As religious and cultural holidays approach, providers can be mindful to offer spiritual and compassionate care to patients. This type of care focuses on a patient's spiritual wellbeing by connecting them to spiritual traditions, rituals and practices as they experience a health crisis. To provide insight into this topic of spiritual care, three IU Health Chaplains, Reverend Donald Stikeleather, Rabbi Justin Kerber and Reverend Anastasia Holman, offer advice for health care providers to help their patients feel spiritually connected and supported this holiday season, especially amid rising COVID-19 hospitalizations.
Reverend Donald Stikeleather, a staff chaplain for IU Health Methodist Hospital and an ordained Buddhist through Dharma Ocean Foundation, is an advocate for spirituality in medicine saying, "Our life journeys are tremendously impacted by illness and the meaning we make based on the limitations that life sets in front of us can be profound in its wisdom. The chaplain brings witness to suffering, reframes stuck thinking, holds compassionate presence to the loss, provides access to ritual away from home, and offers a wisdom opportunity as the patient reflects about life itself."
Those in need of spiritual care often find themselves experiencing spiritual distress, says Rabbi Kerber, spiritual leader of the Congregation Beth Shalom in Carmel, Indiana.
"Spiritual distress is the feeling one gets when they experience an event that injures or severs that connection with something greater, or which contradicts that narrative about one's self," said Kerber. "I have found that spiritual distress often manifests as a sense of 'broken belonging.' And so, spiritual care is a compassionate response to such spiritual distress; especially a way of being present with the person who is experiencing it."
To patients experiencing spiritual distress, Rabbi Kerber encourages health care providers to offer the most effective intervention: an empathetic presence and understand and feel the person's distress, without attempting to 'fix it.' Reverend Holman, Director of Chaplaincy Education for IU Health, encourages health care providers to focus on treating the whole person: "The body, mind and spirit are all connected. One affects the other in the healing process. When a person is in physical distress, their emotional and spiritual wellbeing are also affected. Therefore, spiritual wellbeing is an important part of the treatment plan and quality of life for patients."
SURVEYING THE PATIENT
"Providers must first feel grounded within themselves to start a spiritual conversation. As you prepare for "generous listening," pay attention to the patient's surroundings and your senses. Are there symbols in the room? Are there cards in the room from family and friends? Is there light in the room? This can help gauge attending and listening," said Reverend Holman. She also finds it helpful to ask patients, "How are you coping during your illness or this season?"
Reverend Stikeleather offers additional questions providers can ask patients to begin a spiritual conversation, such as:
What gives your life meaning?
What lights you up?
What helps you understand the world and your own life?
What has being sick meant to you?
How do you make sense of all of this?
How has it changed your life perspective?
Where is your life going?
What does it mean to die; What will happen?
Furthermore, it can also help understand what types of resources are available to you as a health care provider. "For Jewish patients who are hospitalized, the Indiana rabbinical community is available to help even when the patient is not a member of a specific congregation," explained Rabbi Kerber. "I am a fan of www.myJewishlearning.com and the Union for Reform Judaism's website, www.urj.org, which are both rich with content about Judaism and Jewish culture."
In addition to sharing these resources, Rabbi Kerber cautions providers to "never forget that an individual patient or a particular family is just one individual or just one family. It is helpful to be knowledgeable, but please, see what they think by asking them rather than relying on assumptions, even well-informed assumptions."
Hospital chaplains are available and willing to provide support. Check-in with your clinical site to learn more about their compassionate care services.
SUPPORTING PATIENTS DURING THE WINTER HOLIDAYS
HANUKKAH | NOVEMBER 28 - DECEMBER 6
Hanukkah, or Channukah, also known as the festival of lights, is a minor holiday celebrated by followers of Judaism. This festival occurs from November 28 to December 6 of this year. It commemorates the victory of the Maccabees, a Jewish rebellion against the Seleucid empire that took place in about 167 BCE.
Triumphantly rededicating an ancient temple recaptured from the Seleucids, the Maccabees found only one bottle of pure olive oil suitable for lighting the candelabrum. But the oil miraculously lasted for eight days, long enough to restore the Temple for the worship of God. Today, Jewish people light an 8-branched Chanukah lamp called the menorah or chanukiyah, adding one light for each of the eight nights, and eat foods cooked in oil to remember the miracle--not just of oil magically burning, but the miracle of people's dedication to their beliefs and to justice in the face of overwhelming oppression.
