Spiritual Care at the end of life: The Chaplain as a ‘Hopeful Presence’ by Steve Nolan

Book review by Dr Gareth Tuckwell

  • Review

‘The Chaplain as a ’Hopeful Presence' by Steve Nolan

Jessica Kingsley Publishers 2015 £21.24 ISBN978 1 84905 199 6

Talking about dying can be so hard! But sometimes a realistic talk that brings hope without an unrealistic false optimism of recovery can be helpful. Dying with dignity must ensure that family will to be cared for, and that any anger, related to grief can be expressed and understood.

How I wish I had had this book to read during my medical training. I can still vividly remember the sense of helplessness when a 28-year young mother, who was dying of breast cancer, wept as she told me that her husband could no longer face visiting her. I was lost for words, although that may have been appropriate! Within your working life, have you ever had what felt like a difficult encounter with a dying person or their family? Did you feel that you had nothing to offer? Then this book is for you! Forget the fact that you are not a chaplain. This book is an invaluable read for everyone, particularly those in healthcare, who may find themselves alongside someone who is dying and needs to talk about the situation.

The reader is drawn into a series of ‘moments’ in the relationship between a chaplain and a person who is dying. The author reflects on these ‘moments’ with rich learning that is not only well referenced but is very true to life. He develops his theory of the chaplain as a ‘hopeful presence’ – a presence that moves from a tentative first contact to a relationship which brings hope.

Do not be put off by the possibility that the author comes from a different Christian faith position stance from you. He has lived and moved among a number of Christian theological persuasions – Roman Catholic, charismatic, neo-Pentecostal, evangelical, Baptist, liberal. His present liberal perspective is only too common among those working in palliative care.

Steve Nolan encourages us that when our treatment can offer no more, what we have to offer is a person-centred relationship with the dying person. This often has a transforming therapeutic power, possibly because we receive the anger that would otherwise be directed at God. Excellence in end-of-life care means having the courage to offer a simple loving presence as much as a perfect symptom control. We sometimes need to pause and ask: “Are we still striving to ‘make things better’ either for ourselves or for the person dying before us.” Our comforting presence may be communicated simply by staying silently in the pain of the other person’s experience. The balance between professionalism and humanity is never an easy ride. Can we be both fully professional and fully human whist bringing the light and love of Jesus into our relationship as we enable the person who is sick to be the person they need to be?

In his book ‘A short span of days’ , Laurence Freeman wrote: ‘At death’s door only one person can enter at a time. But it makes a great difference to know that on this side of the door there is a loving ’presence‘ to accompany you and to prepare you for the Presence that welcomes you on the other side. That seems to me to be the real mission of (palliative) care-givers. To be that loving presence as fully and as humanly as possible.’ Reading this book will help prepare you to be just that.

Gareth Tuckwell