Church of the Holy SpiritPastoral Care Ministry

Friendly Visitor Training

Saturday, June 7, 2008

Welcome

• Welcome• Introduction

– Housekeeping

– Training Topics

– Goals

– Interactive Activities

– Questions Anytime

• Opening Prayer

How A Person Gets Visited

• Church is Notified of Need

• Friendly Visitor Coordinator is Notified

• Coordinator Matches to Visitor Based on Situation

• Visitor is Notified and Briefed

• Following Visit, Visitor de-briefs Coordinator

Parish Nurse versus Friendly Visitor Roles

Role of Friendly Visitor

• Represents the caring and praying church community.

• Cares about the spiritual needs of patient.

• Is more remedial than proactive

• Walks along side the patient, not trying to fix the situation, but to comfort him/her.

• Gives the message that the patient is cared about, and is not alone.

• Is present to the patient, that is, enters into the patient’s world and responds with feeling.

• Alerts the Pastoral Care team about changes in patient’s progress.

Role of Parish Nurse• Represents the caring and praying

church community.• Cares about the patient’s spiritual needs • Professional Knowledge.

– Asks the right questions regarding medications and treatments.

– Interprets a doctor’s diagnosis for the patient.

– Assists the doctor in exploring options for the recovery process.

– Follows up after hospital stay.– Evaluates home resources.– Interprets to the rest of the Pastoral

Care team about ongoing needs. • Patient Advocacy

– Voices concern to Hospital Staff and physicians with knowledge and credibility.

– Serves as liaison between patient and health care community—e.g., hospice care.

Be-Attitudes of Visiting

• Be Supportive – Leave the patient feeling better than you found him/her; give encouragement.

• Be Silent – Don’t feel you have to fill every moment with meaningless chatter; just be there.

• Be Empathetic – Convey the message that you are here to “travel” with them while maintaining your objectivity.

• Be Compassionate – Convey that you care, not only through your words, but non-verbally through touch and willingness to sit close.

• Be Yourself – Adapt who you are to the situation.

• Be Prepared – Take a moment to collect your thoughts and pray that your presence will show the patient you are concerned.

• Be Present – Be there 100%.

• Be Open – Meet the patient where s/he is. Listen without judgment.

• Be Still – Listen and don’t feel that you have to have the answers.

• Be Sensitive – Be aware of the patient’s needs and condition. Try to pick up on an underlying theme of what is being said.

• Be Human – Admit you don’t have all of the answers and identify with the patient’s feelings whenever possible.

Be-Attitudes of Visiting

• Be ready to pray when given permission

– Recap with the patient what you shared and ask if they have any specifics about which they want you to pray.

– Pray for the patient to have courage to cope, for understanding and for acceptance of God’s plan.

– Pray for strength for the family and loved ones.

– Pray for the medical team to have the knowledge and compassion necessary.

– Pray for peace, calmness and healing for the patient’s emotions, spirit, and body.

– Give thanks.

• Be Selfless – Be there for the patient’s needs not your needs, a lot of good intentions flounder because the visitor feels the need to do something rather than be for the patient

• Be Positive – Delete negative thoughts and words. For example, stop thinking cancer is a death sentence.

• Be willing to get involved – Give part of yourself away by taking risks.

• Be respectful of patient’s diverse beliefs – Don’t cram your beliefs down their throat. Trust there will be an appropriate time to share your beliefs in the future.

• Be mindful of using Scripture appropriately – Share verses of hope and encouragement when appropriate.

Visiting in HospitalsDon’t, cont• Let tubes, monitors, and/or machinery

become barriers to your visit.• Sit on patient’s bed.• Flatter the patient.• Whisper when talking to the medical staff

or family.• Take negativism personally.• Tell the patient your troubles.• Eat or drink in the patient’s room.• Be judgmental..• Criticize the staff or prescribed treatment.• Make promises you cannot keep.After the patient leaves the hospital• Your support may be needed even more.

This is the time for you to notify the Pastoral care team. Then they can mobilize other pastoral care members’ abilities, as needed.

• Have the patient tell you what tasks and activities s/he can do.

Rewards

Mindset of person in hospital

Goals

• Make the patient feel s/he are still part of the congregation.

• That the person is remembered.

What you can do – See book

• Call first.

• Provide reassurance; avoid offering false hope.

• Touch.

• Bring sense of humor; be sensitive.

• Pray.

• Take cues on how long to stay.

• Observe notices on the patient’s door.

• Let the patient cry; affirm losses.

• Depend on the Lord to direct your visit.

Visiting Shut-ins

What you can do, cont.• Choose to care.• Encourage participation in

Church via prayer chain, prayer shawl, other ways.

