your conduct in various situations.

You are going to have to invest some time in taking some courses and one place I’d start is with the National Center for Death Education or NCDE (link: NCDE), which is located at Mt Ida College in Newton, MA. The NCDE offers a number of online courses, as well as a Certificate in Thanatology (death studies), which, if you do not have some sort of ministry or pastoral credential or qualifications in phychology, social work, counseling, etc., would almost be essential as a credential for your bereavement ministry. The NCDE also hosts an annual Summer Institute, which is a week-long event that brings in death specialists from practically all over the hemisphere, and features renowned experts in the field of dying, death, grief, and bereavement. You should contact Diane Moran, NCDE director, at dmoran@mountida.edu. You can mention my name when you contact her and let her know I recommended you. She’s a wonderful person and very, very helpful and knowledgeable. She’ll put you on the right path as far as initial credentials are concerned.

As I mentioned, the field is immense, and the learning is a challenge. Once you get the Handbook of Thanatology, you’ll understand what I mean. But please, don’t buy the book outright; it’s very expensive. Have your community library request it on interlibrary loan for you. Take it out for a couple of weeks and just peruse the chapters to get a feel for the field. It’s the kind of book that you can just pick a chapter and read it rather than one that you have to drag thru every chapter to have some continuity. Then, if it’s your cup of tea, purchase it as your desk reference.

In addition to Charles Corr’s article on A Task-based Approach to Coping with Dying (see below for details), I would recommend another of Corr’s articles articles, Dying and Its Interpreters (see below for details). I find the article is very informative and synopsizes much of the important work that has been done on dying over the past couple of decades. Pay close attention to the end of the article in the “Some Lessons to Draw from the Review”, which I find to be very helpful to students.

If you would find it useful, I can send you a short description of the Intentional Ministry of Presence, which describes being present to the dying and by extension to the survivors.

At this very early stage in your journey, it would be very difficult to provide anything more specific, since the field is incredibly wide and complex, and I’m not sure where you stand in terms of background, education, experience, etc. It all makes a difference.

You see, some faith or belief communities have very systematized doctrines on dying and death, while others treat it merely as a transition to something that follows temporal life. Christian and non-Christian traditions can have very complicated death practices, while others simplify the process to an embarrassing degree.


When life brings terrible storms our direction, we may react with anger, fear, depression, sadness, disappointment, and or disbelief. We may vacillate between these feelings until we come to terms with a solution or acceptance of our grief. The object of our grief maybe the loss of a love one, of a job, of a relationship or loss of security. Also, failure, crisis, divorce or any life changes may be substantial for grief. Remember this, healthy grief comes to a solution or acceptance, unhealthy grief is unresolved and may appear either as a psychological or physical illness.
“We walk in faith not by sight.” 2 Corinthians 5:7


I guess the best way to proceed is to have an open-door policy, that is, once you have a look at some of the material and look at some of the literature, you’ll be better able to articulate what you want to do. I can’t stress enough that you must also be very well read in your own faith or belief tradition to competently apply it to offering hope and meaning to your brothers and sisters in your church community. One caveat: the Hebrew Bible and the New Testament are fine as guidelines but to take them literally may cause problems; they must be read and interpreted in the light of the times and in the context in which they are applied. At the risk of seeming areligious or insensitive, the deathbed, the vigil, the funeral, the memorial is no place to start Bible-thumping or pushing Jesus on the bereaved; what they are looking for is meaning and hope in their faith both for themselves and for the dead loved one. Once they are dead, everything else we do is for the living.

So there you have some ‘random’ thoughts to digest. Please feel free to contact me any time if you have any questions or need any information.

Prayer is good only if it is invited; we can always pray silently even when not requested to do so. So let’s now close with a little prayer of faith, hope and love:

Let me know be firm in my faith as my end draws ever nearer.  When my time comes, let me depart this life peacefully, and join my family and friends, waiting for me on the other side, now more of them gone than remaining here below.  The sands of my time are running out…I am yours, Lord, now and forever, in faith, in hope, in love!  Please, please, hold me ever in Your heart.  Let their souls rise blazingly bright once more, and please receive them Jesus into shining and eternal glory with You! All this I pray to You My good Redeemer, in hope and confidence and burning ardent love. Amen.

Peace and blessings!
Chaplain Harold

Resources:

  • Corr, C.A. (1991). “A task-based approach to coping with dying”. Omega: Journal of Death and Dying, 24,81-94.
  • Corr, C.A., Doka, K.J., & Kastenbaum, R. (1999). “Dying and its interpreters: A review of selected literature and some comments on the state of the filed”. Omega: The Journal of Death and Dying, 39, 239-259.

