I am a spiritual care provider, also known as staff chaplain, at a large hospital complex in Canada. Chaplaincy began as a Christian calling, but spiritual care today is a multifaith proposition and as slippery as a bar of soap. I’m a Buddhist and most of my patients are Christian or agnostic. For me, spirituality is the moment when two people click. And suddenly, you are in it together. Something larger than the two of you is present. Some people feel the presence of God. Some people don’t. But more than half of my patients, no matter what church (or no church) they belong to, all say the same thing: “I want to go home!” Recovering the familiar feeling of being home, of belonging to oneself, is a step toward wholeness.
When I introduce myself to a new patient and their family, I say, “I support all faiths and no faith.” I usually get a laugh, and that is my opening—the seed of rapport that spiritual care depends on. My patients are between the ages of sixty and ninety, with varying levels of dementia. Some of my patients can only speak a word or two. As chaplain, how can I help them?
One of my clients, Dan, is almost blind and a bit paranoid in his confusion. He’s been disruptive and yelling, thrashing in the bed, crying. “They spin me, put me in rooms,” he says. “All dark. I want to go home.”
It’s hard to navigate when you have no compass, no calendar, and no clock. Add cognitive decline to the mix, and my patients are lost. The loss of home is the perfect metaphor for Dan’s experience. Looking for home is a way of trying to find himself.
I sit close to Dan so he can sense where I am. “That must be awful,” I say.
“Home,” he repeats.
“I’d be pretty upset if that happened to me.”
In the twinkling of an eye, Dan and I are friends because I accept and respect what he says. The actual facts do not have a place in this conversation. It is his reality that counts. We chat a bit, figuring out how to talk to each other. I learn that he dislikes plastic spoons, and hates paper straws. The meals are served with both. He wants to go home and eat with proper cutlery. “Home!” Dan says, beginning to wind back up.
“Want to try something?” I ask. Dan does.
“Can you find your right hand?” He can.
“Can you put your hand on your chest, over your heart?” He does that.
“Can you feel your heartbeat?” Dan can.
“Feel it beating?”
He nods with a face full of relief. “Yes. Beating,” he says.
“Good. I’m glad it is.”
Dan smiles, sharing the joke.
“So, that’s where you are.” I pat his chest. “You are right there, all the time.”
Whenever I sit down at bedside, something spiritual and sacred happens: I look at my patients, and they assess me. They come out of their dullness or their panic to inspect me, and when I look at them, I note my reaction. Sometimes fear flashes through me because as I age, I stand a good chance of being much like them. So, I come close—the unwashed hair, the slack or furious face, the dirty nails. If I recoil, if I judge them, what capacity do I have to help them, or to accept my future self? I hold them in my mind, tender and curious. When you don’t know who you are, unconditional acceptance from someone else helps.
Jasmine, age eighty, is admitted for infected pressure wounds caused by her lack of mobility and made worse by lack of hygiene: She sat in a chair all day long, then lost the strength to get up.
Jasmine arrives at the hospital dehydrated and delirious from infection. She yells continuously, “Home! I want to go home!” She stops eating, and often refuses the care nurses try to offer. After her fever comes down and her delirium clears, I ask her if we could visit.
Her hands are balled up into fists. “Can you take me home?” she begs.
I clear off a chair, pull it close to her, and sit down. “Tell me about your home. What is it like?”
Jasmine starts slowly, and then there’s a rush of words about a garden and her mother’s roses. A tan dog without a name, raking leaves and burning them. After church, Sunday dinner with her family, a cake with sparkles.
Contentment spreads across her face as she tells me about a place where she was young, beautiful, strong, and in control. She waves her hands as if conducting music.
Jasmine never sees her apartment again. She waits in hospital for many weeks for placement in a nursing home. But when we visit, she gets to “go home,” a place that no longer exists, if it ever did. Was the dog tan or black? Memory is uncertain, and we get lost if we get distracted by the “facts.” But, the shining familiar self that we have known all our lives is there, filled with feeling.
Spiritual experience exists in the present moment aided by communion with another person, a fellow traveler. We reexperience the past when we name it, say it aloud, tell the story—in the present. This perfect, whole self is recovered and lived now in the naming, the telling. In the exchange.
Jasmine enjoys prayer and Psalm 23 in the Bible. “What do you want to pray for today?” I ask.
We pray for her mother and the dog. We pray for the children and grandchildren, whoever they are, if they are at all. We pray that Jasmine will go home.
Dan does not want any of that religious stuff. But he, like Jasmine, feels a spirituality that helps him find himself through this part of life.
As the spiritual care provider, I open, I listen, and I join my patients wherever they happen to be. In this way, as witness, I provide the context for Dan’s and Jasmine’s spiritual experience in the sharing, the giving and receiving, in the present moment—the only home we have.
Note: The patients in this story are composite characters.
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