Over 1,500

We have now enjoyed over 1,500 visitors to this site. I remind our readers that we are a niche site promoting Hospice Chaplaincy. Hospice Chaplaincy is what energizes my soul. The Chaplain staff here at Cornerstone Hospice is one of the best if not the absolute best corps of chaplains. I pour myself into their work with the intent of developing a top 10% quality group. Your comments and questions are always welcome. If you would like a consult, please let me know.

My experience at the National Institute for Jewish Hospice

Flying to Newark, New Jersey, to attend the NIJH Annual Conference is a highlight in my year. This year was especially good as the leadership was trying a new approach by including a breakout session. Mrs. Lamm, now the out-front spokesperson for the organization called me a week prior to the conference and asked if I would be a facilitator for the Chaplains. I accepted not knowing how incredibly blessed I would be to do so. From the beginning of the conference to the end, the conferees were exposed to the nuances of Judaism that were simply unknown to us. The breakout session was illuminating as our group was comprised of Rabbis and non-Jewish Chaplains. The theme was how we all benefited from the type of information we received at this conference. Rabbis and Chaplains have at least one thing in common__we like to talk… and, not always about the subject! And, that is what made the breakout group so fascinating. I was so very impressed by the professionalism and skill of both Rabbis and Chaplains. We agreed that we needed one another. I believe that in those short moments we were together a bond formed based on mutual respect. Beyond that we agreed that knowledge of Judaism enhanced our ability to serve our Jewish patients. Our Rabbi Chaplains sensed they could better serve their non-Jewish patients through similar events where knowledge was shared. The beauty of the discussions was in the expressed desire on everyone’s part to not be religiously offensive to the patients and families that we serve. And, that is where we came together to agree that we need each other. I was so glad I went to this my third conference. Of course, my generous and spiritually open hospice, Cornerstone Hospice & Palliative Care, Inc. received its re-accreditation from the NIJH. In 2015 we intend to further develop our relationships with Rabbis and synagogues. Building bridges of understanding and mutual respect is a wonderful project. I hope you have to the opportunity to engage in this most worthy effort!

"I did it!"

My little grandson, Mason, is just two, but he has learned how to celebrate an accomplishment. It always makes me smile when I hear him say "I did it!" as he throws his arms up in jubilation. Well, that is sort of how I feel as I share with you that I had a great experience this past Saturday. As an exclamation point to my weight loss, I entered and ran in the Pets and Vets 5K. This race was sponsored by my hospice. The weather was less than nice as it was drizzling, windy, and chilly. But, "I did it!" I ran my first 5K ever and came in second place in my age group. To say that I was elated is an understatement. Self-care cannot be something we tacitly acknowledge as necessary. It is something we embrace and practice. I lost the weight through dieting and exercise. I trained for this 5K for several months and "I did it!" Blessings to you all this Holiday and Holy Day Season!

