Chaplain Jim Rowland on a professional effort toward the process at life's end

Hospital Chaplaincy and Hospice Chaplaincy: A Comparison

It is not unusual for people who are approaching the end of their life because of a terminal illness to experience abandonment for a number of reasons. Sometimes this abandonment comes from a sincere desire not to interfere or detract from the precious short time that the patient has left with their immediate family and/or spouse. Sometimes it might be a subconscious abandonment related to our very human fear of death and/or avoidance of intense or stressful situations. In either case, it is a time when a specific training and understanding is called for especially in the context of Pastoral Care. This specific training and knowledge is standard for any certified hospital chaplain, but this is not currently the case for hospice chaplains.

There is pain and destruction happening all around families in the end-of-life experience, but these same families have been in “the experience” so long that it frequently becomes a weird form of “normal.” Those around them however, in order to enter into that world, must go through these intense emotions and stresses of the dying process in order to be “with” the dying and their family. Being “with” these families is not an easy or pleasant task for either clergy or laity. This is why I believe hospice chaplains need training and certification similar to that of a hospital chaplain to prepare them properly.

Hospice chaplains are frequently local parish clergy persons who have no prior training beyond the typical pastoral care classes offered in completing their Master of Divinity degree at seminary, which isn’t usually very much at all. Many times it is some prior experience with a terminally ill person or family member which has led them to volunteer for hospice work. These same clergy persons represent a variety of denominations, some of whom might see this ministry as an opportunity for evangelism. Finally, it is true for the most part, that these well-intended persons also have little or no training or tools for “processing” their own emotions and issues that working with the terminally ill are sure to produce within them.

When I first worked as a hospice chaplain volunteer, I was barely beginning seminary, was serving as an associate pastor to a large congregation in North-Central Arkansas, and had completed only one course in crisis counseling in seminary, which had taught me “active listening” skills. I did not yet have the knowledge or ability to “process” my own emotions, thoughts, and experiences with these patients and their families. In addition, I had no knowledge or training in the dying process, nor had I even begun to develop a theology that incorporated the idea of a “good death.” How could I assist another toward having a “good death” experience if I wasn’t even familiar with the term, let alone the theology behind it?

Finally, I believe it is time that we give as professional an effort toward the process at life’s end as we give to those in the middle of the journey of life. Human beings need “meanings” to experience harmony in their living and they are just as needy for “meanings” in preparing for having a harmonious end. The assistance given must be focused, trained, and intentional, which is what professional training and certification will prepare hospice chaplains to do. It will give the hospice chaplains the tools for processing their own emotions and thoughts related to their ministry, which will keep them healthy and effective in their caring with others.

Chaplain Jim Rowland is Director of Pastoral Care Services for Wadley Health System in Texarkana, TX.  He has a B.A. in History from University of Texas at Arlington, and a Master of Divinity degree from Phillips Theological Seminary in Tulsa, OK.  Jim is an Elder in the Arkansas Conference of the United Methodist Church and has served continuously under appointment in the local parish and beyond since 1979.

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