Church Army Discovering Faith in Later Life March 2004 Number 1
PARCHE Pastoral Action in Residential Care Homes for the Elderly Registered Charity No. 1094445
Taking the church into residential care homes in Eastbourne Michael Collyer CA Researcher: Older People Exploring evangelism, spiritual needs & fresh expressions of church among older people. The Sheffield Centre Church Army’s Research Unit Directed by Revd George Lings Email: ask@sheffieldcentre.org.uk Email m.collyer@churcharmy.org.uk
Introduction
I first met Buddy Reeve founder of PARCHE1 (Pastoral Action in Residential Care Homes for the Elderly) at a meeting of SCOP (Spiritual Care of Older People) of which I am a member. SCOP was set up to promote and encourage ministry among older people especially those recently discharged from Hospital. It came into being as the result of a conversation in the Churchill Hospital, Oxford, between a social worker and the former Chaplain, Revd Stephanie Bullock, about two years ago in consultation with the Diocesan Board for Social Responsibility Adviser. A small committee was set up and SCOP was born. The aim of SCOP is to organise training events for people wishing to offer a specific ministry to older people in various settings. SCOP is still in its infancy of development. The work of PARCHE came to the attention of SCOP; its vision seeming closely related to that of SCOP. We were anxious not to reinvent the wheel and so an invitation was made to Buddy to share her experience with us. The meeting took place during the summer of 2003. It was as a result of meeting Buddy and hearing about her work in Eastbourne that prompted me to explore the work of PARCHE in more detail as I thought it would be of interest to all evangelists, ministers of religion and others working with older people.
The PARCHE Vision The PARCHE aim: to be available to meet the spiritual needs of every elderly person in residential care. PARCHE achieves its aims by: • • • • •
Supporting and encouraging existing pastoral care Where invited, holding a monthly service in each home Where possible, linking each home with a local Church Offering pastoral help to any resident on request Training local Christians, equipping them for the work
The Birth of PARCHE Buddy had cared for her elderly mother until her death and became aware that mother’s spiritual need had become neglected during her stay in a residential care home. Buddy then worked as a care assistant for five years, and became convinced that an organisation to meet spiritual needs of older people should be set up. She called a meeting of all the churches in Eastbourne of which 27 sent along a representative. This resulted in the devising of a questionnaire (see Appendix A) which was circulated among the 93 Care Homes; 47 were returned requesting spiritual care. Buddy then made an appointment with each of the owners/managers to discover the nature of the spiritual care needed. Buddy also asked for a 5minute slot at local church services to explain the project and ask for volunteers. At this point, churches may make a donation to the project but it is not asked for. Churches may become ‘participating churches’ by making an annual donation that entitles them to vote at the AGM and have a say in the running of the project. The ministers forward nominations for volunteers to Buddy. The volunteers remain the responsibility of their ministers in their pastoral work. Half-day training sessions are provided for the volunteers, which include listening skills, prayer opportunities, evangelism, videos, advice for Services etc., with the aim of setting up a team of 4-6 for each home. Buddy provides hands on support and is now employed as the co-ordinator for 12 hours per week. In an article in Renewal magazine (December 1999) Catherine Butcher, editor, asks the question “Are elderly people in your area forgotten once they move into a care home?” 1
See page 5 for an explanation of the name.
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In my own recent experience in visiting a local home the answer is ‘yes’. Older people comment that they do not see very much of their family members either as a consequence of distance, or their closest relatives are themselves elderly or indeed they have outlived their friends and relatives. In the Renewal article, Buddy said she first recognised the need in her area when her mother had a stroke back in 1991 and went to live in a nursing home. ‘Watching what my mum suffered made me realise the desperate need.’ Buddy says that when her work began in 1997 only 4 of the 93 residential care homes in Eastbourne had a regular church service, some individuals were visited by members of local churches; 14 homes had an occasional visit from a church group at Christmas. She discovered that one rest home manager had only been contacted by a church group once in 17 years; another had asked three different churches to visit the home three times over a span of two years without success. Eastbourne is probably not unique she says, the same situation could be repeated in many parts of the country.
