Rituals: Wearing a lucky red shirt to Razorback games. Family gathering for dinner after church on Sunday afternoon. A ceremony to remember a loved one at his death.
Carla Cheatham spoke Monday at a symposium on pastoral care to many professionals who care for others: clergy, chaplains, nurses, social workers, Stephen Ministers, spiritual-care providers, counselors and more. The Northwest Arkansas Clinical Pastoral Education Institute sponsored the event at the Schmieding Center for Senior Health and Education in Springdale.
Cheatham of Austin, Texas, is an ordained minister in the United Church of Christ. She holds a master's degree in psychology, a master of divinity degree and a doctorate in health and kinesiology. Calling on her years of experience as a hospital and hospice chaplain and pastor of faith communities, she created the Carla Cheatham Consulting Group to offer Spiritual Care Integrity & Excellence: Support and Training for Chaplains and Other Healthcare Professionals.
"People are well-meaning, and just want to show up and love on them," Cheatham said. "Anytime anyone wants to show up for someone, who wants to lead a ritual for someone, if they are comfortable, that's a gift they can bring."
Tool Box
Rituals can provide peace for the family and a patient as they say goodbye, Cheatham explained. It can be as simple as applying lotion to the patient's hands and feet or refreshing the patient with a cool rag on the forehead.
"A ritual is an outward sign of an invitation to grace," Cheatham said. "It's a way of symbolizing who that person was. It builds a connection and brings comfort. It can symbolize an ending or a beginning."
Cheatham offered several ideas for such a remembrance -- a "tool box" to help people move through the rites of passage of life, she said. She suggested a life review, showing books, photos and other meaningful items to the patient. Another ritual could involve the family symbolically giving gifts of nature -- the sun, the moon, the stars ... even songbirds -- with readings to discern the meeting. Or, helping loved ones gradually let go, mourners can be given a flower from the bouquet on the casket at the funeral.
She told the story of one young boy from the Orphan Train, who could not go to sleep his first night in his new home. But his new parents gave him a piece of bread to hold in his hand through the night.
"An orphan experienced in transition was not sure all these new things -- the plenty of food -- would be there the next day," she explained. "But he knew the bread he held all night would be."
Two young girls remembered their grandfather in a special way, Cheatham continued. At the funeral, everyone was given a polished stone and told to put it in a place meaningful to the deceased. "Well, Grandpa loved cars, and owned a classic GTO," Cheatham revealed. "Finally, Grandma found herself able to sell it. As the new owner drove off, the girls giggled. They knew Grandpa loved the car, so they put the stones under the back floorboard.
"Ten months later, they still had those stones, and it helped them," Cheatham said. "It's a transitional object to hang on to memories connected with that person. Then, it was a symbol of letting go."
Do No Harm
"Words aren't necessary for a ritual to take place," Cheatham continued. "A ritual is something to do rather than saying something that, maybe, you shouldn't because what you want to say or do could be harmful."
She noted research shows the positive and protective influence religion can have on one's health. Yet research also shows that any negative experience regarding religion can actually damage someone, she said.
Cheatham warned the professionals of this. "We can't impose on someone in the time of their greatest pain what we think they need. Everyone has different faiths and ideas of the afterlife. And imposing our beliefs can make them feel that much more isolated. We don't need them to feel lonely -- we need to make a connection."
Instead, she told the chaplains and caregivers to meet patients and the family members with a blank slate.
"The family sits staring, not knowing what to do," Cheatham said. "You must first assess their beliefs."
"You have to follow what's best for the patient," said Christie Ginther, bereavement and spiritual care coordinator at Circle of Life Hospice. "When you walk in that door (of a patient's room) you have to leave your preassumptions at the door. You have to provide support for that person in hospice to the end of life."
Cheatham suggested asking family members what they will miss the most about the patient, or having them share experiences that made them laugh and cry ... and maybe some of the struggles.
"Never assume Granddad was a good, decent man," Cheatham warned. He might have been an abusive alcoholic. He might have been elusive. And no two members living in the same house had the same relationship with him.
"When I assume, I fail them," Cheatham said. And it's also not a time to encourage rants or attacks on someone who can't defend himself, she added.
Cheatham told of one family, who had a hard time voicing their thoughts, until one member finally mentioned the patient's cursing. "One member of the family laughed," she said. "Then more members started laughing -- they laughed in stereo. They opened up to say he was stubborn, but the challenges were forgiven.
"As they talked and laughed and shared at the bedside, you could visibly see changes in the breathing of the patient who was dying. Acknowledge the full humanity of the patient," she said.
Even some in the same faith community have different versions of the afterlife, Cheatham said. And many admit to being afraid of death because they have no belief in the afterlife.
"This is not the time to impose your beliefs on them," she warned.
Ginther sees some patients who feel God is punishing them with the disease process. "That they had sinned, and God was getting back at them as they were getting ready to die," she said. "It's not our job to convince them otherwise. We have to follow the patient.
"Whether atheist or agnostic, you must find purpose and meaning in their life," she said.
"With someone who's hurting, we have a sacred trust to care for them," Cheatham said. "We have to be different than to say, 'You're going to hell for your beliefs.'
"But we can use our own beliefs to comfort them. We can be a place of refuge by being God-like to others," she said. "I am a personal believer of Jesus, and I think Jesus likes that."
Instead, Cheatham tells caregivers to ask the patient's thoughts and the patient's best hope for what's coming next -- as well as the family members'.
"Have them paint their own verbal picture, and it becomes less scary," she promised.
"Listen to all share, and try to pay attention to each one," Cheatham said. "When it's time for the ritual, use that information to guide you."
"(Cheatham) reminded me of the importance of presence," said the Rev. Stewart Smith, pastor of First Presbyterian Church in Springdale, who attended the conference. "About being comfortable with saying, 'I don't know.' I'm not there to explain their suffering, but I'm there to be with them through the suffering."
"A chaplain or pastor or whatever, you want to say the right thing. But you have to let them ask and struggle with those questions themselves," he noted.
"What's necessary for the end?" Cheatham asked. "To be given the chance to say, 'I forgive you.' 'I thank you.' 'I love you.' ... To say goodbye."
NAN Religion on 10/25/2014