When you or someone you love begins hospice care, it comes with a team of amazing humans who provide comfort and support at the end of life. You will usually have a doctor, nurse, social worker, spiritual counselor, home health aid and a volunteer. The one I think that receives the most resistance is the spiritual counselor and it is usually because the patient already has a spiritual practice and doesn’t feel they need more than that, or, they don’t practice any particular faith and might not even believe in it at all. Some might have had a bad experience with a chaplain before, or are afraid they will only talk about Jesus or God, which for them, doesn’t resonate. We respect their wishes and never push anything they are not comfortable with, however I do find myself taking a little extra time explaining that their role is not to impose their faith on you, but to instead be fully present for you while you work through the mysteries of the journey toward the end of life, spiritually or otherwise. I think of them as a spiritual guide, which helps to unravel some of the greatest curiosities that people face as they near death.
I once had a patient who as a child, had been forced to practice a religion that she did not understand. She was forced to say prayers she didn’t believe, and was told most of her young life that if she didn’t follow this particular path, she would go to Hell. As an adult, she chose to walk away from the faith her family clung tightly to and in the process she lost her family. When she was diagnosed and given months or less to live, she accepted the care team, and refused the spiritual counselor, despite the multiple times I tried to sway her to at the very least, accept one visit.
We talked almost daily as she neared her last few days, and one day she asked me, “am I going to Hell”? She proceeded to tell me that her sister had called her earlier that day; they hadn’t talked in years. She told her sister that she was going to die soon and asked her if she would come see her. Her sister told her no, that she was still standing strong with their parents and could not have a relationship with her as long as she continued to betray their faith. She told her that the reason she called was because she knew she was dying and wanted her to know that if she did not find faith now she would never go to Heaven.
It was very hard for me to not react, and to not come from a place of how this affected me personally. The truth is, I was so angry inside I wanted to call her myself and tell her what I thought. I was raised Catholic, my Aunt is a nun and I still know all the words to several of the prayers. But as I aged, I found myself not having a connection to Catholicism, and really unsure of what I believe in, or what I needed in my life spiritually. I went to numerous churches, I spoke to people of many different faiths and I found myself embracing a variety of beliefs and being open and accepting to most of them.
At the time my patient asked me that question, I knew she only had hours to days left, and my answer needed to be one that could bring her comfort and relieve her from the feelings she was having. So I told her my truth; which I know might not be one held by all who read my blog. But I had to be honest, otherwise I think she would have seen through it and that could have added to the struggle she was already having after hearing her sisters words.
I said, “I am not 100% certain there is a Heaven or a Hell, nor am I convinced that dedicating your life to a specific faith, or not, will determine where you go when you die. What I do believe, and what I have seen in my work, is that those who do practice seem to have achieved comfort, and peace with their end. I see families pray, I see rosaries and crosses, and I hear prayers of all denominations and the peace it brings is lovely. I have seen someone who doesn’t practice any faith, who has never prayed, and who might not believe, welcome the prayers of others and find true comfort from that. And I have known patient’s that did not have, or want or need any spiritual support, and yet were completely at peace with where they were in their process and where they might be going after they die. I believe that wherever I go when I die, I will be reunited with people who have passed, it will be beautiful and I will be strong, and healthy and have the ability to somehow look down upon those I left behind and watch over them. I do not believe I will go to Hell because I haven’t made a commitment to anything in particular, and while I know I haven’t always been kind, and I’ve told a lie or six, there is no higher power that would punish me for being human. So my answer is no, I do not think you are going to Hell. I think you are going somewhere beautiful, where you are surrounded by kindness and love”. When I finished, I was afraid I might have said too much, or insinuated my own opinions inappropriately. But instead, she reached out to me and hugged me tightly, taking her time to let me go. I could feel her tears fall on to my shoulders, and could hear her sobs in my ear. She just kept saying “thank you” over and over.
I encouraged her to let me call one of our spiritual counselors to come visit her. I assured her that this person would simply sit with her, listen to her and provide comfort and support in whatever way she needed. It was at this time when I truly started to understand the role of our spiritual counselors and the benefits our patients and families receive from them. Their calming presence and ability to respect all wishes and ways of viewing life creates a safe place to help someone navigate through the questions and concerns they might have relative to the end of life, and what that might mean to each human uniquely.
That evening one of the spiritual counselors sat with her. She told me later that it was one of the most enlightening conversations she has ever had. She felt safe to reveal her own personal fears and even some regrets she didn’t realize she had until she started to talk about them. She admitted that facing her own mortality, and subsequent death was powerful and scary and initially she felt alone and afraid, but after talking to the counselor, she felt the freedom to go in peace and was no longer fearful.
My feeling is this; death is hard on everyone regardless of whether you go to church every Sunday, meditate in the woods, or hike the highest mountains to achieve some semblance of inner peace. My work has given me the privilege of experiencing many different spiritual traditions and I am very thankful for that because it inspires me and opens my mind in a deep and powerful way. I do not think it is our place to inflict our own personal beliefs onto someone who is not open to receiving them. Religion is a personal and sometimes private choice and I think we should respect one another for our differences, even when it might be something we absolutely cannot entertain. And at the end of life, it is not kind to tell someone they will go to Hell if they do not pray or believe in what YOU feel is appropriate. Think about the words you might say to someone, especially in their last hours, and ask yourself, “will this provide comfort?” and if not, remember that sometimes it’s best to say nothing at all.