By Jason Cooper

Sitting bedside with patients allows me, as a chaplain, to care for them wholistically as they near the end of life. While physicians and nurses tend to the clinical aspects of their illness, I respond to their spiritual needs. I become a caregiver at a soul level, a source of acceptance and compassion as patients question the meaning of their life or experience distress as their functioning declines.

While many believe that chaplains promote a particular religious system of belief, we instead support the patient in their own beliefs, whether these are rooted in a religion or not. Chaplains respect the patient and their diversity of beliefs and values when providing spiritual care. 

Increasing Patient Satisfaction

Hospice services include spiritual care because it addresses the more comprehensive needs of the patient and is a core value in patient-centered care. Spiritual care contributes to patients’ overall quality of life by cultivating a sense of meaning and comfort during this vulnerable stage of life.

As the patient increasingly comprehends their terminal diagnoses and the implications for them and their family, they often have spiritual questions or want to talk through what they are feeling at a soul level. Guiding patients through this process and helping them transition to a potential sense of peace is a privilege for those of us in the spiritual community.

It is also a benefit for hospitals. Studies show that greater use of hospice care overall for hospitalized patients results in improved patient satisfaction ratings along with lower mortality rates, both in the hospital as well as for those patients with an ICU admission during hospitalization. 1

Having chaplains present with a hospice patient at home often translates to fewer emergency readmissions to hospitals, as patients receiving psychosocial and spiritual support tend to feel less distress that triggers clinical complications.

The holistic care hospice provides contributes to improved post-discharge metrics for hospitals, which is especially significant for facilities intent on reducing readmissions as part of quality and cost-control initiatives. While the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys focus primarily on the inpatient experience, the quality of spiritual care after discharge can indirectly influence patients’ and families’ perceptions and thus impact the hospital’s reputation.

Support for Family Members as Loved Ones Decline

While the patient processes the trajectory of their life, their family lingers with grief needs of their own. Family members may ask questions of hospital clinicians and seek comfort. Chaplains assist families in navigating issues that loss brings up—questions about faith, life, and death.

Grief may evoke many emotions. Family members often feel profound sadness but sometimes also anger, guilt, and relief, especially if their loved one has been suffering for a long time. Others say they feel numb and have a sense of disbelief that this could happen.

Chaplains provide spiritual guidance tailored to the beliefs and traditions of the family. We may also assist in creating meaningful rituals or ceremonies to honor the person once they have passed, such as a religious service, a moment of reflection, or something personal that helps the family find closure and begin to heal.

Entering Hospice Earlier May Provide More Relief for Patients and Families

The sooner an eligible patient enters hospice, the sooner they can access the soul care that is part of their hospice services. This gives patients time to enter spiritual contemplation. It also provides chaplains time to encourage open discussion between the patient and their loved ones to facilitate a healthy grief process.

When a patient dies quickly after entering hospice, loved ones may feel unprepared emotionally. The sudden loss can make it challenging to process grief, and the intensity of their grief may increase. They may struggle to comprehend the sudden change in circumstances.

A longer length of stay in hospice allows the patient’s loved ones time to gradually come to terms with the impending loss. This gift of time can be invaluable for both the patient and their family members.

Understanding the value of spiritual care in the end-of-life process enables hospitalists to make more informed referrals, confident their patients will receive the compassionate care and holistic support hospice offers. This is a cornerstone of palliative and patient-centered care.

To refer your hospice-eligible patient to VITAS, contact us anytime at 800-938-4827. Jason Cooper is Chaplain and National Spiritual Services Lead, VITAS® Healthcare

1 BMJ Support Palliative Care. “Exploring the Association of Hospice Care on Patient Experience and Outcomes of Care.” 2016 Aug 16;9(1):e13. doi: 10.1136/bmjspcare-2015-001001