I lead a pastoral team with a Christian charity, Mission Care, which provides nursing and residential care for vulnerable adults in South East London.
Our team is tasked with providing pastoral support and sharing the gospel with our 200 plus residents, their relatives and our staff. In our situation most of our residents are older, need nursing care, and many are living with dementia. We have Christian and non-Christian residents, and providing pastoral care in this environment is challenging and rewarding. I would like to briefly reflect on the nature of pastoral care in general and then discuss what pastoral support in a nursing home can be like. Although much of our work involves interaction with non-Christians, I will focus on pastoral support for Christians.
Misconceptions
It is easy to have a narrow, but inaccurate, understanding of what pastoral support involves. For many of us, I suspect that the words ‘pastoral support’ or ‘pastoral care’ conjure up images of a member of the clergy providing a listening ear or shoulder to cry on in a difficult time. This is undoubtedly part of what pastoral support involves, but is certainly not all it should involve. Those providing pastoral support (clergy or laity) should be concerned with all aspects of life, not just the difficult times.
The ‘one another’ passages in the New Testament epistles provide some of the ingredients for a more complete pastoral support recipe. In these passages we see that Christians are to honour, offer hospitality, love, serve, encourage, accept, admonish and teach one another (Romans 12.10, 1 Peter 4.9, 1 Thessalonians 5.11, Romans 15.7, Colossians 3.16). Granted, these passages are not specifically written to pastors per se, but are things that all Christians should be doing. However, it is reasonable that those involved in providing pastoral support (being Christians) should do these things in the context of their ministries and seek to help those to whom they minister do the same.
So how might this look in a nursing home? The one another passages mentioned above imply the context of a Christian community, where believers are seeking each other’s best interest. One of the main challenges for Christian residents living in a nursing home is that they can become removed from such communities (this could be equally true of someone who is house-bound). Christian spiritual muscles can deteriorate from lack of use, just like physical ones, and a nursing home can be a climate which fosters such deterioration due to the lack of regular involvement in a Christian community. Those providing pastoral support within nursing homes have the great privilege to get alongside residents and, at least partially, provide and help facilitate the Christian community many residents lack. However, those who seek to rise to the challenge of providing this sort of Christian contact will quickly run into other challenges once in a nursing home environment.
Challenges
One big challenge is communication. Residents are in nursing homes for a variety of reasons. Most will be there because of some sort of physical or mental deterioration, which means that they need specialised care. These deteriorations, in many cases, mean that communication with residents living in a nursing home can be difficult. Sitting down to teach someone the Bible or pray with them when they have trouble hearing, seeing, concentrating or all of the above is not easy. It takes sensitivity and patience on the part of the person providing the pastoral support, as well as on the part of the resident. Once you get to know a particular resident you will learn how to adapt to their limitations. If someone has bad eyesight, for example, you can print a Bible passage in very large type or read to the resident, rather than asking them to read. If you go into a nursing home for the first time to see people you don’t know, then it is wise to first ask the care staff to make you aware of individual residents’ limitations. More could be said about how to deal with communication issues, but the main thing is being aware that you will encounter them and learning to sensitively adapt your method of communication to best suit the residents you with whom you are working.
Reciprocal relationship
For those providing pastoral care, it can be easy to think you are doing the teaching, admonishing and serving, rather than receiving it. In a nursing home this mentality can be heightened when those to whom you minister seem so ‘needy’. However, the one another passages remind us that there is a reciprocal relationship between Christians — we need to teach and be taught. Providing pastoral support in a nursing home may mean that in many cases you give most of the care, but it is important to remember that Christian residents still have something to give back to other Christians, and it is important that they do so. For example, when working with residents who have dementia, music is often a great way to communicate. Trying to have a discussion can be challenging, if not impossible, but some residents with dementia will join in when old hymns are sung. I can speak from personal experience of the encouragement I have received from seeing a resident sing out an old hymn. It is also important to try to provide ways for Christians in a nursing home to meet with other Christians in the home, if possible. Pastoral care in this instance can be in the role of a facilitator, providing opportunities for Christians in the same home to help each other. In one of our homes, we have pastoral volunteers who facilitate a weekly prayer meeting for Christian residents in that home. This gives residents the opportunity to support one another in prayer and generally share their lives with each other.
These brief reflections on pastoral care for older people and those with dementia make visible just the tip of the iceberg. I have focused on nursing home environments, but some of what I have covered is also applicable to those still living at home. The Mission Care Pastoral Team is by no means alone in its desire to see the elderly supported. Other Christian charities, individual Christians and churches across the UK are also seeking to support this demographic, whether or not in a nursing home.
Mission Care would like to help other Christians in their efforts to effectively minister to older people. One way we do this is through our annual training day, which focuses on issues surrounding pastoral support for older people and those with dementia. This year it will take place on June 8, from 10.30 am-4.00 pm, at Bromley Baptist Church (BR1 3HJ). There is no charge for the event, and we are pleased to have speakers Roger Hitchings and Louise Morse join us for the day. Roger and Louise have co-written the book Could it be Dementia?, and both have a wealth of experience in working with older people and those living with dementia.
If you would like more information about the training day, please contact the Mission Care Pastoral Team on pastoral@missioncare.org.uk or 020 3434 0267.