Funeral Homes and Funeral Directors Need to Provide for Spiritual Care

It’s a recognized fact, one that’s been the subject of scientific research and innumerable articles in the professional journals for more than 20 years! That fact is that healthcare and deathcare providers must get with the program and provide holistic services to their clients, and that holistic care must include spiritual care. It’s a recognized fact today that no care, whether of the living or the dead (which is actually care of the living, the survivors), is complete without caring for mind, body and spirit. So why do so many providers chaff at the bit when we offer them the opportunity to provide a complete care package to their consumers?

It’s only natural, almost excusable, that many funeral directors, who have to face death and grieving on a daily basis, become a bit remote from their clients’ experience of the death of a loved one, an unique and transformational experience. That’s why we very strongly recommend spiritual care also for the funeral home staff; they have to reconnect with their human experiences, they have to work through their own experiences of grief, even the grief of others. They, too, are affected, even if they are not consciously aware of it.

Funeral Homes and their Directors Must Get With the Program!

caring for mind body and spirity

Current Awareness and Continuing Education

Current awareness is part of any professional’s ongoing education. That’s why I subscribe to a number of thanatopraxis (the practice of death care; mortuary science and practice) information sources like Connecting Directors, FuneralOne and NFDA, and a number of death, dying, bereavement, grief blog sites such as MaryMac and Everplans; I participate in several continuing education courses and events each year at the NCDE (National Center for Death Education Center) at Mt Ida College and HealthCare Chaplaincy Network and ; I am a member of ADEC (Association for Death Education and Counseling),   and am preparing for fellow certification in death education and counseling, and I share the wealth of knowledge and information I acquire through my blogs, Spirituality, Bereavement & Griefcare, Pastoral Care, and Homiletics and Spiritual Care, where I publish many of my funeral and memorial homilies.

Thanatology Café Events

I’m currently canvassing venues like public libraries, social and benevolent organizations, even churches to host my Thanatology Café events, regular gatherings, where people can hear about and talk about death and death–related subjects, with the collaboration of local funeral homes and funeral directors. This is atwitter grief mourning unique opportunity to learn about death planning, dying, the dying process, death, and after-death care and disposition of the remains. My planned Thanatology Café events will be eye- and mind-opening experiences for everyone involved. Please stay tuned for announcements on my blogs, Facebook and LinkedIn. Find me and my tweets on Twitter at @chaplainharold.

Why all of this in addition to my bereavement chaplaincy practice? Because I, like you, appreciate the fact that death care is really care of the living, and I want to persuade funeral services providers, funeral homes, and funeral directors and their staffs that while they are operating a business, they are practicing an important ministry both the the dead and to the living. It is a tragic and avoidable development in many funeral homes that their goal is to attract as many families as possible in their most difficult moments, to get as many bodies as possible, to move them out the door as fast as possible, to dispose of them as quickly as possible. They manage to do this by appealing to the idolatry of money—we can make grandpa disappear cheaper than the competition. And our death-denying, self-centered culture just eats all of this up. What they don’t understand is the incredible damage they, both the body-disposal services and their customers, are causing to the memory of the deceased, his or her meaning and legacy to the living, to the bereaved in terms of their spirituality and growth, and to the culture and society at large. We need to think outside of the box, people, and return to being human, beings created in the image of the divine. Not just some rubbish that has to be collected and disposed of as neatly and quickly as possible!

griefcareThis past week I spent some time visiting funeral home sites in the Albany, Schenectady, Rensselaer, Greene counties to survey their coverage of spiritual care. As you might guess, the coverage was very poor. While most sites had a Resources page, that page included almost exclusively restaurants and florists, some included hotels and other accommodations. About 5 % even hinted at spirituality or pastoral care services on the site, even fewer referred to spiritual services on the Resources page. This is a serious failure in terms of providing complete service to the bereaved; it’s an ominous development in the death care industry. But it can be fixed.

I have spent years of formal study and have been awarded several degrees, I regularly attend courses and continuing education events to remain on top of the field and as up to date as possible, I subscribe to numerous funeral industry and death, dying, bereavement, grief resources for current awareness, information, and much more. I surf and read funeral home websites to keep abreast of how current they are and what they are doing.

The end result of all of this effort is so that I can provide personalized, specialist interfaith and humanistic chaplaincy services to participating funeral homes and their families in the S.A.R.G. region (Schenectady, Albany, Rensselaer, Green counties in New York state; BTW, did you know Sarg is German for coffin?). I offer those services to funeral homes, hospitals, nursing homes because it’s a recognized essential service to those confronted with spiritual and existential crisis, like the dying and the bereaved.

