The Poor in Long Term Care

During the three months that I have served as a chaplain in long term care, I have identified more individuals who are poor for reasons other than lack of financial concerns. Most of these women and men are living on "memory care" units. (think Alzheimer's disease for many of them).

This particular facility has placed chaplaincy/spiritual care, within the Recreation department! I was aware from the first interview that this person wanted me to plan, preside and preach for three Sunday services as well as manage the music, encourage nursing staff to bring residents to the service, and have time in between to run to the next unit and repeat the process! I questioned the wisdom of this plan and asked if we might instead, spread the three services out during the week. "No, they must be on Sunday."

My second concern regarding worship services was the benefit to those on the two memory care units. I agree that worship is important to many people through all stages of life, but I questioned the formality of the service rather than a more relaxed worship where there might be both group activity as well as time for individual and personal interaction. "No, they must be as I have said."

When does the in depth human interaction happen for most of these residents? I've observed the nursing assistants pulling residents in wheelchairs backward where there is no hope of conversation between staff and resident. I have also observed staff members all sitting together at the desk while 30 residents sit in silence in the recreation area, in full view of those same staff members.

Of course, there are staff members who have grumbled because I question the decision to turn a dying woman on her side and facing the wall making it next to impossible for anyone to get near her, hold her hand, speak softly to her. They are the same staff members who don't seem to understand that one need not be left with drool and medication on their chin because they don't know it's there.

My heart and soul ache for these residents. In less than 90 days, I have shown that a resident who mostly vocalized sound and not words, spoke clearly to me when I patiently encouraged her to "use words." She now perks up in her wheelchair and breaks into a smile when she sees me; we wave and smile at each other now.

On these units especially, the sermon is in the presence of Christ visible and tangible through those of us who extend a hand, smile at, speak pleasantly, show consideration and love, to them as would Christ and St. Francis. It is so natural to me, and so confusing to those who make the "rules."

The poverty resulting from lack of individual attention and concern, screams out through the blank looks of some, the uncertainty of people who do attempt interaction, the tears of a woman who spends her day sitting on a bench outside the unit's elevators. "There but for the grace of God, go I" I think to myself. "I'm not budging on this requirement for three worship services on Sundays," the Recreation director insisted. Why can she not recognize that worship and the lessons from the Gospels are being lived through kind words, smiles, a brief time sitting on a couch with a lonely resident....and so many others.

What I have learned is that the push for Sunday worship as described here, is the fulfillment of recreational "activities" during those times. If I don't lead a group activity, "someone would have to be hired to fill those times in order to be compliant." "Yes, and........."

We share the wonder and the love of God with everyone we meet when we celebrate our connectedness and share our experiences and feelings in friendly one on one conversation, an arm around a lonely resident, a question about their day, a wave to everyone in the dining room, a "dance" with a woman in a wheelchair........ Spirituality is about connectedness and that is the starting point in reducing the poverty experienced by many human beings.