Listening to People with Dementia: A Pastoral Care Perspective

SUMMARY

Pastoral and Spiritual Care approaches to the reduction of depression in residential aged care facilities are considered. They are examined through specific one-to-one pastoral care, through a pastoral care person in the team approach to care and through a one-to-many relationship for group spiritual and religious activities. The suggestions in this article are offered as extensions to a manual, Challenge Depression, on managing depression in residential aged care as a way of including pastoral and spiritual care as part of an integrated approach and as part of a stand alone approach of pastoral care.     

Non-Speech Based Pastoral Care: A Pastoral Care Program for Aged Care Residents with Little or No Ability to Speak

SUMMARY

Pastoral care depends on the ability to communicate, most commonly through the medium of speech. The aged person who has suffered illness or accident that has adversely affected their speech, is in great need of pastoral care. Yet chaplains and pastoral carers can feel helpless in the face of such a significant deficit and may not know what to do. At Tregenza Avenue Aged Care Service, the Chaplaincy service has developed helpful individual programs for non-speech based pastoral care. Using visual and tactile symbols, pictures, touch, and music, we have been able to minister to people with a variety of speech problems, with promising results.     

Mental Health and Spirituality in Later Life: Pastoral Approaches

SUMMARY

This chapter proposes a perspective on providing pastoral care for people at risk of, or who have mental health problems in later life. Two major areas of mental health, depression and dementia are explored, examining their impact on older people and strategies to identify risk in depression, and signs indicating need for pastoral intervention in depression and/or dementia. The work from two studies that examine issues for meaning of people, the first for older people living independently and the second in residential care, form the basis of the material presented in this chapter. It is maintained that pastoral interventions may greatly improve quality of life for these people, their families and carers.¹     

A Survey Report of Nursing Home Ministry and Perceived Needs with Implications for Pastoral Care

ABSTRACT

The last 40 years of growth in the development of pastoral care to the sick appears to have virtually bypassed persons in nursing homes. A study within 13 nursing homes in one city revealed that spiritual ministry within those institutions was generally limited to a series of 9 to 13 worship services per month, attended by approximately 20 percent of the patients/residents. Some patients receive an occasional personal visit by a pastor. The staff perceive that pastoral ministry as good, but inadequate, and expressed their views on that which is needed within their institutions and challenge the clergy with specific suggestions for pastoral care for nursing home patients/residents, their families, and staff.     

Representing the Good: Pastoral Care in a Secular Age

In ‘a secular age’ (Taylor 2007), pastoral care is no longer exclusively associated with specific religious traditions and communities. Pastoral caregivers who work in secular institutions provide care to religious and nonreligious people alike, and in several Western societies the term pastoral care is used in relation to nonreligious (humanist) care. In secular contexts, the term ‘pastoral care’ is often replaced by the term ‘spiritual care.’ Spiritual care, however, is provided by various professionals, so pastoral caregivers face the challenge of developing adequate and convincing language to explain what is distinctive about their work. In this article, the authors turn to philosophical language in order to develop a conceptual understanding of pastoral care that does not depend on the specific worldview—religious or nonreligious—of either pastoral caregivers or receivers of pastoral care. Using the work of Taylor (1989, 2007) and Murdoch (1970), we explain pastoral care as engaging with people’s attempts to orient in ‘moral space’ and the distinctive quality of pastoral care as ‘representing the Good.’ Murdoch associates ‘the Good’ with a secular idea of transcendence that is both a movement beyond the ego and an engagement with the reality of human vulnerability, suffering, and evil. We argue that pastoral caregivers who ‘represent the Good’ have the task not only of supporting the existential and spiritual processes of individuals but also of promoting dialogue and social justice and of critiquing dehumanizing practices in the organizations in which they work and in society at large.     

TOWARDS THE POSSIBILITY OF IMPASSIBILIST PASTORAL CARE

Not a few scholars reject the notion of divine impassibility. Contemporary theodicists in particular often see impassibility as impotent in the face of evil and suffering. At best, it is assumed that impassibility has no contribution to make to pastoral practice. At worst, it is argued that impassibility has negative repercussions for sufferers and carers. The purpose of this article will be to argue that impassibility has the potential to positively impact pastoral practice. It will be proposed that a constructive ‘impassibilist pastoral care’ arises from a well defined understanding of impassibility and an awareness of the weaknesses of passibility. Consequently, five principles of pastoral care will be identified. Relationality engenders practice which is mutual. Particularity resists the tendency in much care towards ‘normalisation’. Equivalence challenges the passibilist by submitting that the incarnation provides an ontologically equivalent divine suffering which stands in contrast to the so‐called ‘suffering of God’ thesis. Arationality affirms that human reason is limited and therefore prevents the carer from over rationalising suffering. Otherness arises from the belief that God is ontologically distinct and therefore he alone is the source of salvation. In light of these principles, the proposed understanding of ‘impassibilist pastoral care’ is brought into dialogue with the questions sufferers ask and a positive and effective definition of impassibility is submitted. In sum, this article seeks to bring together philosophical and theological defences of impassibility in order to submit a fresh approach to the care of those who suffer.     

