REPORT:
SEARCH CONFERENCE ON PASTORAL CARE IN THE ACT & REGION - 2005

APPENDIX

> RETURN from addendum to THE REPORT

Participants workshopped over two days issues about pastoral care, including considering current trends or changes within the community that may affect the future of pastoral care and the impact on the service that we are delivering now.

Edited results - Q 1 - 4 sorted into categories

Question 1      
When we think about the future of pastoral care what trends/changes are starting to occur that will impact on services in the year 2010?

Society

• 25% of population in 5 years will be retired
• Ageing society
• Alienation/fragmentation community groups
• Breakdown of family – demand for intervention
• Care in the home and connection with institutions and continuity with institutions
• Decrease extended family – support issues
• Decrease on emphasis on family/human values
• Expectations of younger generation
• Fiscal constraints on things that don’t add value to bottom line
• Frenetic busyness accepted main stream culture
• Impact of world events
• Improved community resilience
• Increase family dysfunction
• Increase in electronic facilities
• Increased community expectations for all services
• Increased legal requirements and litigation
• Increased loneliness/isolation – health difficulties
• More demand aged society ages
• Need to humanize/”homeise” institutions
• Privacy laws
• Rich – poor
• Support difficulties for 50-60 year olds
• Systems that promote human interaction over bureaucracy
• Technology – living longer with disabilities
• Trend away from personal responsibility

Health

• Decreasing length of stay in acute care
• Greater acceptance of mental illness
• Health budget likely to decline relative to demand growth
• Increase in mental illness/depression
• Increase in rate of substance abuse
• Increased regulation and accountability
• Lack of specialist services in the bush – transferred to centres
• Looking at wellness – preventative measures
• More sensitive medical profession
• New knowledge of brain, mind and body
• New, unimagined treatment regimes

Spirituality & Pastoral Care

• Diverse community backgrounds & religions
• Future requirement – accredited training in pastoral care
• Government funding for pastoral care residencies in hospitals
• Greater awareness of recognising pastoral care included as part of  multi-disciplinary teams and accountability
• Greater demand for volunteers
• Greater recognition of complementary of pastoral care and medical care
• Greater spiritual awareness – society
• Greater supply of retired volunteers to do pastoral care
• Increase in professionalism of pastoral care volunteers
• Increased awareness for the need for pastoral care
• Increased need for accreditation/funding for education
• Increasing need for health care workers to recognise the part spirit plays in illness
• Lack of clergy/religious
• Lack of knowledge of pastoral care
• Move of pastoral care away from religious base
• Need for meaningful rituals at times of transition, grief, loss, trauma, disaster
• Need for multi faith coalition to advocate for spiritual dimensions of human  person because of increase in materialism
• Pastoral care a part of wellness in contrast to focus on illness only
• Research into efficacy of spiritual dimensions in health care
• Support people through process of crisis emotionally

 

Question 2

What are the changes that have occurred to pastoral care over the last 5 years that impact on the service that we are delivering now?

Society

• An increase in numbers of international students not receiving a support system
• Death is taboo, especially for children = death denying
• Drought greater demand on rural communities
• Generational change in attitude (e.g. baby boomers)
• Increase in acceptance of violent policies
• Increased casualisation of workforce
• Increased demand for assistance form groups without enough financial assistance
• Increased tolerance of anger and violence
• Increased vicarious grieving and stresses
• Legislation to protect privacy of patients isolation
• Media violence, pornography in screen and music
• The evil of economic rationalisation – increased awareness that this “sickness” exists

Health

• Accountability in hospitals and facilities
• Because of increased government support individuals to be supported at home
• Change from institution care into community circumstances
• Decline in rural communities and lack of services
• Development for greater profit in institutions
• Doctors and nurses being obliged to have less time for patients because of admin
• Due to individual and family choice increased demand with  frail aged moving away from home-care into institutions
• Growth in remission society
• Increase in people in support of trauma
• Input on pastoral care  need - patients leaving earlier and sicker from hospital
• Lack of GP medical services in Canberra and country
• Lack of mental health institutions run by government
• Mainstreaming of mental health beds to general hospitals
• Shift in medical training – wholistic approach
• Shift of funding control to hospital units
• Shift of Veterans Affairs to state hospitals