Part of the problem is with the families themselves

But, regrettably, too many funeral homes, hospitals, nursing homes are either slow learners or just indifferent to the holistic care of their clients. Why is that? We seriously have to ask. Part of the problem is with the families themselves: They simply don’t ask the right question. They should be asking: What can you provide me in terms of spiritual care to get me through this spiritually, emotionally, in terms of how I can use this experience for growth? Yes, that’s quite a mouthful, but that’s why I’m providing the words.

griefcare-finalIn the past, I’ve offered funeral homes or funeral home groups this service through my mailings and many of them have accepted my offerings. But I’d like to invite you to take one further step: I’d like to see you, my readers, do your part to ensure that our funeral homes and funeral directors are aware of the need to provide spiritual care to the bereaved in the context of providing post-mortem services. I’d like you, my readers, including funeral home operators, funeral directors, and families to be the the leaders in listing on your Resources page sources of spiritual care to the bereaved before the death, during the dying process, at the time of death, and during the final rites for the dead. I’d like to encourage families both at the time of making pre-arrangements as well as when making urgent arrangements, to ask about what the funeral home provides in terms of spiritual care and personalized funeral and memorial services.

Spiritual care is an important aspect of care in the funeral arrangement package!

If you’re familiar with the research and publications over the past two decades, you’ll know that spiritual care is an important aspect of care in the funeral professions. So why are funeral homes and funeral directors so slow to react to this reality? The likely answer is this: Because they can! I’d like also to challenge funeral homes and funeral directors to take the necessary steps to explore spiritual care resources and providers in their service areas, and to make those resources available to their families. Listing those resources and services on your funeral home’s Resources page, and noting that your funeral home has an on-call chaplain is a valuable opportunity for your funeral home to confidently inform your families that you offer a complete spectrum of services with a trained, expert, on–call chaplain. Read the trade literature if you have any doubts about this fact.

Rev. Art Lillicropp performs a Blessing of the Hands Ceremony for Kaiser nurses, Thursday, May 9, 2013.

I’m attaching an example of an entry for your Resources page, and hope that you’ll agree to post it on your site. In return, you’ll be providing access to on-call pastoral and spiritual care for your families (arranged through your funeral home), and you’ll be adding an important and much appreciated service to your program.

Of course, I at all times extend the invitation to funeral homes and funeral directors to contact me if they want further information or if they’d like to meet face–to–face to discuss a collaboration, or if they’d like to have a chaplain present at the arrangements conference with the family. They or the family can contact me either by email or by telephone. I am always very happy to meet with the funeral home or with families to discuss how we can best work together to provide the bereaved and their families and friends with this essential service.

Once again, thank you so very much for taking the time to read my material. I hope you find my observations informed and useful. In the meantime, I’ll look forward to hearing from you when you leave a comment on this post.

Chaplain Harold

If you are a funeral home or funeral director and would like to have some sample texts for placement on your website Resources page, please click this link:
Resource Page Texts for Download or Copying.

Our New Homiletics Blog

Many of our readers are pastoral or spiritual care providers, and only some actually have the opportunity to teach or to preach in a formal way, that is, by way of sermons or homilies.

Here is the Link to Our New Blog, Homiletics and Spiritual Care


When Listening is Greater than Talking

Why the homilist should be a more skilled listener to be a better talker.

bible-notebook

I feel that bereavement provides one of those moments of what we theologians call kairos, a supreme opportunity. If spiritual care providers are blessed with the opportunity to officiate at funeral or memorial celebrations, such opportunities are kairos moments not only for practicing our ministry of compassion for the suffering but also for proclaiming our fundamental sacred doctrines on living and dying, and what may come after.

We tend to talk a lot about homiletics and talk is what we apparently do best. But homiletics, good homiletics and the product, the revealing homily, requires good listening skills. Dag Hammarskold said, “The more faithfully you listen to the voice within you, the better you will hear what is sounding outside. Only he who listens can speak.” This brings me to mind two ways of communicating with that voice within: lectio divina and the lesser known lectio continua. I’ll have more to say about those two disciplines and their role in homiletics in a later article on the Homiletics and Sprititual Care blog. Reflection and self-examination are also very important when it comes to listening authentically. Again, I’ll comment on these in a later editorial.

 

For now it may be interesting to look at some listening statistics:

listening-statistics

But here are some more startling listening facts:

Listening is the communication skill most of us use the most frequently. Various studies stress the importance of listening as a communication skill. A typical study points out that many of us spend 70 to 80 percent of our waking hours in some form of communication. Of that time, we spend about 9 percent writing, 16 percent reading, 30 percent speaking, and 45 percent listening. Studies also confirm that most of us are poor and inefficient listeners.

