Shepherding in the Shadow of Death

In many ways our local hospital resembles my church. In both, people are in various stages of recovery. And in both, people are in various stages of dying.

I thought about this as I watched a PBS documentary about Mother Theresa’s ministry. Her call to Calcutta and my call to Concord have a common focus. We both work with those who won’t get well. Clergy of all colors and collars have the privilege of shepherding people through the valley of death’s shadow.

Such ministry is awesome–in both senses of the word. It is serious and intimidating business. How do we wield the shepherd’s staff in full view of the grim reaper’s blade? What are the most meaningful things we can do for the dying? How can we sincerely say, “I care”? How can we make our visits more personal? What do we say if we are unsure of a person’s relationship with God?

LITTLE THINGS THAT SAY I CARE

In my first year out of seminary, six people died in the Seattle church I served. A veteran pastor invited me to coffee to share how he ministered to families in grief. As we watched the boats in the harbor and sipped forty-weight French Roast, he encouraged me. Within three months he himself was diagnosed with inoperable cancer. Two months later Jon was dead.

Before he died, I heard him say, “When life is threatened, little things mean more than before.” That stuck with me. Ever since then I have looked for small ways to say to those approaching death, “I care.”

Just this week I stopped to see a man who lives near our church. Doctors told Willie he has less than a year to live. On one of my visits Willie said used to play saxophone with a jazz quintet. I located an album in my tape library of saxophone jazz renditions of contemporary Christian music. I gave it to Willie. I wanted to say I cared.

When one man in our church was dying, I learned he had been raised in Wisconsin. I called a friend involved with the Green Bay Packers and asked if he could send an autographed photo. When I delivered the photo, Arvid was thrilled.

Often I’ll photocopy a graphic torn from a magazine or the yellow pages to create a piece of unique stationary that calls to mind an individual’s hobby or interest. On that customized letterhead I’ll scratch a personal note.

I’ve found that personal notes are one of the most meaningful small ways I can show the dying that I care. Such notes allow me the regular and essential contact with the terminally ill, while also preventing me from causing them undue stress. A felt-tip greeting is less jarring than a ringing telephone. Many lack the strength to hold the receiver.

A handwritten note need not be long, but its shelf life certainly is. People can tuck it in a book or drawer and read it over and over again.

One man I recently buried used to chide me for dropping him thank-you notes when, prior to his illness, he helped around the church. But after cancer unpacked for a two-year stay at his house, however, his response was quite the opposite.

Over the years I have compiled devotional thoughts, lyrics, and prayers from Leslie Brandt’s “Psalms Now,” Dietrich Bonhoeffer, and others. I enclose these in my correspondence, choosing material that will give words to the emotions and voice to the prayers of one who is dying.

MAKING PERSONAL VISITS PERSONAL

Written reminders of our prayer and concern, though important, are not sufficient. A person near death longs for companionship and looks forward to visits from the pastor.

Madeleine L’Engle in her book “The Summer of the Great Grandmother” reflects on her mother’s death. She insists that dying, by definition, must be experienced in community. “Death is not a do-it-yourself activity.”

I attempt to pay a personal call once a week during a terminally ill patient’s plateau period. Others from within the congregation also drop by. As death creeps closer, my visits increase.

For home visits I stay less than a half hour. In the hospital I stay ten minutes or less. More important to the dying than the time we stay is what we do while we’re there.

Physical touch is powerful and sacramental. It is an outward sign that you, as caregiver, are entering into their pain.

Diane had just lost her cancerous leg to amputation, but the malignant cells had spread to her lungs. I held her hand as we prayed together. That point of contact underscored for her that even in pain, together we were touching God with our prayer.

Holding a person’s hand, patting their cheek, or gently placing your hand on their fevered brow conveys much.

When I read Scripture, I have found it means a great deal to read a favorite passage of the sick person. Discovering those treasured portions is as simple as asking. For a Christian aware of approaching death, nothing penetrates the heart like Scripture. I note these favorite Scriptures for use in the person’s funeral service.

