Body Language Skills (Pre-test)

Body Language Skills  (Pre-test)

 

Match the following from the left column to the interpretation of the behavior in the right column.  This is a good start at understanding how your non-verbal language speaks as loud, if not louder, than your spoken language.  “Edward T. Hall (1959), a well-recognized social anthropologist, maintained that in a normal conversation more than 65 percent of social meanings are transmitted through the non-verbal channel.” (Kris Rugsaken in body-speaks, Clearinghouse Academic Advising Resources)  If that remains the case in 2016 then the Chaplain has to pay attention to the matter.  The answers to the pre-test are below the exercise.

 

1.    Sitting with legs crossed, foot kicking slightly	a.    Open, relaxed
2.    Arms crossed on chest	b.    Readiness, aggression
3.    Sitting, legs apart	c.    Rejection, doubt, lying
4.    Hand to cheek	d.    Apprehension
5.    Locked ankles	e.    Doubt, disbelief
6.    Head resting in hand, eyes downcast	f.     Evaluation, thinking
7.    Touching, slightly rubbing nose	g.    Boredom
8.    Rubbing the eye	h.    Defensiveness

 

There are many more non-verbal behaviors, but the above tend to occur in a pastoral care encounter.  How did you do?  Will you be more self-aware of your non-verbal communication?  Did you notice that two of the above have the same answer?  Why do you suppose I included two non-verbals with the same interpretation?

 

Answers: 1, g; 2, h; 3, a ; 4, f; 5, d ; 6, g; 7, c; 8, e

3 Powerful Thoughts on Forgiveness

As we work with patients and families and seek to facilitate forgiveness when that issue arises, it is always good to have to have reference points that give you as the Chaplain a means to offer guidance.  As a foundational starting point, explore these thoughts.  More posts on forgiveness will follow.


…When we dare to look at the myriad hostile feelings and thoughts in our hearts and minds, we will immediately recognize the many little and big wars in which we take part.  Our enemy can be a parent, a child, a "friendly" neighbor, people with different lifestyles, people who do not think as we think, speak as we speak, or act as we act.  They all can become "them."  Right there is where reconciliation is needed. Reconciliation touches the most hidden parts of our souls.  God gave reconciliation to us…

~Henri Nouwen

The Judeo Christian Scriptures affirm that the chief end of sacred writ is to guide us into love. A road block to that destination is the incessant search for what is wrong with our community, co-workers, friends, family, neighbors and the world. We get lost in this and become part of the problem. How can I claim to love God, if I do not love people? Perhaps we should strive to welcome people and give them a measure of unmerited favor.  This is the evidence of love; this is our guiding principle: the healing presence of GOD.-Guillermo Escalona

“As I walked out the door toward the gate that would lead to my freedom, I knew if I didn't leave my bitterness and hatred behind, I'd still be in prison.” ― Nelson Mandela

How do these statements inform your chaplaincy? 

Awareness: of Self, of the Dynamics that surround us and how it all affects us

In reading the Hospice Foundation of America December 2014 e-newsletter, I was captivated by the article "A Resolution Worth Exploring". I hope you will be, too!


A Resolution Worth Exploring As you ponder resolutions for [the new year], taking better care of yourself professionally should be close to the top of the list. Ronald Epstein, MD, professor at the University of Rochester School of Medicine and Dentistry, practicing palliative care doc, and published researcher on self-care, says such things as getting rest, eating well, getting exercise, taking vacations, and spending time with family are great to do but don't necessarily translate into better care for patients. Instead, Epstein suggests learning skills that promote mindfulness. What does Epstein mean by mindfulness? "I guess you would say mindfulness is an attitude of mind and mindful practice is what you do in everyday work," he says. "If you are practicing mindfully, you are aware of your own reactions, you are aware of the dynamics in the family, you are aware of how this is affecting you, you are able to monitor the way that you react and also to regulate your own reactions to stressful circumstances so that actions are better aligned with your values." This informs hospice chaplaincy in that if we are practicing our discipline mindfully, we will be self-aware, aware of the family dynamics around us, how our work affects us (positively and negatively), and how we respond to the stressful circumstances surrounding the hospice environment. Living and practicing our ministry means we do not deny our emotions or reactions and seek feedback from colleagues when we feel a bit off balance. I urge hospice Chaplains to practice not just good self-care but 'mindful' self-care. Our work is too demanding to do anything less. May 2016 be your best and most rewarding year in your hospice career

Adaptability: The Most Necessary Trait for the 21st Century

Without question, change is the mantra of the 21st century.


 There have been major changes in hospice regulations: decrease in re-imbursement rates, higher demands for documentation from Medicare, regulations galore, and pressure to perform and survive. These types of changes have brought incredible stress to the leadership of hospices across the nation. Some hospices have not been able to survive. In fact, the myths associated with hospice have taken on a life of their own. From physicians to potential patients and their families, poor information is winning the day. In the IDT meetings the stress of regulatory oversight is taxing nurses with more documentation than they have had to deal with in previous days. And, more is expected of Chaplains regarding documentation and performance standards. In the not too distant future hospices will be reimbursed based on their scores on a family satisfaction survey. The scrutiny is unlike at any time in American hospice history. The IMPACT Act will require hospices to be surveyed once every three years to make sure the organization is competent and efficient.


