Only if you are in the 'in' crowd?

Churches rightly talk much about pastoral care, particularly for the ill, infirm, disabled, shut-in (but probably not if you have suffered a pseudocoma) and the isolated. But what does that mean, particularly if one is not part of the 'in' crowd in the church?

These comments are based on personal and observed experience, along with long experience as a senior executive in human services.

The often asked question, particularly to one with a recent onset of an adverse circumstance is 'how can we/I help?' or 'what do you need?"

As one wit retorted: 'you could always pay the mortgage!' Of course, silly questions get silly answers.

I don't know what the average person in some undesired circumstances is supposed to make of that question, particularly from either a paid Christian or a pastoral volunteer. It's too broad, and has no parameters.

There are a number of domains of need that a person could have in mind.

On the professional level

1. Medical -- probably taken care of;

2. Medical support (that is to accompany to medical appointments and procedures, perhaps provide transport, and related home care) -- some of this is available through general services, others not, of course, but probably beyond the reach of untrained or un-skilled volunteers.

And, more generally:

1. Activities of daily living (ADLs) - personal care: requires training and/or skill for intimate care and, except for some assistance in dressing, and simple washing, not applicable.

2. Activities of daily living - domestic assistance. Most of these would be also out of reach for volunteer systems. This includes domestic duties: cooking, cleaning, laundry and simple home maintenance.

Most churches offer some sort of (very) short term meal support. If a person is infirm, this would be inadequate, and perhaps only a stop-gap while community services were engaged, although still useful. but just think of the volume: meals for three people (two infirm adults, a disabled daughter) over, say four days while community support was organized: 36 meals!

This would be a massive undertaking, and all available through delivery services (at amplified cost, I might add), but I'm sure most parishioners would prefer some church involvement as spiritual encouragement and companionship.

3. Social connection. Here the church community can really start to do its business. The problem is that for chronic conditions, the enthusiasm soon wanes and volunteers get tired, bored, uninterested in the service. One visit or phone call when the need is expressed in not on. Work out the 'pace'; perhaps weekly or fortnightly or anything from three to six weekly. For a person living alone, maybe a quick check-in daily by a pastoral volunteer or a clergy-person could be both prudent and kind in the early stages.

Social connection might involve a low-impact outing: local park or coffee shop, for example, or accompany a person shopping locally. It might be dropping in for a cup of tea, and some light home assistance.

People are often reluctant to ask for this sort of support, so it would be the duty of the ministerial team (paid and volunteer) to gently and politely 'probe' to see what is needed and/or accepted: a couple of unobtrusive calls to say hello and to gauge the scene (pastoral reconnaissance). Often the demands would end up being quite light and easily managed: maybe a weekly or fortnightly or even less frequent contact by a couple of volunteers in team. For volunteers it is important not to 'rush' the person and seek to do too much, but always to listen carefully for need expression from a shy person.

It is also important to avoid a demeaning 'poor dear' demeanor or tone of voice. Kind and careful, yes, but mature adult to mature adult, please. 

Open questions such as 'how are you doing?" or "how are things?" can be next to useless, as most people would give a brief answer as to OK, or if not OK, would not readily know where to start, not wanting to appear demanding or burdensome and so loose any support that may have been available. A skilled discursive conversation is far better to find where the relevant points of support might be.

If the person in question does come along to church gatherings, this is a good occasion for one of the 'team' to probe for service opportunities/needs. This can be a short conversation or to invite the person out for a coffee, or to drop in to the church centre (the eccleseum), or the minister's home, if that's how it works in your parish. Again, this is to both serve and do reconnaissance. Remember, the blunt 'what can we do for you?' is too big a question: undefined and intimidating and probably embarrassing.

In my professional work I came across a person who was asked this by my predecessor. Her answer was a lift so she could remain in her family home. $300,000 later, she was pleased, but when I took over the area, I most definitely was NOT.

If they do not attend regular church gatherings, I would think it is the duty of the minister to call and inquire as to if he/she could visit and spend some time with them.

4. Pastoral. By this I mean the full game. This is the key job of the minister or trained volunteer. It could include 'light touch' reading scripture together, the minster praying (but not expecting the visited to pray...they may be too upset or nervous, or not used to this), and even singing, or saying, a hymn together.

I am part of a church that uses liturgical forms (laughingly known by non-participants as 'traditional'), so if I was very infirm, I would expect the minister to read through morning prayer with me...even if an abbreviated version, or perhaps the Collect for the preceding Sunday could be read, along with the readings set down for that day. The minister might want to conversationally summarize the sermon he/she delivered, or what transpired in a recent study group. They might even read through and conduct holy communion together.

5. Referrals. People in distress are often unable to sort out the public services that are or might be available to them, how to obtain them, and how to sort out eligibility. Sometimes a GP can assist, or perhaps a social worker at a local hospital. The church might be able to help with a relevant contact to assist here, but this game is a complex one and a person with suitable expertise has to be involved.

Experience

Many years ago I was seriously ill with a stage 3 cancer, even worse because of extended radio-chemo therapy. My minister kindly visited every couple of weeks or so and we shared a coffee. He was gentle, un-rushed, and spent time. We just chatted for 30 minutes or so. He prayed, then left. This was fabulously encouraging, even though, while extremely sick (and very thin), I was quite cheerful. He didn't pry, but chatted as an adult to an adult. He didn't comment on my attire, my appearance, my home (which I could do no housework in, but had organized others) or anything but matters that found their way onto the 'agenda'.

More recently I saw one of the paid Christians at church ask an ill parishioner "What can we do for you, just let us know". What was he to answer? He could not know the options and so could not even start to answer. It would have been better to ask if he could be visited, and phone later to arrange a time (for pastoral 'reconnaissance').

Volunteers

Volunteers are, or should be, the life-blood of the local church. It is essential that all who are pastoral volunteers must be trained to understand pastoral care, pastoral conversations, and the special needs of those who are ill, particularly where the illness produces functional or cognitive deficits or is terminal. Based on what I've had reported to me, volunteers must be trained to have reserved (that is, non-judgmental) spiritual conversations, not to insist on spiritual acts such as prayer or reading the scripture or prayer book, and to be un-rushed. They must double check any rendezvous locations and times, and either take the fault for misunderstandings, or handle them neutrally. In dealing with trying conversational circumstances, some training in assertive pastoral conversations would help.

Volunteer driving is not the cinch it is often considered to be. Knowledge of locations and a careful driving style that considers the needs of the passenger is essential, as is good road sense and a clean driving record. An ability not to see the car as a conversation lounge is important. Your job is driving, not chatting.

As with any volunteering role, all volunteers must be trained to understand the general flow of the Bible, of Christian belief, pastoral practice and pastoral conversations and to handle the 5 basic questions. They are, after all, the public face of the church in this role.