Spiritual Care: A Guide for Caregivers (12 page)

Figure 3. Why pray?

Most seriously ill people experience an overwhelming sense of isolation at some point. Whether or not the person has a strong support system, he or she often feels alone and cut off from human
relationships. Maria, a thirty-three-year-old woman with a brain
tumor, described her sense of isolation: "It is difficult to express
the deep inner cravings of my heart during these last few months.
I longed night and day for someone to reach out to me with an
understanding hand and heart. It was as if I had a huge, gaping
wound that could not be treated. The pain, the fear, the irritability,
the turmoil pressed upon me daily. It seemed as though no one
was near me, no one cared. I thought I would collapse for want of
understanding. I felt that I must be the only person to have ever
experienced such a need." The fact that warm, loving friends and family surround the person does not always cut through that sense
of isolation.

When people cannot perceive the love and concern of other
people, whom they can see, their ability to sense God's presence
and concern is even further impaired. When that illness forces
them into dependency upon others, the emotional struggle surrounding loss of control and independence may further complicate
their ability to trust in God.

Often persons who have had a strong faith will undergo the most
distressing difficulties in their ability to trust God and to pray. Prior
to her brain tumor, Maria was a missionary with a vibrant faith, yet
she concluded, "I needed someone to say in words the things I was
unable to say to God." She felt comforted because others were praying for her, but she also felt guilty that she suddenly seemed
estranged from God. She desperately wanted to trust God, but at
the same time, she felt angry and betrayed by him. All of the hurts
and perceived failures of her missionary career came crashing down
on her, sending her into a spiral of fear and depression. Her friend
Ginny listened quietly as Maria shared her feelings, then offered to
pray with her. In her prayer Ginny told God exactly what Maria
had told her, asking him to give Maria strength, peace and healing.
As Ginny prayed, Maria began to feel hopeful.

Our prayers for others are important not only for the comfort they
may receive but because God hears our prayers and answers. We
have a responsibility to pray for those who are suffering. However,
praying with them has additional advantages beyond the psychological ones. Jesus instructed the disciples, "If two of you agree on earth
about anything you ask, it will be done for you by my Father in
heaven" (Mt 18:19). Praying together is important to God.

Praying together is also important to the sick person. When we
say, "I'll pray for you," without finding out what the person wants us to pray for, we may be of some comfort, but we offer only minimal support. The person never knows what we will pray or has
the assurance that we really aid pray.

When Ginny prayed aloud for Maria, Maria knew that someone had truly heard her concerns and understood her needs.
Ginny facilitated Maria's relationship to God as she became a temporary channel of God's grace. She also broke through the interpersonal isolation that Maria felt as she joined her in bearing her
burden before the Lord.

Shared prayer has some unique interpersonal side effects; it can
be one of the deepest forms of human communication. Hospital
chaplain Daniel DeArment claims that shared prayer allows "intimacy without exposure."' When we pray with a patient, expressing to God what the patient has told us verbally and nonverbally,
we break through the person's isolation without directly discussing what we have observed that was not verbalized. For instance,
a person may deny he is fearful of surgery, but his affect betrays
him. To confront that person directly by saying, "You are afraid; I
can tell," would probably send his defenses up further. But to pray
with him, "Lord, this is a scary situation -comfort John tonight,"
might free him to talk about the fear he is experiencing.

The question of meaning, especially finding meaning in an illness, can be dealt with more deeply in shared prayer than in
casual conversation. A relationship with God can supply meaning
when human resources cannot satisfactorily explain the suffering.
In praying with patients we do more than support them; we join
them in their quest for meaning and purpose by going with them
to the Source.

When a crisis has distorted a person's view of God, we may be able to demonstrate a healthy picture of God through shared
prayer. For instance, someone we are caring for may feel that God
is far away and does not hear. As we address God personally and
confidently, the suffering person's perception of God's love and
concern may be renewed.

The work of the Holy Spirit through us and within us cannot
be explained scientifically, but it is a reality. Romans 8:26 states,
"Likewise the Spirit helps us in our weakness; for we do not know
how to pray as we ought, but that very Spirit intercedes with sighs
too deep for words." The observable interpersonal dynamics-the
sense of intimacy and unity-which result from shared prayer are
not a psychological gimmick. They demonstrate the power of a
personal God at work in his creatures.

Prayer must be used in the context of compassionate presence, in
a relationship in which adequate communication has taken place.
When a person has expressed pain, fear, anxiety, stress, helplessness or joy (either verbally or nonverbally) to the extent that we
can identify what the person is feeling, then we can pray appropriately. If you do not have a fairly clear understanding of what is
bothering the other person, you are not yet ready to pray. Praying
prematurely with someone is likely to cut off further in-depth
communication.

On the other hand, be careful to avoid using prayer as a way to
end a conversation or visit. Prayer often triggers deep feelings
within a person. The verbal interaction after shared prayer may be
more significant than the conversation beforehand. DeArment
states, "A further test of dynamic and thoroughly legitimate use of
prayer at the bedside is your willingness to stay and respond to the
feelings and words of the patients which the prayer has touched."2

In situations where anxiety is high, be alert for spiritual needs.
Times of waiting and uncertainty provide opportunities to pray
with others. Prayer can be especially helpful preoperatively,
before major tests, after admission to an unfamiliar environment
or when potentially frightening equipment is applied (such as ventilators, electrodes or monitors).

