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Chaplaincy in Palliative Care Settings

Next Reply: Re:Point of Chaplain Intervention?
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Post Point of Chaplain Intervention?
Author: DenverC
Date: May 19, 2008 1:53 pm

We want our patients to receive chaplain services but are unsure about what point chaplain intervention is needed? Also, when our patients recieve chaplain services we want to make sure that they are not proselytized to. How can we do this?

Replies: order by [Date] [Author] [Subject]
Re:Point of Chaplain Intervention? (by Palgal1 on 05/19/2008)
Re:Point of Chaplain Intervention? (by JJCASTELLO on 05/19/2008)
Re:Point of Chaplain Intervention? (by EMeyerson on 05/19/2008)
Yes- a properly CPE trained chaplain will know and understand that proselytizing is NOT the chaplain's role- actually the direct opposite. A major role of the chaplain is to remind the patient of who s/he is- not try and convince the patient of something else. And so, when providing support for the patient- whether it be spiritual or emotional (God does not always play a role for the patient or family), the chaplain is trained to provide that support- support that is essentially catered to the specific patient or family member where that specific person is at that specific moment. I think the word "intervention" should be discarded. The chaplain must initiate his/her visit after the Palliative Care consult takes place (within that same day or the following day). If Palliative Care is alleviating suffering (physical, emotional, existential, etc.) at any stage in an illness, then a spiritual assessment must take place at that time as well. Once the chaplain is present and is understood, to the patient and the patient's support system, as part of the healing team, the chaplain becomes a resource and a support as days, weeks, months, years progress. And so, to answer the question head on, at what point should a chaplain become involved? Ideally, day zero or one in the hospital. By involving the chaplain early in the process, this allows the patient and family to better understand the chaplain's role. We are not there only in times of death- we are there in times of life; we are there to witness, provide support, and acknowledge the struggle to live that life in the way the patient wants to live it while in the midst of illness. -Chaplain/Rabbi E. Meyerson
+ Re:Point of Chaplain Intervention? (by ghandzo on 05/20/2008)
Re:Point of Chaplain Intervention? (by Tim_Ford on 05/20/2008)
Re:Point of Chaplain Intervention? (by ghandzo on 05/21/2008)
+ Re:Point of Chaplain Intervention? (by MarciP on 05/29/2008)
Re:Point of Chaplain Intervention? (by cynmb on 05/29/2008)
Re:Point of Chaplain Intervention? (by GeorgeHankinsHull on 05/29/2008)
Concerning proselytization: The College of Pastoral Supervision & Psychotherapy (CPSP) accredits clinical pastoral education programs and certifies board certified clinical chaplains. We trust that the following would address some of the concerns about proselytization: From the CPSP Code of Professional Ethics: Respect: Colleagues, students, clients, parishioners, and patients deserve our respect. Therefore, members will not proselytize nor force their own theologies on others. CPSP members will refrain from exploiting relationships or using them to their own advantage. Exploitation includes emotional, financial, sexual, and/or social gain. Records, evaluations, personal notes, and informational conversations will be kept confidential. Competency in Pastoral Care: The basic requirements in CPSP for certification as Board Certified Clinical Chaplain: 1. The characterological make-up for ministry, including an ability to bond with others, an ability to give attention to others, and a tolerance for diverse religious traditions and values. 2. Basic self-understanding, so as to limit unconscious imposition of one’s own agenda on others. 3. Endorsement by a faith-group community to perform ministry. 4. 1600 hours of clinically supervised ministry or a year of Clinical Pastoral Education. 5. Continuing education and annual recertification. 6. A Master of Divinity degree or equivalent, which means three years of post-graduate academic study. Access to Pastoral Care: CPSP affirms the right of the of patient’s and their loved ones to have access to pastoral care that is directed in accordance with the patient's and their family's faith tradition. CPSP affirms the right of the hospice patient to have that care provided by a religious professional from the patient's own faith tradition. CPSP advocates that religious professionals employed by hospitals or hospice programs work cooperatively with parish clergy so as to facilitate ongoing pastoral support by community clergy. CPSP acknowledges the patient's right to refuse the provision of pastoral services. Pastoral Evaluation in the Clinical Pastoral Tradition: CPSP affirms that pastoral care, in the clinical pastoral tradition, must include personal evaluation with the specific purpose of bringing the appropriate pastoral resources to bear. CPSP advocates for a dynamic process of pastoral assessment over against the use of a written instrument that requires nothing more than the recording of a patient’s answer to a predetermined set of questions. CPSP affirms the communication of the pastoral evaluation of the patient’s and family’s pastoral needs to the interdisciplinary team. CPSP supports the patient’s right to be a partner in their treatment plan so as to determine the goals of the care. George Hankins Hull CPSP Diplomate in Clinical Pastoral Supervision http://www.cpsp.org/
Re:Point of Chaplain Intervention? (by revnenn on 05/29/2008)
Re:Point of Chaplain Intervention? (by Chaplain_Al on 05/30/2008)
Marci writes: "In our PC program, we have an interdisciplinary team that works together on appropriate referrals and interventions." The interdisciplinary process is key. The clinical chaplain needs to be integrated into this team. At UAMS Medical Center here in Little Rock, as a Board Certified Clinical Chaplain, I not only work as a part of the interdisciplinary team, but also coordinate our Palliative Care program. Each consult order for palliative care comes through me, and I do an initial screening for needs. I call in the members of the team, as appropriate. I offer this as a model where the chaplain is central to the palliative care team process. At a minimum, a palliative care consult involves our palliative care physician, myself as chaplain/PC coordinator, the patient's nurse, the attending physician, and a social worker. We also meet each week for interdisciplinary team staffing conference (IDT). Members of our IDT include physicians, a nurse, a social worker, a psychologist, and chaplains. At each IDT meeting, we staff each patient from that week including medical assessment, social assessment, and pastoral assessment. In addition, we discuss the interventions, plans, and outcomes of each case. Our IDT meetings also have an educational segment as well. In my role as chaplain, a part of my pastoral assessment includes an evaluation of the religious/faith/spiritual resources already available to the patient and family. Many, not all but many, of our patients and families have a connection to a faith community (cf. S. Pulchalski's FICA model - C for faith Community). As chaplain, it is important that I help facilitate the role of the patient’s and/or family’s faith community and clergy to offer pastoral support and nurture. In addition, it is most always beneficial, if possible, to involve a patient’s clergy in our team process for that patient as well. As an academic medical center, we are implementing a medical fellowship in palliative care AND a palliative care fellowship for chaplains through our CPE program. I will keep this group informed on the progress of both fellowship programs.
Re:Point of Chaplain Intervention? (by ghandzo on 05/31/2008)

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