• Send cards; call on phone.• Schedule time with the shut-in—

short visits, set boundaries.• Promote laughter.• Bring something with you-

child’s picture, flower, etc.• Bring catalogs for shopping at

home.• Smile, give hugs, and pray.• Avoid getting involved in family

disputes; can be a sounding board.

• Parish nurses: Provide info on resources.

Rewards 

Mindset of Shut-in

• Feels like a prisoner.

• Feels alone and unloved.

• Feels guilty.

• Sees chores going undone.

• Not likely to ask for what is needed.

• May not know where to turn.

Goals

• Help the person to be as active and as independent as possible.

• Make the person feel part of the congregation.

What you can do• Run errands/perform some chores

—don’t say, “Call me if you need anything.”

• Encourage them to grow—Art, music, writing, taking courses.

Visiting in Nursing Homes

Challenges:

• Depressing to see a person who is waiting to die.

• Don’t know what to say.

• Difficult to talk to someone who cannot hear.

• Hard to listen to the same old stories over and over and over again.

• Reminds the visitor that growing old can be difficult.

• Person may not recognize you.

Mindset of resident in a nursing home

• Wants to go home.

• Feels loss of independence—has to depend on others for basic needs—humiliating and frustrating.

• Feels treated like a child.

• Doesn’t feel remembered.

• Nothing can be done about the situation.

• Is most at risk for suicide.

Goals: Make the person feel:

• Remembered.

• Important.

• Loved.

• Still part of the congregation.

Visiting in Nursing Homes

Rewards (The resident)

• Gains so much joy when visited.

• Are able to share their knowledge, experiences.

• Feel loved.

What you can do:• Remember whose needs you are

serving.• Pray before you go.• Schedule short visits—10-15

minutes.• Visit during non-holiday times.• Talk about mutual friends, church

members.• Share letter or picture you received• Ask for advice.• Offer a friendly touch—hugs,

holding hands.• Take children.• Take something—not flowers in

Alzheimer’s unit.• Speak to those in hallways.• Write letters/cards for the person. 

Visiting Children—Developmental Stages

Ages 10-12 Prefer doing things with best

friend/group. May/not be starting to mix with other

sexes due to insecurity surrounding changing body image and developing sexual identity.

Trapped between being too old and too young.

Can be a confusing time as self confidence diminishes and as they begin to exercise independence.

Ages 13-17 Influence is moved from the parent to

peers. Adolescents need each other; to be

accepted—this is what drives behavior and self-esteem.

Boys and girls discover each other first in groups and then singling each other out.

Under Age 5 Take things literally. Have a hard time with the concept of

time. They live in the present and the future is a hard concept.

They think in magical terms. Concept of Death is best understood as

it relates to physical body—the cessation of bodily functions.

Ages 6-9 Have a penchant for details and facts. Begin to ask how and why questions. Are more social, while still self-

centered. They start to come up with conclusions

on their own rather than relying on what adults tell them to be true.

Visiting Children

What you can do, cont. Keep the information about

developmental levels in mind. Don’t overwhelm child with

information; explain in terms appropriate to the child’s level.

Be honest—otherwise you can lose the child’s trust.

Do not provide prognosis to the child, that is the responsibility of the parent(s).

Do not make child feel responsible for the illness.

Listen to the child Tune into what s/he is saying. Let child talk about fears and

frustrations. Affirm feelings and loss, esp.

adolescent’s feelings of self-image.

Mindset of a Child who is sick• Hospitals are scary places.• Doesn’t understand what is going on

(esp. younger child).• Has fears of abandonment and loss.Goals• Recognize the characteristics of the

child’s age and maturity• Meet the child where s/he is• Affirm child’s feelingsChallenges• Understanding the different

developmental stages.• Child may regress to earlier stage.What you can doVisit the child—Not the adults Don’t whisper around the child

Visiting Children

Helping the parents of a sick child

Listen

• Let them talk about their fears and frustrations.

Support

• Validate and empower them.

• Don’t tell them they shouldn’t feel guilty, because they probably do.

• Offer respite, but don’t feel hurt if they do not accept it.

• Parish nurses can provide referral info.

Pray

• Pray for and with them.

 

What you can do, cont.Bring something. Cards and/or letters from peers. Bring small age or developmental

appropriate gifts—puppets/paper crayons, CDs, etc.

Do something. Keep visit interactive. Tell stories; draw pictures. Help with homework.End visit on a high note.

Rewards

• So much to learn from the child.

• Helps to make time pass.

