Ministry to Shut-Ins and Hospital Patients

By V. Rev. Arthur Liolin

This guide is intended for   laypeople who want their service in Christ’s Church to include visitation with   those confined to home, elderly housing facilities, or hospitals. (For a Biblical   reflection on this, see Matthew 25:31-46.)

Lay involvement in this ministry   is vitally important. While the pastor brings the holy mysteries and his pastoral   skills to the bedside, the care and concern of the committed lay visitor offers   its own authentic assurance of God’s love and mercy. Arrival at the bedside   by the lay visitor poignantly expresses and underscores a vital link between   the “people of God,” and one of their own who is experiencing pain,   sickness, and separation from family and community.

A lay ministry of the type   outlined here is not intended to be isolated from the parish’s outreach to the   infirm; rather, it should be seen as drawing upon the personal gifts of the   laity, and as a complement to the vocation of the pastor, upon whose guidance   such a program should depend.

Understanding   the Patient’s Situation

However pleasant the facility,   every patient must still adjust to a foreign setting and experience the disjointed   and often impersonal sights and sounds of the clinical environment. The new   patient’s life-style has changed abruptly, with routine upset, and familiar   surroundings altered. Faces appear strange, attitudes condescending. Changing   shifts of staff mean more adjustments and the antiseptic setting often deprives   one of identity and, therefore, of security. Even well-trained nurses and aides   seethe patient as part of their job, for to become overly and personally concerned   raises problems for them as well. The patient often feels lost, out of control   with life and dependent on others.

Experience has shown that   the visiting layperson can enhance the patient’s sense of self-worth and caring   with this ministry, when it is properly exercised. You, the visitor, are a contact   with the community where the patient is regarded as an equal, where he or she   is valued in his own right. Coming on behalf of Christ and His Church, you bring   hope: a reminder of healthier days, of an anticipated return to an integrated   life. You bring faith: that with the prayers of fellow parishioners the burden   of illness may be transformed into a deepened strength and understanding of   the human condition shared by all of God’s creatures. And by your coming, you   express love.

Here are some   suggestions for conducting visits:

What To Talk   About

This may be divided into three   parts:
  a) General Conversation; b) The illness and Problems; and c) Restorative Prayer.

GENERAL CONVERSATION.   Initial meetings should be light, friendly, and unstudied. You may wish to discuss   the person’s family, events in the parish community, the weather, the hospital   environment. But be careful not to make the visit a shallow one. A patient is   all too aware that things are not normal; pretending that everything is “just   fine” only detracts from the visit’s healing purpose, and patients can   usually see through pretense. At the start, don’t be afraid to “test the   waters” to determine the patient’s willingness to accept your visit for   what it is: a special mission and outreach of you and of your church. If you   are new at visiting, give yourself time to feel comfortable doing it. Be yourself,   to be sure, but also expect to be challenged and to develop your own God-given   gifts with people.

THE ILLNESS   AND PROBLEMS. Patients are surprisingly often willing to discuss their   reasons for being confined. The lay visitor should expect, and even encourage,   a patient to air complaints. Patients need a responsive ear to hear them out.   Expect them to go into minute detail about their circumstances. They will, and   do. They are often at the “cutting edge” of their existence and your   attentive support may help them accept their situation and grow in Christ because   of it. This type of discussion is usually the most uncomfortable for the layperson   to share, but it is absolutely essential if the visit is to have meaning for   both. Time and experience aids in managing this, though few laypeople—or   clergy—have the stamina to incorporate the pain of others into their own   self-understanding.

Sometimes well-meaning and   devoted people have no pattern or mechanism when thus confronted: they hide   in roles or pleasantries, they weep internally, they may withdraw and, for this   purpose at least, they fail. But if a personal prayer life, guidance and training   accompany any initial discomfort, then the visitor’s own ministry is on the   threshold of growth. As a visitor you can expect to be both exalted and drained:   exalted because the personal reward can be mutually fulfilling, and drained   because, if you care, you’ll often so sympathize with the patient that his or   her ills become your own concerns.

If you have come this far   as a visitor, it may bolster your confidence to realize how many kinds of help   your visits are offering. First, by listening you bring the community to the   patient and restore a feeling of self-worth and value. Second, in talking to   you as a “church friend”, the patient begins to overcome the feeling   of depression at being an object (probed, inspected, cleaned by others, defenseless)   and somehow becomes a person again.

Then too, you may recognize   needs that others would not. You may see that the patient needs to talk with   the priest and receive the Holy Mysteries. You may be able to help dispel any   fear of Communion that the person has (because it may be associated with the   approach of death) so that the sacramental healing of God’s grace can become   effective. You may, in this same vein, be the one who sees the need to encourage   more visits by the patient’s family, or encourage them to fill special requests   the patient has made. All of these services are valuable, and your visits can   provide them.

RESTORATIVE   PRAYER. The priest is trained and ordained to pray for the patient   and to administer the sacraments of unction, confession, and communion, as well   as to give pastoral counseling. But the lay visitor can pray with and for the   patient as well. Doing so serves the very important function of recalling for   the patient the feeling of being in church with other laity. It reflects the   Orthodox belief that physical separation of the faithful is overcome by their   spiritual unity. Praying with a patient can have tremendous restorative power.

As a visitor, you may use   brochures which the priest gives you for such prayers, reading them alone or   with the patient, and beginning and ending your prayer with the invocation of   the Holy Trinity and the sign of the cross.

Resources:   What To Bring

The pastor may provide the   visitor with several kinds of Orthodox reading matter, many of which are also   available through seminary bookstores. These are important in several ways.   First, shut-ins often get bored; Orthodox pamphlets and brochures provide an   opportunity to enrich the patient’s understanding of the Orthodox faith, place   the illness in a theological context and often transform the patient from a   passive communicant into a future helper of others who become ill or confined.

