Chaplains in healthcare settings offer patients spiritual care that involves companionship, counselling and maintaining hope. This is particularly important at the point where a patient has run out of treatment possibilities. This book reflects creatively on the work that chaplains do with people who are dying and the unique quality of the relationship that palliative care professionals construct with patients at the end of life.Based on qualitative research with practising palliative care chaplains, Spiritual Care at the End of Life explores the nature of hope in its different forms at different stages of terminal illness, and asks how chaplains can help dying people to be hopeful even when facing the inevitability of their death. The book identifies key moments in this relationship, from the person's initial reaction to the chaplain, to the chaplain becoming an accompanying presence and creating the potential to provide comfort, strength and ''hope in the present''.This thoughtful and inquisitive book investigates the underlying theory that spiritual care is rooted in relationship. It has implications for practice in the work of chaplains, counsellors and all healthcare professionals supporting people who are dying.
Acknowledgments. Introduction. An overview. With thanks. 1. Redundant Hope. Daniel: my critical incident. The development of hope: Rumbold's 'three orders'. First-order: Denial of symptoms and hope for recovery. Second-order: Denial of non-recovery and hope beyond recovery. Elaine: moving on fromangry. Third-order: Hope that faces existential extinction. 2. Evocative Presence. A visitor in Room 20: 'And ... ?' Peter: How now to pray? The chaplain as an 'evocative presence'. Positive projection: 'Positive' outcome. Positive projection: 'Negative' outcome. Rosetta: 'You wouldn't want him here!' Negativeprojection: 'Negative' outcome. Negative projection: 'Positive' outcome. How chaplains work with negative transference. Summary. 3. Accompanying Presence.Karl: they want us to let go. Physical presence: being-there. Thomas: separate lives. Emotional presence: being-with. Joan: So many questions. Arthur:staying with the bewildered. Summary. 4. Comforting Presence. Phoebe: a very tired 86 year old. Active presence. Michael: 'Because'! Passive presence.Alfred: the 'Ya-neva-know' defence. Sally: Chipping away at a big block of terror. Summary. 5. Hopeful Presence. Yvonne: 'Cancer - welcome aboard'! Ray:'Nuthin' I can do about it'. Reconfiguring hope: from hope to hopeful. The strength to live hopefully. Presence and the reconfiguring of hope. Summary. 6.Rethinking Spiritual Care as Presence. Managing the anxiety of death. Penny: 'If I could get control of my emotions everything would be fine'. Owning theanxiety our own death. Sue: I'd love to have my nails done! Returning to Daniel. 7. Towards a theory of 'chaplain as hopeful presence'. Summary. Evocativepresence. Accompanying Presence. Comforting Presence. Hopeful Presence. Conclusion. By Way of an Ending: A Personal View. Chris: A birthday kiss. Appendix: The research project. Introduction.Research process. Analytic method. Credibility. Ethical issues. References. Index.
'This book is written by someone who knows only too well the distress and turmoil of those adapting to the knowledge that their life is short. He also knows how people fluctuate in their acceptance of death approaching and yet wish to live. Cicely Saunders said that ' dignity is having a sense of personal worth'. Connecting with people is fundamental to restoring the sense of a person's worth, understanding them in the unique biographical context of their life. Some turn to religious faith, some turn away. But all need to know their uniqueness is respected and need to be listened to. Hope then emerges again; realistic hope for what can be achieved and acceptance of what cannot, hope to complete life's tasks well, hope to do whatever the individual needs in the time left. And hope is confirmed in the secure knowledge that they will not be abandoned. The author's experience of 'being there', advocating for patients and giving voice to those who feel they are becoming voiceless underpin his writings. His remit concerns spirituality and personhood far more than any particular religious faith. His work is truly uplifting as it restores the essence of being.'- Baroness Ilora Finlay, Professor of Palliative Medicine and Independent Crossbench member of the House of Lords'Steve Nolan clears away the clutter and gets to the very heart of spiritual care. He explores the human capacity to 'stare into the sun' of one's own mortality, and invites an authentic engagement with the dying, which offers hope beyond recovery. This book, which is all about 'being-with' the other, in the depths, shifts perceptions of hopeful journeying and spiritual care and is an essential read for all who care for the dying soul.'- Ian Stirling, Editor, Scottish Journal of Healthcare Chaplaincy and Association of Hospice and Palliative Care Chaplains
