These training recommendations will help board-certified chaplains address the unique needs of patients living with serious illness.

Foundational Skills for All Chaplains

Assess the Needs and Concerns of Patients

  • Know what palliative care is, and when to request a consult
  • Assess for emotional, existential, and spiritual distress
  • Take the patient’s spiritual history, including whether the patient is part of a faith community
  • Assess caregiving needs and resources

Strengthen the Clinician-Patient Relationship and Understand Goals of Care

  • Identify the patient’s surrogate decision-maker
  • Have conversations with patients to understand what matters most to them now that they have a diagnosis of a serious illness, and participate in shared decision-making that is aligned with patients’ values and preferences
  • Conduct skilled conversations with patients and families about:
    • Serious news
    • Patient/family understanding of the meaning of their illness
    • Family conflict
    • Fear and grief
    • Meaning-making
    • Death and dying
  • Identify how culture, race, gender, sexual orientation, and context (e.g., social determinants of health) influence patient and family decision-making in the context of a serious illness, and deliver responsive, unbiased care matched to needs and priorities
  • Support patients who are eligible for hospice in the process of deciding whether to enroll

Manage Pain and Symptoms

  • Assess the spiritual/existential underpinnings of suffering caused by common symptoms associated with serious illness, and alert the care team to symptom burden
  • Identify patients that would benefit from a specialty palliative care consult for complex or intractable symptoms, and refer or discuss with the care team

Prevent Crises and Plan Ahead

  • Connect patients to spiritual supports, including outreach to faith communities
  • Recognize the need for social work or behavioral health services, and make appropriate linkages to these services
  • Identify functioning or mental health needs and make appropriate referrals

Complete the Learning Pathway, Foundational Skills for All Chaplains, to acquire these skills.

Additional Skills for Chaplains Who Focus Primarily on Supporting People with Serious Illness

Examples include chaplains working in geriatrics, home-based care, or nursing home settings


Assess the Needs and Concerns of Patients

  • Recognize common sources of suffering for patients with serious illness, and perform a comprehensive assessment using culturally appropriate tools, including:
    • Social risk factors, including presence of caregiver; caregiver burden/needs; racism and other culturally-bound factors that influence care; financial strain; access to housing, food, and transportation
    • Emotional and spiritual distress, and how these might manifest as physical symptoms (e.g., pain, shortness of breath, constipation)
    • Communication barriers (e.g., vision, hearing, language, and health literacy)
    • Protective factors that can support resilience during serious illness

Strengthen the Clinician-Patient Relationship and Understand Goals of Care

  • Provide support regarding coping with serious illness and self-care
  • Conduct advance care planning conversations and complete advance directives
  • Provide bereavement support for families and caregivers
  • Support the care team to deliver spiritually-sensitive care; effectively communicate with members of the care team

Manage Pain and Symptoms

  • Contextualize treatment and/or interventions to incorporate the values and priorities of each patient to provide person-centered, family-focused, and culturally congruent care
  • Assess the feasibility of the care plan with the patient (e.g., whether prescribed medications are accessible and affordable)

Prevent Crises and Plan Ahead

  • Identify community resources that can support patients living with serious illness, and their caregivers, either directly or by connecting your patients to a social worker (e.g., housing, food, transportation, faith communities, state and local agencies)
Learning Pathway

Complete the Foundational Skills for All Chaplains Learning Pathway to acquire these skills.

View Learning Pathway