Eastbourne in context Prompted by this last comment I compared the situation in Eastbourne with that of Worthing, both seaside towns on the South East coast with a similar population size. The table below sets out the differences. Table showing comparison of population size
MALES FEMALES TOTAL
EASTBOURNE 41650 48017 89667
WORTHING 45764 51804 97568
(Source: figures extracted from the Census 2001)2
Table below shows the population figures for those over the age of 65 AGE RANGE 65-69 70-74 75-79 80-84 85-89 90 & over TOTAL OVER 65
EASTBOURNE 4665 5054 4748 4743 2465 1493 22168
WORTHING 4619 4859 4820 3782 2785 1739 22604
(Source: figures extracted from the Census 2001) 2
http://www.statistics.gov.uk/census2001/pyramids/print/V/45UH.asp http://www.statistics.gov.uk/census2001/pyramids/print/V/21UC.asp
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The table above expressed graphically. 6000 5000
65-69
4000
70-74
3000
75-79 80-84
2000
85-89 1000
90 & over
0 EASTBOURNE
WORTHING
The tables above show that the two populations are very similar in size. Worthing’s total overall population is slightly higher than that of Eastbourne’s by 8% and the population over the age of 65 in Worthing is 19% higher that in Eastbourne. Given these differences in size, one would assume that the number of care homes in these two towns would be similar or if not slightly higher in Worthing. In fact, the opposite is true. Based on the anecdotal information given there are roughly twice3 as many homes in Eastbourne as there are in Worthing! This could be a reflection on Worthing’s preference for care in the community or on the demand for residential care homes in Eastbourne because of its popularity with older people. One could go further and speculate about the differences. However, the figures seem to support the Strategy that PARCHE had adopted in concentrating its outreach to residential homes. It might be worth noting that, according to the figures provided by the 2001 Census, the number of older people over 65 in both Eastbourne and Worthing are above the UK average and the number of those below the age of 65 are under the UK average. Those between the ages of 60 and 65 reflect the national average.
Church Army’s response to Worthing Church Army, aware of the growing population of older people in Worthing, appointed Captain Howard Schnaar three and a half years ago to work as an evangelist with special responsibility for reaching older people in the many residential homes in Worthing. On a recent visit to Howard I was struck by the fact that one street in the town was lined by residential care and nursing homes. Howard has regular contact with fifteen of the thirtythree homes in the Town. All the other churches in the area visit the homes but only visit individuals known to them. At present there is no coordinated attempt to visit the homes and provide activities and services. Howard says this is the long-term vision and the church recognises the need but lack the resources.
Back to Eastbourne Buddy says, “Once elderly people enter residential care, they are easily forgotten by most of society. Unable to get out and about, elderly people rely on others to visit them. They 3
The number of residential care homes in Eastbourne has been reduced to 71 from 93 homes in 1991
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may have been keen Christians with a vital role in church life 20 years ago. Now, many have lost most of their family and friends. No matter how caring the staff are, many elderly people feel rejected and unwanted”. Buddy felt guided by God to do something about this appalling situation. Buddy now runs PARCHE which has brought together 33 of Eastbourne’s churches into action and reports that teams visit 63 of the remaining 71 homes4 so probably 1,500 residents have the opportunity to benefit from team visits. The majority can no longer go to church, so the church needs to go to them. With insight and experience as a care assistant, Buddy prayerfully invited other churches to consider the need and Pastoral Action in Residential Care Homes for the Elderly (PARCHE) was born; the inspiration for the name coming from Isaiah. Ch. 41: v.17, ‘The poor and needy seek for water but there is none; their tongues are [parched] with thirst’. Now there are teams going into 63 local residential homes, providing friendship, caring, listening and where appropriate, prayer to encourage the faith of an individual. Some have even come to faith in Jesus Christ, and others have had their faith renewed. Part of the task she says is to help people with their concerns over issues related to death.
