Ministry to the Sick and Dying

Care of the Chronically Ill

Chronically ill patients are patients who have an illness that has no cure and requires treatment over a period of time. Chronically ill patients come to the hospital for something that can't be fixed, but needs to be followed and treated. Those with chronic illnesses will sometimes have a crisis situation, which will require them to seek immediate help. Pastors who know their flock, know of those in the flock who have chronic illnesses. The pastor should keep them in his prayers. He should ask the member and family to keep him informed of any changes in the person's health. Many times there will be an acute episode that requires hospitalization, bed rest, or some other form of care. If the pastor is advised when an acute situation arises, he can minister to the member accordingly. There are many illnesses and diseases, which are chronic. Heart Disease, MS, HIV, and many, many other diseases can be chronic and debilitating. Chronic diseases may continue indefinitely and ultimately result in death or they may continue for the remainder of the person's life but not be life threatening.

Guideline for hospital visits

Matthew 25:36
Naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me.

Call ahead to confirm that the patient is still in the hospital if you plan to visit a patient in the hospital. Ask to be connected to the patient's room. Talk to the patient and ask if they feel up to a visit. Be sensitive to what they say. The patient may feel exhausted but fear hurting the pastor's feeling by saying they aren't up to a visit. Ask if there are any tests or therapies scheduled and when would be a good time for a visit. Always tell the patient that if they are not up to a visit that you would be happy to come at a time when they are feeling better. The pastor should allow the patient to set the time whenever possible.

Stop at the nurse's station when you arrive on the patient's floor. Identify yourself and ask to speak to the patient's nurse. The pastor should ask the nurse if there is anything that he should know. Sometimes the nurse will give you some insight into the patient's day. They may tell you that the patient has had some bad news or that the therapy session was particularly difficult. It is also a good idea to ask the nurse about any precautions you should take. The pastor should wash his hands before entering a patient's room so that he does not carry germs in that will expose the patient. NEVER visit a patient if you have a communicable disease. This means a cold or anything that can be passed on to the patient.

Let common sense be your guide in the length of visit. If the patient has just undergone surgery and is weak, a short visit is in line. A patient who has been in-patient for a length of time may like a longer visit. Have an amount of time on your mind but always take your cue from the patient.

The pastor should gather information during his visit. Allow the patient time to tell you about his/her illness. Many times the family will want to do this, but it is important to let the patient talk if he /she wants to. Allowing the patient to speak will also let everyone know that the patient understands what is happening. It will also send up a red flag if there are misunderstandings between the patient and family. The patient may be frightened and allowing them to talk will help ease that fear. The pastor should listen to the patient and family for clues as to how the church can minister to them. Assessing the patient's spiritual condition is covered in a later chapter.

In chronically ill patients I have found that asking some leading questions will open the lines of communication about how the person is really feeling. I quite often ask the patient how the disease has affected his/her life. By asking this question I am opening the door for the patient to talk about things like unfulfilled dreams, problems with family or work, or anything at all that may be on their mind. I also ask what the hardest thing has been for them to deal with. When I ask this question to a patient in the hospital it is almost always answered that they miss being at home. A person struggling with cancer who is hospitalized frequently will often say they don't like being away from home. I have seldom heard anyone respond that pain has been the hardest thing to deal with. Most patients handle the physical aspects of the disease better than the emotional aspects.

The visit should include three forms of communication. There should be talking, listening and touching. The patient should be given the opportunity to talk. Sometimes simply talking about problems will help. The pastor doesn't have to have all the answers. The patient may ask questions or may just want to talk to someone he/she trusts. It is important for the pastor to listen. The pastor must show understanding and acceptance. He should not back away or act shocked at what the patient says. Touching the patient is also important. Unless strict instructions have been given to not touch the patient, the pastor should make physical contact. A gentle touch on the hand can relay the message that you care. The patient whose hand the pastor holds will feel reassured and cared for. The gift of touch can be the most valued of all gifts to a patient.

In concluding the visit, the pastor should ask the patient if he would like prayer. Many people don't like to pray out loud in front of others, especially their pastor, so clearly ask, "would you like for me to pray for you?" I also ask what in particular the patient would like for me to pray. This gives the patient a chance to be open about what is on his/her heart. The patient may have concerns about other family members, about test results, or about anything at all. The pastor must be attentive and listen carefully. If you need to take notes, then take them. Don't ask a patient what they need prayer for then forget them in prayer. The pastor can also conclude the visit by offering to read scripture. The patient may have a favorite passage or a Psalm that has special meaning. I have covered in a separate section some passages that offer comfort to the patient.

Sometimes when the pastor enters the hospital room there are others present. This can present a challenge to the pastor. He may sense that the patient would like some time alone with him. This can be handled by offering to sit with the patient and allow the others to take a break or go for some coffee.