I spend more time in a long term care facility than your average twenty-something year old. I’m not a resident there, though: I provide spiritual care. What does that mean, you may ask? You’d be forgiven for thinking it amounts to not much more than praying for people or maybe talking to residents as a priest would—pastoral counselling. That was something like my general impression when I first started, that it was a lot of talk. And to be fair, it sometimes is. It’s actually a lot like therapy. Many spiritual caregivers are also licensed psychotherapists, and the line between the two can get blurry. However, common to both in the context of long term care is that you have the opportunity to get more creative than mere talk.
In long term care, you will find many people who can’t talk, or can’t talk very well, or (to be honest) are just old. Some of them need to do nothing but be listened to. Maybe they’re lonely. Some of them say they are. And in my admittedly small amount of experience in the field, I’ve found this to be the case: spiritual care is going to look different for different people, but for many people, at least in the context in which I work, they need only to be approached as a human being.
Allow me to explain, since that might sound bad to you, but I assure you, I don’t mean to injure the reputations of any doctors or nurses. Just consider this: when you’re in hospital or LTC, particularly as you begin to lose function as you age, people are going to spend an increasing amount of time talking about you than talking to you. This is natural since, for many doctors who are seeing many patients in a short amount of time, you are a case. Hopefully they realise you’re more than that—many do—but it can be easy to objectify the person when one only examines the material. Your body is the machine, your doctor the mechanic.
Not so in therapy. The nature of it prohibits this kind of reductionist thinking because there are always two people at work in the therapeutic relationship. I might, for example, read with a resident, plant a flower with them, or watch a hockey game—something to connect with them on an authentically human level, as more than a piece of meat on the operating bench. But even then, one must take care not to see them as a file on a desk nor as a case or problem to be solved. Such is the temptation for those who provide professional care.
But dear reader, do not suppose you’re off the hook! This can happen anytime someone begins to lose the ability (if only in part) to care for themselves. How does one end up in long term care, after all? Probably not by choice. And in my own life, I’ve seen the process by which such a choice might be made, and in those moments, the very person whose well-being is the concern might be talked over. That is why it is so important to give those people a voice, and ensured that they are spoken with, not spoken about.
I believe that cases where people are spoken about rather than with is where human beings are truly in danger of losing their dignity. As I said, people are more than their material or medical conditions, conditions that may wrongfully be used to define them, thereby removing what sense of personhood they had. So how does one restore this sense of dignity? Simply, stop seeing people as problems to be solved.