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Cancer of the Uterus - Chaplaincy
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Contents
Chaplaincy for Professionals
Whereas the medical professional seeks to cure and to alleviate pain, the chaplain/pastoral carer seeks to bring peace, acceptance, truth and realistic hope, allowing the innermost part of the patient to attain a balance with the external manifestations of illness. In other words, if the inner spiritual harmony and balance is in place, what life then offers in the form of treatments through doctors, nurses and other health professionals can be accepted and integrated peacefully. This in turn may well be greatly conducive to better and more immediate healing, or alternatively, a more peaceful process of life's ending. Cancer of the Uterus for Chaplains
In relation to gynaecological cancer matters, all chaplains would need to draw on their attending and listening skills in helping unfold the woman's underlying story, as this is a sensitive and delicate issue for her to reveal. Her role as nurturer, family carer, worker, household manager and even her wifely role are all on hold. Women of different ages may grieve for different reasons. For a younger woman, grief may be about the loss of the capability to bear children; for an older woman that she can have no more children; for a middle-aged woman that the physical aspects of her person are either inactive or even removed - all of these issues might be huge parts of the grief she may not yet feel in her frozen state. The woman can refuse to address her own grief in the concern she shows towards her partner and their relationship and to her family. This is all part of the great grief she has. The chaplain/pastoral carer needs to allow time and sensitive, empathic listening for these deep feelings to surface before fears and options can be addressed. A further issue for the chaplain/pastoral career is to be aware of the partner's issues and the family concerns. The partner needs to verbalise grief, anxiety, stress, feelings of helplessness, and to be allowed to be part of the partner's pain, otherwise it may result in emotional detachment and failure to face the problems. The same unhurried care needs to be extended to the family - the whole family: mother, father, children and the extended family, all need to be listened to as they define their new roles, becoming comfortable in them as far as they are able. The pastoral carer needs to be aware and help others to an awareness of the many grief issues that are part of the concerns of the patient. Books by Elizabeth Kubler-Ross detail many grief issues; Abraham Maslow's work discusses the issues that concern people when their life structures seem to topple around them; Erik Erikson discusses life's stages and the concerns of a person in each of them; and William Worden details the tasks of grief. Details for these and other materials can be found in the 'further information' section below. If the whole team is aware of the specific approach used for the individual needs of a patient then a greater cohesion and ease can develop in the team. What Are The Chaplaincy Issues For Patients?
Gynaecological cancer often results in invasive treatment of the most private areas of a woman's body. She needs to call on all her coping skills to handle the situation and to realise that, while outwardly her life can continue without anyone beyond her immediate circle knowing what has happened to her, her big hurdle may be in accepting her 'new' or 'treated' self. She needs to allow her body time to recover as much health as possible, and to work through with her partner what this illness may mean to them both. Loneliness, fear, feeling useless and used up, pain and discomfort, and the disengaging of her emotional responses to invasive treatments are all natural reactions. Other concerns include the personal grief felt over what some women perceive as the essential loss of womanhood; issues of mortality; concern over work situations and the negative effect on her career; and issues of the care of her partner, children, household pets, her home or her wider family. These issues often take precedence over her own personal care, and while all are real concerns, they are often used as a way of refusing to address her own grief. The sensitivity shown by chaplains to these issues can reflect them back to the patient, so options can be discussed - one by one. What Are The Chaplaincy Issues For Carers And Families?
Always dependent on the stage the illness has reached, it is important that family members be engaged in giving support to the patient, adapting to her moods and needs, and developing tolerance all round. The pastoral-carer can be of great assistance here. The pastoral-carer will encourage family members to speak naturally and openly, and, without dwelling too much on the negatives, ensure that the extra needs of the patient are met. This may involve resolving any legal difficulties she might have (e.g. updating her will); resolving any differences between family members, relatives and friends; and bringing closure to certain parts of her life. If the condition is terminal, other issues need to be addressed. These may include talking about death; getting the family to recognise the process and naturalness of dying, and the naturalness of discussing funeral arrangements. The patient might like to be involved in this discussion, as it relates to the type of celebration and closure to her life. The woman's partner will also have various issues and family concerns that must be dealt with. There may be feelings of grief, anxiety, stress, and helplessness, and a need to be part of the partner's pain. These issues can be resolved with the assistance of a chaplain, otherwise it may result in emotional detachment and a failure to face the problems. Further Information.
In-service sessions within hospitals, the internet, e-mail, fax, and phone are all part of the information highway available today for patients, carers and all needing care and information. An awareness of and participation in the many GRIEF COURSES offered throughout the city, state and country are options that can be picked up even before one becomes involved in caring for gynaecological and cancer patients. Such participation would help develop an understanding of grief and the help available in working towards its resolution. Even integrating a grief weekend into one's yearly programme would have great benefits in caring holistically for the patient and her family. Any of the major Hospitals through their Chaplaincy /Pastoral Care Departments would be able to give information about courses that may be available. One Institute of Learning that offers grief courses three or four times a year is the Academy for Chaplaincy and Community Ministries, with the Postal Address as The Registrar Books: Erikson, E. (1982) "The Life Cycle Completed", New York: WW Norton. Erikson, E. (1976) "Identity, Youth and Crisis", New York: Harper. Kubler-Ross, E. (1978) "On Death and Dying", London: Tavostock Publishing. Maslow, A. (1962) "Towards a Psychology of Being", Princeton: D van Nostrand, Inc. Worden, J.W. "Grief Counselling and Grief Therapy", New York: Springer Publishing Company. Rita Steptoe, June Loxton
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