Sometimes my visits are musical. Although I am not a great singer, I can carry a tune and like to sing. Having grown up in the church by default I have committed scores of hymn texts to memory. Singing them, I’ve found, can be a means of distilling faith. The ailing appreciate hymns of assurance. At times they sing along. Often they close their eyes in private worship. A familiar tune and cherished words can enlarge the faith housed within a shriveled frame.

Don, a strong Christian who had served his church for more years than I was old, lay motionless near death. I leaned over his bed and softly sang Horatio Spafford’s “It Is Well with My Soul.” A tear drop scurried down Don’s cheek, and he smiled a thank you.

When I pray, along with asking God to minimize physical discomfort and envelop the patient with a tangible sense of his presence, I try to help the person turn their eyes and hopes on the glory that awaits them. Using Revelation 7 as a backdrop, I sometimes invite a person to visualize the throne room of heaven and hear the voices of worship.

In prayer with Ralph, I talked about his future with Christ. I painted verbal pictures of heaven and thanked the Lord that in a brief time Ralph would realize the purpose for which he had been born. Prayer can celebrate the patient’s acceptance of death.

Some shy away from the Lord’s Prayer as a mechanical ritual, but I often incorporate it into my prayers with the dying. Familiar words are especially meaningful near death. I have watched parched, lifeless lips begin to move to the cadence of my voice as I recite, “Our Father who art in heaven … “

A prayer repeated since childhood can engage the mind of someone decreasingly aware of the present.

THE SOUL OF THE VISIT

An essential part of my pastoral care to those who hear death knocking is to prepare them not only for death but for eternity. Many who face death, however, are afraid to acknowledge the topic. When they seem uneasy about discussing such things, we also may feel awkward talking about eternity.

I have found it helpful simply to ask:

“Are you afraid of what’s ahead?”

“How are you feeling about leaving your family?”

Or “Do you feel ready to meet the Lord?”

These opening questions give a dying person opportunity to express their desire for assurance.

I can’t assume a person who attends my church has a strong sense of peace and assurance about life after death. I’ve made it my policy to quote familiar Scriptures of assurance such as Psalm 23, John 14, Romans 8, and 1 Corinthians 15. Such passages indicate God’s companionship is available on the other side of the border. Reading these Scriptures can water their parched faith.

I stood over Leslie’s bed. Cancer had robbed him of his muscular physique. Yet as I stood beside his shriveled body, using familiar promises from the Bible as well as poems to remind him that “Christians don’t just die; they enter into the presence of the Lord,” I saw a smile cross his face.

I will read the same verses when I am not sure where a person stands with God. This enables them to see the benefits to which a believer is entitled. I don’t want to give them false assurance if they have not received Christ as Savior. But asking about their fears and hopes allows me to probe their spiritual status. Such probing requires creativity, sensitivity to the circumstances, a sense of timing, and courage to “just do it.” Every person is different.

I met a man on the golf course whom I later learned was dying. I sent a number of get-well cards. At times I included a devotional article. The last time I saw Jerry before he died I asked if I could pray with him. In my prayer I talked about God’s plan of salvation, admitting my own tendency to not take God seriously enough.

“I think Jerry is just like me,” I added as I thanked God for his love in sending a Savior to the cross and bringing out of the grave to prepare us a place in heaven. I concluded in such a way that Jerry could receive Jesus into his life by agreeing with my prayer. He did.

HOME AND FAMILY

“There’s no place like home,” it is said. That may mean the place we reminisce about where we grew up or the place to which we retreat after a harried day at the office. Many are now finding, when it’s time to die, there is no place like home.

Certain illnesses and circumstances require a patient to be hospitalized until their death. But when they can, more and more are opting to die in familiar, loving surroundings of home.

In many communities, hospice programs offer in-home nursing care for the terminally ill and their families. Besides medications and medical equipment, hospice provides professional workers who can talk about what is happening and what to expect. Many I’ve met are Christians. I view hospice nurses and social workers as members of my pastoral care team.

Many terminally ill people are helped by having not only a place to die but also permission to die. Sometimes the family, especially a spouse, has difficulty adjusting to what lies ahead. That’s when I need to help the family give the dying member permission to die.

