I've been working through James D. Berkley's Called into Crisis: The Nine Greatest Challenges of Pastoral Care (Carol Stream, IL; Dallas, TX: Christianity Today; Word Books, 1989). At the end of each chapter is a "Quick Scan" section where a minister can quickly consult some considerations when facing a pastoral crisis. Here are the considerations from the book when a minister is facing situations involving major illness and injury.
MAJOR ILLNESS AND INJURY
Immediate concerns:
1. Allow the medical personnel to do their work unimpeded.
2. The shock of sudden illness or injury affects not only the patient but all those around him or her. If you can’t get to the patient immediately, minister to the family.
3. Timing is important; get to the people as quickly as possible.
Keep in mind:
1. People with terminal diseases probably know it. Our failure to talk about it doesn’t shelter them; it isolates them. Whether now or later, they need to talk about it.
2. The adjustment to a new (and often inferior) body image can be a great crisis for illness or injury victims.
3. People need to grieve their losses or approaching death. The five stages of grief—denial and isolation, anger, bargaining, depression, and acceptance—can be expected in both patient and
loved ones. These are normal, acceptable, and even therapeutic.
4. Hospitalized children need opportunities to be victors over the oppressors of pain, loneliness, and fear, to be recognized for little victories and significant steps.
5. With children, although hospitalization is traumatizing, it often is no indicator of future emotional difficulties.
Things to do or say:
1. Provide emotional and social support for the hospitalized and their families. Transportation, meals, baby-sitting, companionship, help with bills—all are part of the crisis response of caring churches.
2. Help patients sort the probable results of their injury or illness from the irrational or overstated fears, and then help them decide how to cope with impairment.
3. Give patients human touch, control over their situation, someone to talk with about what they want to talk about, the sense of being important.
4. Offer realistic hope. Help build the will to live.
5. Listen to the person who is ready to talk about death. Help her put life and faith in order so that death becomes a natural transition to real life, not a dread doorway to terror.
Things not to do or say:
1. Do not normally withhold information from the patient. In extreme circumstances (for instance, a car accident where a family is killed except for a lone member fighting for life) it may be prudent to time the release of all the details, but normally people have the right and the need to know the facts.
2. Do not make light of the adjustments an injured person may have to make to a new body image.
3. Do not talk about a patient in his presence—even one in a coma—as if the person were not there.
4. Do not give patients a sense of abandonment. Let them know when they can expect to see you, and make every effort to visit regularly.
