HOLISTIC APPROACH TO MINISTRY

RESOURCES FOR CONNECTING PARISH TO LONG-TERM CARE


15,000 ISLANDS OFF THE ATLANTIC COAST

“Consider the hypothetical scenario of Americans discovering over 15,000 islands off the Atlantic Coast with inhabitants that tallied up past 1.4 million indigenous people. What would be the response of the Church in America?  It is conceivable that the level of evangelistic fervor for the heart and soul of each island would lead to one of the greatest revivals in American history.

For all intents and purposes, those who live in nursing homes live on islands. There are currently 1.4 million people living in American nursing homes.  The CDC has found that these people are living in these facilities because they can no longer take care of themselves.  With this reality most are incapable of leaving the facility, so their only interaction with the world outside of the home is the television and the employees of the facility who come in like ferries from the mainland.” (Bradley Winsler, 2016)


Parish Life: Conversation Between Generations


We must raise our sights beyond reaching those who cannot reach the Church (with ourselves as missionaries to the islands).  Residents have much to offer the Church (on the mainland) and there is great value inherent in the conversation between the elderly and the young.  The future of nursing home ministry is not so much in the image of the Good Samaritan helping the helpless as much as it is in the sustained embrace of the living and those who are near death.  For if the elderly and infirm must always be the beaten man on the side of the road, when do they get to be the Good Samaritan?

Ultimately, residents are people who have experienced the trauma of diminished free will and independence.  But in the final analysis, they are residents in neighborhoods trying to lead their vision of a good life. Understanding the facilities as geographical boundaries—neighborhoods, islands, planets—is critical in formulating a strategy for the future of your nursing home ministry effort.

In the modern American city, a church-planter can count on attracting a specific type of believer according to the tradition and ministry philosophy he espouses.  Churchgoers shop around and are often willing to drive over an hour to attend a church they like.  In sharp contrast, if a church adopts a nursing home, typically they are the only church to do so in that facility.  It will not do for the ministers to open the doors only to like minded residents. In most cases, the minister (lay or clergy) in the facility, no matter his personal tradition, is the minister to all.  In this peculiar situation, the minister must adopt the parish model of the ancient church.  A parish was not a collection of members but a geographical boundary. In this view of nursing home ministry, the facility is a geographical boundary, all inside are to be loved by the Church.

With this philosophy in view, one must consider what a nursing home needs by considering what a parish needs.  A parish would not be considered healthy if it only offered sporadic visits from a pastoral figure.  Neither would a parish be considered healthy if it only held services once a week.  Churches and parishes are healthiest when they offer the full array of pastoral care for the parishioners.  The ministry philosophy underpinning the two basic strategies we suggest as pathways toward parish is a view that the nursing home is a neighborhood—a forgotten neighborhood—that needs Christ and can offer Christ back to those who reach its residents. (Bradley Winsler, 2016, adapted from his MA Thesis, found in resource section of this webpage)

Parish Life Components

A recent study found that 100% of the participants felt personal relationships are the most important component of parish life!  This makes sense.  God made us for relationships — with Him and with each other.  In a nursing home relationship, belonging and meaning are the same thing.

In a small deviation from people outside the nursing home context, a recent study found that 86% of residents (compared to 57% of people from outside nursing homes) felt having a pastor is a high priority component of parish life.  At heaven’s very door, this matches our experience.

This is different than having rotating clergy, which another study found to be helpful, nevertheless.  Residents apparently desire to see clergy.

Numerous studies found that any visitor is far, far better than none.

71% of residents, according to a recent study, indicated that prayer is a very important or important part of parish life.  Another study found that 100% of dementia patients report that they pray.  Another found that 100% of residents that pray do so for loved ones, most especially for their children.  Corporate prayer is similarly important because of the special presence of Jesus when two or three gather together in His name.

86% of the participants in one study identified church services and/or the sacraments as highest or high priority parish life components.  Another study found that 54 out 0f 56 evangelical protestant Christians living in nursing homes and who were interviewed who did not receive Communion weekly were afraid of dying.  This means only two were not!  In contrast, 54 out of 56 other Christians who received Communion each week were not afraid of dying.  This means the vast majority of people who live in nursing homes who receive Communion were found to be unafraid of dying.  Our experience is similar to the study results.

Many nursing home ministries can be started by offering a special event.  One can call the Activities Director and offer to sing Christmas carols room to room, for example.  If your church or small group has a children’s pageant, consider a nursing home as a perfect venue!

Mission, evangelism, and outreach happen, as the church that the Holy Spirit gathers and matures inside a particular nursing home lives life together…with the missing generations and resources injected by the Church outside.

