Chaplaincy is the term used to describe those people who specifically offer spiritual and emotional care and support to community members. The Chaplain is sometimes referred to as a pastoral carer. The pastoral carer/chaplain has usually had life experiences in pain, illness and
grief. (S)he has been trained to help facilitate an understanding of the confusion and disarray of emotions and thoughts in the patient that often accompanies pain, illness and grief.
When dealing with gynaecological cancer matters, there are a number of issues that face a patient. The sensitivity shown by chaplains to these issues can reflect them back to the patient, so options can be discussed - one by one. The pastoral-carer will be there with the woman as she delves into the deeper issues of her own concern and sensitively together they will examine the issues as she unlocks them. The pastoral carer will respect the patient's own story, will treat it with confidentiality and together they will work towards a peaceful acceptance of the reality of life as it now presents itself.
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.
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.
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
Academy for Chaplaincy and Community Ministries
P.O. Box 5868
WEST END. Q. 4101
Telephone: (07) 3255 2112 Fax: (07) 3255 2113
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.
Corey, G. (1991) "Theory and Practice of Counselling and Psychotherapy", California: Brooks and Cole - see section "Reality Therapy" by W. Glasser (chapter 12)
Fowler, J. (1981) "Stages of Faith Development - the Psychology of Human Development", San Francisco: Harper and Row.
Glassock, G.T. and Rowling, L. (1992) "Learning to Grieve: Life Skills for Coping With Losses", NSW, Millennium Books.
Holst, L. (1985) "Hospital Ministry, the role of the chaplain today", New York: Crossroads.
McKissock, M. (1992) "Coping with Grief", Sydney: ABC Centreprises
Mitchell, K and Anderson, H. (1983) "All Our Losses All Our Griefs", Philadelphia: The Westminster Press.
Rando, T. (ed) (1986) "Loss and Anticipatory Grief", USA: Lexington Books.
Smith, R.E., Sarason, J.G and Sarason B.R. (1986) "Psychology: the Frontiers of Behaviour" (3rd Edition) New York: Harper and Row.