Spirituality & Pastoral Care

• Acceptance of pastoral care in hospitals, universities and schools
• Adverse press on large churches – affects community perception of pastoral care
• Availability of spiritual help on Internet
• Demonstration of pastoral care by untrained
• Development/widening of understanding of pastoral care
• Emergence of qual. pastoral care services
• Emergence of sexual abuse cases “out of the closet”
• Greater demand for pastoral care in businesses
• Growth in multi-culturalism and multi-faith
• Increase in personal spirituality
• Increased government support for pastoral care
• Increased qualified lay pastoral care practitioners working alongside those ordained chaplains, etc.
• Lack in a relief of a God of any name
• Lack of clergy and religious
• Lack of culturally appropriate services
• More openness of individuals to speak of crises
• More people not affiliated to religious institutions/community
• Multicultural fragmentation causing increase in fragmentation and lack of support
• Pastoral care training
• Require records of pastoral care with case notes
• Requirement to train, mentor, accredit, supervise denominational and interfaith pastoral carers
• Research into spirituality
• Secularisation of pastoral care
• Setting up of volunteer pastoral care groups in hospitals in regional areas where they were not before
• Support for carers giving pastoral care
• Understanding of pastoral care brought into communities

 

Question 3

What are the things that seem to be unchanging that will continue to impact on pastoral care?
Characteristics

• Continued dignity of each person
• Continuation of stretching of hearts and minds
• Need for laughter
• Importance of empathic attunement
• Pastoral care always involves personal encounter
• Pastoral care myths
• The healing that comes from being visited and respected, listened to, understood and assistance to recognise one’s inner resources

Needs

• A spiritual yearning
• Need to be heard
• Person’s basic need to be loved
• Search for the meaning of suffering

Context

• Ethical dilemmas in medicine
• Existing facilities, hospitals, spiritual centres will continue
• Inadequacy of staffing levels
• Need for institutions to understand needs of different cultures at time of death
• Need to care for the children of adults being helped
• Pastoral care is integral part of health care
• Problem in finding where help is
• Exploration of alternative funding models

Spiritual & Religious

• Arising need for spiritual awareness in later life
• Assisting multi-faith chaplaincy to work side by side
• Fights over religious lists in hospitals
• God’s visit to the Abraham community at time of circumcision
• Gospel injunction to be with the sick
• Need of the human soul for recognition
• People search spiritually at times of crisis
• People’s needs for emotional & spiritual care
• Prayer and reflection are part of pastoral care
• Spiritual importance of telling the human story

Sources

• Continuing desire for people to help others
• Feeling of inadequacy when faced with other’s grief
• Labourers are few
• Need to create channels to bring forward volunteers
• Some people will be appallingly inept at pastoral care
• There are people who really care
• Need for pastoral care courses and the funding them

In groups

Question 4      
What are the strengths and weaknesses of services that are currently being provided?

Strengths

Characteristics

• Freedom from bureaucratic traditions
• Gives hopes, strengths and support to consumers
• Good pastoral care is inclusive
• Good pastoral care supports staff as well as patients
• Loyalty and deep understanding of individual
• Non discrimination of the individual
• Pastoral care as advocate
• Pastoral care continues to create awareness of compassionate care
• Pastoral care does make a difference – evidence to support this
• Pastoral care humanizes
• Pastoral care offers respect in times of crisis
• Powerful invisible support system!!!
• Standing beside people in crisis – giving clarity to fragmented services
• Team work
• Diversity

Contexts

• Available at both Calvary and The Canberra Hospital
• CPE paid for and conducted in rural area
• Focus of pastoral care starts with hospital but awareness of other situations of need for pastoral care
• In some rural centres abundance of fully trained (CPE) ecumenical team
• Inclusiveness with various chaplains (gaol)
• Interdisciplinary co-operation (regional)
• Offer pastoral care to patients and staff and families
• Pastoral care spread across the whole institution
• Quality pastoral care at hospice
• We are re-arranging the current boundaries
• We are THERE

Acknowledged

• Acknowledgment by patients of a pastoral carer role in hospital
• Familiarity of nurses of pastoral carers (country hospital)
• Government acknowledged/supported the service
• Increased acceptance and awareness of pastoral carers
• Increased acceptance of ecumenical approach
• Information available on the web about pastoral care
• Lots of positive feedback from consumers/families
• Personally known and supported by executive staff (regional)
• Recognition of spiritual dimension/needs in treatments
• Recognition that pastoral care is needed

