PlainViews

Re: Response to "Bad Death" (PlainViews, 6/4/08, Vol. 5, No. 9)

In response to Jim Ek's letter defining death's ending in "cide" as filled with "self-doubt, worthlessness, void of meaning," I suggest we revisit Dorothy Soelle's excellent book, "Suffering" in which she defines suffering on several levels: physical, social, psychological, spiritual. It is a pain that has no words out of which emerged liberation theology.

I personally have never experienced that level of suffering, although I have witnessed it in many of my patients. As a bioethicist (University of Washington Medical School and UC Berkeley) who has sat on many ethics committees, I have written against assisted suicide although, along with Jensen, I recognize that "intractable pain" does exist and may in some instances justify euthanasia when palliative care is not enough. Fortunately, good hospice care can address many of these levels of pain. But, there are no categorical imperatives at the end of life.

I suggest that Mike may have been experiencing Soelle's definition of suffering. We don't know. We will never know. We can intervene, offer hope, comfort, be an Anam Cara for our patients. But we can't BE our patients. So I invite compassion, forgiveness and understanding that Mike's pain, his "suffering without words" is now over. We should not judge; that's God's job and I believe She wept with Mike.

Rev. Penelope A. Thoms, M.Div., M.A., BCC
Chaplain
Capital Hospice
Leesburg, Virginia

Report from the International Council on Pastoral Care and Counseling (ICPCC)

It is almost impossible to keep up with all of our day to day obligations, much less to stay in contact with International Organizations. As such, the ICPCC will begin to send short Updates every three to four months to keep you informed about our ongoing work and ministry.

The 8th World-Congress of the International Council on Pastoral Care and Counseling, ICPCC, took place in Krzyzowa, Poland from August 7th to 14th, 2007. The theme of the World-Congress was “Treasure in Earthen Vessels: Care of Souls facing Fragility and Destruction – individual and systemic perspectives.” There was also a very moving pre-congress held in Dresden, Germany whose title was “Siblings by Choice: Intercultural Empowerment Facing Global Processes of Conflicts by Story Telling, Research and Cooperation” that was organized and led by Professor Dr. Ursula Pfaefflin. The impetus of the pre-Congress was to enhance mutual knowledge among ICPCC members, and work toward ongoing networking.

The World-Congress was chaired by Professor Dr. Ursula Pfaefflin from Germany, and designed and organized by the Convenor of the Congress, Rev. Helmut Weiss, along with an extensive International (Central European) Planning Committee. The World-Congress was a great success!

The accounting and auditing of the World-Congress and Pre-Congress have been completed. The total flow of funds was more than 130.000 Euro! There is not space to thank all of our donors, but know that without your support and commitment this important event could not have taken place. We would like to say a special ‘thanks’ to grants from Scandinavia, to a group of private donors from Belgium, and to the Society for Intercultural Pastoral Care and Counselling (SIPCC) for attracting many grants.

The Previous Executive Committee decided to publish the Krzyzowa material; Helmut Weiß and Klaus Temme have taken responsibility for the editing. The launching of the 2 books is well under way. The German version will be printed in June, and the English version probably in July! More news will follow about price, and how to order the Books. [1]

Since then, we want to celebrate the retirement, from her teaching position, of our former President, Dr. Ursula Pfaefflin! She was honoured with a celebration, in Dresden, Germany, on March 28th, 2008, and the surprise publication of a book, Gerechtigkeit und Heilung (Justice and Healing), which includes chapters by various members of the ICPCC.

The new Executive Committee has been quite active since the World-Congress, dealing with questions of revising the Constitution, participation in International Conferences, and ensuring the ongoing life of the International Council. We count on your ongoing support!

James Farris
Publicity Officer
ICPCC

[1] Bibliographical information:
Helmut Weiss, Klaus Temme (Eds.) Treasure in Earthen Vessels, Intercultural Perspectives on Pastoral Care facing Fragility and Destruction , Bd. 6, 288 S., 24.90 EUR, br., ISBN 978-3-8258-1138-9. Serie: ContactZone. Explorations in Intercultural Theology http://www.lit-verlag.de/reihe/ceit

Helmut Weiß, Klaus Temme (Hg.) Schatz in irdenen Gefäßen , Interkulturelle Perspektiven von Seelsorge angesichts von Zerbrechlichkeit und Zerstörung , Bd. 34, 288 S., 24.90 EUR, br., ISBN 978-3-8258-1137-2.
Reihe: Ökumenische Studien / Ecumenical Studies http://www.lit-verlag.de/reihe/oekstu