Holistic ministry may be even more critical than ever, for becoming “part of the facility” as one Activities Director noted our ministry has become in one facility, may very well be necessary to operate freely in private, for-profit nursing home.  Both of these issues — the matter of being an asset to a profit-driven organization so as to be welcome and caring for and establishing mission-minded local churches — are intertwined.  A holistic approach to ministry was found by several researchers in multiple studies to be the best way to address them both in their entangled state.  This would mean that even the parish life components that are not the highest priorities may still have critical functions in the life of the parish.


TWO BASIC STRATEGIES FOR ADOPTING A NURSING HOME

WORSHIP TO RELATIONSHIP

This strategy begins with offering a worship service with a goal of pleasing God, of course, and of meeting residents and getting to know them, and becoming part of the fabric of the facility’s life.  It is a long-term strategy that uses the most resources.  It can be used as an extension of what is already in place in some nursing homes to extend a single weekly service or once monthly service into a greater effort to know people.  There are resources later on this page that are available to you to use.  Also, contact us for help which we are glad to give.  Seriously, we want to help you!

RELATIONSHIP TO WORSHIP STRATEGY

This begins with a visit.  One visit.  The first visit.  Think about each visit as putting a drop of milk in a glass.  Eventually the glass will be full of refreshing milk to drink.  A full glass of milk, with all those relationships can be a wonderful place for worship to take place.  The analogy might be like bringing a wonderful cookie, a chocolate chip cookie, and dipping it in the glass of wonderful relationships and the whole thing becomes, over time, little by little, almost without being noticeable, truly spectacular but simple.  It started with God calling you to visit once.

VIDEO RESOURCES

SELECTED RESOURCES AND LINKS

WORSHIP TO RELATIONSHIP STRATEGY AID: SUGGESTED LITURGY

This is the liturgy used in three facilities.  It is designed over 25 years of trial and error.  We are producing a video explaining how to use it, but in the mean time, please feel free to download it and use it.  Also feel free to contact us and we can explain the reasoning behind the choices we made.  There are two parts:

The Liturgy (Morning Prayer and Communion of the Sick): http://goo.gl/qJRBo0

The Hymnal (information about obtaining proper licenses can be found included):  http://goo.gl/Aklza2

ACADEMIC THESIS: PHILOSOPHY OF MINISTRY
(by BRADLEY WINSLER, 2016)

This is a valuable work by one of our key leaders, Bradley Winsler.  It is fast reading and lays out the two-strategy viewpoint, the parish model approach, and other aspects of holistic nursing home ministry.

Forgotten Neighborhoods:  Developing Parishes and Parish Life in America’s Nursing Homes by Bradley J. Winsler, 2016:  https://goo.gl/2Z5vGl


Nursing Home Ministry: A Manual by Tom McCormick, 2015

This is a good resource to help you learn the basics about visiting people in nursing homes.  It is what we use within our organization.  It is made available by the generosity of Tom McCormick.  You can reach him directly by email at twmc@idirect.com

Nursing Home Ministry:  A Manual by Tom McCormick, 2015:

From Amazon.com (we highly recommend having a copy): https://goo.gl/r96TVW

Faithful Friends has Tom McCormick’s Manual (2015) neatly organized on their website for easy reading at http://faithfulfriends.org/manual.html

Also, you can get a PDF of the whole book, made available, solely by the generosity of Tom McCormick, only for training and ministry use at https://goo.gl/HH4zf9


Leaders Packet: A Resource for Leading the Beginning of a Nursing Home Ministry

This is a resource that can be helpful for beginning a ministry in a nursing home environment.  It was originally a paper written as part of an independent study in a master’s degree program.  Feel free to use it for ministry purposes: http://goo.gl/WWkncc



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Theological Reflection and Recent Study

This is a study of a nontraditional parish located in nursing home.  It was conducted to discover what various constituents consider to be the most important parish life components.

Chapter Three contains a Theological Reflection (beginning on page 34).

We direct you to Chapter Three in case you are only interested in this part.  We would direct you to Chapter Six (Recommendations) for the model we suggest.  This chapter begins on page 90.

Here is the study: http://goo.gl/FPsPuI

Value of a Memorandum of Understanding in a Relationship with Nursing Home Management

Trust.  Five letters that spell disaster if they are not present.  Building trust between a church ministry and a nursing home’s management who cares for residents and their well-being and, frankly, don’t know you from Adam at the beginning, is essential for the success of ministry in long-term care facilities.  

We suggest meeting with the Activities Director and writing down what you promise to do, when you will do it, and what you will do if, for example, you are going to be late, or if extenuating circumstances are going to cause you to have to be absent.  

It happens.  Perhaps you might get a bad cold.  You do not want to be like Typhoid Mary and bring in a disease that harms residents!  Never, ever, bring in a communicable disease!  Never.  