Religious

• Ability to visit across denominations (Goulburn)
• Increasing awareness of the need for ecumenism
• More interdenominational
• Opportunity of visit by own denomination is important
• Place to worship or have prayer in hospitals
• Unity of denominations

Skills

• Ability for the wounded to be healers
• Ability to mobilise quickly and effectively when needed
• An increase in development and diversity of pastoral care
• Approachability and availability of pastoral care workers in immediacy of crisis
• Compassion, kindness, understanding
• Life skills
• Professionalism yet freedom to relate at personal level
• Recognised need for referral

Source

• Bundles of experience/wisdom/big hearts
• Committed group of people interested in pastoral care
• Ongoing resilience of pastoral carers
• People’s passion
• Skills of existing of existing pastoral carers
• Some volunteers come from a personal/faith community
• Volunteers available
• Volunteers’ generosity/commitment
• Having an awareness of spirituality
• Different levels of pastoral care

Training

• Equipping of pastoral carer givers – CPE, etc., etc.
• Ongoing training of pastoral carers

 

Weaknesses

Name

• THE NAME!  Unfortunate label!

Contexts

• Chaplaincy is at bottom list (gaol) as imperative
• Gap between leaving institution and re-entering community
• Inter-disciplinary acceptance (city)
• Lack of acceptance/recognition by establishment/institutions
• Lack of follow up (continuity of care) on discharge
• Lack of knowledge and referral by medical/nursing/allied staff
• Lack of understanding by clinical teams of the scope of pastoral care
• No protocol, procedures included in acute care centres or institutions
• Not fully integrated at all health sites
• Overwhelming need
• Pastoral care in not just hospitals – pastoral care is about people
• Pastoral care not applied sufficiently to other caring professions – building it into all training programs
• Pastoral care not yet recognised as integral and part of services
• Un-informed management
• Unlikely to be known by executive (city)

Understanding

• Difficulty in communicating the scope of pastoral care as distinct from social work
• Lack of knowledge of available services (amongst all communities)
• Lack of knowledge of services
• Lack of promotion to community
• Lack of recognition of professional ministry, service – government needs to understand this
• Misunderstood image
• No web based information on pastoral care services offered by hospitals
• Not explained sufficiently to patients
• Perception of do-gooders
• We don’t talk enough about then difference pastoral care makes

Programing

• Different levels of pastoral care
• Inadequate lobbying for inclusion in team
• Insurance issues
• Lack of assessment of spiritual needs
• Lack of awareness of spirituality
• Lack of backup – operating in institutional vacuum
• Lack of a clear language
• Lack of evaluation of services
• Lack of organisation
• Lack of policies and procedures as to what we do
• Liaison between all services (+ regions)
• Need for good case management – inclusion
• Not a clear distinction between religious visitor and pastoral carer.
• Profile and marketing
• Traditionally pastoral carers not lobbyists
• Lack of financial and admin support
• Lack of funding
• Lack of funding, e.g. to attend conferences, training
• Fragmentation through denominations (The Canberra Hospital) although united as a department
• Lack of involvement of other cultures as well as awareness of different beliefs
• Lack of understanding of requirement of different faiths

Source

• Desire –v- appropriate suitability to help
• Drop out of volunteers
• Duty of care of volunteers – lack of backup support
• Human limitations (emotional capacities)
• Lack of pastoral presence when needed
• Lack of personnel resulting in reduced services
• Lack of personnel, especially in regions
• Lack of value of pastoral care as an occupation
• No acknowledgement of prior learning
• Over extended religious personnel as substitute for pastoral care service
• Poor rate of pay
• Reaching the young requires younger pastoral carers
• Volunteers have limited hours

Training & Support

• Lack of awareness of standards and guidelines
• Lack of support for pastoral carers, e.g. debriefing
• Lack of training
• Lack of training – haphazard – no standards for pastoral care
• Lack or accreditation and standardisation and training
• Need for debriefing
• Need for professional supervision
• Networking
• No regulation/accreditation of pastoral care professionals
• Running out of puff – burn-out/compassion/fatigue

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