Visiting the Terminally Ill

 

Mindset of the Terminally Ill• Passes through the same emotional

grief stages as survivors do after someone has died. (See Stages of Grief on right)

– Unfortunately, some patients never reach the last stage before they die. Attitudes of loved ones/family may have contribute to this.

• Sees loved ones going through their own anticipatory grief.

• May feel guilty for making others grieve.

• Often is ministering to those who visit. May hide fears and appear cheerful.

• Feels alone.Goals• Meet the patient where s/he is. • Allow the patient to speak freely.

Stages of GriefBy Elisabeth Kubler-Ross“On Death and Dying”

Denial—“There must have been a mistake.” “The doctor misread the reports.”

Anger—“Why does this have to happen to me?” “I don’t deserve this.” “Where’s God when you need Him?” “ I worked hard all my life—for this!”

Bargaining— “I’ll stop smoking if you heal me.” “I’ll become active in church… “Just let me have enough time to …”

Depression— “I’ll never feel good again.” “What’s next?”, “I’ll never see my grandchildren again.”

Acceptance —“I’m not enjoying this, but I am at peace.” “I’m ready.”

Visiting the Terminally IllWhat you can do, cont.

• Listen!

• Touch!

• Be honest.

Relationships

• Help the patient to communicate by writing notes/cards.

• Encourage the patient to mend broken relationships.

Make Everyday Count

• Encourage them in attainable hopes. Don’t give them false hopes.

– Note: Hopes in a dying patient may change from visit to visit.

• Pray for and support the patient’s hopes.

• Journey with the person by allowing her/him to stay in, or move on to the next hope.

Challenges• Loved ones may be out of synch

with the terminally ill person’s stage of grief.

• The person may be in a different place each time you meet with her/him.

• Need to recognize and address feelings of inadequacy/hurt on our part.

What you can do• Become somewhat knowledgeable

about the patient’s illness.• Ascertain where the person is in the

grief cycle.Keep Visiting• Help lessen the patient’s feelings of

being alone.• Let your foremost message be, “I am

on this journey with you.”• Keep visiting even when you feel

inadequate/unwanted.

Visiting the Terminally Ill

What you can do, cont.

Practical Needs – Friendly Visitor

• Help to take care of practical issues not provided by external resources, e.g., cut the grass.

• Notify Pastoral Care Team if uncertain, you should be doing what patient is asking.

Practical Needs – Person assigned by Vicar.

• Alert family/others to available resources.

• Ensure the patient’s affairs are in order. For example, are her/his wills in place?—living and testamentary.

• Seek out professionals.

• If asked, help gather documentation together.

What you can do, contMake Everyday Count, cont• Ask questions to find out what you can

do to make each day count for the patient and how you can support her/him.

– “What have you always wanted to do?”– “How do you want to leave this earthly

home?”– “How do you want to be remembered?”

• Work together with the patient to come up with a plan. Encourage the patient to follow through on its implementation.

• Help the patient to reflect on her/his uniqueness, and special qualities to ease loss of dignity.

• Be open to hear her/his feelings of fear, helplessness, love, and concern, and share yours.

Visiting the Terminally Ill

What you can do, cont

• If unconscious, continue to talk to the person; hold her/his hands.

• Allow her/him to let go and say good-bye.

Rewards

• Deepening friendship.

• Knowledge that you helped her/him to die well.

• Knowledge that something holy has happened.

What you can do, cont

Spiritual Needs

• Allow the patient to share feelings and hopes in the present and future.

• Allow the patient to verbalize areas of her/his life that are unsettled.

• Be available when s/he wants to discuss God, salvation, etc. Look for overt and subtle cues.

• Offer scripture verses that speak of God’s forgiveness, love, mercy, and salvation.

• Pray openly when it is agreeable with the patient.

• Tell the patient that loved ones will be okay, and that they will look out for each other.

A Bit About Boundaries

Know Thyself….

Important To Know….

• Scope of your mission and guidelines for visits• Your own personal strengths and challenges• Some details of the situation prior to your visit –

what are you walking into• Other limitations on your time and talents• You can say “NO” and how to say it• You can refer back to Friendly Visitor leadership• You can listen to your “gut” feelings

Role Playing Exercise

Chose a partner and practice an exchange that might prove a challenge to your boundary for that visit

• Role play as both the visitor and “patient”

• Share with your partner after each role experience

• Share your experience with the group

• There is no right or wrong response

How This Ministry is Built

• A Vision for this Ministry• Recruitment and Training of Friendly Visitors

– Practical Aspects– Setting Boundaries

• Communicating about this Ministry to Church Leadership and Congregation

• Ongoing Training• Support of Volunteers• Evaluation

Summary & Wrap Up