Re: Where God Calls Me in Japan, Kyoko Hamamoto (PlainViews, 5/21/08, Vol. 5, No. 8)

I was delighted to read Chaplain Hamamoto's article "Where God Calls Me in Japan". I had the opportunity to go to Japan in 2001 and work in that hospital with Chaplain Hamamoto. I was impressed with the quality of pastoral care I saw her provide, and realized that physical, emotional and spiritual pain are the same the world over. I still use examples of my brief but rich experience there in my ministry today. My experiences,too,like many of hers, were holy moments.

Larry M. Connelly, MDiv., BCC
Director of Spiritual Care Services
Piedmont Hospital
Atlanta, Ga

Re: Providing an Ear and an Open Heart, Sharon Frank (PlainViews, 5/7/08, Vol. 5, No. 7)

After reading last issues’ opening article by Rev. Sharon Frank entitled "Providing an Ear and an Open Heart" sharing her prayer to “release a dying baby back to God”, I feel compelled to share a simple prayer service that I created after the tragic death of a friend’s full-term baby boy during labor. As a result of being a part of this incomprehensible grief process, I was moved to create the following blessing / ritual, which I dedicate to Ronan Jack (born & died October 24, 2006) and his loving heart-broken parents.

Prayer When a Baby Dies

God of love,
We come before you in shock and sadness.
Through grace and love these parents created new life;
now we feel our human frailty and brokenness.
Hear our cries of bewilderment and anger
because of the loss of this new life.
Be with us as we struggle to understand the mystery of life and death.

Naming ….

Gracious God, we want to acknowledge this child with a name as we lift up our broken hearts and prayers to you.

Ch: What name do you give your child?

Parents: ___________

Chaplain: Child, you shall be called ______________. This name is a sign of your uniqueness. You are beloved to us and before God. By this name you will be remembered.

Baby Blessing …

___________, your parents have loved and cherished you as you grew in the darkness of your mother’s womb for _______ wks/months. We pray, God, that you receive _________ into your caring arms. Grant this precious child complete contentment and security in your eternal love.

Blessing of parents ….

(Parents) ______ & ________, may the God of consolation be w/you in your sorrow and grief. May your friends and family surround you with love and kindness as your mourn the death of your baby ______.

[May your faith sustain you where there is no understanding; give you hope when you feel hopeless and light when you experience only the darkness.]

Be with this family ( parents/grandparents, etc. ) as they grieve, and draw them close together in your healing love. You are present in their love and care for one another.

Finally, __________& __________, may you find strength and comfort in knowing that love was all your baby ever knew.

We make this prayer in the name of Christ the Lord. Amen.

Chaplain Jean McQuiggin, BCC
Pastoral Care Department
Portland Providence Medical Center
Portland, OR

News of All-Ukrainian Association of palliative care, May 2008

17th April 2008 Minister of Health of Ukraine Vasyl Knyazewich signed the Order (# 210) about creation of the Coordination Council on palliative & hospice care. The main task of the Council is development, coordination and monitoring of further implementation of the State program of development of palliative care in Ukraine in 2010-2014, further improvement of legislation which regulates provision of palliative care to citizens of Ukraine etc.

Co-Heads of the Council: Deputy Minister of Health Zinowy Mytnyk and President of nongovernmental organization All-Ukrainian Council for patients rights and safety Prof. Iurii Gubsky.

The Co-ordination Council consists of representatives of Ministry of Health, Ministry of Social affairs, hospices, educational facilities, non-governmental non-profitable organizations, religious leaders and international experts.
The first meetings of the Council is planned for end of June 2008 in Kyiv.

* * *

Thanks to the close cooperation between central and regional authorities and non-profitable organization and support of international organizations, firstly, Open Society Institute, the number of facilities providing hospice care in Ukraine increases. In 2002 in the structure of Ministry of Health there were 12 in-patient units (palliative care wards, hospices etc) with 400 beds. But in 2008 these number was increased to 19 facilities and 600 beds. Mostly, the increasing of numbers began in 2006 when the state policy in the sphere of development of palliative care began to be formed. In July 2006 the Task Force on improvement of legislation on palliative care was established as well as All-Ukrainian Association of palliative care.

