Survey: Public prefers family to clergy at death
Survey: Public prefers family to clergy at death
Openings for hospice outreach suggested
A recent survey of public attitudes toward spirituality and end-of-life care has concluded that professional clergy are not the most trusted source for the kind of spiritual support and solace that dying Americans overwhelmingly say they would want at the end of life. A telephone survey of 1,212 adults, conducted by the New Jersey-based George H. Gallup International Institute on behalf of the Nathan Cummings Foundation and Fetzer Institute, identifies what Americans fear at the end of life and what they want in the way of end-of-life care.
The survey "clearly shows that dying is more than the end of existence; it’s a time of serious spiritual and emotional work for many people," concludes the Institute’s George H. Gallup Jr. "The overarching message that emerges from this study is that the American people want to reclaim and reassert the spiritual dimension in dying."
Among the findings: half of those surveyed consider prayer important at the end of life and 44% would like to reach spiritual peace as they are dying, but only 36% would look to a member of the clergy for spiritual comfort in their dying days. Even fewer, 30%, would turn to their doctors; most would rely on family (81%) or friends (61%) instead. Strong fears about dying were also identified, such as being in a persistent vegetative state, not being able to say good-byes, experiencing severe pain, and becoming a burden on loved ones.
The majority also say it would be important to them to have someone with them as they died and to have someone with whom they could share their fears and concerns about dying. Seventy percent of respondents say they would prefer to die at home, rather than in a hospital. These results seem to confirm the goals and approaches of hospice care, and growing recognition of hospice concepts, even if not an explicit endorsement of hospice care by the public.
Other important conclusions reached by the researchers: Religious groups and seminaries need to devote more training and attention to spiritual needs at the end of life. The medical profession, too, needs to understand that its relationship with terminally ill patients is more than just a discussion about medical decisions, and needs to include other dimensions of patients’ lives, including the spiritual beliefs that guide them. The stronger that Americans feel about religion, the more likely they are to favor life-extending treatment rather than comfort-oriented care.
The results may also suggest an opening for hospices to network with physicians, clergy, and seminaries in their communities, to share their expertise in spiritual caregiving at the end of life. Hospices can work with these institutions to support other professionals in counseling the dying, and to address public fears about dying.
"I’m not surprised about the findings, which underscore several problems" in American society, observes Jeanne Brenneis, MDiv, STM, chaplain and director of the Bioethics Center at Hospice of Northern Virginia, Falls Church, and Consulting Editor for Hospice Management Advisor. "Clergy have a lack of training in dealing with the elderly in general, and with the dying in particular. Going to seminary doesn’t necessarily put you in good touch with your own feelings about your own mortality, and the clergy can be just as uncomfortable talking about dying as anybody else," she says.
"I think there needs to be better training for the clergy. Hospice chaplains, I believe, are very good at dealing with these issues and helping people. But not enough hospices employ chaplains, and there aren’t enough of us to go around."
Details were announced at press time for an "End-of-Life Care Innovators Meeting," sponsored by the Center to Improve Care of the Dying (CICD) at George Washington University in Washington, DC, and building on that group’s work in promoting the Medicaring concept. (See Hospice Management Advisor, December 1997, pp. 140-141.) The meeting will be held March 23-24 at the Hyatt Regency Hotel in Crystal City, VA. Unlike CICD’s invitation-only Medicaring meeting held last November, the Innovators Meeting is open to any end-of-life care professionals.
For information call Joel Smith at CICD, (202) 467-2222, fax: (202) 467-2271, or e-mail: cicd@ gwis2.circ.gwu.edu. You may download a registration form from this Web site: www. abcd-caring.com.
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