A Memorandum of Understanding (MOU) can spell out what the nursing home staff can expect you to do — probably call to let them know you are sick — if you cannot visit.  This enables staff to plan their day.  It takes the staff a great deal of time and effort to prepare for most visits and you need to be aware of this.  You are a blessing, yes.  But you are also a lot of work.  Show love and courtesy (which is stylized love).  

Also, a MOU can have a time period for evaluation by both parties to see if your relationship is working.  For example, if you say, “Christian Church of Springfield will visit every Wednesday from 1:30 pm until 3:00 pm.  After six months we will jointly review this to see how we can improve and if this program is working,” you give the Activities Director the peace of mind to know that he or she is not committing up front to a marriage of 25 years.  

Please do not be afraid to contact us for advice and suggestions if you are an Activities Director or a Volunteer.  An easy way is to fill out the contact form found immediately below:

 






10 Tips to Help You Communicate with a Person who has Dementia

  • Approach the person from the front. If they are seated go down to that level.
  • Identify yourself. Tell them your name and offer to help.
  • Maintain eye cocntact. It will help them focus on what you are saying.
  • Address the person by name. Speak clearly and slowly.
  • Present one idea at a time. It will help them understand.
  • Repeat or rephrase the person’s responses. This can help clarify what they are trying to tell you.
  • Ask ‘yes’ or ‘no’ questions. Allow time for a response.
  • Use gestures. They can help back up your words.
  • Listen actively. Acknowledge their emotional state.
  • Let the person know if you are going to touch them. It prevents startling them.

According to the Census Bureau, 42% of people in nursing homes suffer for dementia, making these tips relevant. (Adapted from Societe Alzheimer of Canada, http://rethinkdementia.ca)


Other Suggested Beginner, Intermediate, and Advanced Reading

Foundational/Beginner

Goodrich, B., & McCormick, T.  (2009).  Nursing home ministry:  Where hidden treasures are found (3rd ed.).  Avon Lake, OH:  God Cares Ministry.

Hunter, G. (2000).  The Celtic way of evangelism:  How Christianity can reach the West…again. Nashville, TN: Abingdon Press.

Landes, S. D., & Ardelt, M. (2011).  The relationship between spirituality and death fear in aging adults.  Counselling and Spirituality, 30(2), 87-111.

McCormick, T.  (2015).  Nursing home ministry (3rd ed.).  Lexington, KY:  Thomas W. McCormick.

Pohl, C. (1999). Making room: Recovering hospitality as a Christian tradition [Kindle version]. Retrieved from Amazon.com

Vincent, G. K., & Velkoff, V. A. (2010, May). The next four decades: The older population in the United States: 2010 to 2050 (U.S. Census Bureau, Administration on Aging). Washington, D.C.: U.S. Dept. of Commerce, Economics and Statistics Administration, U.S. Census Bureau. Retrieved May 19, 2016, from http://www.aoa.gov/Aging_Statistics/future_growth/DOCS/p25-1138.pdf

 

Faunce, F. A. (1969).  The nursing home visitor:  A handbook written from the inside.  Nashville, TN:  Abingdon Press.

Friedman, D. A. (1995).  Spiritual challenges in nursing home life.  In Kimble, M. A., McFadden, S. H., Ellor, J. W., & Seeber, J. J. (Eds.), Aging, spirituality, and religion:  A handbook (pp. 362-373).  Minneapolis, MN:  Fortress Press.

Hallahan, L. (2008).  Things:  Exploring disability and spirituality.  In MacKinlay, E. (Ed.), Ageing, disability and spirituality:  Addressing the challenge of disability in later life [Kindle version].  (pp.  95-105).  Retrieved from Amazon.com

Hammond, G.  (2011).  The holistic care of older people in nursing homes.  In Jewell, A. (Ed.), Spirituality and personhood in dementia [Kindle version] (pp. 111-120).  Retrieved from Amazon.com

MacKinlay, E.  (2001).  Spiritual dimension of ageing.  London, GB:  Jessica Kingsley Publishers.

Trevitt, C., & MacKinlay, E.  (2009).  ‘Just because I can’t remember…’ Religiousness in older people with dementia. Journal of Religious Gerontology, 16(3/4), 109-121.

 

 

Advanced:

Buschart, W. (2006).  Exploring protestant traditions:  An invitation to theological hospitality.  Downers Grove, IL:  Intervarsity Press.

