Chaplain’s care guided grieving widower to ‘a deep peace’

Teresa Galvin Anderson recalls how, over the course of 10 years, a chaplain helped a participant in one of Trinity Health’s PACE programs cope with grief, estrangement from children and his complex medical condition to find what she calls “a deep peace” before the end of his life.

Anderson, mission leader for Trinity Health PACE and Trinity Health At Home, shared the details of the man’s final decade to illustrate the impact spiritual care can have on quality of life and health outcomes for the frail elderly. She did not name the man or the chaplain out of concerns about federal health care privacy laws.

Anderson

The chaplain worked with the man and his medical providers on interventions to address the unresolved grief he’d experienced since the death of his wife and the stress of his complex medical needs. The services the chaplain provided included grief counseling and support, assistance enrolling in a smoking cessation program and aid in crafting an exercise regimen the client could do in his wheelchair that helped restore some of his vigor.

children. The man was at the bedside when the son took his final breaths. The daughter was again part of her father’s life when it ended. She even got grief support from the same chaplain who had cared for him.

“I think the care helped him die at peace and it helped her carry forth her grief afterwards to resolve that in a healthy way because it was complicated,” Anderson says.

The African American widower was in assisted living when he joined Trinity Health PACE, at about age 70. A military veteran, he had supported himself and his three children as a short-order cook after the death of his wife when he was about 38. He had once been athletic and a coach but was using a wheelchair and largely immobile when he enrolled in PACE.

The man had taken an “authoritarian approach” to parenting that, Anderson says, caused a rift with a daughter that had persisted into her adulthood. He also had become distant from a son who had contracted HIV/AIDS at a young age.

The chaplain helped the man become a regular at a Baptist church, where he restored a faith connection that he had let lapse amid his grief and anger.

Anderson says the chaplain provided encouragement and arranged supportive services such as transportation that led to the man reconnecting with his estranged the 12 PACE programs it owns or manages at 21 centers across nine states.

Those programs all have chaplains, most of whom are full-time employees. Their services include conducting spiritual assessments, working with clinicians to develop interventions to improve clients’ health outcomes, assessing goals of care, and assisting in advance care planning and in identifying surrogate decision makers.

Anderson says the chaplains are unofficial members of the interdisciplinary PACE care teams of clinicians, therapists, aides

Trinity Health provides spiritual care to its PACE participants without outside reimbursement because the system recognizes that the care can have a major impact on their well-being, Anderson says. She supports a call for the Centers for Medicare and Medicaid Services to expand its very limited coverage of spiritual care so that more participants in PACE or other integrated care programs have the option for the services.

“If we can work out the right reimbursement, then programs can hire chaplains to do this important work in these integrated health settings,” she says.

— LISA EISENHAUER

and social workers. Right now, chaplains’ services come courtesy of Trinity Health as part of its Catholic mission.

If CMS integrated direct payment of chaplaincy care into federal health coverage for dual eligibles, Anderson says researchers could mine the related data to assess impacts on health outcomes.

“The chaplain often has the unique skills in communication and listening and assessing the values and the hopes and fears of each stakeholder,” she points out, adding that stakeholders in PACE programs