Thought speed greater than speaking speed. Another reason for poor listening skills is that you and I can think faster than someone else can speak. Most of us speak at the rate of about 125 words per minute. However, we have the mental capacity to understand someone speaking at 400 words per minute (if that were possible).

So listening is a critical skill that needs to be developed by us as spiritual care providers, particularly those of us involved in a teaching/preaching ministry that requires us to confect effective homilies.

big ear buddha 2

No doubt you have seen depictions of the Buddha with long pendulous ears and probably have asked yourself, “Why does Buddha have such big ears?” Well, in the Orient large ears are looked upon as auspicious because they indicate wisdom and compassion. So, the Buddha is depicted as having big ears because he is the compassionate one. He hears the sound of the world – hears the cries of suffering beings – and responds. The important thing for us is not how large our ears are, but how open are our “mind ears.”

As a professional interfaith chaplain practicing primarily in bereavement and grief facilitation, I find that listening, effective authentic listening is profoundly important in several prominent situations:

  • Initial interview
  • Family interview
  • During lectio divina and lectio continua
  • During reflection on potential readings
  • When selecting hymns
  • When rehearsing the homily.

Listening for the interfaith chaplain is also especially important when communicating with colleagues in spiritual care ministries of other faith and belief traditions, and in exchanges with hospital, nursing home, funeral home staff, and with members of the community.

An important concept to bear in mind when writing homilies is that while the assembly is listening to the words, the sounds coming from my vocal apparatus, they should be moved to listen to the internal voice that speaks in them during that outside listening. After all, that’s our target as homilists, to get that internal voice speaking and the listener listening to that voice.

Chaplain Harold

ListenHeart

 

An essential asset to the mortuary services provider and to the consumer

New Article

Unity SymboldThe professional interfaith bereavement chaplain: an essential asset to the mortuary services provider and to the consumer

A straight – from – the – hip discussion of the state of affairs, solutions and recommendations by an experienced provider of professional interfaith bereavement services.

Abstract. This article presents an uncosmetized impression of the deterioration in quality of death services, and based on firsthand observations makes practical recommendations for improving the services provided to and requested by the bereaved and supportive of mourners. This article makes recommendations to the consumer as well as to the mortuary services provider, that include among other things: sensitivity to the spiritual needs of the mourner, addressing those needs with appropriate sensitivity, providing for those needs through the services of a competent professional bereavement chaplain. This article highlights not only the human-spirit aspects of dignified and personalized funeral and memorial services but also points out the considerable economies to be realized by both the consumer and the service provider by enlisting the support of an on – call professional interfaith bereavement chaplain. With the holistic interdisciplinary team approach advocated in this article, the insidious deterioration in care and support services can be deterred if not prevented by the mortuary services provider partnered with the on – call professional interfaith bereavement chaplain, and the necessary grief work, healing and transformation effectively nurtured.

While this article focuses in specific terms on providers and consumers of mortuary services, its principles and applications, and recommendations can be extended and generalized to any of the helping professions.

While this article attempts to address a number of points, which are high in priority to both the consumer and service provider, many points must necessarily remain unmentioned. With that in mind, we do encourage feedback and comment from our readers, and we invite you to provide your thoughts either by private e – mail to compassionate.care.associates@gmail.com or by using the comment feature on this blog.


Keywords: Funeral, memorial, mortuary services, funeral director, funeral home, grief, mourning, chaplain, pastoral care, spiritual care, officiant, helping profession


“Death is psychologically as important as birth. Shrinking away from it is both unhealthy and abnormal … because it robs the second half of life of its meaning and purpose.”
Ernest Becker

CONCLUSION

The professional interfaith bereavement chaplain is an important but frequently overlooked professional support person available to the funeral home as well as to mourners. As a professional member of the funeral home team the on-call or p.r.n. chaplain assumes the responsibility for the funeral and memorial service design, organization, coordination, execution, and follow-up, freeing the funeral home staff to concern itself with other important matters. As a highly trained, empathetic, authentic, facilitator and support person, the professional interfaith chaplain provides essential and necessary support to the bereaved and mourners, and forms a de facto therapeutic alliance with them, facilitating the grief work necessary to the healing and transformation process.

The on-call or p.r.n. chaplain virtually eliminates personnel, equipment and logistics overheads

On the more mundane side, the professional interfaith bereavement chaplain represents a cost-saving model for both the mortuary services provider and for the consumer of mortuary services. The on-call or p.r.n. chaplain virtually eliminates personnel, equipment and logistics overheads by being available for effective liturgical, spiritual, religious or humanistic services on site at the funeral home or mortuary services facility, practically eliminating the need for organizing and coordinating resources for complicated and costly movements of staff, equipment, remains, and mourners. The funeral liturgical service, the memorial service or other rites are done right at the funeral home. The chaplain processes then with the cortège directly to the cemetery or crematorium for the graveside, cremation, or columbarium rites.