A Christian for the Christians, a Muslim for the Muslims? Reflections on a Protestant View of Pastoral Care for all Religions

Whereas in the first half of the 20th century, proclamationwas the focal point of pastoral care in Germany, the 1970s witnessedan embracing of the American pastoral care movement. From thenon, pastoral care was increasingly understood as accompanyingpatients whilst adopting the spiritual dimension. Nowadays,Christian chaplains are encountering an increasing number ofpatients from different religious communities. Various modelshave been proposed to help Protestant chaplains find an authenticform of pastoral care suitable for all religions. Until a clearposition is assumed with regard to Christianity's demands ofabsolutism, however, none of these approaches can be satisfactory.     

Disembodied Souls or Soul-Less Bodies: Spirituality as Fragmentation

SUMMARY

‘Soul’ and ‘body’ are two linguistic expressions of one and the same reality, the human being. In pastoral care, aged care, and palliative care the stated aim is always to care for the whole person. An increasing focus on ‘spirituality’ has also led to objectifying and measuring what is ultimately beyond calculation. To care for each person as an ‘ensouled body’ and ‘embodied soul’ is to acknowledge we are in the service of one another. In entering one another's stories, words like impose, define, and manage are replaced by trust, love, and faithfulness. Measurable outcomes are then replaced by risk, ambiguity, and mystery: the heart and soul and body of human care.     

Chapter Five: Aging in Rapidly Changing Chinese Societies: A Summary and Interpretation of Our Study

ABSTRACT

Older adults at a church-related continuing care retirement community perceived themselves as being more spiritual in their later years and having a stronger emotional connection to their spirituality than when they were younger. Respondents were currently stable in their religious practice and spirituality, suggesting that changes occurred prior to the recent past, possibly around the time of retirement. This may uphold the notion that increased spirituality in the later years is a natural developmental phenomenon of the aging process. The association between religious coping and perceived health was noted, suggesting that religious coping may buffer perceived health from the negative impact of medical problems. The contribution to spirituality by physical environment and pastoral care was also noted.     

Managed Care and Pastoral Counseling: An Opportunity for Spiritual Growth

Managed care has forced changes on pastoral care. Among these changes are increased demand for and volume of clients. An appropriate response to this demand is for pastoral counselors to adopt a more short-term oriented treatment approach. While this approach has historically been at odds with the pastoral counseling movement, the authors argue that a combination of the therapies of Albert Adler and Albert Ellis provides a framework for addressing the needs of clients. Social Work at the     

A Safe Space for Healing: Boundaries,Power and Vulnerability in Pastoral Care

Abstract

This article is a theological reflection on issues of power and vulnerability in relation to pastoral boundaries. It starts with a reflection on my experience in training ordinands and pastoral carers, and an awareness that mandatory training in safeguarding often seems to focus on regulations and procedures, rather than power dynamics and self-awareness. The article goes on to summarize recent literature relating to pastoral boundaries, before exploring the underlying concepts of power and vulnerability, using theologians such as Moltmann and Bonhoeffer on the vulnerability of God, and the feminist writings of Carter Heyward and Mary Grey on mutuality. It concludes by arguing that boundaries provide a safe space for the delicate balancing of vulnerability, risk and power in the pastoral relationship.     

From the word to the conversation: Paradigms and psychology in German protestant pastoral thought

Under steady pressure from ordinary pastoral practice German Protestantism gradually made proclamatory pastoral care more responsive to human need and more adequate to human complexity. In doing so it drew heavily from psychology, but the very refinements helped obscure its original intent. For that and other reasons it came into crisis and was replaced by therapeutic pastoral care, which now dominates German pastoral thought and practice. Each of these paradigms of pastoral work reflected in its own way on the theological aspects of pastoral care, producing quite different theologies of pastoral care and employing psychology in that process in quite different ways.Dr. Burck is Assistant Professor of Religion and Health and Chaplain-Supervisor at Rush-Presbyterian-St. Luke's Medical Center, 1753 W. Congress Parkway, Chicago, Illinois 60612. This article is a sequal to his The New Pastoral Care in Germany, published in the Summer, 1978 issue ofPastoral Psychology.     