The compelling story of Telemachus in light of today’s chaos

In this particular post, I clearly identify my theological stance as Christian. If this offends you, I am sorry. In times of chaos, we all embrace that which makes sense to us. My faith makes sense to me and is my strength at this time. Also, this post may come across as political. It is not meant to be. It is a clarion call to peace. Peace transcends politics. I am sure each of us holds an opinion about what is happening in our country right now. The core of the problem is spiritual. Please indulge me as I share a story I hope you will find enlightening. In today's America we need not one but many persons like the character in this true story. May God raise up a corps of Telemachus'. It is said that in the year 402 AD, the young monk felt called to leave the monastery and head out into the pagan world to not only learn what the world had to offer, but to spread the message of Christ to all who would listen. One day in prayer, Telemachus felt called by God to leave immediately and head to Rome. If monastery’s were the hub of a local community’s society, Rome was considered the hub of the world. This was the center of society during this time. Not sure what he would find, or why God had called him on his mission he headed from the monastery and began his trek. Upon arriving in Rome, he was immediately caught up in the crowd. The crowd was immense and excited. Soon Telemachus found himself giddy with the contagious excitement of those around him. He wasn’t sure where he was headed but he knew whatever it was, it had to be great, and there was no way he was going to miss out on it. Within a few moments he found himself deep in the seating area of the Roman Coliseum. Asking those around him, he learned that the Romans had just defeated the Goths, and the emperor had commanded a circus to be held for the celebrating crowd. As he took his seat, he couldn’t have missed the emperor sitting in his seat of honor. He most certainly would not have missed the arrival of the gladiators into the coliseum. As the gladiators lined up below the emperors seat, together they stood and yelled out: “We, who are about to die, salute you”. It was the traditional greeting of the gladiators to their emperors, and in that instant he knew exactly what he had stumbled upon. The Bishops and leaders of the church had spoken out about the gladiator games in Rome, yet most believed it legend. In that moment, Telemachus realized it all was true. Soon the gladiators pulled their weapons and the bloody brawl began just a few hundred yards away from him. The grotesque nature of the sport appalled him. Worse yet, was the reactions of those around him. The spectators where in a blood thirsty ecstasy over what they were seeing. Telemachus was sickened and shocked. In that instant he realized that it must stop. From his seat, he yelled out to the warriors: In the Name of Jesus Stop… But no one heard. Without thinking he jumped over the wall and into the battle arena of the fighters. The gladiators surprised by the unexpected guests momentarily stopped their fights and stared at the monk. “IN THE NAME OF JESUS STOP!” he yelled over and over again. After a few moments, the silence turned to chuckles and outright laughter. One of the gladiators, with a sick enjoyment, took a swing at Telemachus with his sword, just barely missing him. With that the others began to draw their swords. Soon they were chasing this man, across the field of battle to the laughter of the crowd. Most who witnessed the spectacle thought he was a clown or there for comic relief. That was until they heard what he was yelling; For the love of Christ, Stop!… He ran, jumped, dodged and ducked, and with each passing moment his words grew clearer and louder; In the name of Jesus, Stop. In the name of Jesus Stop. IN THE NAME OF JESUS STOP! Eventually the gladiators surged and when the dust cleared, there laid Telemachus on the ground with a sword in the center of his chest. There was silence in the crowd. It was said in that moment, that his words still echoed in the coliseum; In the name of Christ Stop. After what seemed like an eternity, one man got up from his seat, and left in silence. Then another… Then another… Until everyone got up from their seat and left in silence and disbelief. I shout to the community destroyers, "In the name of Jesus STOP!" Will you join me?

5 Keys to Maintaining Your Reputation When Undergoing Serious Personal Stress

It will happen to every Chaplain. There will come the “evil day” (using the Biblical idea found in the Bible book of Ephesians). It may involve health, finances, family, or something deeply personal. The issue I want to address has to do with how the Chaplain handles these types of situations and maintains his or her reputation. I am not for a moment suggesting or advocating for stoicism or grin and bear it response. I am advocating for a response to serious stress that will prevent the Chaplain from losing the most valuable possession in all that he or she has …reputation. I want to suggest 5 Keys to maintaining one’s reputation: 1. Develop a support system that will be there for such a time as this. I recall a number of years ago when I was a senior pastor. It was obvious to me that I made a terrible mistake in moving my family across the state to this new place of service. The church was in disarray and in no way ready to even think of becoming a witness to the community. There were factions upon factions. I called upon the local denominational leader and spoke to him about my assessment of the situation. He agreed with my assessment and then told me it was much worse. That was not what I wanted nor needed to hear. Time proved he was correct. I then asked him a question that he scoffed at. I asked if there were a safety net of sorts for such a situation so that I could move from that place. I learned something of great value from that experience. The lone ranger style of life and leadership will leave the pastor or Chaplain with no resources at a time of crisis. I began to build a network of like-minded ministers who I could call or meet to unload the pain I was enduring. There is almost a syndrome among ministers to go it alone, to be a lone ranger. Build a network of colleagues who will encourage you and support you. 2. Watch your emotions. It is very easy to express emotions that will border on bitterness, but will definitely express anger or rage. Lay persons will never understand the level of stress you are experiencing as a Chaplain. The work of chaplaincy is something all to itself. If you express the depth of your emotions, which probably are valid, but way too strong at the moment, you will leave your colleagues and managers wondering about what really is happening with you. Of course, you haven’t told them the entire story, so they only hear what they hear and see what they see. Be very careful at this point. It is not wise to unpack your emotions with colleagues. Unpack emotions within your network of close friends, instead. 3. As you counsel those you visit and provide spiritual support, seek to deepen yourself spiritually. Use your well-developed spirituality to find inner peace. Pray, read your Sacred Texts, journal, ponder, meditate, and promise yourself you will keep the emotions between you and God. If need be, seek counsel from your Pastor, Priest, or other Faith-community Leader. Getting it out often helps reduce the stress level for a time. 4. If you choose to speak to someone up the leadership chain, choose your words carefully. Be careful that you do not come across as assigning blame on them for your plight. That will not turn out well for you. It’s not that they are too busy to hear you out, they need to understand what is happening and what it is you would like them to do to help. Again, I caution, choose your words, your tone of voice and attitude carefully. 5. When you come through the crisis (as you will) approach any and all you spoke to and assure them that their listening ear was helpful to you. Exude humility and genuine gratitude. Be gracious in expressing how much the time they took with you meant to you. That will go a long way to solidifying your relationships. Crises happen. It’s a fact of life. Ruining your reputation over the crisis is rarely the first choice of the Chaplain. Do your best to maintain your poise and dignity. Tears are fine and understandable. Emotional outbursts in front of the wrong audience will have lasting negative results. Bless you as you endure.