To show a Jewish patient or family that the hospital is aware of this holiday, health care providers can display electric menorot (plural of menorah) and provide Chanukah food options to patients (if diet permits). A video conference call with family lighting candles or playing dreidel (a special game for the holiday) can help the patient connect and celebrate with family and friends. It is important to note that Hanukkah is considered a minor Jewish holiday. The most important festivals are Rosh Hashanah (the Jewish New Year) and Yom Kippur (the Day of Atonement).
YULE | DECEMBER 21
Yule is a holiday celebrated by many cultures in honor of the Winter Solstice, which falls on the shortest day of the year—giving thanks for the return of light, hope and promise. Many present-day Christmas customs and traditions stem from pagan Yule traditions. To help patients celebrate Yule, contact the hospital's chaplaincy services.
PANCHA GANAPATI | DECEMBER 21 - 25
Hindus celebrate Pancha Ganapati to honor Lord Ganesha, the lord of culture and new beginnings. The celebration lasts over five days and includes outings, picnics, feasts and the exchange of cards and gifts. A shrine is set up in the living room. Placed in the center is a large wooden or bronze statue of Lord Panchamukha ("five-faced") Ganapati, a form of Ganesha. A large picture or statue of Ganesha will also suffice. To help patients celebrate Pancha Ganapati, contact the hospital's chaplaincy services.
CHRISTMAS | DECEMBER 25
How people choose to celebrate Christmas vary based on religion, faith group affiliation, tradition, culture, experience and practice. As an ordained Elder in the African Methodist Episcopal Zion Church, Reverend Holman celebrates the Advent and Christmas Season as part of a liturgical calendar. The significance of the Christmas holiday and season is for Christians to celebrate and remember the birth of Jesus Christ.
Each patient's personal preference and celebration style may be different during the Advent and Christmas season and is an important part of patients' healing process. Through song, prayer, reading of sacred texts and spending time with family and friends, patients who are of the Christian faith tradition can connect to the anticipated hope of the season and celebration of Jesus' birth. Others find that giving is the most important part of the holiday and being in the hospital may be a disruption to these values and rituals, causing sadness and loss.
Chaplains and health care providers can offer support and seek to find out what is meaningful to patients, families and staff during this time by using attending and listening skills. We can listen for the 'Soul Story' by using what Dr. Rachel Naomi Remein calls "Generous Listening" in her book Kitchen Table Wisdom. While there are different ways to express values and beliefs, one thing patients have in common in the hospital during the holiday season is that they will not be at home or celebrating in familiar ways.
KWANZAA | DECEMBER 26 – JANUARY 1
Kwanzaa is celebrated by many of African descent in America and occurs from December 26 to January 1. In Africa, there are many customs celebrated by ethnic groups, such as celebrating the harvest and giving thanks for their good fortune. Here in America, these basic principles of the harvest celebrations in Africa were adopted to create the observance of Kwanzaa. Although it is recognized that overall, African Americans do not live in an agricultural setting, Kwanzaa emphasizes the basic principles found in producing the harvest, which include building and maintaining strong and wholesome communities. Kwanzaa is a time to reflect on our use of these basic principles, share and enjoy the fruits of our labor, and recommit ourselves to the collective achievement of a better life for our family, community and people.
During Kwanzaa, it is customary to greet friends and family with the Swahili phrase, "Habari gani," meaning, "What is the news?" To respond, answer with the principle of the day (Umoja, for example, is the response given on December 26.) Fasting, or abstaining from food, is often done during Kwanzaa as a means of cleansing the mind, soul and spirit. There is also a candle lighting ceremony that reinforces the meaning of the seven Kwanzaa principles: Umoja (unity), Kujichagulia (self-determination), Ujima (collective work and responsibility), Ujamaa (cooperative economics), Nia (purpose), Kuumba (creativity), and Imani (faith). These principles are represented by seven candles colored red, green and black. The evening of December 31 (Day 6) is the KARAMU, a joyous celebration with food, drink, dance and music for the collective family and friends. It is a time of rejoicing, reassessment and recommitment. The ZAWADI, handmade or similarly meaningful gifts for children, may be opened at the KARAMU or on the final day of Kwanzaa when Imani is observed.
To help patients celebrate Kwanzaa, a chaplain or health care provider can write down Kwanzaa's seven principles so that the patient can read about this tradition. During the week of Kwanzaa, a chaplain can help patients light a new candle each day if they have an electric kinara (candle holder). During the COVID-19 pandemic, a chaplain or provider can also help to facilitate family celebrations through Zoom. Depending on a patient's interest, food brought in from home could add to a small celebration.
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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