The Funeral Home Staff Should Bear In Mind The Importance Of Spiritual And Religious Or Pastoral Care Support

In the context of the 21st century death and bereavement culture, the professional interfaith chaplain plays an enormously important role both to the funeral home or mortuary services provider and to the bereaved and mourners. Wherever possible, the funeral home staff should bear in mind the importance of spiritual and religious or pastoral care support to the bereaved and should impress the importance of such support to families when making funeral arrangements. Even if the bereaved do not list a religious or faith preference, even if they do not belong to or actively participate with a faith or belief community, they may have a significant religious commitment without even realizing it, and will benefit from the meaning-making and closure effects of a well-designed funeral or memorial service. It would be a disservice if funeral home staff and mortuary service providers were to ignore this important element of mortuary services.

RECOMMENDATIONS

Empirical observation supports the medical, psychiatric, psychological, pastoral care literature and the growing consensus that spiritual care, whether religious or non – religious, plays a significant role in the health and well-being of all sufferers, including the bereaved. Spiritual care supports the mourner in myriad ways both in the acute grief period into the grief work and mourning stages and well beyond. Spiritual care as offered by the professional interfaith bereavement chaplain represents a significant added value to the funeral home’s product offerings and further represents substantial tangible and intangible benefits to the insightful funeral services manager and his or her establishment.

Corresponding author
Chaplain Harold W. Vadney BA, [MA], MDiv
Interfaith Bereavement Chaplain
P.O. 422
New Baltimore, New York 12124 – 0422
e-Mail: compassionate.care.associates@gmail.com

Click here to view or to download the entire article: Interfaith Bereavement

Patient Assessment: What to include?

As chaplains, ethicists, pastoral and spiritual care providers we have the obligation the ensure that we are responding to the patient’s real needs and not needs we have identified ad hoc for the patient, whether that person is in chronic, long-term care, acute care, or in paliative or end-of-life care.

spiritual_assessment_individual

It is extremely important that providers in each of the disciplines providing care based on a holistic, multidisciplinary model be aware of the cultural, ethnic, spiritual beliefs and values, and the expectations and desires of the person receiving healthcare services.

At all times we must separate ourselves from our own belief and value systems, a process that is not without its overheads, and concentrate on the person before us, recognizing his or her autonomy, dignity, and self-determination, and not losing sight of our potential roles in violating those ethical principles of the person.

We must also bear in mind the personal, professional, and instituional  boundaries, both rigid and flexible boundaries, that constrain our behavior and conduct.

We must train ourselves to be active listeners, providers of a ministry of intentional presence, empathetic and compassionate, and at all times humble.

We must also be acutely aware of the potential for transference and countertransference to occur in the therapeutic alliances we forge with our patients and their families.

I am personally convinced that a thorough biopsychosocial and spiritual assessment procedure helps considerably in our work. To that end, I have done extensive research to finally consolidate my findings into what I call an Intake Template for use bythe  professional chaplain or spiritual/pastoral care provider in the clinical setting.

The Intake Template is rather long but is not intended to be administered all at once, though it could be and to do so would require about 45 minutes to 1 hour, depending on the situation. Some information should be elicited in one session, face-to-face, other information, such as the scoring forms, can be left with the patient and later collected, discussed with the patient, and analyzed and discussed in the care planning meeting.

I am providing a downloadable pdf of the Intake Template and would ask my readers and colleagues to download the template and, at your convenience, to review it and comment on it. That would be very helpful in tweaking the template so that it can find broader application and use.

spiritual assessment toolClick here to view/download the Intake Template.

Althought the Template claims copyright protection, I hereby grant permission to you to use the template as a professional chaplain/care provider in your professional environment.

Thank you in advance for your collaboration and support,

Ch. Harold W. Vadney
pastoral.care.harold@gmail.com

flowing water brook

Chaplaincy Sunyata Before Chaplaincy Nirvana

I rather enjoy reading what some of the contemporary pundits of professional chaplaincy have to say about the current status of the professional chaplain and state of affairs IN professional chaplaincy as a healthcare discipline.

George! Do you really mean that?

George! Do you really mean that?

