BY: DIANA ANDERSON
The Alexian Brothers Health System, based in Elk Grove Village, IL, is implementing what it calls a "spiritual wellness" paradigm in its long-term care facilities.
Spiritual wellness changes the traditional focus of pastoral care in long-term care centers. As in the traditional model, a spiritual wellness staff attends to the religious and sacramental needs of residents, ministers to the dying, and counsels residents and family members in crisis. Spiritual wellness staff, however, do these things within the context of a holistic approach to care, considering the needs of the whole person: body, mind, and spirit.
Members of a spiritual wellness staff, ministering within this holistic approach, are aware of the many elements of a given resident's "core identity," and are therefore more in touch with what makes the resident's life meaningful. At the facility where I work, for example, our Holy Week liturgy planning group chose a certain traditional hymn this Easter because we knew it had meaning for many residents. A resident later thanked me for singing "Tantum Ergo" because it reminded her of childhood and for a moment made her feel safe and carefree again. She remembered her childhood trust that God would take care of her. That trust was part of her core identity.
The core identity of another resident of our facility included sitting quietly outdoors and watching the birds. Some people thought it was too hot for the resident to sit alone, so the spiritual wellness staff took turns sitting with her. The resident later said that being outdoors rejuvenated both her body and her soul. She thanked me for not only sitting with her but also for respecting her need for silence. It was, she said, the only time she had the quiet space she needed to think about, and talk to, God.
The spiritual wellness concept can also contribute to the building of a community of care composed of people who, being ideally in touch with their own core identities and having a sense of what makes life meaningful, are eager to foster relationships with others, both the living and the dying. (Most of our residents are not physically healthy.) Spiritual wellness is a process, a faith journey grounded in the mission and values of a community in which, as the Alexian Brothers' charism puts it, "The love of Christ compels us."\
The spiritual wellness paradigm is manifested in slightly different ways in each of the system's long-term care facilities.
The Paradigm at Four Facilities
Alexian Brothers Lansdowne Village and Transitional Care Center, St. Louis
This 178-bed facility includes 28 beds in its transitional care unit. As its director of spiritual wellness, I supervise mission services with the assistance of Br. Richard Lowe, CFA, who serves as the pastoral care services coordinator. I also supervise mission services, pastoral and sacramental care, community outreach projects, spiritual wellness educational programs, and volunteer services. In addition, I conduct liaison with local clergy and religious and serve as the preceptor for clinical pastoral education.
But I also address the spiritual needs of residents, family members, and staff in a more informal way. I do this by building trusting and respectful relationships rooted in the sharing of our core identities and faith journeys.
Alexian Brothers Sherbrooke Village, St. Louis
This facility has 44 assisted living apartments and a 120-bed long-term care unit. Br. Richard Dube, CFA, is the director of the facility's spiritual wellness department and regional director of mission services. He agrees that spiritual wellness is a process of integration, making sense of one's life experiences and finding meaning. It is very important for a person coming to live in a nursing home to retain a sense of purpose in life. Indeed, Br. Dube says, "We involve the resident and his or her family members in the process even before the resident is admitted. We do this by encouraging them to join support groups that deal with the issues of aging, retirement, and the alternative lifestyle of long-term care."
Once the resident is admitted, family members participate in providing the holistic care that will help the resident flourish, Br. Dube says. When the resident dies, the family is invited to the facility for a memorial Mass, a service that facilitates the grieving process.
Alexian Village of Milwaukee
In this continuing care retirement community of 350 residents, the spiritual wellness approach is reflected in the expanded role played by its chaplain, Rev. Joe Jagodensky, SDS. In addition to making traditional pastoral care visits, Fr. Jagodensky is responsible for developing a spiritual wellness program; organizing volunteer services; mentoring students who are completing their field education work; and supervising the parish nursing program, the clinical pastoral education program, and the validation theory program.
Alexian Village of Tennessee, Signal Mountain, TN
This facility is home to 400 people residing in three different levels of care: independent living, assisted living, and long-term care. Rev. Valerie Carnes, an Episcopalian, is the director of spiritual wellness and mission services, responsible for pastoral and sacramental care, mission services, community outreach, the facility's day care center, and liaison with local churches and clergy.
About 85 percent to 90 percent of the facility's residents are cognitively impaired, many with Alzheimer's disease. Carnes says her primary task is to "communicate God's reassuring, nonanxious, and loving presence as a haven of stability. Framing our ministry in terms of spiritual wellness allows us to provide a stable core of meaning, value, and purpose in the Alzheimer's resident's unstable world."
Listening to Residents' Stories
We can best understand the state of people's spiritual wellness by listening to the stories in which they reveal who they are as individuals. And even when they lose the ability to put their stories into words, they can, through their actions, show us what they consider to be meaningful.
There used to be, for example, an elderly Italian-American woman at our facility who suffered from dementia. She had a habit of wandering around the unit collecting artificial flowers from various places, including other residents' rooms.
Some people were upset by the woman's behavior. Her family was embarrassed to hear she was "stealing" from her neighbors. Some staff members worried that, burdened by an armload of flowers, she might fall and hurt herself. But no matter what was said to her, she would not give up the flowers.
One afternoon the woman came downstairs to the chapel for Mass, her arms as usual full of artificial flowers. I approached her, speaking to her by name, and said, "What beautiful flowers!" Then I asked her if she would like to place the flowers on the altar as an offering. Her face was suddenly lit by a tremendous smile. "Yes, yes," she said, in both English and Italian, and laid her flowers on the altar.
With that simple gesture the woman clearly demonstrated her spiritual wellness. She showed us that, despite her dementia, she retained that part of her core identity that found meaning in giving flowers to God in the form of an offering at the altar.
In meeting the healthcare needs of the elderly, the challenge is to move away from the medical model, which focuses mainly on the resident's physical health, and toward a social/relational model in which the resident's core identity is the primary determinant of the care he or she receives. Spiritual wellness provides a foundational paradigm enabling caregivers to make this transition.
For more information call Diana Anderson, 314-351-6888, ext. 219.
Ms. Anderson is director of spiritual wellness, Alexian Brothers Lansdowne Village, St. Louis.
Copyright © 1998 by the Catholic Health Association of the United States
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