Pastoral Care Of Dying

Pastoral care of dying is a specialized type of ministry to dying individuals and their families, relatives, and friends. The caring pastor is a symbol of religious faith and an active spiritual life. Around the death experience, his or her presence and tangible ministry are much appreciated and welcomed by all communities and cultures. The pastor represents assurance, comfort, and hope in a time of great uncertainty, transition, and need.

Death and dying have been a major focus in religious education, human services, spiritual ministry, and helping professions for decades. Both the physical death (cessation of bodily functions) and the theological death (separation from God) have been the center of much thought and attention in biblical literature.

Dying is a process. It is similar, in some ways, to other major processes of life. Care for the dying is in the heart of pastoral ministry. People need pastoral contact. It is a central part of the Christian call and an essential way of showing incarnational love. The dying process affects the psychosocial roles and attitudes of the people involved. An understanding of thanatology is essential for the helping professional who comes in frequent contact with the dying persons.

The dying person looks to the pastor for assurance of faith, company in the midst of fears and loneliness, help in communicating with his or her family, perhaps for the last time, guidance in reflecting on the quality of life, and, finally, comfort in a major transition as the self prepares to leave the body and the familiar physical world. Also, survivors look to their pastor for help with family arrangements, funeral and burial planning, as well as personal decisions and social demands. The minister needs to be prepared to serve as a major support system for a long while after the death, especially when the survivor is an older widow(er).

For some individuals, death is the worst aspect of life. They try to avoid any reminder of it at any cost. In certain families, death is never discussed. Some children grow up naive in this area, having to create their own unrealistic concepts of separation, loss, and mortality. They become protected from the real experiences of life and, too often, are left alone to develop their own distorted views of death.

People's view of death is shaped by their cultural background, religious beliefs, community heritage, social norms, personal philosophy, and individual worldview. Some view death as a real stranger, an ugly disturber, or an aggressive intruder into normal living. They perceive it as the ultimate problem and serious enemy of life. Others view death, including pain and suffering, as integral parts of life. They possess a natural ability to integrate its reality with the broader reality of existence, and, therefore, reconcile the concept of dying with the idea of living. To them, death virtually gives meaning to life.

Western societies tend to perceive death as an enemy which must be conquered or as an obstacle which must be overcome. Modern medical sciences, especially, try to go to a great extent in order to stop, reverse, or control the dying process. Perhaps health care providers tend to view death as a failure or a defeat. They indirectly, or unconsciously, engage in a war against it, employing sophisticated technologies and powerful medications possibly more than the average dying patient can bear.

In the mind of the dying person and his or her family members or loved ones, the pastor is an agent of genuine comfort, spiritual guidance, and existential stability as they, together, go through significant mental and emotional adjustments. In their mind, the pastor represents both a spiritual connection with the after-life and a supportive social agency. As the condition of the dying progresses further and death becomes inevitable, family and friends normally begin to feel closer to each other and to their minister. Therefore, they start to look forward to his or her presence, receive his or her guidance, increasingly rely on his or her judgment, and depend on his or her nurture and soul care.

The pastor is usually called upon to help in making crucial decisions involving moral, medical, ethical, and familial issues. The situation can be highly charged and complex. For example, they need to decide whether to continue treatment in the case of a terminal illness, to remove life-support machines from an unconscious family member (young or old), or to bring the dying person home from the hospital for his or her last days. Reasonable suggestions, sound interventions, adequate care, and appropriate resolutions may be, at times, difficult to formulate and achieve especially when there is tension in the family, opposing views among the professionals, and conflictual feelings toward the dying person.

The clergy, like any other helping professional, may find himself or herself in the midst of an intense situation, a major accident, a sudden loss, or a social crisis. Besides being knowledgeable and ready to help spiritually and existentially (with meaningful Scripture readings and compassionate prayers), ministers should acquaint themselves with the issues related to grief, loss, bereavement, terminal illnesses, biomedical ethics, family dynamics, crisis intervention, stress management, and conflict resolution. It is essential to realize that the pastor is not dealing only with one dying individual but with a circle of family members, relatives, and close friends (and at times, even adversaries) in whom the anticipated death has stirred a host of issues, emotions, behaviors, and attitudes.

So, caring for the dying person means also caring for those who are around him or her who perhaps are equally affected by the process of death. The pastor may succeed, at times, in helping facilitate the intense emotions, express the deep thoughts, and disclose the unresolved matters and, by doing so, helping family members reach some resolution and closure. The pastor may witness healing of past wounds, relief from current tensions, and emergence of fresh communication, transparency, and mutual forgiveness. He or she may be instrumental in causing substantial emotional cleanliness, spiritual renewal, or a marvelous sense of bonding, closeness, and affection. All this usually leads to a smooth ending, significant relief, and a peaceful death.

However, this is not the case all the time. In many instances, the death occurs without any possibility for peace, closure, or resolution. Instead, people become highly resistant, more divided, and deeply resentful as they drift further apart, perhaps not to see each other again. Therefore, the minister must not place high expectations on himself or herself or on the situation but rather he or she should realistically deal with such unfortunate losses, major disappointments, and missed opportunities.

K.C. Brownstone

K.C. Brownstone is an independent scholar who believes that critical thinking and spiritual reasoning should not be mutually exclusive. She received theological education from Dallas Theological Seminary and Asbury Theological Seminary. Personal subjects of interest are psychology and counseling.

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