In addition to strictly prayer-oriented   brochures dealing with sickness and death, other material can be brought, such   as a parish bulletin. The Orthodox Church newspaper, descriptive pamphlets on   confession, announcements of future social and church events. These help to   assuage boredom during hospital stays and become a visible evidence of the church’s   presence with the patient. The layperson may also wish to bring a memento: an   icon button, or icon print, flowers, a perfume or a soap; something personal   for a person! It is the thought that counts more than the item itself. Some   patients may enjoy a tape cassette or a book, and every parish should provide   for this as part of its outreach.

Following   Through

Concern for the shut-in does   not end with the visit. The layperson. having taken on this ministry, will often   feel the need to pray for those visited and to ask the priest to pray for them   during divine services. One parish has a listing of those in hospitals posted   for all to see, although some prefer not to have their infirmity widely known   and this is to be respected. In some instances a visitor may be expected to   inform parish agencies of a parishioner’s confinement so that a card may be   sent and other parish groups can visit.

However, lay ministry to shut-ins   is not to be confused with the group visits normally conducted by parish societies.   This is why the visit should preferably by made by only one person, so that   the individual nature of this work is kept intact. Group visits may, however,   be beneficial in some instances, as in the case where a patient is unable to   speak. Here the normal conversation of several makes for a less awkward experience.   A group visit might also be useful in the case where a pastor is training a   new layworker who needs initial encouragement in making visitations.

A phone call to patients after   the visit to see how they are doing, whether they have other requests or desire   another visit, is always a good idea.

Many layworkers keep a casebook   to record their impressions both for themselves and in order to refine their   approach. This casebook may be shared with the priest during regularly scheduled   meetings With other laypeople visiting the sick, and provides an ongoing record   of the development of the local parish program. The visitor’s role can increase   at this stage. Perhaps he feels that the priest should be asked to speak with   the patient’s physician, for example. Does the patient know the extent of his   illness (and should he know?) Does the patient need Consultation regarding nursing   home or rehabilitation stays? The layperson may serve as a facilitator, providing   the suitable information and contacts to pastor or to family, while keeping   the necessary emotional distance required to safeguard the program’s real effectiveness.

Some Cautions

Any layperson engaging in   hospital ministry does so out of Christian charity and human compassion, love,   and concern. Often, it is a rewarding experience, accompanied by the smiles   and gratitude of the patient. But certain unpleasantness occurs which should   also be anticipated. For one, the patient, once back to normal life, may avoid   his or her former visitor! Why? The clergy and layperson have seen the patient   precisely when he or she is most vulnerable. The layperson now knows the patient’s   weaknesses and this knowledge is often difficult for a past patient to bear.   That same layperson who was so necessary, and comforting during illness now   becomes a reminder of former insecurities. Any priest, social worker, or layperson   involved in this type of ministry should expect this baffling yet understandable   response.

Family of a patient usually   are appreciative of church visitors; however, you are entering into a most private   sphere, that of illness and family stress. People become highly sensitive and   unpredictable during such crises. Be prepared not to be thanked as you might   expect; or be prepared for suspicion and defensiveness following an initial   expression of gratitude. This is the most disheartening part of this vocation;   it is more unexpected and challenging than confronting illness with a terminal   patient.

Remember that you are not   God. Attachment to the people you are serving often brings with it a sense of   power which is not your own. Serving as instruments of Christ, His Church and   His mysteries, we often associate so closely with these same gifts that we blame   ourselves when things do not go as we expect, or ascribe to ourselves the things   which are of God. This also is a prevalent attitude among those in social services   and human resources, and something to watch out for.

Do not be disheartened by   these cautions but be humbled and purified in thinking about them. The layperson   is not immune to these pitfalls and should rely on a personal prayer life, regular   consultation with the pastor, and objectivity!

The vocation and tasks which   you have undertaken are holy and blessed by God. Something in you has prompted   this endeavor: care for people, service to God and His Church, a need to extend   your faith with prayer and action (Orthodox ‘praxis.’) You will bring your own   strengths, love, talents, concern, and faith with you to the hospital bed. But   you will also bring your fears, prejudices, doubts, and failings. For you a1   so are a person in need of salvation and healing.

Strive to assist, but do not   expect perfection. Indeed, your very fears and flaws can enable your ministry   to be more effective and authentic. How can you help someone who feels lost,   threatened, and dependent if you have not, in some way, felt this yourself?   No; let your shortcomings turn into the very gifts which the patient you visit   needs most: a sympathetic ear, a loving heart, a prayerful spirit and a friend   from the Church who has come to be at bedside during a time of need.

  Fr. Arthur Liolin is Chancellor of the Albanian Archdiocese and Dean of St.   George Cathedral in Boston. A graduate of Princeton, he has studied Clinical   Pastoral Psychology at Andover-Newton Theological School in Newton Centre, Mass.


The Sacrament   of Holy Unction
  An Orthodox Euchologian

Together by Your   Side
  Rev. Joseph M. Champlin

On Death and   Dying
  Elizabeth Kubler-Ross

Intimacy; Essays   on Pastoral Psychology
  Henri J.M. Nouwen

“The Orthodox   Pastor and the Dying”
  Rev. Joseph Allen (St. Vladimir’s Quarterly)

A Grief Observed
  C. S. Lewis

Death: The Final   Stage of Growth
  Elizabeth Kubler-Ross

For the Life   of the World
  Alexander Schmemann

Orthodox Spirituality
  By a Monk of the Eastern Church

  Taken from the OCA Resource   Handbook for Lay Ministries