Fiona Horwood writes: A hospice patient once told me he wasn’t at all religious, but that if you look at a poppy seed head, you could see the wonder of all creation! It was working as a volunteer member of the Spiritual Care Team at that hospice, St Michael’s in Hereford, that led me to want to train to become a OneSpirit interfaith minister.
My sources of inspiration are quite diverse. My background is Buddhist, and my faith also has been shaped by the Christian writer Dave Tomlinson, who showed me the type of minister I wanted to be. Sufi poetry makes my heart sing. And my deep faith in God — the God of my understanding as a universal, connecting loving consciousness — owes much to Taoism.
So how does an interfaith minister fit into the hospice chaplaincy team? Actually, the same as everyone else. We all see and support everybody. Our approach is that there is someone for everybody. Each member of the team is allocated a day and is then responsible for visits, the relationship they build up with patients and the support they require.
You just can’t tell what support someone will need from a label. Occasionally we’ve had Buddhist patients in, and the staff may say “Oh, you must see Fiona”. My experience is that there can be too many assumptions and expectations on one or other side. A person’s spirituality is highly personal and it takes trust and rapport in order to discuss deeply-held beliefs. Being human, being able to connect on that level, being able to create that sacred space and be given permission to walk on their holy ground — that’s what’s important.
I believe that it is understanding our own faith or position that enables us to be grounded enough to support someone in their’s, but they don’t have to match. In fact, sometimes that difference really helps. I was with one devout patient of a different faith path who was able to tell me that he was scared, and we then had a conversation around that. He told me he wouldn’t have been able to reveal that to a member of his own faith community.
Each interaction we have is completely unique, diverse, and, from our perspective, totally inclusive.
In mid 2016 St Michael’s appointed me as Chaplain to the new Hospice at Home Service. It is nurse-led and managed, but in order to apply the Palliative Care Model of meeting the physical, social, psychological and spiritual needs of patients and their families, they also recruited a social worker, a counsellor and a chaplain. The three of us then worked closely together to develop a support service.
One of the issues we had to overcome is that we can’t just wander around to people’s homes hoping to make contact as we could on the ward. Now we need referrals from the specialist community nursing and care staff, who all had their own assumptions of what a chaplain is — and therefore what help, or not, they think I could give.
The challenge has been in building relationships so they trust me enough to be a safe pair of hands with their patients. It has taken time, effort and good humour on both sides. It’s helpful that I sit in with the team and muck in — answering the phone, making tea, lending an ear and providing support and hugs.
Swearing has been a very useful tool (actually it’s something I’m quite good at). It really seems to reassure people that I’m normal and that they don’t have to mind their Ps & Qs around me. By being in the office I’ve also been able to respond straight away — for example to go and sit with a 100 year old patient who’s relative was at the end of their tether and just needed to get out of the house and get some air.
I have even picked up a patient’s dog and took him home with me so the patient could be admitted to the hospice accompanied by his wife in the ambulance. I then conducted his funeral a week later (the patient, not the dog — the dog was fine).
As I’m surrounded by nurses, I’ve tried to operate to the RCN definition of spiritual care: “That care which recognises and responds to the needs of the Human Spirit when faced with trauma, ill health or sadness and can include the need meaning, for self worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament, or simply for a sensitive listener.”
I think that covers every eventuality and the patients, clients and/or the referrer can choose any or all of it. And it has worked. Referrals are coming in that cover the whole gamut of spiritual care, and I’m now building my own team of volunteers.
It has also been important to show that we embrace diversity in spirituality in its broadest sense . We support all faiths and none — and everything in between!
This blog is based on Fiona Horwood’s talk at the conference of the Association of Hospice & Palliative Care Chaplains, May 2017.