Pastoral Counseling in Palliative Care as Assistance to the Patient in the Face of Their Suffering

Abstract

The article analyses the conception, principles and significance of palliative care for the patient, as well as the need for pastoral counselling. The author discusses the possibilities and developmental assumptions for interaction of palliative care and pastoral counselling in health care institutions. Great attention is given to the conceptions of suffering in the Bible and to their interaction with presently available and possible pastoral counselling of ill people. The article presents partial results of empiric qualitative research which reveals the patients’ experiences in the face of illness, their emotions, empathies and necessary assistance. The need for pastoral counselling providing spiritual, emotional and psychological support not only to the patients, but also to their relatives and to the medical staff in healthcare institutions is analysed.

The article analyses the conception, principles and significance of palliative care for the patient, as well as the need for pastoral counselling. Results of the research are presented revealing patients’ experiences and feelings that emerge during the illness and the need for pastoral counselling providing spiritual, emotional and psychological support not only to the patients, but also to their relatives and to the medical staff in healthcare institutions. The purpose of the research was to present pastoral counselling in palliative care as an aid to the patient in face of personally experienced suffering. The author sought to clarify the conceptions of palliative care and benemortasia by identifying their holistic character and interaction with pastoral counselling of patients; to identify the conceptions of pain in the Holy Scripture by reviewing their connections with patients’ experience of suffering and pain (N=5 purposely selected female respondents). With reference to that the pastoral assistance provided to those participating in the system of palliative care in the future might be more effective and its need, possibilities and challenges could be determined more precisely. To achieve these aims, the following methods were used: analysis of scientific sources, ecclesiastical documents and content, as well as in depth interview, content alaysis, partial results of qualitative empiric research are included.

Palliative care is understood as a team work system based on holistic approach to the patient characterized by integral cooperation of medics, nurses and their assistants, kinesitherapists, psychotherapists, pastoral counsellors and volunteers. The patient and his relatives are included into the team of palliative care as full members. Holistic approach to the person enables the team to provide the patient with individualized assistance considering the multiplicity of their unique situation, the peculiarities of their personality, strengths and weaknesses. One or another strategy of pastoral counselling can be applied depending on the conception of suffering and God specific to the patient. Biblical conceptions of suffering have been presented, namely: punishment, trial, educative measure, etc. Pain as propitiation sacrifice is found in the image of Suffering Servant, as prototype of Jesus, in the Book of Isaiah and in the passion narratives of Jesus in the New Testament. Such transfiguring conception of pain may help the patient to change their approach to personal physical and spiritual pain, to give meaning to it and to unite it to the atonement sacrifice of Christ.

The attention is paid to the greatest obstruction to promote the pastoral counselling in healthcare institutions in Lithuania, i.e. undeveloped unified system of pastoral counselling and palliative nursing, resulting in reductionist approach to the patient when only physical dimension of health is cared about, while emotional, psychological, social and spiritual dimensions are neglected. The challenges in pastoral care arise because of the lack of pastoral workers and due to denominational variety among the patients. It aggravates the possibility to offer the patients proper pastoral services corresponding to their religious beliefs.