 In a recent posting on a popular forum for professional chaplains, a renowned personality, albeit from the podium of a branded accreditation organization, George Handzo, in a post “Lack of Integration for Chaplaincy is an International Issue” (that links directly  to his Handzo Consulting blog article) preaches some disputable notions about the profession and the burden of responsibility attaching to the community of professional chaplains (“we” per Handzo), and ipso facto to the individual professional chaplain.

In this posting I take issue with three of the venerable George’s distillations of statements made in two published texts cited by him (Wendy Cadge, Paging God: Religion in the Halls of Medicine, University Of Chicago Press (2013) ISBN-13: 978-0226922119 and an article by Ian Macritchie appearing in the Scottish Journal of Healthcare Chaplaincy (not more specifically cited by Hanzo)).

While George Handzo is generally more or less on target in most of what he exposes to the professional community of [healthcare] chaplains, and while one cannot discount his allegiances, especially to the ACPE, he sometimes appears to preaching from his cathedra of laurels than from a more praxis-oriented position of insightful compassion for the frontline, in-the-trenches chaplain.

In general, I found his comments to be facially insensitive, almost indifferent to the actual obstacles facing the institutional chaplain, and he fails to note fairly that those obstacles have little to do with the professional chaplain but with the larger picture of institutional models and cultures, not the least to do with how we educate, train, and form the hierarchs running those institutions. Here my responses:

Handzo Point: “1. The responsibility for the lack of full integration and lack of growth of professional chaplaincy in health care rests mostly if not entirely with us as chaplains.”

This is placing an inordinate and unrealistic burden on the shoulders of professional chaplains and does not take into consideration the real fact that developments in both “professional” (viz. interfaith) as opposed to “denominational” chaplaincy, socio-cultural changes, and models of healthcare in the past half-century. Whereas prior to the most recent five decades chaplaincy was generally the purview of the ordained cleric or, in the hands of “religious,” it is now, like spiritual guidance, up for grabs, if you will, for just about anyone discerning a “calling” to serve the suffering. This, compounded by the problem of over-marketing of certification and the suspicion associated with the process. Some of that suspicion granted is pure envy and professional lassitude but some is factually based.

Yet another problem is posed by the fact that the practically inexhaustable availablity of unqualified volunteers being welcomed by ignorant volunteer coordinators with the blessing of indifferent institutional hierarchy is not even broached, despite the fact that it is an insidious affront to professional chaplaincy and its institutional and public image!

The decline in membership, rather active participation, in mainstream faith traditions, the aging of faith communities, the declining availability of qualified and formed clergy and religious, and the various popular theologies espoused by overzealous agendas have fostered, and nurtured, a climate of “apostolic missionary ministries” and programs, volunteer programs are the most culpable, that welcome the half-baked, baggage-laden, “chaplains” and pastoral care associates responding to nebulous “callings” into nursing homes and hospitals. Why? Not because professional chaplains (those with professional degrees, appropriate life experience, necessary acquired skills, and an understanding of the organization and dynamics of their chosen or preferred work environment) have shirked their duty of “evangelizing” hierarchy in institutions that would benefit from the ministrations of professional chaplains and well-organized pastoral care departments, but because the hierarchy is generally inculturated with the focus on institutional efficacy and efficiency in a fiscal, technical and regulatory sense, rather than in a customer-centered wholistic sense.

While I do not disagree that the chaplain, as a professional minister, bears some responsibility to guide and to educate institutional hierarchy, we are also inculcated with the notion of boundaries and avoidance of making and impression of overstepping, trespassing. We are admonished against proselytizing, evangelizing where inappropriate; so, too, we are admonished against proselytizing the important role of chaplaincy in an institution that feels expanding the gift shop has priority over providing the chaplain with a respectable space. This requires an attitude shift not in hierarchies that are focused on corporate business objectives but in the very early stages of education of the individuals who will later become the board members, the vp’s of quality, customer relations, public relations, etc.

Healthcare delivery models have changed. No longer is there the family physician or event the primary care physician at the bedside. The hospitalist model has taken the lead. In some respects this is good for chaplaincy because the chaplain has a finite number of physicians to deal with and a chief hospitalist to recruit to the cause, with whom to communicate, and from whom to gain access to the inner sanctum. Analogous models can be found in other institutions benefitting from the ministry of spiritual support such as jails, long – term care facilities, colleges, etc. Indeed, no amount of theology or scriptural studies, nor human developmental theory, nor spirituality and prayer discipline is of practical value when attempting to communicate and to work in such an environment.

The bottom line here is to first of all to access the decision-makers of the institution, to speak their languages (sometimes also their institutional dialects), and to make the impression of understanding the culture and the concerns (especially the institutional strategic mission and how chaplaincy plays an integral role in that mission) of hierarchy.

