Hospice's volunteer chaplains create space
for people who are dying to reflect spiritually

As chaplain manager with Hospice of Spokane, Ann Hurst blends skills from nursing, law and spiritual care as she encourages volunteer chaplains to identify clients’ needs, so they can focus on living as they progress towards death.

Ann’s nursing background attunes her to physical changes in clients and to sensing how close to death they are.

Ann Hurst

Her legal skills help in her management role, planning policies for the organization as a whole.

Catholic all her life, she finds her faith and training as a chaplain help in how she views suffering.

About a third of Hospice’s clients sign up for spiritual care with a chaplain.  Some have support from their own churches.   Hospice of Spokane has 14 volunteer chaplains from various faiths and denominations. Some are retired and some have other jobs.

Ann works full time and has two part-time staff members, Maggie Albo of St. Mary’s Catholic Church and Sheryll Shepard of St. Stephen’s Episcopal.

Visiting at a mutually agreed frequency, each chaplain follows a client and family until the person’s death, which may be in two weeks or up to two years.

Chaplains connect clients who have a faith community to their clergy.  About half claim a denominational tie.  Even though they may not have been active for years, about half of them want to reconnect with their tradition.

Some people are reticent to give a religious preference or see a chaplain, fearing they may be preached at or feeling guilty they don’t attend church, Ann finds.

“We’re not church police, checking on those who have not attended in years,” she said.

To dispel myths, she provides a booklet on spiritual care, pointing out, for example, that a chaplain’s presence does not mean death is imminent. It also distinguishes between religion and spirituality.

“All people have a spiritual side affected by and affecting life-threatening illnesses,” Ann explained.  “The earlier people call us, the better they work through issues so they come to a sense of peace and can have quality time with family.”

She believes people need time to express love, forgive, ask for forgiveness and say thank you.   Accomplishing those steps gives people peace.

“Physical symptoms and spiritual issues often go hand-in-hand, so the better the pain is addressed, the easier it is to deal with spiritual and relationship issues,” she said.

While pain medicine can make people sleepy, Ann said, there are now many medicines and variations so people can have the wakefulness they want.

“Sometimes spiritual distress causes physical suffering, so relieving spiritual suffering also relieves pain,” she added.

Starting her career as a nurse in Connecticut, she served as an Air Force nurse in California, where she met her husband, Charles Latimer. 

After leaving the service, she went to McGeorge School of Law and earned her degree in 1982.  She and her husband lived in Denver, the Philippines, Shreveport, Omaha and at Travis AFB in California before he was assigned to Fairchild AFB in 1990.  He retired in 1995.

From a home office, Ann worked with a federal union for teachers of military children in the Philippines, South Korea, Japan and Okinawa, traveling overseas for hearings.

A health concern in 1992, a seminar on “Conscious Living and Conscious Dying” and a book about a near-death experience led her to rethink her travel.

At St. Charles Catholic Church  Ann became religious education coordinator there and organized Eucharistic ministry for the homebound.  Then she was parish associate at St. Patrick’s and now attends St. Aloysius. 

While training volunteer pastoral companions to visit homebound people, she decided chaplaincy training would help.

She began studies for a master’s degree in spirituality in 1999 at Gonzaga University and took a year of training Gonzaga then offered in clinical pastoral education (CPE)—a satellite of the Tri Cities Chaplaincy CPE program.

She worked three years in pastoral care and two as manager of pastoral care at Deaconess Medical Center.  As a chaplain, she dealt with life and death—even in neonatal intensive care and pediatrics.  Eventually, she realized she wanted to do hospice care. 

Like hospital chaplains, hospice chaplains relate with the spectrum of life—currently from infants to a 103-year-old.

 “Spiritual issues at the end of life, when there is no hope of recovery, are different, but the emotions are the same,” she said.

Because suffering is not just physical, but a cumulative result from people’s lives, Ann knows that some pain cannot and should not be medicated away. 

“Some people value suffering and are open to being changed by suffering,” Ann said. “Some do not want to be medicated or unconscious to avoid pain.  For some, a certain amount of suffering helps them grow spiritually. 

“In suffering, people examine their beliefs and values in a way that may transform their understandings of what is important in life and relationships,” she said.

When people are dying, many want relationships healed—especially if they are estranged from a family member, like a child. 

“People suffer because of unreconciled relationships,” she said, adding that there are ways in an inward process for people to be reconciled, even if the estranged person is far away or dead. 

 “Do all have a peaceful death?  No.  Do all have an ideal death?  No.  Do all reach a sense of inner wellbeing?  No!  Some struggle to the point of death about things left undone,” Ann said.

Chaplains are companions on clients’ journeys, creating a sacred space, even for those who do not believe in God, so they can do the interior work.

Chaplains first must establish trust, so clients will talk about feelings and find inner strength.

“Then they share their suffering and hopes.  Their struggles are theirs, not ours.  We do not fix anything,” Ann explained.  “We merely mirror what they tell us about their lives and feelings.  In their busy lives, people rarely verbalize feelings or think about their spiritual lives or relationship with God.”

While some clients in faith communities have thought about dying, chaplains find even some of them have not considered the meaning of their lives or their relationship with God. 

“People have head knowledge about afterlife based on what they learned as children, but many do not consider it at a heart level until they face death with their fears and doubts,” Ann said.

She finds people tend to look back and judge their lives as good or bad, critical about what they have done or not done.  When they tell a chaplain, they may be speaking and hearing it from themselves for the first time.

“As a mirror, we help them connect with their spiritual world and sort things out,” she said.  “We create space for them to talk about their emotions.”

“We help individuals express their needs and hopes as they die, so they can focus on living as they want to live the rest of their lives—at home with the people they want around them,” she said, adding that to accommodate those who need more care, Hospice of Spokane is raising funds for a 12-bed, inpatient hospice house with private rooms.

Volunteer chaplains need nurture, so they meet quarterly for training and sharing experiences.

When enough people volunteer, Ann offers a chaplains’ training. Ann and volunteers speak to congregations on end-of-life care.

Chaplains also consult with her or raise concerns in care-team meetings with a client’s nurse, social worker, chaplain, nurses’ aides and volunteers.

More than 200 volunteers help clients with grooming, music therapy, massage, household chores, yard work, transportation, companionship, pet therapy and respite for caregivers.

To address grief, Hospice offers rituals to honor those who died each month to help staff and volunteers grieve.  In November and May, it holds memorial services for families and survivors.

Hospice also provides grief and support groups and counseling for families, and a free grief camp for children, regardless of whether their loved ones were clients, to give them a chance to talk with peers about their loss. 

In addition, Ann is starting a spiritual support group for people interested in talking about the impact of their loss on their faith. 

Hospice also arranges education programs for clergy on spiritual care issues at the end of life.

Hospice of Spokane covers from Liberty Lake and Newman Lake, into Idaho, south to Fairfield and Rosalia, into Stevens and Lincoln Counties, west to Cheney and Sprague, and north to Elk and Deer Park.  In addition, there are 21 hospice and palliative care programs serving other communities in Central and Eastern Washington and North Idaho.

For information, call 456-0438 or visit www.hospiceofspokane.org. Ann Hurst is no longer chaplain at Hospice of Spokane - current information is online.

By Mary Stamp, The Fig Tree - Copyright © December 2005