3 Outstanding Clinicians … 3 Outstanding ways of saying the same thing

Carl Rogers, Kathleen Rusnak, and Douglas Smith… only one of those names may be familiar to you. Yet, for the hospice Chaplain, I urge that Rusnak and Smith be much more a household name. What is that these three say that is similar and foundational for pastoral care relationships? Rogers identifies 3 essential attitudes in providing client centered therapeutic relationships: 1.Unconditional positive regard; 2.Empathic understanding; and, 3.Congruence. Rusnak identifies 7 attributes of the pastoral care relationship: 1. Why a Brick Wall?; 2. Loss of Future; 3. Grieving; 4. Life Review and Change; 5. Vulnerable; 6. Authentic; 7. Paranormal/Symbolic. And, Smith adds 1. Eliminating relationships of dominance, and humility training. So, who are these people and what are they trying to bring to the Chaplain and pastoral care? Carl Rogers, the creator of client-centered therapy and counseling, student-centered education, and person-centered approaches to human relations and community building, is arguably the most influential American psychologist of the 20th century. While some may dispute this, pointing to the domination within academic psychology of the behaviorism of B.F. Skinner, if the view is widened beyond the academy to include the entire sphere of influence, the fact is indisputable that Rogers' profoundly humanizing psychology of human potential has been embraced by not only American culture but by much of the developed world. Those spheres include education, organizational consulting, health care, psychotherapy and counseling, community action and social agency, adult development, communications training, parenting education, and pastoral care. (By Maureen O’Hara, http://www.carlrogers.info/aboutCarlRogers.html). Kathleen Rusnak is an ordained Lutheran pastor with a doctorate in Psychology and Religion. She has been the pastor of three Lutheran congregations, a hospice chaplain in two hospices, the director of spiritual care and bereavement at The Connecticut Hospice (the first hospice in the United States), and lived and worked in Israel for over two years as the director and study coordinator of the theological department at a post-Holocaust Christian European kibbutz in the Galilee, which focused on repentance and renewal towards the Jewish people. She is an internationally known speaker and writer on the topic of end-of-life issues. Her Brick Wall2 is an outstandingly clear presentation on the experiences of persons who have just received the notification that they have 6 months to live. Douglas Smith is a professional speaker, trainer, consultant and counselor. He has worked in hospitals, hospices, and social service agencies. He is the author of several books, including The Tao Of Dying, Caregiving: Hospice-Proven Techniques For Healing Body And Soul, Being A Wounded Healer, and The Complete Book Of Counseling The Dying And The Grieving. His manner of speaking is far different than Dr. Rusnak and his approach to writing is different than that of Dr. Rogers. However, his message is very clear as are the messages of Dr. Rusnak and Carl Rogers. Each of these educators is passionate about treating the client as someone who matters and communicating that fact. They urge us as therapists, pastoral counselors, and chaplains to accept people where they are, be gentle with those at end-of-life and explore with them such things as meaning-making, emotional/existential pain, and communicate in a manner that does not set up a relationship of dominance. I ask you as a reader, have you been to Dr. Rusnak’s website or Douglas Smith site? I am sure you have read Rogerian theory. So, I extend an invitation to you to expand you knowledge to include http://www.dougcsmith.com/workshops.html and http://www.thebrickwall2.com/ I am grateful for all three of these educators in pastoral care. May you be blessed as well.