Preparing the Way The questionnaire mentioned above paved the way to establish the extent of church involvement in all the homes and to find out which of the homes would welcome contact with the Church. This was sent to every home Matron/Manager, followed by personal contact with the managers, a very important stage in the process. It was also important to communicate to church leaders that the project was not intended to increase their work-load but to open up ministry for lay people. Invitations were therefore sought to speak to congregations to tell them about the project. Volunteers are then invited to attend training sessions before they begin work.
Training Training is very much a part of the PARCHE project that involves a simple training course for church teams. This gives church groups guidelines on how to win the respect of the care home staff and how to relate to residents who may be blind, deaf or have problems with other communicating skills, for example, those who have experienced strokes. The training includes useful resource material, such as sources of large print material, the importance of listening and praying with residents, preparing services. In addition, the Chairman of the local Alzheimer’s Society gives some training – from a Christian perspective. For those visiting homes caring for people living with dementia, volunteers prefer to work within teams5. Training seminars are also offered to care staff in the Eastbourne homes. A typical halfday programme falls into two parts. Part 1 begins by exploring and explaining spirituality, defining spiritual needs, and looking at bereavement (all losses) causes and effects. After a coffee or tea break Carers are helped to meet spiritual needs in everyday life, bringing spiritual comfort (one-to-one) and sensitively preparing Residents for death.
4 5
Due to closures there are currently 71 homes compared to the 93 homes when the project was first conceived. At present volunteers do work within teams, it is hoped to train one-to-one pastoral visitors in the future.
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A small charge is made for each person attending the seminar and a certificate of attendance is issued to each person.
Resources offered by PARCHE Training materials have been developed. For example the PARCHE Pack has been designed for Home Owners and Managers the spiritual needs of older people and seminars are offered. So far three homes have taken advantage of this. Use is made of other agency services offered by Age Concern and Help the Aged. PARCHE has put together a collection of 26 short talks for ministers and volunteers conducting services for elderly people in care. A hand out is also available on the nature of Alzheimer’s disease and other dementias.
Structure of the organisation The aim is stated as, ‘Churches in the town working together to meet the spiritual needs of every elderly person in Residential Care’ SETTING UP 1) Executive Committee formed of ten responsible people from various Churches (Baptist, Methodist, Anglican, U.R C., Free, etc.) 2) July 1997= Inaugural meeting to launch PARCHE: all 48 Eastbourne Churches invited: 27 were represented. 3) Part-time co-ordinator (12 hours a week) appointed to set up and maintain the work. This is an employed position with job description: contact Home Managers and explain project; contact Church leaders to raise teams; connect Homes and Churches, provide training, produce newsletters etc. FINANCE Churches give annual donations— minimum £25. Some churches give by monthly direct debit. Our annual budget is around £6,0006 at present. TRAINING A training scheme has been set up to give information, guidelines and resources for teams leading services in Homes. Training re Dementia is also offered to the teams by the Chairman of the local Alzheimer’s Society. COMMUNICATION A quarterly newsletter keeps everyone informed of all that goes on. Prayer Meetings twice a month take place in different churches, encouraging people to get to know one another across the boundaries. The A.G.M. in April and a general meeting in November are times for business, praise and prayer. In May an Annual Service for Residents is held in a suitable local church with disabled facilities. In September there is a half-day for all teams, and anyone interested, to praise God, share news, and pray.(We take a picnic lunch to Ashburnham Place and it is great FUN'!). 6
Figure for 2004
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CO-WORKER Appointed in 1999 to assist Co-ordinator 5 hours per week. PARCHE PACK In 2000 a Spiritual Care Pack was developed for Home Owners/ Managers offering information and ideas. This includes a training seminar for CareStaff, mobile Christian shop, Christian video lending library. MINI-BUS In October 2001 a mini-bus made available to PARCHE for the use of Homes, Monday to Friday, on a donation basis. Trips with driver arrangeda great success.
