What to Expect from a Visit with the Hospice Chaplain

When I was caring for my mother during the last days of her life we received a call from the hospice chaplain who wanted to schedule a visit. But Mom refused, saying she didn’t need a chaplain because she had her own pastor and didn’t want a stranger to provide spiritual care. At the time I was busy with caregiving duties and felt relieved that I wouldn’t have to accommodate another visitor, so I agreed with Mom’s decision and turned down the chaplain’s offer.

In retrospect I now recognize that spending a few moments with the chaplain might have been very beneficial to me as well as to my mother. Her pastor didn’t visit us at all during those final days because he was too busy with his work. A supportive listener who understood the overwhelming time experienced by a caregiver could have brought some relief to me even if Mom didn’t want to talk with her.

The chaplain is an essential member of the hospice team whose visit is one of the benefits offered by all Medicare-certified hospices, though it is always optional. But surveys have shown that up to one third of hospice patients refuse a chaplain visit for various reasons. Some, like my mother, feel that their spiritual needs are already being met, while others see no need for spiritual care or have had a negative experience with religion in the past.

But underlying these reasons for refusing a chaplain visit may be a basic misunderstanding of the work of chaplains, who are trained to serve everyone regardless of their beliefs or practices.

Here are some of the benefits of a chaplain visit for hospice and palliative patients:

Chaplains are trained to listen

One of the greatest needs for patients and families who are facing the end of life is for someone who can listen without judgment to their concerns, fears and regrets. Chaplains understand the need for a listener who does not necessarily offer advice or solutions, but who simply holds space for every emotion and challenge that arises.

Chaplains bring a calm presence to the room

Chaplains are trained to remain calm in the midst of crisis and chaos and to focus on what is most important in the moment. By listening and asking the right questions the chaplain can help families heal their conflicts and find peace with one another. According to surveys, patients and their loved ones who receive chaplain visits experience less stress during the end-of-life process.

Chaplains can take things slowly

Some visits with other members of the hospice team might seem overwhelming with many forms to fill out and questions to answer in a short amount of time, but the chaplain is able to slow down to allow deeper conversations to take place with both patient and family members. In addition the chaplain may spend time in silence with the patient when there are no more words to say, simply being present and bringing calm compassion to the situation.

Chaplains don’t preach or proselytize

As part of their training chaplains learn to relate to all individuals without bringing their own religious or spiritual beliefs into the relationship. Chaplains can work with patients of any religion or those with no religion because they don’t focus on dogma or specific teachings. The chaplain helps each patient find her or his own personal meaning in life and death.

Chaplains support family members too

Many times the chaplain serves family members in addition to patients by offering them a listening ear and a shoulder to lean on. As mentioned before, this support would have been helpful to me when I was a caregiver for my mother to remind me to focus on what really matters and not get lost in all the details of caring for another person.

Chaplains provide balance to the care team

In addition to the assistance the chaplain offers to the patient and family members the rest of the hospice team benefits as well when the chaplain is included in patient care. The chaplain brings a unique perspective to the team by reminding everyone of the need to find meaning in both life and death. True whole-person medical care at the end of life takes into account all needs of each patient—physical, mental, emotional, and spiritual—and the chaplain is an integral component of that care.

In my own work as a hospice physician I often relied on the insights and observations of our chaplain to help guide care decision for patients. The importance of the chaplain visit was underscored for me when I had the chance to view the end of life through the eyes of a caregiver. So I highly recommend saying “Yes” to a visit from the chaplain even if you are not religious or spiritual.