I was called to go to a patient's bedside to sit vigil...he happened to be Catholic.
Sometimes the bedside vigil happens - but less than you might imagine. The conditions of hospice are chaotic. We pretend we are in control, and we are of some things, but life happens. Today, the IDG (or IDT) team communication was well oiled and functioning as it should be. And we had time to respond appropriately, which is mostly out of our control.

Previously, this patient had several ups and downs as it typical of the end of life. Last week, when she came onto our service, she was talking about getting back to her old neighborhood and house...I thought she might make it, too, which does happens.

​The Catholic Faith Tradition and the Sacrament of the Anointing of the Sick
As a devout Catholic who went to mass three times a week, there was a question that I immediately looked for an opportunity to weave into our beginning conversation.  This is tricky–because she does not know me. We do not yet have a relationship of trust. But when an opening did present itself, last week she was very clear with me that she did NOT want a priest to visit. A eucharistic lay minister to give her communion was good but no priest.

When any patient comes onto hospice service, as a clinical chaplain, Medicare asks us to open the subject, as gracefully as possible, of any spiritual anxiety they may have. It is a beginning point to help them explore their inner landscapes.  Have they made peace with this condition they are in? Or are they still wrestling and resisting ? The questions are more important than the answers...and that they know the chaplain or the medical social worker is able and trustworthy to speak with them, should they wish.

​Family is not always easy for the patient to talk with for so many reasons. I am Switzerland and an interfaith chaplain.  I respect all faith traditions. Either I don't have a dog in all the religious diversity and contentions or they are ALL my dogs. The answer probably doesn't matter because it is the same result.  I respect them as voices of the Holy One of Many Names.

The relief that some patients have in having the conversation is what matters.

Essential Chaplain Superpowers: a Bluetooth Speaker and iPhone
I studied while in seminary with a wise and eloquent Dominican Nun.  I know a lot but am quite humble and without assumptions to be complete support.  Generally speaking, this is a healthy assumption for all. However, I speak a dialect of fluent 'Catholic" with the help of my Bose Bluetooth Speaker and iPhone superpowers.  

The patient was non-verbal at the point I arrived.  It was going to be a couple of hours until his people arrived so I called up YouTube and put on a high mass which lasted for an hour and a half.  It was amazing.  The patient seemed to like it - not because he said so (he was non-verbal but not unresponsive...).  I explained who I was and what I was about to do and checked in with him regularly.

​I wiped his face with a wet cloth and sat with him.

Questions of Readiness or Denial?
But to respect the Catholic faith, the question of 'would you like a blessing from a priest?' is an essential one.  The phrasing is a 'softball' way of asking if they want an Anointing of the Sick sacrament.  A 'yes' can be an admission of readiness to pass from this life or not.  The answer is always illuminating of their process. (Are they in denial? Are they hoping for a miracle? Do they really want to try and cure this illness...which at least one of their doctors has already recommended to them as an unwise use of their hope?)

The conversation about spiritual anxiety or spiritual readiness is an important conversation for all patients, but there are different ways to gently inquire of a patient who is not Catholic.   But, that is another post.
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A remembrance ceremony is a requirement by Medicare for all hospices to do each year.

The ceremony does not have to be expensive.  As in life, we use the resources which present themselves and weave 'what is' into a beautiful thing to come together in community and remember...

Here are are some ideas which we have done or attended:

Schedule Before the Holidays.
Thanksgiving and the end of year holiday and Christmas are a difficult time for someone grieving. It is hard to 'celebrate' when our hearts are weighted down by loss. Schedule the celebration in the fall before this time. 

Be sure to send your bereaved some helpful holiday survival information on grieving & mourning.

Weave in the Local Context
This year we created a Candlelight Remembrance Celebration on a Wednesday night, which just happened to fall on Halloween this year.  We incorporated the festivities of the local neighborhoods kids.  (It is hard to be sad when presented with a 2 year old bunny rabbit or a 3 year old Spiderman.) The children helped lighten our spirits as we came in but the service itself was very contemplative.  A Five Candle Remembrance Ceremony.  If you wish to know more about it.  Email us and we will give you the PDF.

Collaborate with Other Chaplains
This year we also had three hospices join to do one ceremony.  Small hospices can do this, especially if the chaplains are friends, which we were (and still are).  It shared the load; we consolidated ideas, harmonized in singing a hymn, and it was a completely lovely afternoon. 

We created a ceremony of stones and roses. Upon arrival, we gave everyone several colored glass pebbles (because one chaplain had them left over from a wedding...) which they held during the ceremony. After the names were read, each person came forward and let go of the pebbles they were able to and threw them into the water (big container that held the roses) , they kept some pebbles ( such is the nature of grief...we release only in good time) and each person picked up a red rose.  Lots of opportunity here to normalize grief and explain about the grieving process etc.

Use Candles for an Evening Ceremony
This is an easy way to set the tone of the sacred within the most secular of venues. Add some iPhone hymns or soothing background music and you have set a safe place for all to be welcomed.

Hold it in Nature
There is a lovely Japanese Tea Garden near one of the hospices I support.  We have offered several celebrations there, if we want to meet  before sunset (when it closes). Their gazebos are beautiful, just the right size, and  free.

We are borrowing the beauty of the nature to set a place for remembering well. Other ideas include local parks or senior centers which rent out space.  Small churches or other religious venues might allow you to gather for little or no money if you give them enough notice.

Read the Names with a Bell...
Reading hundreds of names can be a bit much.  We have switched readers every ten names and rung a Tibetian bell for creating a bit of space and the sheer pleasure of hearing it ring.

Please comment with ceremonies of your own here, if you feel so moved.