Introduction

Important Issues in the
   Care of the Dying

Your “Job” in the Death and
   Dying Process

Hierarchy of the Dying
   Person’s Needs

Living with Spiritual Distress

Overview on Death from a
   Traditional Jewish Perspective

The Role of Culture and Diversity

Signs of Impending Death

Resources

Action Ideas That Work

“Real” Intersection of Systems

Helping Individuals Face Important
   Decisions at the End of Life

Questions That are Good    Conversation Starters

Common Questions and Answers

Advance Care Planning

Advance Health Care Directive

Living Will

Durable Power of Attorney for
    Health Affairs

Hospice Care

Helping Survivors Deal With Grief

Questions and Answers About
    Health Care Directives

Handouts

References

Action Ideas That Work

Workshop(s) on End-of-Life Issues Using the Wesley Approach

In Durham, North Carolina, The Reverend Carolyn H. Burrus spends much of her time with people who are dying and their loved ones. Based on her exeriences, she created a workshop on end-of-life issues. She based the workshop around the John Wesley’s quadrilateral elements (scripture, tradition, reason, and experience). The Wesleyan quadrilateral allows people to match their basic faith beliefs with contemporary contexts and concerns. In so doing, they can discern how to live their faith in new and changing circumstances.

Each workshop in the series started with a hymn and discovery of Scriptures related to a particular end-of-life issue. Next, members explored their own notions about the topic, and then discussed these as a group. For instance, one seminar in the series helped participants plan their own funerals, choosing Scriptures and hymns that reflected their own theology and values. They then talked about the what the process felt like, how it changed them, and how it encouraged them to face their own deaths.

An example of a possible two-hour seminar outline for Advance Care Directives topic using the Wesley method of theological reflection to explore death and how you feel about it:

• Scripture (the source of faith guidance): What does the Bible say about this issue? Did Jesus say anything about it? Pairs or small groups could look up these or other pertinent Scriptures and report back to the larger group, answering questions such as: What does the Scripture say about how we are to treat individuals nearing the end-of-life? What does it say about decisions around death, especially an issue like advance care directives? How does God feel about people who choose the way they want to live out the ending of their life?
• Tradition (wisdom of the past): What has our religion done in the past for individuals nearing the end-of-life? What has [name of congregation] done? What has the larger, ecumenical church done?
• Experience (accountability to past and present): How have I experienced death? Do I know people who have died, or are dying now? Have I had any experience with an Advanced Health Care Directive? What do I feel about it?
• Reason (interpretation): What do I know about this issue? What, according to the facts, appears to be right, reasonable, and logical? What do experts in the field have to say? What do families of individuals who have died have to say? What can we learn from them? For this part, you could invite a medical professional, loved one of a deceased congregation member, and a person who has decided to complete an Advanced Care Directive to speak to the group about their experience with the topic.
• Conclusion: When you have explored Advanced Care Directives through all four elements, ask the large group to sum up each element. What conclusion can they draw about how they should respond to Advanced Care Directives? Then, most important, let them decide how they will respond. For those who are interested, you could have copies of a Directive for them to complete, and advise on the next steps after they have it notarized.

As a parish nurse, you could combine this type of reflection with bible study groups in your congregation. Or, the many issues regarding end-of-life could be held as a series of seminars on topics such as advance health care directives, ethical wills (http://www.ethicalwill.com/index.html) , and exploring personal thoughts on death. Personal Loss History (pdf 492KB).

Advanced Care Planning – a Fair

This fair is patterned after highly successful “health fairs” held in congregations across the state. Over a four-hour period, typically on Saturday mornings, the parish nurse organizes a number of exhibits and presentations centered around a particular issue – this one would be based on Planning for the End of Life.
Exhibitors would be invited to represent such groups as estates planners, long-term care providers, hospice providers, home health agencies, city/county health agencies, hospitals, grief support groups, caregiver support groups, attorneys with knowledge of end-of-life decisions, etc.

Throughout the morning, mini-sessions could be held on various applicable topics, exploring the clinical, social, spiritual and legal issues surrounding end-of-life:

• Advanced Care Directives
• Hospice care
• Pain Management
• Fears at the end-of-life
• Funeral Planning
• Estate Planning
• Grief, Loss and Acceptance

The fair could be advertised in bulletins, newletters, posters, and the local media – inviting congregation members and the general public. A sample press release follows:

Advance Care Planning: A Seminar Linking the Patient, Family, Provider and Legal Community

This seminar would be designed for all who assist individuals at the end of life – attorneys, physicians, nurses, social workers, clergy and health providers involved in health care and end-of-life care. It would provide an opportunity for professionals to learn how to best work together, using effective facilitation skills to ensure their clients' legal and health care objectives are met. The purpose is to link all aspects of the professional community together in a careful approach to end-of-life.

Length of seminar: 2.5 hours

Seminar Content:

• Introduction (congregational leader) – 15 minutes
• Facilitating discussions on advance care planning with those facing the end of life and their loved ones (psychologist) – 30 minutes
• Completing Advanced Health Care Directives (attorney) – 30 minutes
• Options for the end-of-life (hospice provider) – 30 minutes
• Understanding the grief process (clergy) – 30 minutes
• Closure (congregational leader) – 15 minutes

The seminar could be promoted in bulletins, newletters, posters, and the local media – inviting congregation members and the general public. A sample press release follows: