Spiritual Support and Dying  

When the role of Spiritual Support Coordinator emerged at the hospice where I work I decided to apply for it. This Catholic organisation, wisely and courageously, decided it was time to change the role of chaplain or Pastoral Care Coordinator to Spiritual Support Coordinator. In doing so they opened the position for someone like me who is not a minister. Although I am familiar with religion, I am also passionate about including all spirituality and sentient beings in our care of the dying.

 After 6 years working at the hospice as a psychotherapist it took a little while to make the shift from individual therapeutic sessions to a leadership role within the organisation. My task now is to build the Spiritual Coordinator role into something that can be handed on in a few years time. In a largely medical setting the challenge is to raise awareness of the spiritual dimension of end of life care, to provide education for all staff and volunteers, to assist patients and families, liaise with religious and spiritual communities, facilitate rituals as required and network with those in similar roles throughout New Zealand.

Last week I facilitated a group of staff and volunteers in exploring their own spirituality, finding their deepest self and how it linked to a place on earth. They also completed a dying exercise, which was the most popular experience of the day. I run weekly mindfulness sessions (Process Work style!) for anyone who wants to come. I work with patient's existential distress, dreams and visions. It is great to see how an attitude of deep democracy is slowly emerging amongst the staff and within the organisation as a whole. Deep democracy means valuing all experience even those experiences that are more unknown, dreamlike, even scary, weird, or subtle and sentient. Whatever the person is experiencing is somehow meaningful for their process.

It is quite common for many people near death to become less responsive, going into more remote states of consciousness or coma. While in these states it is more difficult for us to connect with them so we tend to leave them alone to fend for themselves. However Process Work provides us with a range of skills and tools such as, pacing the person's breath, commenting on and unfolding minimal signals like small hand movements, sounds and eye movements. These skills enable me to assist the person to bring awareness to what they are experiencing. They are then able to complete what is trying to happen and often die peacefully. As well as teaching staff I like to pass these skills onto the person's family members so they can stay connected up until death and even beyond.

It is indeed a great privilege to be with patients and families at end of life accompanying them as they move between their inner and outer worlds. I am grateful for Process Work and the skills and tools it gives me to assist people who are facing the completion of this life and prepare for whatever comes next. Despite the emotional impact this work can have I find myself telling people how I have the best job of all!

Kay Ryan

 Kay is a registered Psychotherapist and facilitator/trainer at the Auckland Mercy Hospice.  With over twenty five years experience, she runs regular training seminars on end of life care for hospice and hospital staff, caregivers, health professionals and volunteers, throughout New Zealand.

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