* * *

One of the priorities of the Association in 2008-2009 is development and implementation of the educational programs on palliative care. In this direction accordingly to the agreement between our Association and Hungarian Foundation of hospice care in Budapest there will be organized training of Ukrainian organizers of public health and social work & practising medical, social workers and psychologists. Dates of this event 9-13 June 2008. 8 representatives of Ukraine are selected to participate (from Kyiv, Smila, Mykolaiv, Donetsk and Kherson).

* * *

Our young Association unites Ukrainian hospices, hospitals, NGOs and personalities who wish to dedicate their activities to development of palliative care in Ukraine. We need technical assistance directed to education of medical, social and other workers, volunteers in end-of-life care, on palliative care, on ways of pain management and other topics related with palliative care. Also as our organization is nongovernmental organization we will be glad to continue dialogue with other non-profitable organizations concerning the topic of involving public society to the process of improvement of public health in Ukraine.

Further information about these and other activities you can get from Mr. Alexander Wolf, Director of the advocacy of palliative care in Ukraine. His phone is + 38 044 234 84 02, and his mobile is 8 097 14 17 456. His e-mails are dzvony@yahoo.com and alexander@tb.org.ua.

Re: Providing an Ear and an Open Heart, Sharon Frank (PlainViews, 5/7/08, Vol. 5, No. 7)

I served as an OB chaplain in a secular hospital system and had several experiences similar to the one Sharon shared. Her compassion truly reflects the essence of what chaplaincy is: to journey beside, without judgment, and to be present to the suffering. She did both so beautifully for this family. For many of us, myself included, the issue of pregnancy termination touches the deepest part of us and sometimes presents struggles between our own values and beliefs and those of our patients. I was always amazed how that struggle would fall away, and how my heart would become opened to the grieving family before me, simply doing their best to walk the path in front of them.

Beverly M. Beltramo, MA, BCC
Staff Chaplain/Spiritual Care Coordinator
Oakwood Southshore Medical Center
Trenton, MI

Re: Karol, Marcia Klepper-Smith (PlainViews, 5/7/08, Vol. 5, No. 7 )

I sent this to my sister-in-law who is has been an ICU R.N. for more than twenty years, to get her response. I went from thirty years on pharmacy to chaplaincy two years ago and I concur with her assessment:

Wow, she hits it right on the head. I have seen many patients that the MD's and RN's try to get the family to make them a DNR or to withdraw but the family stands firm. Sometimes the patient survives to get out of the unit, other times HIS will is done. What I have to tell myself and others when we hit these situations is that HE is the one in control and that what HE wants will happen. Many times we forget to put ourselves in the families shoes and to see just how hard it is to say good-bye and to let go. When HE is ready for HIS child, nothing that we as humans do will prevent HIM from calling that child home. We just need to respect and stand by the family, no matter what and know that HE is the one in control and that many times HE is allowing closure to take place.

George H Brisges
PRN Chaplain
Carolinas Rehabilitation
Carolinas Healthcare System
Charlotte, North Carolina

Re: Chaplains: Are Hospitals Our Houses of Worship and Its Staff Our Congregants?, David Plunner (PlainViews, 4/2/08, Vol. 5, No. 5)

It is true that how we define our role is important in our relations with the professional staff of the hospital. On the other hand is it not equally true that the parishioner (hospital staff) chooses his own pastor, whether a chaplain or a local pastor, irregardless of how the chaplain defines his role.

I can also recall while on active duty asking another officer (I was only chaplain on the ship) to be my pastor and he was very helpful, reminding me of my unrealistic expectations of my commanding officer.

Rev. John R. Thomas
Retired Chaplain
Madison, WI

David Plummer asks: "Who sees the hospital as their house of worship? Why?" As a follow-up comes that great classic clinical pastoral education question: "Whose needs are being met?"

I am not a chaplain, although I have supervised chaplains in a spiritual care program and as a pastoral counselor, I consider chaplaincy a sister-discipline.

Plummer’s comments suggest that holding the pastoral role for the institution one serves rather than just its patients smacks of proselytizing and the imposition of one’s spiritual authority. I don’t believe that’s the case in my experience.