HAILSHAM During 2001 the work developed independently in Hailsham, Polegate, and Willingdon with a local co-ordinator. RETIREMENT ACCOMMODATION March 2002—Asked to extend the work into Sheltered Housing by Eastbourne Borough Council. VIDEO Summer 2002—The Eastbourne Camcorder Club produced a short Video giving an overview of the work of PARCHE. This was completed by December 2002. Cost £2.50p (+p&p 50p) FUTURE PLANS • To continue to expand in Eastbourne and to be available to travel and speak about the project. • To encourage others in different areas to set up similar schemes with churches working together. • To offer training for both Christians and Care Staff as required. UPDATE 2003 • At present there are 71 Residential Care Homes in Eastbourne of which 63 have a regular church service and visit from a PARCHE team. • There are 45 Retirement Housing Schemes and currently 11 of these are visited by a PARCHE team. • There are 33 of Eastbourne's Churches supporting the work: every denomination is involved. (Source: Parche Information 2003)
Ongoing work and aims The work aims to be as creative as possible; Buddy says that spiritual activity opens up people to the Holy Spirit. One-to-one ministries are encouraged for people who are without visitors or relatives. The project had hoped to explore visiting people in their own homes, with referrals coming through the Care at Home Agencies. But for the time being it remains an unfulfilled vision, the project would be too big at present: not enough hours, people or finance to go forward. 7
Eastbourne Association of Voluntary Services (EVAS) and other agencies now meet for seminars on work with older people. The Sheltered Housing Manager from Eastbourne Borough Council has approached PARCHE and asked for a team to visit their retirement accommodation. In Eastbourne there are over 45 retirement complexes, many owned privately and some owned by the local authority. It is hoped that in time each one will have its own church team! One recent innovative resource developed is a mobile Video Library, which is taken around the homes by volunteers.
Management and Trustees Buddy, operating from a spare bedroom at home, manages the project. PARCHE is now a charitable trust, (Charity No. 1094445) and eight trustees are appointed. The Chairman is a Care Home owner – who has knowledge of relevant legislation. The trustees hold varying policy opinions on funding issues from moving forward in faith and the Lord will provide, to being secure with funding before any new initiatives are undertaken. The Board of Trustees is made up of members of the different denominations. Expenses are met entirely from donations from the Eastbourne churches and individuals.
Difficulties/Barriers • • •
A few Home Owners have declined to meet and discuss the project. Some volunteers have given up for health reasons necessitating replacement, not always easy! In one Home a staff member objected to the worship and message on the grounds, that it upset the residents. The occasional emotion shown was in fact response to the gospel but this is not understood. The team were asked to leave! After 6 months, Buddy arranged for a replacement team to go in and all is well!
ALBERT7 was non-churched; a surly bad-tempered man in his 80’s who refused to take part in our Services although he elected to stay in the room. After about 9 months, he started to accept a Hymn sheet and follow the words. After a talk one day on ‘knowing sins forgiven and peace with God’, he admitted his desperate need. He privately confessed to a male member of the team his burden of guilt for apparently grievous sins. Subsequently the staff said he was a different man, no longer bad-tempered but pleasant to everyone. Three months later went to be with the Lord. • • •
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Occasional verbal opposition from residents opposed to Jesus Christ (bad language and blasphemy where there has been occult involvement) Lack of able volunteers to organise the visiting Christian Shop and Video Lending Library: they have temporarily ceased. Limited finance: currently the annual expenditure is about £6000 of which £5000 covers the wages for the Co ordinator working 12 hours per week and a Co-worker working 7 hours per week. The remaining income covers administration costs such as telephone, postage, photocopying, stationary, petrol, and producing resources for the wider church. With more money coming in we would be able to employ another
Names of residents in these boxed examples have been changed to maintain confidentiality.
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worker to develop the one-to-one pastoral visiting scheme and make contact with isolated older people in the community, living alone or with a partner.