Listening for Safe Places: Networks of Playing and Chalcedon in Disaster Pastoral Care

Disaster pastoral care operates in diverse contexts, which may challenge clergy responders in ecclesiological meaning‐making of their practices of care. This article argues that pastoral care may be imagined as part of a larger “network” of caring acts understood as a collective, multiple care practice. Such practice reflects deep‐rooted movements described in psychoanalytical theory as playing, and the christological idea of communication of properties. Therein, spiritual “safe places” can be seen to emerge, even in the midst of traumatic events.     

The Subject of Pastoral Care: A Discussion Based on the Theology of Henning Luther

In this article the author discusses the differences between pastoral care and psycho-social therapy. She clarifies the specific identity of pastoral care on the basis of Henning Luther’s theology. He distinguishes different anthropological presuppositions in pastoral care and psycho-social therapy. Consequently, she demonstrates the relevancy of Luther’s theology for today’s Practical Theology.

Learning to Be a Professional: Two Models of Competence and Related Learning Strategies

SUMMARY

Occupations required by the health industry, specifically in aged and palliative care, include nursing, pastoral care, medicine, and social work amongst many others. Professional education for these health disciplines incorporates competence for practice and critical thinking skills. Two different conceptual models of competence, personal and operational, reveal different approaches to learning. Personal competence, currently dominant in the higher eduction (tertiary) sector, privileges theory over practice. Personal competence can exclude non-propositional forms of knowledge, making it difficult for students to explain their practice experiences. The operational model of competence, which is emerging in professional education, has the potential to develop critical approaches to learning and practice, skills required for practice development and quality improvement in today's health environment.     

Intergenerational Relationships Within the Local Congregation

ABSTRACT

The following article explores the effect of the quality of intergenerational relationships on the health, healing and wholeness of the congregation. The fundamental premise is that an intergenerational approach to congregational life is a conscious, intentional choice on the part of the leadership and membership of that congregation to honor both the contributions and the requirements of each and every generation for the good of that generation as well as the good of the whole community. A casestudy is presented to demonstrate this approach. A reflection on the casestudy focuses on three dimensions of this approach to building up intergenerational relationships, i.e., the revelation of 1 Corinthians 12, the approach of family systems theory, and the paradigm of pastoral care.     

Told in Memory of God’s People: Beloved

The purpose of this article is to show how Toni Morrison’s novel, Beloved, can be used in pastoral care and counseling courses to encourage the development of empathy and to illustrate themes in the communal contextual and intercultural paradigms emerging in the field of pastoral theology.     

The Social Construction of Emotions: A New Direction in the Pastoral Work of Healing

Interviews with pastoral practitioners revealed that exploration of feelings, both personal and interpersonal, is considered the sine qua non of pastoral care and counseling. This emphasis on personal and interpersonal feelings is largely attributable to the enduring influence of Carl Rogers on contemporary pastoral care and counseling. While recognizing that Rogers was not as narrowly focused on personal and interpersonal relationships and oblivious to the larger social order than is generally assumed, I contend that he did not give sufficient attention to the fact that emotions are socially constructed and draw on recent literature on the social construction of emotions and on critical race theory to argue for a new direction in the pastoral work of healing, one that takes more adequate account of the sociocultural factors that create and sustain unhealthy emotions and that recognizes that emotions are signals about the social order.     

Phenomenology and pastoral care

The author discusses phenomenology as a potential resource for pastoral care generally and then illustrates its implications in two specific areas of pastoral care. After a brief discussion of the development of phenomenology, he defines pastoral care and identifies its methodological problem. Phenomenology, it is argued, offers potentially helpful methods and interpretative categories in its attitude, its attempts at self-aware, ordered discernment, and its anthropology. It serves to militate against the temptation in pastoral care to understand human problems in terms of individual and social pathology, in the case of individuals, and to illumine the ways the community functions as a dimension of pastoral care.He is the author ofEcclesial Man.     

For Now We See Through In Vitro Darkly; But Then Face to Face: An Alternative Theological Perspective on In Vitro Fertilization

Abstract

This article uses the techniques of discourse analysis to highlight the ways in which official Church documents on IVF have eclipsed from view the desires, dilemmas and pastoral needs of women seeking treatment for infertility. Furthermore, this analysis reveals how an overriding concern for the embryo has also curtailed debate upon the wider social context in which the procedures of the biomedical community are located. It is argued that the insights generated through feminist debates concerning an ‘ethics of care’ can effectively challenge the androcentric ‘rights’ perspectives enshrined in the moral teaching of the churches. The attention to context generated within this feminist ethical framework would provide a more effective means of challenging the commercial activities of the biotechnology industry than is currently employed.