Handzo Point: 2.  To the extent that our status in health care is due to the lack of understanding by others of our capabilities and possible contributions, we need to bear full responsibility for that situation.”

Vide supra (the above is included here in its entirety by reference).

The status of the professional healthcare of the professional chaplain is that of a healthcare provider. Period. Again, I beg to disagree with the venerable George on the point that we (I am assuming George is referring to the community of professional chaplains) “bear the full responsibility for lack of understanding by others of our capabilities and possible contributions.” That statement is not wholly true and if not wholly true, is false.

Neither the individual chaplain nor the various corporate entities that claim to advocate for the individual chaplain can claim to bear full responsibility for the general, regional, and local understandings of attitudes towards the capabilities and contributions of chaplaincy. First of all, the statement is overly broad and overreaching in its scope. Acceptance of chaplaincy in general differs widely from locale to locale, from institution to institution. To homogenize this understanding to positively affect the overall acceptance and admittance of the role, competency and contribution of chaplaincy would be an almost impossible task. It would have to start at a national level, preferably in the form of recommendations, regulations, and legislation. This is, in fact, in the making when one considers more recent HIPA and JCAHO statements and provisions, and while I may rightly be accused of strong criticism of the various chaplain accreditation organizations, I do admit that they may have a role in a sort of lobbying activity to nudge legislators and key bureaucrats and other influential pundits of healthcare.

Again, I must make a point that chaplaincy can be advocated and promoted only early in the formation of the hierarchs or, in the alternative, with an organized authoritative presence in places where the hierarchs convene to discuss their agendas such as at conferences and congresses. If recognized authorities in chaplaincy–not branded accreditation schemes or representatives of such agendized operations–are admitted a place at the head table or on the discussion panel, then we may gain certain ingress to the minds of those hierarchs, and through those sacred spaces, to their institutions as bona fide healthcare providers.

Handzo Point: “3. We have failed to make the case about how we ’help address larger institutional issues’ or how dispensing with chaplaincy would be a ‘great loss to healthcare outcomes.’”

Again, I must take issue with this statement, and again, vide supra.

I take umbrage that venerable George uses the corporate “we,” or in the alternative that the “we” is intended generally to embrace the community of professional chaplains. Here, too, we cannot go where we are barred access or where we are not expressly invited. It’s a long haul to move beyond the first level caregivers (nurses, techs, support staff, even physicians) to get to the boardroom. Nor do most “chaplains” have the credentials with which to impress hierarchs that what the chaplain has to say carries reliable business weight.

Take, for example, the hospital: How many chaplains can say that they have an adequate knowledge of the structure and organization of the hospital? Or of the myriad regulations that affect the hospital? Is the hospital a too  complex example? Take, then, a prison, if you will. What does the generalist chaplain know about prisons? About the regulations affecting prisons and their operation? So, absent specific, specialist training in specific and particular institutions, how does the chaplain addresss “larger institutional issues?” Without such training, knowledge, experience how does the chaplain address “larger institutional issues?” Does the professional chaplain have to have a degree in theology, in pastoral care, in business administration, public administration, and social work to do that? Or, in the alternative, does s / he forge inter –  or multi – disciplinary networks or support resources to do that? Does the professional chaplain need to be the epitome renaissance person or just know how to finagle and kibutz?As to the suggestion that “dispensing with chaplaincy ‘would be a great loss'” I must comment that to experience loss you must first attach value to the thing lost. And so we make full circle.

But what is pristinely clear to me is the fact that, like efficacious chaplaincy itself, the response, if not the answer, lies in an early access to the core decision makers…

The basic question to be answered, far from heaping the burdens of responsibility on the community of professional chaplains, as George Handzo appears to be willing to do, we must ask ourselves: At which point and how do we inculcate the much touted holistic healthcare model (spirit, mind, body) in the hearts and minds of the seculars who call the shots? It’s a very complex question and, since chaplaincy is such a variegated ministry and the cultures in which the ministry is done are so myriad, I personally doubt that there is really one answer. But what is pristinely clear to me is the fact that, like efficacious chaplaincy itself, the response, if not the answer, lies in an early access to the core decision makers, effective formation of the decision makers, comprehensive education, training, and formation of professional chaplains (after an appropriate period of reflection and ongoing discernment), frequent, open, and affordable continuing formation for chaplains, and express support from mainstream denominations of the ministry of chaplaincy based on a spiritual rather than a traditional model.

If I commit the offense of overgeneralization by making the statement that in the past chaplaincy has been its own arch-enemy, I humbly apologize. But chaplaincy must advocate itself as a professional healthcare discipline both internally and ad extra.