The Existential Slap

A hospice patient goes through a lot before they become a hospice patient. They have been ill for some time, they haven’t felt well, and to top all of this off, like a wrecking ball comes the terminal diagnosis from the physician that they have 6 months to live. The reaction of the patient to this devastating news is called “the existential slap.” In the International Journal of Palliative Nursing (November 2004, Vol. 10 Issue 11, p520) Nessa Coyle pens an article that focuses on the psychology of patients when a physician discloses the diagnosis of a life-threatening illness. The usual habit of allowing thoughts of death to remain in the background is now impossible. Death can no longer be denied. This awareness precipitates a crisis for most individuals, who are suddenly faced with addressing and most likely rearranging, their priorities in the time they now anticipate is left. The "existential slap," occurs when the reality and inevitability of one's own personal death sinks in. (Abstract to the article) Following this diagnosis a recommendation to hospice is made. In a flurry of activity the patient and family is met by an Admissions Nurse for a 3 hour meeting to enroll the patient in hospice followed by the Case Manager/Nurse, Social Worker, and Chaplain all within a 5 day Medicare mandated window. Is it any wonder that one of the key personality traits we look for in hospice Chaplains is compassion? The patient is reeling from the diagnosis of 6 months to live and is thrown into an environment they are totally new to and may never have heard of before or at least not understood. The Rev. Dr. Kathleen Rusnak references how her new patients described their reaction to the Existential Slap. The first time I heard a patient say, “When the doctor told me I had less than six months left to live, it felt like “I hit a brick wall,”-- I didn’t hear it. The second time a patient said that to me, I heard it the first time. And then I read this metaphor in a hospice nurse-practitioner’s thesis on suffering. The interviewed patient stated that she felt like she “hit a brick wall” when the doctor told her she had six months left to live. Metaphors are very powerful. They express in symbolic language the depth of raw feeling and emotions that cannot be directly expressed in words. (www.thebrickwall2.com) For now, as there is so much more to be explored in the Existential Slap, I want to do a deeper dive into what Dr. Rusnak so candidly wrote when she described her response to the patient, “I didn’t hear it.” If there is one regret I have as a Chaplain, it is that like Dr. Rusnak, I didn’t hear or at least didn’t “get” what the patient was actually trying to communicate. Could this be what Heidegger refers to as “the forgetfulness of being?” We, the IDT, the Chaplains as a group are so incredibly busy that we often are thinking ahead to the next patient, the next this, the next that that we are not in the moment, but in the next moments! And, we forget. We forget that before us is a new patient who has just started the hospice journey and is about to have the most daunting experience of a lifetime that will conclude with the end of life on this planet. Which among us has died before and lived to tell about it? I’m not talking about near-death experiences. I’m speaking of the real experience of death. With that clarification, the answer is simple, none of us. Can we grasp the magnitude of what this new hospice patient is attempting to process? It’s pretty hard, isn’t it? In this article, I simply want to urge my fellow Chaplains to do whatever is necessary to be in the moment with your patients. We who are living fall prey to the “forgetfulness of being” while the patient we serve is moving rapidly to the stage of the “mindfulness of being.” Simply put, the mindfulness of being is encapsulated in the long hours of self-reflection where the patient pours over life searching for answers to these questions and more: “Who am I? What was my purpose? Did I have a purpose? Did I waste my life? Did I love? Was I greedy? Did people love me? Will I be remembered? Did I make a difference?” (Rusnak) I am sure you recognized that these questions are core issues to spirituality. And, that is why we are present with them as hospice Chaplains. Blessings to you my Colleagues.