Evangelistic Method Delivery •
•
The main medium of contact is through the conducting of services led by the visiting team. The words of gospel hymns, Christ-centred 5-minute talks, and personal testimony all form part of the overall message. Informal contact with the residents takes place after the service when the team circulate for personal chat and opportunity to pray with residents as required.
JOHN was non-churched but believed there was a God ‘somewhere up there’! He was a lovely gentle man who did not attend services. Buddy visited him in his room and one day when he was in great pain I asked if I might pray for him. The Lord came by His Spirit and met with John completely releasing him from pain and revealing Himself to him. John confessed Jesus as his saviour and died peacefully a few months later never having attended a church service! •
Gospel literature is available for the residents to keep. This includes booklets, tracts, scripture verses, bibles etc. In the course of general training the teams are encouraged to do all the above.
What connects with the residents? • • • •
The old familiar hymns (‘I had this at my wedding’) Scripture Union choruses from Sunday School days! Reminiscence about the past: answers to prayer especially during the war. Talking about family, both past and present.
Follow-up • • • • •
Extra visits to a new believer. Large print bibles from Gideons. Worship and teaching tapes available. Linking up with other Christians in the Home, staff or residents. Talking to church meetings where this is possible.
Homes Relationship with the Church The PARCHE project has made a significant impact on the homes and residents in the following ways. • Many Home Owners/Managers that once had a poor opinion of the Church now see the Church as relevant and caring. One Manager has become a Christian because of the team visits. • Residents who are believers now feel loved and included again, where once they blamed the Church for neglecting them. • Many from Anglican and Catholic backgrounds have been re-connected with a local Minister/Priest to receive communion again and are included in the prayers of their chosen denomination.
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ALICE was a lapsed Christian who once had a vibrant faith, came into the Nursing Home very unwell but also sick in spirit and clinically depressed. After 2 or 3 visits to get to know her Buddy encouraged her to pray and return to the Lord. She was immediately and remarkably transformed, her depression vanished, and she became a radiant witness to the other residents for the remaining 18 months of her life. •
Those with no church connection or faith in God are often glad to receive spiritual help, are awakened to their need, and recognise the ministry of the Church.
Proportion of Residents in the Categories of Churched, Dechurched, and Non-churched No accurate survey has been carried out but the following estimate was produced: • • •
Approx 1 in 10 is a Christian with Church Membership Approx 7 in 10 had Sunday school/church teaching when young but drifted away Approx 2 in 10 are atheist or other faith
Reflection In our society the single most striking portrayal of old people is their loneliness. Friendship with the elderly is almost unimaginable, as our very conception of what it means to be old is one of isolation. This isolation compounds with frailty, lack of usefulness to the world, dislocation from home and possessions, forced dependency, and nostalgia to construct a pitiable picture of a person who is unloved and, in many ways, unlovable8. This statement reflects that of Buddy’s on p.4. Many older people become de-churched through no fault of their own. In response to a research question that I recently sent out asking whether people thought organised religion offered by mainline churches helped or hindered the spiritual growth in older people, one respondent replied We train people to believe they need to attend church/meetings and when they cannot we fail to provide a suitable alternative. The PARCHE project is an example of providing a suitable alternative, that seriously challenges and seeks to do something about the sense of isolation that older people feel as so graphically described above. It is not only an inspiration but offers a model that works for taking the Church into Residential and Nursing homes. • • •
It is appreciated by those on the receiving end of their ministry by both staff and residents. It encourages lay ministry to the elderly by volunteers and builds their faith and confidence in sharing the gospel within the team. It is a challenge to the Church operating in areas where there is a large population of older people living in care.
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Quoted from and Essay entitled Captured in Time: Friendship and Ageing by Stanley Hauerwas and Laura Yordy in Growing Old in Christ, Wm. Eerdmans Publishing Co. 2003
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•
It is an example of Churches working together across traditional boundaries and where combined effort can make a very real difference in meeting the spiritual needs of older people who would otherwise be forgotten –out of sight and out of mind!