Chaplains carry their spiritual authority and an archetypal role wherever they go. The same is true of all ministers. One of the reasons I (finally) was ordained, despite my devotion theologically to the principle of the priesthood of all believers, was that it became apparent to me that the professional minister receives the unconscious projections of God or divine power from people – all kinds of people. It’s being the screen for those projections that allows us to work with the faith experience in a deep and profound way with patients, staff, colleagues – all whom may have their own pastor or pastors outside the institution in which we cross paths. The same dynamic is present for doctors, nurses, police officers and others. In assuming these roles, we have attached ourselves to a strong current of cultural power and influence, far beyond our own personal resources. The flow of this power is both seen and unseen. This is why it’s so important to weigh ethical issues carefully, and balance personal freedom against the responsibility to carry this professional role lightly and yet gracefully.

I do believe the chaplain is not only chaplain to patients, but to the institution. Chaplains are often called to engage the entire system on questions of ethics, to advocate for patients and their families and to interpret matters of faith to a constituency far beyond the patient’s room. I have seen chaplains spared criticism, given free coffee, and all sorts of special privileges because of unstated and assumed beliefs about what and who they represent to staff in the institutions they work. Chaplains cannot create an atmosphere devoid of this special influence and power within these institutions, and thus they exercise personal freedoms only within their professional role there.

Rev. Elizabeth (Betsy) Ritzman
AltCare Health Center
Oak Park, IL

I appreciated David Plummer's provocative questions about how we view fellow employees in our institutions...as "parishioners" or not. (I was also glad to hear of other discussion about the ER chaplain character beyond the comments of Nancy Berlinger and myself in a previous PlainViews).

While I do not view the hospital in which I work as a house of worship, staff and I often acknowledge that we are witnesses to sacred events about which they want to talk, albeit not usually in religious language.

I do not see hospital staff as congregants but - as part of our Spiritual Care Department mission - very much potential recipients of pastoral support. I go beyond waiting for staff invitation to pastoral dialogue, often initiating it when I've observed a staff member having a particularly challenging day, or when we've been involved together in an intense event. I judge whose needs are being met by the responsiveness, or lack of, from the staff member..and base my next steps accordingly. Requests from staff for periodic support groups - with our chaplains' involvement - tell me that our pastoral approach seems to be received well.

Thanks for the dialogue.

Julie Allen Berger, B.C.C.
Anchor Chaplain, Oncology Services
Barnes-Jewish Hospital
St. Louis, MO

My job description requires me to provide spiritual care to patients, their families and staff. Therefore I consider the hospital to be my parish and the staff come under my pastoral care, if they choose to seek it out.

I have had staff that I have previously had no relationship with approach me for pastoral care – the point being that any staff member can contact the chaplain at any time. They do not have to have had a previous relationship with them.

With regard to the comment about what other healthcare professionals would regard workplace colleagues as a part of their charge, calling, or responsibility – Chaplaincy like all forms of ministry is a vocation. I have difficulties with the idea of ministry being a profession in the sense of non religious professionals. Yes I am a professional in the sense of education, training, and competency, but I am called by God to serve his people in the institution in which I serve.

With regard to the chaplain in the ER Programme ( I have not seen it yet as we are some months behind the US with TV programmes, my real issue would be that chaplain enters into a sexual relationship outside of marriage. Many churches take the stand, “If single, celibate, if married, faithful”

Rev Ray Bloomfield QSM JP
Rotorua
New Zealand

I was involved in the conversation on the listserve that David Plummer referenced. It's possible that my point was not understood or was not stated clearly. Anyone who carries the title "Chaplain," whether ordained or not, is a designated "spiritual leader" in the organization that has conferred that title. The person carrying the title may be a CPE student who will have the title just for three months. That person is still a "spiritual leader" in that place and for that period of time. The title and role carry a certain set of behavioral expectations that likely do not attach to one with a title like "nurse," "doctor," "medical student," etc. A person who functions as a chaplain in an emergency department who begins to date a resident physician in that emergency department is "flirting" (irony intended) with the boundaries of those expectations. If the publicly observable behavior by the chaplain and the doctor in the emergency department leads the unit clerk to ask (mostly rhetorically) the physician: "Are you banging the chaplain?" then the boundaries have definitely been crossed. This has nothing to do with how I (or any other) chaplain views the nature of our relationship with the folks who work at our institutions. It does have to do with the role of "spiritual leader."

