Spiritual Care: A Guide for Caregivers (4 page)

Connie had always considered herself a faithful Christian, but when
she learned that one of the responsibilities of the lay visitors in her
church would be to "meet spiritual needs," she hesitated.

She could understand the need to provide emotional support
and meet the practical needs of the people she would be visiting,
but weren't spiritual needs the pastor's responsibility? She certainly didn't see herself as an expert in theology. If she was visiting
in the name of the church, wouldn't that be spiritual enough?

On her first visit to Helen, a homebound member, she gained
some insights into what spiritual needs might include. At eightyseven, Helen had been an active member of the church until she
broke her hip. Now she was restless and felt isolated. She talked
and talked when Connie visited, not wanting her to leave.

"It's not just the people I miss," Helen explained. "Sometimes I
feel so far away from God when I can't get to worship services or come to the prayer meetings." Connie urged her to explain further, and Helen continued, "Well, I like being able to pray with
other people. It just seems that God hears other people better than
he hears me sometimes. Pastor Jessup's sermons always helped
me understand the Bible better too. When I read it for myself, I
have so many questions. The tapes are okay, but it's not the same.
I like the singing and the choir, but most of all I miss the hugs.
Nobody ever touches me anymore-church was the only place I
got hugs."

Connie asked Helen about her family, only to discover a complex web of anger, bitterness and tension in Helen's family system.
Her husband had died six years previously. Two of her sons inherited the family business, but they could not agree about how to
manage the finances. A third son, who had moved to another
state, received no interest in the business and felt unfairly treated.
Helen felt caught in the middle. The sons constantly bickered and
came to her, expecting her to choose sides. She finally refused to
speak to any of them about anything. Her eight grandchildren,
who were all young adults, still visited occasionally, often asking
to borrow money that they rarely repaid. She loved them deeply
but did not approve of their lifestyles and worried about them
constantly.

The longer Helen talked about her family, the more she
dropped her cheerful facade and began to tell Connie about the
concerns that had been nagging at her since she broke her hip.
"I'm just an old lady, and I'm going to die soon. What kind of a
legacy am I going to leave behind? Just a bunch of squabbling
sons and grandchildren who haven't darkened the church doors
since they were confirmed. What do you suppose God thinks of
me?"

Connie didn't know what to say. How could she help Helen? What did God think of this situation? How did hugs and family
finances fit into spiritual needs? Suddenly she noticed the time
and stood to leave. "Helen, I have to go, but let me give you a
hug l "

Helen brightened and said, "Oh, you have helped me so muchl
Thank you so much for coming. Do you think you could say a little prayer before you go?"

Connie fought the desire to hug and run. She sat back down
and reached for Helen's hand. She thanked God for their time
together and prayed for Helen's concerns, including her family
and her desire to leave a legacy that pleased God. Helen grabbed
her hand tightly and wept as Connie prayed. "You just don't know
how much this means to me," she sobbed.

This was the first time Connie had ever prayed out loud spontaneously. Although she felt awkward at first, she was glad Helen
had asked her to do it. The prayer obviously met a need Helen
was feeling, but it also touched something deep inside Connie. She
felt a new bond with Helen and a shared hope that God would
work in this situation.

Just as understandings of spirituality differ widely, so do the definitions of spiritual needs. Some see spiritual needs as those areas
involved with creativity and the arts. Others see them as psychosocial needs--associated with mental health and social systems. A
person's understanding of spirituality will determine the resulting
view of spiritual needs. However, the Bible presents a distinct picture of spiritual needs.

The foremost spiritual need that the Bible reveals is our need to
be in right relationship with God. A spiritual need is anything required
to establish and maintain a dynamic personal relationship with God. That is why the gospel is good nerve. God loved us so much that he provided for our need by sending his Son, Jesus (Jn 3:16), through
whom God "became flesh and lived among us" (Jn 1:14). His love
frees us to love others (Jn 13:34; 1 Jn 4:11-19). We are all living
lives of quiet desperation, immersed in the results of sin and in
need of forgiveness (Rom 3:23). It is through the death and resurrection of Jesus that we find forgiveness for our sin (Mt 26:28;
1 Jn 1:9) and the ability to forgive others (Col 3:13). Furthermore, we need to have our lives make sense and be purposeful.
The need to be needed is a spiritual need. We find meaning and
purpose through our relationship with God and his people, and
through the love and forgiveness we experience from them.

According to Ephesians 1:5-14, not only does God meet our
spiritual needs, he overwhelms us with more than we could ever
imagine. He gives us a glorious purpose for our lives when we
accept the love and forgiveness that God offers us in Christ. That
lends deep meaning to every human encounter, every decision we
make and even to our illnesses and suffering.

To summarize, all people experience three basic spiritual needs:
(1) to be loved and to love in return, (2) to experience forgiveness
and extend it to others, (3) to find meaning and purpose in life and
hope for the future. Spiritual needs can ultimately be met only by
God, but when we receive from him, the benefits overflow into
our human relationships. We become channels of God's love, forgiveness and hope. Paul explained to the Corinthians, "But we
have this treasure in clay jars, so that it may be made clear that
this extraordinary power belongs to God and does not come from
us" (2 Cor 4:7). We may be cracked pots, but God uses us anyway.