Mary knew her husband had only weeks to live. She had accepted it cognitively but had not been able emotionally to embrace her husband’s departure. Whenever I’d stop by the house, she’d greet me cordially and then excuse herself while I visited with Hap. Before leaving I’d stick my head in Mary’s office (where she buried herself in her work) and inquire of her feelings. I always encouraged her to call. She never did.

When hospice nurses increased their visitations, however, I watched as Mary gradually accepted what was happening. When I visited, she stayed in the room with Hap and me. She lingered at the door as I began to leave. We’d chat. She’d express her fear.

At one of our doorside chats I encouraged Mary to give her husband permission to let go. Initially she balked at the suggestion. After fifty-two years together, she couldn’t imagine life without him and couldn’t bring herself to hasten his death. She wanted him to hang on at all costs. But such permission is essential to the healthy passing of the terminally ill. Mary finally recognized the value of this gift and gave her husband permission to wait for her in heaven.

One of the last ways we help someone die is to assure them we will comfort and care for their loved ones after they are gone. We can express some of the love they no longer can.

Dr. David Gardner shocked his colleagues several years ago when he resigned his position as president of the University of California. Citing the inexpressible and crippling sorrow that accompanied his wife’s death nine months earlier, Gardner confessed to being unable to perform the tasks his job required. Gardner was praised for his candor. Psychologists validated his reasons. He is not alone.

I have a friend who is a funeral director. Scott routinely concludes his remarks at the committal service with a challenge to friends and extended family of the grieving. He invites them to remember the spouse and family members with a call, a card, or a visit a month down the road, at six month intervals, and especially on the anniversary of the loved one’s death. Pastors can coach their congregations in the same manner.

MAKING THEIR LAST WORDS COUNT

The phone rang in my study. “I think we should do it soon,” Bill said. I knew what my middle-aged friend was signaling. His inner clock said it was time to plan his funeral. We did it the next day. Within two weeks Bill was dead. At his funeral the words and music he chose to celebrate the resurrection was a powerful witness of his faith to his family and colleagues.

Most people don’t plan ahead as Bill did. When their doctor tells them to put things in order, they don’t think that includes outlining their final visit to church. It is up to me to encourage the dying to think of such things. Once the person accepts his or her condition, most are receptive to the idea. Planning their own funeral gives the dying a sense of purpose in an otherwise purposeless period of life.

I ask them to choose whom they would like to participate. I encourage them to think of musical selections, Scriptures or readings, hymns or praise songs for the choir or congregation–even sermon themes. When Hap planned his service with me, he gave me a message he wanted his fellow employees to hear. Because he was willing to anticipate the inevitable, his coworkers heard their friend’s values and final good-byes with unmistakable clarity. Though dead, he still spoke.

The Sunday after Bill asked me to help plan his funeral, I mentioned it in church. I wanted to model for the congregation what it means to trust God.

“Bill and I talked about heaven this week,” I said from the pulpit. “And it appears he will be moving there soon.” I was verbalizing as much faith as if I had asked God to heal his worn-out heart.

When Hap was dying, I referred to him in the pastoral prayer on Sunday and said, “Please come quickly for our friend, Happy. He’s ready to meet you, Father.”

Our people need to know that in God’s health care plan, healing doesn’t always mean getting better. Sometimes it means resurrection.

I reached my friend Eugene less than half an hour after he died. I gripped his fragile, still-warm hand beneath the sheet. Tears crawled down my face as I realized that his hand, with that familiar half-severed thumb, would not grip back this time.

I kissed him on the forehead and thanked the Lord for his life. Eugene had not only taught me how to serve God and his church, he had taught me how to serve a tennis ball. He showed me how to live. He taught me how to die. He taught me how to escort others to the edge of eternity.

I left his bedroom and headed for the den to comfort the members of his family. As I walked down the hallway, I felt a warmth of contentment surge through me. Despite the sorrow, I had no regrets. For the past six months I had invested my gifts and concern in Eugene’s life.

Helping a person die with grace is one of ministry’s most significant privileges.

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Greg Asimakoupoulos is pastor of Crossroads Covenant Church in Concord, California.