Jon Altman, Chaplain
Southern Care Hospice
Jackson, MS

The hospital where I have worked 16 years is not my house of worship. I worship in the congregation of my choice and do not have to put on a service of worship for patients and staff on the weekends. However, my position description states that I am to offer spiritual care to all who come to me for it, including staff. I sometimes counsel them individually a time or 2. If more is needed I refer them to our excellent EAP. So I choose not to form “best friends” with any of our staff as I may have occasion to be a “listener” for them. I believe strongly it’s the same with those who are pastors of congregations. One’s intimate associates should not be those for whom one is pastor. It’s the pastor’s and/or chaplain’s responsibility to set the boundaries in a relationship. I think calling the hospital one’s house of worship is different than maintaining pastoral boundaries with the hospital staff. This is not to say that we don’t enjoy each other’s company both on and off site. But none are my close friends, by my choice.

Mary E N Hanke, MDiv, CT
Chaplain
Stevens Hospital
Edmonds, WA

As a chaplain, I consider my patients, mostly hospice patients, to be my “flock” if you will, especially if they desire that relationship and have no other spiritual support.

As a support staff chaplain, I am friends with colleagues, but only broach a pastoral stance if they initiate the conversation and ask for guidance/support. At first, I attempted to be the chaplain 24/7, but found I was absolutely too drained. I realized that is precisely why I did not go into pulpit ministry and relaxed in knowing that God would have there the one who needed to be with that patient/family at that particular time.

Rev. Frankie B. May
Chaplain, Trinity Hospital/Hospice
Augusta, GA

Re: Health care and the rights of children, Jeanne M. Tessier (PlainViews, 4/2/08, Vol. 5, No. 5)

As a chaplain who worked for over twenty years primarily on the pediatric unit in one of the world’s premier cancer centers, I am sympathetic to Chaplain Tessier’s plea to give children a voice in their own care, especially at the end of life. Certainly, children must have a say in their own care, especially when that care is life preserving or palliative as opposed to life saving. There clearly are still too many places in our country where children’s voices are not routinely heard in these contexts.

However, given all of that, Chaplain Tessier far overstates her case and, in the process, does a significant disservice to several generations of care givers who have worked very hard, often at great sacrifice, to achieve many of the goals that Chaplain Tessier implies are not even underway.

First, she does not seem to appreciate the difference between consent which, generally by law, is not a right that minors have, and assent which is a right now written fairly routinely into experimental protocols that enroll children and incorporated generally into many pediatric practices.

Dr. Bluebond-Langner wrote her seminal work a full thirty years ago. While her vignettes are still highly instructive and should be required reading for anyone in pediatric chaplaincy, much has changed in the interim. In the unit I worked on, it would never be the case that a child would be given an experimental treatment such as a third bone marrow transplant without their assent. And this unit is far from unique. We have come a long way from when I trained in the early 1970s when parents were often not even allowed to stay over night on pediatric units.

Chaplain Tessier is simply wrong in stating that the effort to have children’s voices heard in health care is only beginning. Yes, much left to be done. However, there are scores of dedicated nurses, doctors, social workers, child life specialists, and even a few chaplains who have made sure that, on the pediatric units where they work, the voice of the child is certainly heard and respected. Their work needs to be honored.

Rev. George Handzo
Vice President, Pastoral Care Leadership & Practice
HealthCare Chaplaincy
New York, NY

Re: Reaching Beyond Our Walls, Carolynne Fairweather (PlainViews, 3/19/08, Vol. 5, No. 4 )

Thank you to Chaplain Carolynne sharing her story, "Reaching Beyond Our Own Walls." Wow, another reminder of what can happen when one listens to the Spirit guiding.

Rev. Louise Shepard,MATh,, MS Ed, CT
Pediatric Chaplain
SUNY, Upstate Medical University
Syracuse, NY

Re: Judaism and (Our Struggle with) Dependence, Daniel Coleman (PlainViews, 3/19/08, Vol. 5, No. 4 )

I very much enjoyed Rabbi Coleman’s article on Judaism and our struggle with Dependence. It gave me several good points to think about and to incorporate in my care giving with others. I appreciated the richness and depth of his thoughts, questions, and pondering and how he connected them so intricately with his faith tradition. It is an article that I will reflect on as I muster additional tools for my chaplaincy belt. Thank you for sharing your gifts Rabbi Coleman.

George A. Teachey, M.Div.
New York

My colleague Rabbi Daniel Coleman's magnificently crafted article on "the freedom to just be" hits the most defining issue in medical ethics on which I am presently writing a book--the "Jerusalem" approach to health care versus the "Athens" aapproach to health care. According to the ancient Greeks, you had to be a "do-er" in order to deserve life. Biblical thought considers every human life sacred and infinitely worthwhile simply be virtue of being created in G-d's image. It is "Jerusalem" that gives us the right to simply be. "Athens" says "Be a do-er or die!" We can only hope that Jerusalem triumphs.

