Spiritual Care in Long Term Care Settings January 15, 2014

1. Spiritual Care in Long Term Care SettingsJanuary 15, 2014 Catholic Health East Spiritual Care Champions Series Kevin Clark, M.Div. Sister Jackie Leech, M.A. Rick Charles, M.Div.

2. Introductions • Kevin Clark, M.Div., Chaplain, Legacy Hospice, Castle Rock, Colorado • Sister Jackie Leech, M.A., Chaplain, The Gardens at St. Elizabeth, Denver, Colorado • Rick Charles, M.Div., Chaplain, The Villas at Sunny Acres, Thornton, Colorado

3. Introductions • The Gardens at St. Elizabeth, Denver, Colorado • IL, AL, Memory Care • Catholic identity • The Villas at Sunny Acres, Thornton, Colorado • IL, AL, SNF, Memory Care

4. Increased need for long term care • Aging population • Called the “silver tsunami” by some • Oldest Baby Boomers turned 65 in 2011 • Youngest Baby Boomers turn 65 by 2030 • 77 million Baby Boomers make up 25% of US population • Over 70% of Americans age 65+ will need some type of long term care within their lifetime

5. U.S. Population age 65 and over Year Pop. in millions % of total pop. 2000 34.9 12.4% 2010 40.2 13.0% 2020 54.8 16.1% 2030 72.0 19.3% 2040 81.2 20.0% 2050 88.5 20.2%

6. U.S. Population age 85 and over Year Pop. in millions % of total pop. 2000 4.2 1.5% 2010 5.8 1.9% 2020 6.6 1.9% 2030 8.7 2.3% 2040 14.2 3.5% 2050 19.0 4.3%

7. Long Term Care population SNF (2011) = 1.5 million AL (2010) = over 750,000

8. Need for Memory Care Number of Americans with Alzheimer’s Disease 2010 5.1 million 2025 7.1 million 2050 13.8 million

9. Honor your father and your mother • One of the ten commandments (Exodus 20:12) • Pope John Paul II reminds us and calls us to “honor, respect, welcome, and help” the elderly (Letter to the Elderly, 1999) • The elderly have much to give: wisdom, love, life experience, guardians of shared memory, elders in the faith

10. Unique features • Ministry in diverse settings including IL, AL, SNF, Memory Care • The LTC facility becomes the resident’s home • Ministry to residents, families and staff • Diversity of spiritual traditions among all of these different people

11. Unique features • The chaplain develops long term relationships with the residents and their families • Many residents struggle with issues of pain, loss, suffering and death • Many residents have lost their connection to their faith community • Opportunity for life review

12. Unique features • Many residents wrestle with issues of: • Purpose (Why am I here? What can I do to be of service? I don’t have much to offer.) • Identity (Who am I now? I don’t want to be a burden to my family.) • Community (Do I fit in anywhere in this community of people?)

13. Spiritual Needs Many are dealing with loss: • Moving from their home • Leaving possessions behind • Loss of ability to drive • Loss of friends who are dying • Loss of connection to their faith community • Loss of physical health

14. Spiritual Needs • Loss of meaning • Boredom • Loneliness • Forgiveness issues • End of life planning • Respect for dignity and autonomy

15. Spiritual Care Interventions • Welcoming new residents • Building relationships with residents and families • Spiritual assessment • Life review • Meaning making • Individual and family counseling • Leading and coordinating worship services

16. Spiritual Care Interventions Worship at The Gardens at St. Elizabeth: • Daily Mass, daily rosary • Holy Week services • Anointing of the sick quarterly • Annual memorial service • Weekly scripture study group • Sacred music on the memory care unit • Blessings for special occasions

17. Spiritual Care Interventions Worship at The Villas at Sunny Acres: • Four unique worship services for the four different levels of care • Independent Living • Assisted Living • Skilled Nursing • Memory Care • Work with community clergy to offer worship services, Catholic Mass

18. Spiritual Care Interventions • Ethics consultations • Conflict resolution meetings • Celebrating holidays and special days • Honoring veterans • End of life planning • Planning and leading memorial services • Providing grief support to residents, families, staff

19. Spiritual Care Model • Spiritual care flows from relationship, so relationship building is essential • Spiritual care to individuals • Spiritual care to families • Spiritual care to staff • Spiritual care in community • Spiritual care triage

20. Special competencies needed • Knowledge of the aging process as a stage of life • Knowledge of end of life issues • Caring, pastoral presence • Flexibility • Patience • Leadership • Confidentiality/trust

21. Special competencies needed • Basic counseling skills and ability to make referrals • Ethics: knowledge, committees, consultations • Able to work with palliative care and hospice teams • Team approach

22. Unique challenges • Working with people with memory issues such as dementia or Alzheimer’s • Working with families who are not able to see that the resident needs a higher level of care • Lack of a dedicated sacred space • Dealing with family conflict • Dealing with conflict among staff • Often only one chaplain: need for support

23. Specific issues • Be careful to avoid “triangulation” between individuals, families, staff • Practice good self care • Maintain good boundaries • Find a place where you can be ministered to

24. Group work • Worship services • Bible study groups • Theological Roundtable • Other learning or discussion groups • Prayer groups • Using art or music activities • Grief support groups

25. Types of interactions • Face to face visits • Phone calls • Email • Hospital visitation

26. Discussion • We welcome your questions and comments