Center for Disease Control and Prevention (CDC).  (2013).  State of aging and health in America.  Retrieved June 3, 2016, from http://www.cdc.gov/features/agingandhealth/state_of_aging_and_health_in_america_2013.pdf

Cohn, D., & Taylor, P. (2010, December 10).  Baby boomers approach 65 — glumly.  Retrieved June 11, 2016 from http://www.pewsocialtrends.org/2010/12/20/baby-boomers-approach-65-glumly/

Dalby, P.  (2011).  To live and do and help – A life that’s worthwhile:  Reflections on the spiritual meaning of generosity for people living with dementia.  In Jewell, A. (Ed.), Spirituality and personhood in dementia [Kindle version] (pp. 64-74).  Retrieved from Amazon.com

Delgado, C.  (2015).  Nurses’ spiritual care practices:  Becoming less.  Journal of Christian Nursing, 32(2), 116-122.

Dougherty, K., Whitehead, A.  (2011, Spring).  A place to belong:  Small group involvement in religious congregations.  Sociology of Religion, 72(1), 91-111.

Hunter, S., & Levett-Jones, T. (2010, February).  The practice of nurses working with older people in long term care:  An Australian perspective.  Journal of Clinical Nursing, 19(3-4), 527-536.

Justice, W. C.  (1991).  A survey report on nursing home ministry and perceived needs with implications for pastoral care.  Journal of Religious Gerontology, 8(2), 101-111.

Killick, J. (2011).  Becoming a friend of time:  A consideration of how we may approach persons with dementia through spiritual sharing in the moment.  In Jewell, A. (Ed.), Spirituality and personhood in dementia [Kindle version] (pp. 52-63).  Retrieved from Amazon.com

Lai, C. K, Leung, D. D., Kwong, E. W., & Lee, R. L.  (2015).  Factors associated with the quality of life of nursing home residents in Hong Kong.  International Nursing Review, 62, 120–129.

Larkin, M. (2015).  Choosing your approach.  In Smith, J. (Ed.), Qualitative psychology: A

practical guide to research methods. (3rd ed.). (pp. 249-256).  London, GB:  Sage Publishers.

Liu, Y. (2012).  Long term care residents’ views about the contributions of Christian-based volunteers in Taiwan: A pilot study.  Journal of Religion and Health, 51(3), 709-722.

MacKinlay, E.  (2002a).  Listening to people with dementia:  A pastoral care perspective.  Journal of Religious Gerontology, 13(3/4), 91-106.

MacKinlay, E.  (2002b).  Mental health and spirituality in later life:  Pastoral approaches.  Journal of Religious Gerontology, 13(3/4), 129-147.

MacKinlay, E. (2008a).  Introduction:  Ageing, disability and spirituality.  In MacKinlay, E. (Ed.), Ageing, disability and spirituality:  Addressing the challenge of disability in later life [Kindle version].  (pp. 11-21).  Retrieved from Amazon.com

MacKinlay, E. (2008b).  New and old challenges of ageing:  Disabilities, spirituality and pastoral responses.  In MacKinlay, E. (Ed.), Ageing, disability and spirituality:  Addressing the challenge of disability in later life [Kindle version].  (pp. 44-56).  Retrieved from Amazon.com

MacKinlay, E.  (2011).  Walking with a person into dementia:  Creating care together.  In Jewell, A. (Ed.), Spirituality and personhood in dementia [Kindle version] (pp. 42-51).  Retrieved from Amazon.com

MacKinlay, E. (2012).  Pallative care, ageing and spirituality [Kindle version].  Retrieved from Amazon.com

MacKinlay, E., & Trevitt, C. (2012).  Finding meaning in the experience of dementia:  The place of spiritual reminiscence work [Kindle version].  Retrieved from Amazon.com

Shamy, E. (2013).  A guide to the spiritual dimension of care for people with Alzheimer’s Disease and related dementia:  More than body, brain, and breath.  London, GB:  Jessica Kingsley Publishers.

Uhlman, J., & Steinke, P. D. (1985, March).  Pastoral care for the institutionalized elderly:  Determining and responding to their need.  The Journal of Pastoral Care, 34(1), 22-30.

U.S. Census Bureau.  (2015). Table 3. Projections of the population by sex and selected age groups for the United States: 2015 to 2060.  National population projections: Summary tables.  Retrieved May 20, 2016, from http://www.census.gov/population/projections/data/national/2014/summarytables.html

Vallee, S.  (2007, Fall).  The complexities of Eucharistic sharing in homes for the aged:  A study in pastoral ecumenism.  Journal of Ecumenical Studies, 42(4), 619-635.

Wallace, D. (2011).  Maintaining a sense of personhood in dementia.  In Jewell, A. (Ed.), Spirituality and personhood in dementia [Kindle version] (pp. 24-29).  Retrieved from Amazon.com

 

 

“BEING LONELY IS A STATE OF THE SPIRIT THAT IS HAS THE PHYSICAL MEDICAL EFFECT OF SMOKING 15 CIGARRETES PER DAY” (Dr. Lorraine Ste-Marie at Building Hospitable Communities for Aging Conference, St. Paul University, Ottawa, Ontario, Canada on 30 September, 2016).