Rabbi Louis J. Feldman, Ph.D.
Retired Chaplain
Board Member
Scholl Institute of Bioethics
Los Angeles, CA

An up-date from the Ukraine about their Palliative Care movement

Dear Colleagues:

Let me inform you about our further steps in direction of development of palliative care in our country.

The Association takes active part in a project began on January in 2008 for initiatives of All-Ukrainian Council for patients rights and safety. The project is entitled «Experience exchange between Ukraine and France for the humanizing of medical and social services to the citizens of Ukraine». In the frameworks of the project, development of changes to the Ukrainian legislation which regulates rights of patients, mutual relations of the state and church in the field of providing medical services, development of palliative care (care for incurable patients) is planned. A project is supported by Embassy of France in Ukraine and by Protestant Federation of France. Also, to the realization of the project Ministry of health, Ukrainian orthodoxy church and All-Ukrainian Association of palliative care are actively attracted.

A working visit of Ukrainian delegation to Georgia took place on January 23-29, 2008. Seven representatives of state, public and church organizations visited Tbilisi and Batumі (Republic of Adjara) for discussing the possibility of collaboration in the field of new legislation, concerning access to opioids, future collaboration in the field of palliative care providing and safe public health development. A question concerning pain management is one of the most essential, as it is known that no less than 20-25 % patients which have the incurable diseases suffer from pain. However the Ukrainian legislation, unfortunately, remains bad both for citizens and medical workers.

During meeting in Georgian parliament, in which the First Lady of Georgia Sandra Rulofs, numerous deputies and representatives of Georgia government took part, it was agreed about the collaboration and mutual assistance in this sphere.

The Round table "Development of palliative care in Ukraine: availability of pain management and оpioids turnover" took place with the support of Ministry of Health on February 15, 2008. The participants were: Minister of health protection V. Knyazevich, first Minister’s deputy M. Prodanchuk, representatives of Ministry of Labour and social policy, Ministry of internal affairs, public and religious associations representatives. As a result of round table it was decided to acknowledge importance and actuality of the Interdisciplinary Task Force (working group) on the improvement of legislation on medical and social care, created in accordance to Order of MoH #201 issued on 06.07.2006. The Interdisciplinary Task Force has 3 Co-Heads which present MoH, Міnistry of Labour and All-Ukrainian Council for patients rights and safety.

It was decided it is necessary to extend composition of the Task Force and to invite representatives of other ministries and stakeholders and continue the advocacy, informational, raise awareness compain on palliative care.

The Minister V. Knyasevych marked priority of palliative care development in Ukraine. So there is “political will” for development of palliative care in our country.

We will be very grateful for your suggestions concerning palliative help development in Ukraine.

Please send them to alexander@tb.org.ua or dzvony@yahoo.com,

Mr. Alexander Wolf
Palliative care program director
(All-Ukrainian Council for patients rights and safety, All-Ukrainian Association of palliative care)

Re: Health Care Chaplaincy in Scotland, Derek Brown (PlainViews, 3/5/08, Vol. 5, No. 3)

I am delighted with your decision to feature different countries. I recently went to Uganda, Africa as part of a Health Mission trip. I was looking for materials to help me better understand the culture and customs I would be entering. One of your articles was written by a man from Nigeria and I found it a helpful glimpse into some African health care.

More efforts, like the one I was on, will happen and you can help prepare us to go forward and not offend.

Kathleen Brown, MAPS, NACC
Regional Chaplain
Luther Midelfort-Oakridge and Chippewa Valley
Mayo Health System

Re: Judaism and (Our Struggle With) Dependence, Daniel Coleman (PlainViews, 3/5/08, Vol. 5, No. 3)

As a student chaplain with 5 units of CPE and an MDiv. in progress, I beg all of you PLEASE stop using the nomenclature "nursing home". Look into the eyes of the person you've said them to and see the injury those words have caused. The senior care industry is working to use the words that describe the level of care offered, i.e. independent living (IL), assisted living facility (ALF) or skilled nursing facility (SNF). It DOES make a difference which words are used and surely chaplains should support words that heal rather than injure.

Donna Zuroweste,
CPE Resident, VAMC-STL
St. Louis, NMO