A lot has been achieved since 1997 when the idea was first conceived by Buddy. The careful process of setting up the project by first selling the idea and bringing others on board, and in gaining the confidence and support of the local church leaders, has resulted in a sustainable project supported by Trustees and charitable status. Every project is faced with difficulties not only related to the lack of adequate financial resources but also the recruiting and training of volunteers from increasingly aging congregations to take the project forward. Perhaps there is room to involve children and youth in the project by experimenting with different forms of services from time to time; for instance holding a baptism service or even funeral or memorial services within the home! This might provide the means of building faith communities within the homes. At present, PARCHE is providing a unique ‘church on wheels service’, which is meeting a very real need, but some might ask is this real church? I read an account the other day of a baptism that took place in the context of a residential home. The frail elderly grandfather of the child was not able to attend a service in the Church. Therefore, the Church brought the service to the home resulting in the following observation: We knew, and know, that this service was a gathering of persons in community for the praise of God. Community was a verb that day. That congregation, including persons ranging from a three-month-old baby to people a few months away from death, only some of whom possessed very strong cognitive capacities or much productive usefulness, provides an extraordinary example of life shaped by worship and of worship transforming life9. Another way to involve the younger generation would be to give older people an opportunity to become “surrogate grandparents” or even become godparents as they have the time and the wisdom to offer their experience of faith and would value the contact offering young people additional support. There is room for experimenting with different forms of service for building up faith. In this enterprising way, the Church can meet the very real spiritual needs of older people by taking the church to them. Currently these needs are being met in the context of Worship, in one-to-one conversations, and other occasional community activities. This method is proving to be an effective means of evangelism as the three testimonies have shown. PARCHE must be praised for its pioneering work in taking the church into residential homes and meeting the distinctive spiritual needs of older people. That is, a need to be valued by the church and to feel valued through the time the volunteers are able to give in listening to their concerns related to death and other losses and in the sharing of their faith by befriending. Let us hope that the ‘Official’ church leaders that oversee the local denominations will give the project due recognition as a valued expression of church and include the numbers attending the services in the official records of attendance.
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Recorded in an essay written by Susan Pendleton Jones and L. Gregory Jones entitled Worship, the Eucharist, Baptism, and Ageing in ‘Growing Old in Christ’, Wm. B. Eerdmans Publishing Co. 2003
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Appendix A PARCHE QUESTIONAIRE FOR RESIDENTIAL HOMES
Name of Home
Matron/Manager
Date
1. Do you have a Church team to lead a regular service? Yes/No If Yes:a. Which Church?........................................................................................................... b. How often, day, time?................................................................................................. c. Average number of residents attending? d. Do you find this beneficial? Yes/No If No:Would you like a service? Yes/No If No:Please could you state your reasons………………………............................................ ………………………………………………………………………………………………………………….. 2. Do you have a regular communion service? If Yes:If No:-
Who leads this service?...,............................................................................................... How many residents attend?............................................................................................ Would you like a service? Yes/No
3. Do any other clergy visit? If Yes:If No:-
Yes/No
What denominations?...................................................................................................... Are any visits needed? Yes/No
4. Do any of your residents attend Church? If Yes:-
Yes/No
Yes/No
How many?..................,........................................................................................................
Would any residents like to attend Church if transport was provided?
Yes/No
Give details............................................................................................................................................................ 5. Would you welcome a small group for prayer/bible study in your home If Yes
Yes/No
Day/time...................................................................................................................................
6. In your staff training programme is any mention made of spiritual needs? (helpful material available if required)
Yes/No
7. Are residents helped in any way to prepare for death?
Yes/no
Thank you for taking the time to answer this questionnaire Please contact Buddy Reeve 01323642471 PARCHE is a project sponsored by Eastbourne's churches
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This paper was written and produced with the support of the Sheffield Centre, Church Army’s Research Unit. Directed by Revd George Lings. For further information contact c.dalpra@sheffieldcentre.org.uk or 0114 272 7451. Also visit www.encountersontheedge.org.uk & www.churcharmy.org.uk
Sharing Faith through Words and Action
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