Early in my nursing career, Rosella Valenti taught me the value
of prayer in a time of high anxiety, hers and mine. Recently reassigned to the intensive care unit, I still felt unsure of my competence when Rosella was admitted after a major heart attack.
Rosella belonged to my church, but I did not know her well. She
seemed relieved to see me there and asked me to pray for her,
which I did. The head nurse was not pleased. She sternly warned
me to keep my religious practices out of her unit. The next morning, however, Rosella seemed delirious, complaining loudly about
the "green men" who had violated her privacy and treated her
roughly. She seemed to think she was on a spaceship. She continually cried out, "Oh God, help me!"

Then I caught a glimpse of a surgical team making rounds in
their green scrub suits and considered how Rosella must feel in
her cubicle, attached to monitors that beeped and an IV catheter
dripping a strange solution into her veins. Of course those men
must have looked like aliens from outer space! I went to the head
nurse and told her that I honestly thought I should pray with
Rosella, explaining that it might calm her. Then I gently laid my
hand on Rosella's arm, explained where she was and what was
happening, and prayed for her. She relaxed, smiled and said, "I
really did know those men were doctors, I was just so scared-but
I know the Lord is here too." She never "hallucinated" again-and
I had blanket permission to pray for patients after that.

A basic guideline to determine whether prayer is appropriate in a given situation might be to ask yourself, "Whose need am I
meeting-my own or the other person's?" If your own need compels you to pray, then you would do better to pray privately,
rather than to use the suffering person to meet your need. If I had
indiscriminately prayed aloud with every patient in the ICU, the
head nurse would have been entirely justified in reprimanding me.
However, because I assessed her need for prayer first, my intervention with Rosella became clearly appropriate.

Rarely will a person turn down your offer to pray. I can only
think of two occasions when this happened in my own experience.
Both incidents occurred when I was visiting as a hospital chaplain, never when I was caring for someone as a nurse. One situation was an older woman, who told me, "No, my own pastor is
coming this afternoon." The other was a high-powered businessman, who seemed to need to feel in control. He said, "I'll be fine, I
don't need any help from the Man Upstairs." When this happens,
respect the person's refusal and simply continue with your conversation. Communicate acceptance of the person, even if he or she
does not accept your offer. Be sure you don't just turn on your
heel and leave at that point.

When we pray with a person, we express to God what that person
would pray if able. The most helpful prayer is usually a short, simple statement to God of the person's hopes, fears and needs, and a
recognition of God's ability to meet the person in his or her situation.

For example, Rose Wade was admitted to the emergency
department with a gunshot wound of the nose and mouth inflicted
by her husband during an argument. Her condition was stable.
She was alert, but she could not talk because of the pain and swelling of her tongue. She appeared frightened and uncomfortable. After orienting her to her surroundings, a nurse brought her
a pencil and paper and asked her to write down any questions or
needs. Rose wrote, "Where are my babies? What did they do with
my husband? How long do I have to stay here?" The nurse promised to try to find the answers to Rose's questions and went out to
the desk to make the necessary phone calls.

The children were located at a neighbor's house. The nurse
then called the neighbor from Rose's bedside phone to reassure
Rose that they were fine. Her husband was in jail. Rose's physician could give no estimate of the length of her stay. It would
depend on her progress. After receiving the information she
requested, Rose seemed less distressed but still quite anxious. She
wrote, "I love my husband. It was an accident. I don't want them to
lock him up!" Then she lay back with a hopeless look. The nurse
asked, "Rose, would you like me to pray with you?" Rose looked
relieved and nodded.

The nurse prayed, "Father, thank you that you know what's
going on in all this confusion. Thank you that Rose's babies are
being well cared for. We pray that you will be with her husband in
jail and ask that he will be treated fairly. Give him peace, Lord.
Help him to know that Rose loves him and you love him. Give
strength and healing to Rose now, so she can go home soon. She's
frightened now, Lord; please comfort her. In Jesus' name. Amen."

In the prayer, the nurse mentioned problems that Rose
expressed: her babies, her husband and her length of stay. The
nurse, sensitive to Rose's nonverbal communication, also prayed
that her husband would know Rose loved him. At that point in the
prayer, Rose began to weep, indicating that a deep feeling had
been touched. The nurse also recognized Rose's fear in the prayer,
although they had not discussed it directly. The nurse prayed what Rose would have prayed had she been able.

If we are to pray as the other person would pray, we need to
consider the religious background of the person, including the
types of prayers which have been meaningful to that person in the
past. Most people appreciate the simple, informal expression of
their needs to God, but many have been accustomed to formal,
written prayers. Some people may even feel that spontaneous
prayers are disrespectful to God and may prefer a selection from a
prayer book. The Lord's Prayer usually touches a deep chord in
most Christians-both Protestants and Roman Catholics. Even
demented and semicomatose people will often be able to pray the
Lord's Prayer with you, though they are unable to respond to
other verbal stimuli.

When the other person comes from a non-Christian background, you can still offer to pray to God. That offer will usually
be graciously accepted. However, if the person insists on praying
to another god, you can simply say, "I can't do that, but I will try
to find someone else who can help you." Most hospital chaplains'
departments will be able to find appropriate spiritual leaders from
various faith traditions. Even Jesus allowed people to make their
own choices, giving them the freedom to turn away from him (Mt
19:22).