We Need An Anchor

 When I started at St. Anne 2 1/2 years ago, I was new to a Skilled Nursing environment and new to hospice/end of life care.  My ministry and work experience consisted of Case Management for kids, working with people in recovery from Drug & Alcohol Addiction,  and Directing a Worship Ministry.  

I was excited about the new challenge and nervous about the end-of life care aspect of the job.  I had only seen 1 or two people that had died prior to starting my job here.  But I was given a very quick, intense, education!  I started in mid-October and in the month of December that year we had 10-11 residents die in 1 month.  

Thankfully, the Spiritual Care Department has the resources to help educate me on the dying process.  In our Journey home carts, we have little blue books called "Gone From My Sight" by Barbara Karnes, who is a hospice nurse who has a rich understanding of Spirituality at end of life.    There is also a DVD titled “New Rules for End of Life Care”.  She has the beautiful gift of taking something that is scary & unknown and explaining it in a way to make it simple & accessible for everyone.  Of course, what you read in a book gives you knowledge, but through experience you gain understanding.  

The most impactful death experience I witnessed was around the beginning of January that first year I was here.  We had a resident sent to us from Winona Health, and she was actively dying the moment she was brought here.  She had a brother and sister in town, but they didn't want to come, there was a rift in the relationship.  She had no husband and no children.  She was alone.  And when I brought the journey home cart to her room, she was calling out for help, and sadly, medication wasn’t alleviating her pain.  

A lot of us are afraid of witnessing the dying process:  when a person is more spirit than they are body.  They look different than they did when they were more alive.  They are frail.  Our culture doesn't really have a lot of hands-on practices surrounding someone who is actively dying. It's really scary for a lot of people.  I was scared and nervous, but I knew that this human being made in the image of God was Sacred, and what she was experiencing was more than physical.  So, my nervousness and fear didn't matter.   I stayed.  I held her hand.  I tried to comfort her with words, many of the same words I use to comfort my children.  But sadly, the medication didn't appear to be reducing her suffering.  She continually winced and called out for help.  I stayed until she finally seemed to have some peace, about an hour.  In the spiritual experience of dying, some people find comfort in the words of our prayer cards, the music we play, or other religious rituals.  What she needed was the ministry of presence. I gained understanding of what Spiritual Care was that day.  

Conversely, I have witnessed my own grandmother, who had been suffering for years with Alzheimers, finally find some peace at the end of her life.  In November of 2019, she was admitted to hospice and I am unbelievable grateful that I was there with my dad with the hospice social worker came to explain what was now happening.  When it was time for my family to make the 17 hour drive back to Minnesota, I hugged her as she slept on her chair, skinnier than I had ever seen her, and said a prayer.  "Dear God, please, let her fall asleep and not wake up.  Please.  Take her to heaven today."  Watching your grandmother deteriorate from a loving, sweet, giving person to someone who is scared, confused, and crying all the time gives you understanding:  there are some things that are worse than death, and she, and my parents, who took care of her, were living it.  

By mid-December, she was actively dying.  Because she took her time going home to heaven (10 days), I was able to make arrangements to come be by her side while she was sill tied to her physical body.  What I witnessed in her dying process was peace.  She was surrounded by family, by songs, visits from her pastor & the chaplain.  It was Christmastime, so the lights created beautiful ambiance.  She went to heaven around midnight the first night I got there.  I like to say she wanted to see my baby Ben again before she left.  Her spiritual experience of actively dying was full of peace, love, comfort.  It was beautiful. 

When someone is going through the dying process, it can be scary for them, their family, and if they live in a skilled nursing facility, the ones who have cared for them for years.   The dying one is leaving, and their family & loved ones are heading to uncharted waters. 

This year has been one of constant change, upheaval, and many of us have felt disoriented, lonely, afraid, isolated, and exhausted.   None of us have lived through a worldwide pandemic before.  It's uncharted waters.  And it is so hard.  

So where do people go to find hope again or, to retrieve their peace, and stabilize their lives? What brings our residents peace when they are journeying through the dying process?  When disturbing things happen, family, friends, counselors, rituals, and faith are positive, grounding sources for renewed hope and encouragement.  

An anchor attached to a boat or ship and then dropped in the water will keep it from drifting in the wind and current. An anchor is needed to safely ride out storms, to stay on course and avoid rocks or nearby reefs. Even in a safe harbor, the ship can drift, hit something, and sink. Whether we are in the storms of life, or our lives are comfortably calm, we all need a solid anchor for our soul and spirit.

Our journey home process has been an Anchor at Saint Anne's for several years.  It is a distinctive, holy practice that makes us stand apart from many other skilled nursing facilities.   It's more than a ritual and reading prayers off a card.  

When I bring the journey home cart to an actively dying resident’s room, light a lamp & start the soothing music, I’m also discerning what this individual person needs.  If they have a loved one in the room, I listen.  I ask questions about their lives together.  If they have a religious tradition:  what significance has it had in their lives?  I sit, hold the dying residents’ hands, and when it feels right, I leave.  I then advocate for their needs: pastoral presence from a local pastor, a specific song, passage of scripture, or symbol that brings them comfort.  What all dying people need is peace & presence.  And all of us here needs some sort of anchor to hold keep us steady throughout this pandemic.  We need help to endure.  

Our journey home process and ceremony is a reflection of our core values, our tradition of the ministry of hospitality to the beautiful souls that spend time here with us.  It gives our staff the opportunity to take an anchoring pause to honor the sanctity of life.  Our ceremony and memorial services gives us as CNAs, therapeutic rec staff, directors of departments, restorative aids, culinary aids & and housekeepers, permission to pause from the hustle and bustle of our daily activities, and take a moment to acknowledge the humanity of our own grief.  We pour so much care into our residents and we need to honor the grief in ourselves, because we are also sacred human beings created in the image of God.  These truths about honoring our collective humanity and sacredness transcend spiritual or religious beliefs.  

I'm grateful for this anchoring practice that we have here in Saint Anne's, especially during this pandemic.  We need this space and time to breathe and grief.  I want you all to know that this has been a tough year and it's ok if you're not ok.  You have permission to grieve.  You have permission to feel what has been happening.  You are precious.  You are sacred.  The work you do here matters.  

If any of our associates need a safe place to talk about or feel this year, Spiritual Care is here for you.  If you need to cry, I'll probably cry with you.  And that is ok.  If you don't feel comfortable talking to either Laura or myself, every associate has access to our EAP program.  You get 5 sessions to be able to talk to someone.  I am currently using this program and it has been so helpful to have someone to talk to to sort through my own disorientation, grief, and loss.  

As always, thank you for all you do to care for our residents.  Find and keep the anchors in your life.  Thank  you for taking part of our journey home process.  You're all doing a great job.  

Peace, 

Laura Gould