Corinne Smith on ministry to the dying

I first met Alice (not her real name) when I was on-call one weekend at the Churchill Hospital, Oxford, where I was working as chaplain. The ward had called me because Alice was very distressed. She had learned that her cancer had spread very rapidly, and that she had only weeks to live.

As we talked, Alice told me she was a Christian Spiritualist – so I asked if she would like me to ask someone from her faith community to come and see her. ‘No’, she replied, ‘you’re doing ok!’

I suggested she might find it comforting to hear Psalm 23. When I read the words ‘surely goodness and mercy shall follow me all the days of my life, and I shall dwell in the house of the Lord forever’, she asked ‘Isn’t there something else in the Bible about rooms?’ I replied that I thought she might be thinking of the passage from John 14, which contains the words ‘In my Father’s house are many rooms…’

As our conversation progressed it was clear that Alice saw herself as being very much on a journey – both physical and spiritual – and I saw my role as being to provide companionship and comfort to her along the way.

When I visited Alice a few days later, she had been moved to a side room. She reminded me of the passage in St John’s Gospel that I had read to her, and said how comforting she had found it. She added ‘and now I’m going to yet another room’, because she was going to be transferred to a hospice later that day.

Alice was very impressed with the room she was given at the hospice. She was a woman for whom colour and design were very important, and she took a childlike delight in the furnishings and fittings.

‘This room is much better than the last two,’ she said, ‘but I guess the best one is yet to come’. Clearly, Alice was aware of a real sense of progress in her journeying towards her ultimate home; and it was humbling to observe that – although her physical condition was worsening daily – she seemed at the same time to be growing spiritually.

It occurred to me to read from 2 Corinthians [2 Cor. 4: 89; 6-17]:

We are afflicted in every way, but not crushed; perplexed but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed… So we do not lose heart. Even though our outer nature is wasting away, our inner nature is being renewed day by day. For this slight momentary affliction is preparing us for an eternal weight of glory beyond all measure, because we look not at what can be seen but at what cannot be seen; for what can be seen is temporary, but what cannot be seen is eternal.

Alice said that exactly described how she was feeling.

A couple of days later, Alice was allowed to go back to visit her flat for a few hours. When I saw her on her return she said she had found it helpful to be able to say goodbye to her flat

and all her belongings, and that she felt she could now start to move onto the next ‘bit’, as she put it.

She meant that she was getting ready to let go and move on in terms of her own physical body. I read to her from 2 Corinthians again [2 Cor. 5.1-2; 4-5]:

For we know that if the earthly tent we live in is destroyed, we have a building from God, a house not made with hands, eternal in the heavens. For in this tent we groan, longing to be clothed with our heavenly dwelling . . . for while we are still in this tent, we groan under our burden, because we wish not to be unclothed but to be further clothed, so that what is mortal may be swallowed up by life. He who has prepared us for this very thing is God, who has given us the Spirit as a guarantee.”

She cried as I read it, and said: ‘It could have been written for me.’

Prayer and reading sacred writings can be very comforting to someone who is dying. I usually ask if a patient has a favourite Bible passages, or a particular translation that they would prefer me to use.

Some people, when they come into hospital or a hospice put ‘none’ in the space marked ‘religion’; but I would say that that doesn’t necessarily mean they have no spiritual needs. I

would say we all have ‘needs of the human
spirit’. This is the need to try to find meaning in life’s experiences and make some sense of what is happening to us: in relation to those closest to us, and in our relationship with God.

Although many people are not consciously aware of their spiritual needs, the threat of disease and impending death can make them come to the fore. I have never met anyone who has said ‘I wish I’d spent more time in the office.’ Any sense of regret has usually been in connection with how they have treated those closest to them.

Enabling reconciliation towards God, other people, and ourselves is therefore a significant part of care of the dying. The way it is done will vary from an informal sharing of their need to ‘put the record straight’ to a sacramental confession (for which, as a deacon, I would need to involve a priest). A deep sense of guilt can be the cause of much spiritual distress, and – in my experience – if people can be helped to ‘let go’ of the past, they can be freed-up to die far more peacefully than they might otherwise.

When someone is dying we need to be prepared to sit quietly and hold a hand, or to put an arm round the shoulder to express concern. Touch that has no clinical or medical purpose can be very important: so much of people’s experience at the end of life may be of having physical things ‘done’ to them which are not necessarily pleasant.

I remember taking Holy Communion in another hospital to a very elderly priest who was dying. When I arrived, his sheets were twisted round him, and he said he felt very hot. I suggested that I might straighten his sheets and then wash his face. He agreed to me straightening the sheets, but said ‘I’m not sure about you washing my face, because when they [the nurses] do it, it hurts.’ I said that perhaps I could try, and he could tell me to stop if it was uncomfortable. As I gently wiped his face with a cool flannel, he turned his head from one side to the other and said ‘Oh yes, this is God’s work. When “they” do it, it is not God’s work. This is God’s work.’

I have also found that laying on of hands, whether or not it is accompanied by anointing by a priest, can also bring a sustaining sense of peace to a patient that is almost tangible; and is especially helpful when a person is nil by mouth and unable to receive Holy Communion.

Holy Communion is obviously a hugely meaningful part of ministry to the sick and dying, however. It has been humbling to see how communicants, through receiving the Body and Blood of Christ, are given the grace and strength they need to sustain them in whatever they have to face; or to be able to allow the everlasting arms to enfold them and carry them on the next stage of their journey. The rites and rituals around and after the time of death can also bring tremendous comfort and peace to both the dying person and their loved ones.

When I am called to the bedside of a dying person, I always addressed them by name and say who I am, whether or not they are conscious. I then explain what I am going to do, prefacing my prayers by saying: ‘The prayers I am about to say are the prayers of the Church, which have been said for hundreds of years,’ because this gives the prayers a weight and an authority which many people find helpful. In my experience it often gives people ‘permission’ to accept death, especially if they have been fighting it.

It has been my privilege to accompany many people as they have been dying and, as I often say at funerals, ‘I couldn’t do my job if I didn’t believe there is more to life than this life’. My experiences as a hospital and hospice chaplain have shown me the truth of the words from Romans [Rom. 8.38]:

‘I am convinced that neither death, nor life, nor angels, nor rulers, nor things to come . . . nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.’

The Revd Corinne Smith is a Permanent Deacon and a former chaplain of the Churchill and John Radcliffe Hospitals in Oxford, and of the Sue Ryder Hospice at Nettlebed. ND