 The Chaplain is the soul and conscience of the IDT. I have noticed that as the Chaplain’s demeanor goes, so goes the Team. That is a very broad statement but I believe it is true. The Chaplain has the power of influence. He or she usually opens an IDT meeting with an inspirational presentation and prayer (in many cases). The Team looks to the Chaplain for stability and strength. Our Chaplains are doing a great job supporting their Teams by actively caring for the Team members and through ancillary actions such as The Blessing of the Hands, Celebrations of Life, Memorial Wreath, and the daily work which highlights their clinical skills. The underlying element that makes the Chaplain so effective with the IDT is the characteristic of adaptability. When change is announced or experienced, adaptability requires a calm demeanor as evidenced by a relaxed facial expression and body language. If there is a need for a decision, the Chaplain will remain poised and use his or her wisdom in making a decision. In conclusion, change is upon us. This is not a new phenomenon. The question boils down to "will you be flexible and adaptable?" Bless you, Chaplain Friends, in your great work.

 

Test Your Knowledge of Terms Describing Limitations of Dementia Patients

In the list below, match the term on the left with the description on the right.  The answers are at the bottom of the page.  I would be interested to know how you did. Please comment.

Aphasia	Number problems
Apraxia	Writing disorders
Anomia	Body image disorders
Alexia	Movement disorders
Agraphia	Impairment of language
Visual Agnosia	Inability to recognize familiar people
Spacial Agnosia	Inability to recognize writing and pictoral material as a whole_only parts
Simultanngagnosia	Difficulty finding words
Prosopagnosia	Inability to find one’s way around familiar place
Anosognosia	Inability to name or use an object without touching it
Acalcula	Reading difficulties

Answers:

1. e
2. d
3. h
4. k
5. b
6. j
7. i
8. g
9. f
10. c
11. a 

 

How did you do? 

10-11—You’re an Expert  7-9 You’re Advanced  5-6 You’re New To This

The Role of Clinical Chaplaincy

The Role of Clinical Chaplaincy

 

From time to time, great articles are written that need world-wide distribution.  This article by George Hankins Hull is one of those articles.  It stands juxtaposed with my article titled, “Seriously, you want Chaplains to do what?”

 

Thank you, George Hankins Hull for a definitive statement on the work of the clinical chaplain.  May we all embrace these truths.

 

November 12, 2013

ELEMENTS OF CLINICAL PASTORAL ASSESSMENT: The Role of the Clinical Chaplain By George Hankins Hull

 

Clinical Chaplaincy is relational, neutral and non-judgmental. It is a patient centered approach in keeping with the person centered model as advocated by Carl Rogers, integrating the arts and sciences relative to psychodynamic theory in pastoral practice.

Around any illness is a collection of stories. The chaplain endeavors to be present to the patient as a fellow human being, as the patient’s stories unfold; bearing witness to the patient’s dilemma- not judging the patient for what they say or how they choose to express themselves. This narrative approach places the chaplain in the unique role as the interpreter of metaphors, assisting the patient in making the connections to their story.

At times these stories are confessional in nature, as a patient, through narrative seeks to reconcile themselves with the life that they have lived. At other times, the stories they relate represent more a review of their life inextricably interwoven with finishing the business of living.

Consequently, clinical chaplaincy is a patient centered narrative approach. Integral to that, is the patient’s family. Working with the stories that patients and families share, the clinical chaplain can begin to assess how the family approaches illness, and in particular, this hospitalization.

The Clinical Chaplain also assesses how the patient utilizes their religious experience or their philosophy of life as a means of support as they seek to come to terms with their diagnosis and its attendant ambiguities of living each day.

Extensive clinical training and a proactive integration of the social sciences, especially in the fields of counseling and psychotherapy is essential to the work of the Clinical Chaplain.

George Hankins Hull, Dip.Th, Th.M.

Director of pastoral care and clinical pastoral education at UAMS Medical Center. He is a Diplomate in the College of Pastoral Supervision & Psychotherapy and a board-certified clinical chaplain.

 

 

 

 

 

Seriously, you want Chaplains to do what?

Seriously, you want Chaplains to do what?

The role of the Chaplain has changed in some hospices nationwide.  The reasons vary, but one of the key reasons is financial.  It is more affordable to have a Chaplain perform certain duties than an RN.  For instance, there are Chaplains who are being directed to pronounce patients.  In Florida, I am told this is perfectly legal.  Interesting… 

This raises an ethical conundrum.  Just because a Chaplain is legally allowed to do something, is it the right thing to do in the dynamic of hospice care?  Having attended hundreds of deaths, there were clear-cut roles defined by hospices I served.  The hospice nurse attended the dying patient, the chaplain attended the grieving family.  Somehow, that was a strategy that worked very well for all involved.  The family members expected the medical issues, including pronouncing, to be the role of the medical professional, not the spiritual care professional.  What exactly is a hospice trying to accomplish by assigning this medical duty to a chaplain.  If it is to save money, then that is an ethical issue that that hospice will have to wrestle with.  If, as so many hospices trumpet, patients and families come first, why would any hospice blur the clear distinctions between the disciplines of medical and spiritual care?  And, further, what are the repercussions on the chaplains who are required to do this?  I cannot answer the first question, but I can answer the second.  In fact, if a spiritual care manager from one of the hospices requiring pronouncing of its chaplains wants to know, then I suggest they enquire of their chaplaincy staff.  If you still can’t find an answer, let me share this with you, on a weekly basis I receive calls from Chaplains who do pronouncements who are concerned they are doing something they are grossly unqualified to do and thus in their un-comfortability in this task, are seeking other places of service.