Providing continuity of spiritual care from hospital to home
BRF hosted an online round table discussion (8 March 2022) to explore links between hospital chaplaincy and Anna Chaplaincy. Twenty-one participants attended including: seven hospital chaplains from across the UK; seven from local Anna Chaplaincy projects in diverse locations; four BRF Anna Chaplaincy team members; representatives of Parish Nursing, Linking Lives UK and Faith in Older People.
Hospital Chaplains and Anna Chaplains aim to ensure continuity of spiritual care when older people move between hospital and home. The vulnerability caused by being unwell and apart from friends and family (particularly with Covid-19 visiting restrictions) can prompt an older person to reach out for spiritual care during a hospital stay. Some have strong Christian connections, and their ongoing spiritual care is, hopefully, offered by their local church family when they are discharged home. For other patients though, there are barriers to continuity of spiritual care.
The patient may not be a person of faith but value the spiritual conversations chaplaincy affords as they explore often painful subjects in looking back over their lives. The patient may have a long-dormant faith which is rekindled through support from the hospital chaplaincy team, lack recent contact with a Christian community or have past experiences of church that may have been difficult (this might make being nudged into connection with a local church inappropriate). Then there is the patient who is placed on discharge from hospital into a care home or rehab facility miles from their church community, friends and family. The conversations an individual has with a chaplain may be of a different nature entirely from the ones they might have at church. How can we continue to offer this kind of spiritual care once they return home?
While there was a consensus in the group that joining up hospital and community-based chaplaincy for older people is helpful, the discussion unearthed barriers stemming from how hospitals and churches operate. Confidentiality, data protection and safeguarding protocols in hospitals can prevent information from being passed on, even if the patient is willing for their details to be given to a community chaplaincy service. There is also limited awareness of spiritual and religious care among health and care professionals, with an assumption that it is limited to end-of-life support. Discharge plans rarely include spiritual and religious care.
In the community, the barriers are partly linked to capacity. Anna Chaplaincy is not yet established in every part of the UK. Local churches may lack resources to respond to all the pastoral and spiritual needs of older people in their communities, which may explain why chaplains in the group often struggled to engage local church leaders in taking an interest in patients they felt would benefit from being connected with a church.
Setting the scene for the round table discussion, the hospital chaplain at Furness General Debbie Wilde and Anna Chaplaincy lead for Churches Together in Cumbria Katherine Froggatt, spoke about plans to link Anna Chaplaincy with hospital chaplaincy, initially in Barrow and eventually across the county. In Barrow parish, nurse Ruth McDonald already gives support from hospital to home for some patients. The newly-formed Anna Chaplaincy team will now also be double-badged, so they belong to the hospital chaplaincy team as well. This will give Debbie oversight of their work and allow hospital protocols and training requirements for volunteers to be followed. If funding can be secured, a further broader pilot will build upon this one, spanning hospitals and Anna Chaplaincy teams across Cumbria. There are also plans on the Isle of Wight for hospital chaplain Janet Hallam to work with the newly-formed Anna Chaplaincy team to allow patients to receive continuing spiritual care on discharge.
Looking to the future of Anna Chaplaincy, structures that can sit more easily alongside hospital chaplaincy were considered. An Anna Chaplaincy project that sits within an independent ecumenical charity spanning an area coterminous with the local hospital may provide the necessary flexibility to work across traditional ‘parish’ boundaries. A named and trusted lead Anna Chaplain who takes referrals on behalf of local churches of all denominations, recruiting and training volunteers, may provide easier channels of communication between hospital chaplaincy teams and churches than exist at present.
Encouraging indications from Scotland were shared by Maureen O’Neill, director of Edinburgh-based Faith in Older People. Spiritual care is now within the remit of the Scottish government, with an adviser appointed to develop a wider strategy. Maureen has been invited to join the programme board. This will allow a focus on the links between hospital and community chaplaincy and will highlight the need for spiritual care training for those working with older people in health and care roles.
BRF will follow with interest these developments in Cumbria, Scotland and the Isle of Wight. As models of Anna Chaplaincy mature and structures conducive to its flourishing are discovered, it is our sincere hope that older people’s spiritual care is strengthened as they move between different settings through times of frailty and ill-health.
Several resources written by participants were signposted during the roundtable:
Celebrating the Seasons in Residential Care Homes: A service for every week of the year, by Lindsay Pelloquin & Jaye Keightley, will soon be available to order on Amazon.
Into the Depths: A chaplain’s reflections on death, dying and pastoral care by Rosie Deedes (Sacristy Press, 2018) – available to buy here.
Honorary chaplain at Good Hope Hospital Solihull Sian Nicholas wrote a paper in 2021 on spirituality and dementia, giving guidance for hospital chaplains supporting those with memory problems, which is available here.
Addenbrookes Hospital chaplain Phil Sharkey created an anthology of poetry drawn from the words of patients with dementia: Words to Remember: Poems lost and found.
(see the Anna Chaplaincy blog from 10 November 2021).