Got a problem? Ask your pastor!
Whatever your profession, you will have things which you were trained to do and other things which you learn on the job. Some of these are important, vocational tasks; others are just things you need to know. Pastors are no exception. There are lots of things you might expect us to know: how to construct acts of worship, how to preach, how to offer pastoral care well and so on. We learn many other things too, and some of these might be unexpected.
Life-limiting illnesses
An important part of pastoral care is helping people who are living with a life-limiting illness. When I was ordained, I did not expect to become an expert in cancer and dementia, but I have navigated them with others many times. At any given time, in any church community, there will be people who are living with cancer and those who have dementia. When I was a curate in training, I remember being concerned about a lady who was declining in capacity due to dementia. She was going out at odd times and turning up in random places, sometimes at night, which led to concern for her safety. In the end her family organised a care home place for her. This is a story which has been repeated many times. A dementia sufferer’s next of kin usually reach a stage where they are unsafe to stay at home and need specialist residential care, and this moment can be fraught if they have a tendency to go AWOL.
People are generally afraid of the decline that dementia brings. However, as a pastor I have often observed that one person’s increased vulnerability can release gifts of kindness and capacity in others. We are meant to bear each other’s burdens, not to suffer alone. When you reach out to other people for help, it gives them an opportunity to be kind, and perhaps to stretch themselves. People are often concerned at how a person with dementia will experience themselves when they are at an advanced stage. We cannot know this, though, and often people in this condition seem very peaceful and content.
The cancer journey has more variations. Some forms of cancer are highly treatable and can be resolved by chemotherapy, radiotherapy or a combination of the two. Other forms can be life-limiting, where treatment could be curative or palliative. Depending on the variety, the point of diagnosis can be important: most types are more treatable if caught early. One thing I learned from a family member’s cancer is that doctors deal with probabilities when it comes to cancer treatment. You need to be able to cope with some maths! At the point of diagnosis, you are told the percentage probability of success for each of your treatment options. If your diagnosis shows an advanced disease, it is likely to have spread to other parts of your body. At an end stage, the cancer will spread either to the bones, the lungs or the brain, and this will be treated accordingly. Doctors are extremely good at reducing pain these days, so not many people suffer a great deal of pain at the end.
I have spent some very special times with people who have life-limiting diagnoses. It is a particular privilege to pray with people who are about to die. I have been inspired by the faith of Christians who have gone through a great deal of treatment and reached the end. Having a pastor alongside them is also comforting for family members.
Most hospitals offer chaplaincy, and local church leaders work in tandem with chaplains. If a parishioner is admitted to hospital, I contact the chaplain to let them know, and someone from their team will go and see them at the earliest opportunity. If I visit them, I drop into the chapel to let the team know.
If you, or someone you know, is facing a life-limiting diagnosis, talk to your pastor. I say this whether or not you are a churchgoer or a person of faith. You may be surprised at the expertise and care you will find.
Navigating the NHS and social care
If you have never experienced hospitalisation (your own or someone else’s), you may think that the right care just falls into place when someone is taken ill. Medical notes get read, care transfers seamlessly from one person or institution to another. Unfortunately this is generally not the case. Pastors have walked alongside enough people to be able to offer advice on navigating the system, whether within the NHS or social care.
If someone you look after is hospitalised, the first thing you need to do is to find someone responsible and make sure they understand the patient’s history. On a hospital ward, this generally means the staff nurse. Is the patient on prescription medication? Are there things their carers need to take on board? If so, make sure they are noted and acted on. Do they have your details in case of any queries? Keep a written note of conversations you have and the names of individuals you speak to. It is valuable to understand the hierarchy of the NHS. A staff nurse has more clout than a regular nurse; a consultant is higher up the chain than a registrar, who outranks a senior house officer. If you do not like an answer you get, escalate up the chain.
Now, I did not learn this through my work, but in my experience most pastors have learned how to navigate the NHS successfully, one way or another. They may also have local knowledge of your hospitals, which is valuable in a crisis.
With social care, a pastor’s safeguarding training tells them who to contact if you have a concern about someone’s safety at home. For example, this could be a child who appears to be suffering from neglect, or an adult who is struggling to care for themselves. Councils have a duty of care to vulnerable people; you can always get hold of a duty social worker and report concerns you have, and you can do this anonymously if you prefer. In a case of a person with advanced Alzheimer’s whose carer was admitted to hospital, the sufferer was themselves admitted for assessment within hours of a concern being raised, ending up safely in residential care when it became clear that their carer was no longer able to look after them. If you are concerned about someone, you do not know what the authorities may already know. You may simply observe someone in your child’s class at school who displays unusual behaviour or looks uncared for; social services may be aware of much more, and your report could help them connect the dots.
Local knowledge
One thing which many people do not realise about a church community is that, no matter what you are going through, someone in your church has almost certainly been there first. This is where your pastor comes in. Some of this information is confidential, but your pastor knows a lot about what people in their church are experiencing. For example, a few years ago, someone in our church was a victim of an online scam which led to identity fraud. When I heard about it, I was able to connect them up to someone else in our church family who had recently been through something very similar. These events were not generally known, but the first victim did not mind sharing them. One of the reasons that Christians often wonder how people cope with life’s challenges without a faith, is that, as part of a church, you are never alone. When you share your struggles with your pastor, they can often link you up with someone who has gone through something similar.
Another thing about church leaders is that we know our local communities very well. We have contacts in other charities, businesses and organisations. We know our councillors and our MP. Churches need their windows and floors cleaned; they need electricians and plumbers, and so on. They know which venues or caterers to use for an event. When you need a recommendation, from a tradesman to a coffee shop, you can be sure your pastor can help.
Your pastor is concerned with much more than just this Sunday’s service. They are running a sophisticated local community, normally containing a wide variety of people. Whether you need help at a major turning point in your life, you need to find NHS or social care help, or a local service, speak to your pastor. We are often better informed than you might think.