If we fail to communicate or document “outcomes” might it not be the shortcoming of the CPE programs themselves and not of the product they churn out as “chaplains”?

Handzo continues his editorializing by noting the problem of outcomes in chaplaincy. According to Handzo, “We often still resist the idea that outcomes are something chaplains should have. We don’t have commonly understood sets of outcomes, we don’t train our students to work toward outcomes, and we often don’t document outcomes so other members of the health care team know what we do.” Again that ubiquitous, corporate “we,” that contributes only to the ambiguity of what Handzo is writing. Who is this “we?” It certainly cannot be the in – the – trenches professional chaplain, or can it, George? It also seems a bit misleading to hear an apostle of the CPE movement, a board member of the consulting firm Healthcare Chaplaincy and a past president of the Association of Professional Chaplains (APC), would make such a statement, especially in view of the reasonable prestige that Rev. Handzo allegedly has in the chaplaincy movement. If “we” have not established “commonly understood sets of outcomes,” and we “don’t train our student to work toward outcomes,” “and we often don’t document outcomes,” that is, we do not communicate to other members of the inter –  or multi – disciplinary team members, whose fault is that? Might it not be the shortcoming of the CPE programs themselves and not of the product they churn out as “chaplains.”

Handzo is describing a lack of community, a lack of consensus, a lack of fraternity among professional chaplains –  – could this be attributable to the plethora of competing “advocacy” or “standards” or “certifying” organizations and competing “outcomes”

Handzo continues, “I am convinced that one of our greatest barriers is our own infighting and the time we waste debating internally whether professional chaplains should have outcomes, demonstrate value, and have measurable outcomes. I find myself increasingly disinterested in engaging those questions.” I am appalled that a leader in the chaplaincy movement and a leader in the CPE movement should be “disinterested” (I am somewhat at a loss what Handzo intends to mean by “disinterested.” Does he mean “indifferent?” “Impartial?” “Dispassionate?”) in engaging such questions! It would seem that Handzo is describing a lack of community, a lack of consensus, a lack of fraternity among professional chaplains –  – could this be attributable to the plethora of competing “advocacy” or “standards” or “certifying” organizations and competing “outcomes.” I’m also having some difficulty with the notion of “outcomes” in spiritual support, and wonder where that one came from. Handzo conspicuously avoids any further elaboration of what are the outcomes to which we should aspire, or how we demonstrate value and to whom. I have not problem demonstrating value to the suffering nor demonstrating value to my contributions to staff education, institutional image, community outreach, service retention, etc. but my point is: How many readers understand these to be values to be demonstrated?

My further point is that Handzo fails to define his terms like “demonstrate value.” Measurable outcomes poses another problem. From the administrative, management point of view I can appreciate the the board or the corporate director for quality might be so limited as to grasp only PowerPoint depictions of measureable outcomes, metrics, etc. If that’s what Handzo is meaning, does that really fall on the lap of the in-the-trenches chaplain? True, the professional chaplain very frequently wears the administrative, managerial hat, too, of director of “pastoral care” (Ugghhhh!) but does the in – the – trenches provider have the time, energy, inclination to start recording “measurable outcomes?” I think not, especially when the professional chaplain, if the institution even has a professional chaplain, has the burden of impossible numbers of patients and the responsibility to triage who gets the visit and who doesn’t. There seems to be a serious disconnect between Handzo’s statement and the real world.

There are many saints that are locked out because of the rigor of artificial and ambiguous certification agendas; likewise, many individuals with more temporal than spiritual / apostolic aspirations gain access to sensitive precincts and cause much damage…

Regrettably, Handzo’s concluding statement: “I continue to rejoice that this is a large and growing group both in the US and abroad that I hope and trust will continue to make a difference in how spirituality is integrated into health care” does not lend much lucidity to what he attempts to share with us. In fact, it reveals a deplorable lack of sensitivity to the complexity of chaplaincy, especially when considering chaplaincy in terms of international models. Which group? The wannabe’s or the professionals? The branded certificated or the natural vocations? The international organizations’ membership censuses or the invisible ministers of spiritual support to the suffering. I’m not quite clear what Rev. Handzo’s point is, really.

There are many saints that are locked out because of the rigor of artificial and ambiguous certification agendas; likewise, many individuals with more temporal than spiritual / apostolic aspirations gain access to sensitive precincts and cause much damage. As impractical, even impossible as it may sound, we must self-police, inter-form, and inform each other as co-disciples, and then corporately police, form, and inform our target institutions. We can do this only if we are humbly authentic and emptied of self-interest and attachments. In other words, we much attain chaplaincy “sunyata” before we can attain chaplaincy “nirvana.”

plant in hand