Caring for the dying – reflections after 42 years of priestly ministry

  • Spiritual Issues

Mark Thomas, a Church of England clergyman writes about his encounters with those who are dying

Caring for the dying – reflections after 42 years of priestly ministry

I was ordained in the Church of England is 1978 and during over 40 years of ministry in the Wakefield, Chichester, Lichfield and now Oxford dioceses, caring for the dying and their families has always been a priority.

As a parish priest

I learnt a lot from Karen, a young parishioner, in the 1980's in West Yorkshire. She was a wife and mother in her thirties who was diagnosed with breast cancer. Despite chemotherapy the disease made rapid progress and she and her husband pursued all possible solutions, including visiting the Bristol Cancer Centre. One day I was called to the local hospice and told she didn’t have long to live. I anointed and prayed with her, and a few days later she was able to walk out of the hospice and go back home. It soon became clear that she had been healed rather than cured; above all she had lost her fear. The illness progressed but there was a radiance about her. Bishop David Hope came to confirm her one weekday afternoon, supported by many members of the congregation. Soon after she bought a new dress and dressed up beautifully for a night out in the town. 48 hours later she was dead. Reflecting about her life and death, it was the distinction between healing and curing that has stayed with me.

Supporting my GP wife in End of Life Care ventures

Keri my wife was a GP and palliative care doctor who always took a particular interest in end of life care. She started a voluntary sector not for profit Company, the National Gold Standards Centre in End of Life Care in which I have always been involved as Non-executive Director. I worked for the Company from 2012-2016, taught compassionate and spiritual care to care home staff and worked for the Care Quality Commission as a specialist advisor, taking part in hospital inspections. Upon retirement in 2016 we moved to Oxfordshire and I was invited to join the Witney ministry team and to become voluntary chaplain to Witney Community Hospital. It was a sadness to have to give up the chaplaincy role on the outbreak of COVID due to my respiratory condition, but it had been a fulfilling experience.

Working as a Hospital Chaplain

Witney hospital is part of the Oxford Health NHS Foundation Trust and specialises in rehabilitation and palliative care. It has two main wards each of 20 beds, and a small Emergency Multidisciplinary Unit. The average length of stay was 28 days, its population largely elderly and often in transition back home from the Acute Hospitals in Oxford.

I visited the hospital one afternoon a week and found it a very rewarding ministry with the freedom that came from not being responsible for running a church and being able to focus on all the hospital patients and staff of any faith background or none. I always began the session in the hospital chapel and on the wards found it easy to detect who wanted my attention; the priority was the same as in parish ministry: to listen for signs of God’s Spirit in people’s lives. Sometimes interesting relationships developed from an initially negative response.

Caring for patients

I met a practising Muslim, a senior member of the Oxford mosque. On our first meeting he told me that I should probably spend time with others. But in subsequent weeks we built up an excellent relationship based on mutual respect, and discovered that we had much in common and that we shared a spiritual longing which crossed religious boundaries.

On another occasion a man in his 60's told me that he didn’t want to see me, but next week called me over to his bed. He had been a soldier who had served in Northern Ireland and had been responsible for a number of deaths. He wouldn’t have used the word “Confession” but that was effectively what he wanted to do – to make his peace with God and with the world. I had discovered in parochial ministry that conversations with the dying often led to what was effectively a confession about something that had happened many years before – an extra-marital affair for example – so that they could find peace.

Help with conversations

Ira Byock in “The Four Things That Matter Most” said that we each need to say four things in preparation for death, to get our house in order as it were:

I love you;

Thank you;

I forgive you;

Please forgive me.

I found it very helpful to have that in mind at the bedside of those nearing the end of their lives; and also to have in mind the key questions for those facing their own mortality which are part of the Advance Care Planning process taught by The Gold Standards Framework:

"What is important to you?

What’s not important?

What do you want to happen and what don’t you want to happen?

Who will speak for you if you can no longer speak for your self – Lasting Power of Attorney".

This triggered deeper discussions about areas of their lives that they hadn’t found easy to talk about. ( )

The deeper conversations that those questions prompted brought into sharp focus what I felt was the priority of my visiting, which was to help people reflect about their lives in the light of their mortality, to live and die well, to get their house in order as it were, including relationships and spiritual needs – anything that stood in the way of reaching an inner peace before the end, and to support staff on the wards in caring for their patients. Sometimes that conversation would lead naturally into prayer, but never without asking the patient’s permission. If they asked for Communion I referred that request to the patient’s own minister as an opportunity for him or her to establish a good relationship with the hospital.

Letting go

Some of the most useful conversations happened with relatives. I was always moved by elderly married couples living out their wedding vows: “in sickness and in health till death do us part” after over 60 years of marriage. People often feel guilty that even after many faithful hours by the dying person’s bedside, the death happens when they have left the room. Research suggests that their physical presence acts to hold the patient into life, and that they need to leave in order to give the person permission to die, as it were. And I know the effectiveness of priestly prayer and anointing of dying people, enabling the journey to take place into whatever lies beyond death, letting go peacefully and without fear.

Key themes

In conclusion, some common themes emerge from this vital and fulfilling ministry both in parochial ministry and in hospital:

meeting people where they are;

listening for the Spirit of God in their lives;

helping them forgive themselves and others;

enabling them discover meaning and purpose in their living and dying;

the importance of presence and of sacramental ministry;

supporting staff to provide corporate care.

Mark Thomas

February 2022