Spiritual needs may seem elusive. Although we may observe
the effects of unmet spiritual needs, they can be difficult to pin down or to measure. Yet there is a deep yearning in the heart of
each person to seek God and, in doing so, to find love, forgiveness
and hope. Paul explained, "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" (2 Cor 4:16-18). Most people sense, deep down inside,
that only the eternal -the spiritual -holds real value.

When Connie visited Helen, she indirectly discovered that Helen
was experiencing all three spiritual needs. She felt cut off from the
love of others at church and in her family, and her loneliness hindered her relationship with God. She missed the hugs! She was
also embroiled in family controversies that settled into her heart as
bitterness. She needed to forgive and help her sons forgive one
another. Instead, she had cut off communication. She worried
about her sons and their children, and she worried about what
God thought of her. Through it all, life began to look futile. She
lost hope and the sense that God could fulfill his purpose in her.

The Holy Spirit worked in the situation, prompting Helen to
ask for prayer. Connie prayed with sensitivity to the concerns
Helen shared with her. It was a move toward wholeness.

To responsibly meet the needs of those in our care, it is important to systematically assess spiritual needs. Most people will not
be as open as Helen.

The most natural approach to assessment is simply to keep the
three spiritual needs in mind as you talk with a person you are visiting. Ask about relationships with church, family, neighbors and God. Follow up on hints that lingering anger or bitterness
may be preventing a person from offering or receiving forgiveness. Listen carefully for references to underlying guilt feelings or
fear of God's wrath. Discuss hopes, dreams and goals, as well as
encouraging reminiscence about meaningful past events and relationships.

The purpose of a spiritual needs assessment is to determine the
nature of a person's relationship to God and other people, and to
give the person the opportunity to accept spiritual support. While
the Holy Spirit or our sanctified intuition may guide us into recognizing spiritual needs in some cases, we can't rely on that. Sometimes a more formal approach to assessment will enable us to
recognize deeper needs that may not be evident in casual conversation.

The first step in assessment is observing the person and the context that surrounds the person. Use your eyes and ears to find
clues about spiritual concerns.

Look around the room. Is the television on? Is it tuned to a worship service or the soaps? Is it just background noise, or does the
person you are visiting have difficulty taking her eyes off of it long
enough to talk? Is a Bible or other religious literature handy?
Does it look as if it has been read much? What other reading
material is lying around?

Notice the pictures displayed. If you see religious art, what
does it seem to convey about God? Does the room seem warm and
inviting or stark, uncomfortable and disheveled? Do you see any
odd objects? For instance, when one pastor visited a church member, he noticed several small pyramids prominently placed near
the woman's favorite chair. When he asked about them, she explained that her son had made them for her and they conveyed
spiritual power. She then invited him to join her in sitting inside a
large pyramid in the basement. As he politely declined, he was
able to turn the conversation to her understanding of God.

Explore the things you observe. Ask about the people and places in
photographs displayed. See if there is a special memory attached
to particular pictures. Ask about specific reading material, favorite
Bible verses, devotional guides. Inquire about the history behind a
unique piece of furniture or decor. For example, asking about an
antique pump organ in Henrietta's living room led her to reminisce about playing that same organ in the church when she was a
teenager. The good memories were clouded by the time she was
reprimanded by an elder for playing popular tunes on the organ
after church. She stayed away from church for many years and
bought the organ at an auction decades later.

Note affect and attitudes. Does the person appear lonely,
depressed, angry, anxious or agitated? If so, is he or she on medications or receiving counseling to help -or might that be contributing to the problem? The side effects of some medications can
cause mood swings or depression; chronic depression can often be
helped considerably by antidepressants. On the other hand, some
depressions can be triggered by unrealistic guilt feelings or fear of
God's punishment. Don't assume that every emotional problem
has a spiritual component, but don't rule it out, either.

Be alert to behavior that might indicate spiritual need. Does the person appear to pray before meals or at other times? Does he or she
read religious literature? Does sleep seem to be a problem? Does
he joke inappropriately? For example, on the night before his
open-heart surgery, Harold began telling jokes about hell and
remarking that he might go there-a loud cry for spiritual help!

Listen carefully. Often people will throw out subtle clues that they want to talk about spiritual things, but they aren't sure how
you will respond. Does she mention God, prayer, faith, church or
religious topics (even briefly)? Does he want a visit from the pastor? Does she express fear of death? I once cared for a postoperative patient in the hospital who kept putting on his call light to ask
for cough syrup. Finally, he said, "I keep coughing and coughing.
Do you think I might die?" I could have merely assured him that
his trachea was just irritated from the breathing tube used during
surgery, but something made me explore further. It turned out
that he was afraid that he had lung cancer (which he did not),
because he thought God was punishing him for being unfaithful to
his wife.

Notice interpersonal relationships. How do family members interact? Who visits? How does the person respond to visitors? Does
the person appear to be a loner? If so, does that seem to be a deliberate choice or the result of poor interpersonal skills? Could the
person be a victim of emotional or physical abuse?

For example, after suffering a mild stroke, Myrtle moved in
with her son and his family. A sweet, quiet woman, she had faithfully attended worship services and a women's Bible study for
years but stopped when she could no longer drive.