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Supporting Spiritual Needs During End of Life Care

Hospice chaplains provide comfort and peace by authentically meeting individuals where they are during that challenging and most sacred time.

Hospice is a model of care — a program where palliative care (expert management of symptoms and suffering) is intensified as individuals move closer to death. Hospice is a type of palliative care for people who likely have six months or less to live. In other words, hospice care is always palliative care, but not all palliative care is hospice care. 

Pre-modernity and early modernity explicitly utilized spirituality in the practice of medicine because spirituality was one of their primary ways of manipulating and understanding the situation. With the onset of science, reason, and technology, medicine evolved from care-orientated concern to a functionally curative orientation. Attending to the whole person in mind, body, and spirit is the goal of healthcare, and chaplains are at the forefront of the type of compassionate care that is required.

Hospice involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes as well as care for the family. A member of the hospice team visits regularly, and someone is always available 24/7. 

The beauty of hospice care spiritual care delivery is that it is fluid enough and substantial enough to change and evolve with the times. Fundamentally, it is about meeting the needs of those who are seriously ill or terminally ill. Effective support of patients, families, and staff involves cultural humility and sensitivity, and the ability of the interprofessional team to incorporate awareness of different points of view. Therefore, chaplaincy in hospice care involves the intentional implementation of interventions that are designed to provide comfort and peace by authentically meeting individuals where they are during that challenging and most sacred time.

Those who work in hospice chaplaincy should be specially trained to work in the clinical setting, caring for the spiritual needs of terminally ill patients.  Now, it is important to understand that the titles “spiritual counselor” and “chaplain” are not the same. In fact, a chaplain that is properly trained will have a myriad of skills that are inclusive of spiritual counseling. Therefore, to equate a professional board-certified chaplain to a spiritual counselor diminishes this important role.

Hospice chaplains should possess the same training and skills as any other chaplain and complete the board certification process to demonstrate their competency. In addition, hospice chaplains should complete additional training specific to the skills needed to provide, document, and communicate end-of-life care for the patient and their families; working within a specialized team; and bereavement support and services.

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