good evening.

Thanks so much for watching PBS Fort Wayne and HealthLine tonight I'm your host Mark Evans.

>> Something very, very interesting and very important we'll be talking about tonight.

It's nurturing a spiritual care and it has something to do with hospice care as well.

But these are also things that not only if you're going to be in hospice or you know someone who is in hospice, I think it's just going to be good for your well-being in general.

We have a couple gentlemen here who are certainly experts at that.

We have hospice chaplains on hand and they're going to discuss what they do as well as some of the intricacies and what they do.

>> First of all, we have Michael Deeter, Chaplain Deaner, good to have you here and then Michael Springer.

Yeah, so too Michael's to Michael's on the mark tonight.

>> That's right.

So it's it's a pleasure to have you both here.

We have done some shows in the past on hospice and hospice care but we've never really delved into the nurturing spiritual care and I think it's very important.

>> So I think I'll just start I got some some fine points that you gentlemen have provided to me and I think I'll just follow that because this is what you would like to talk about and I noticed right off the bat and before we get into the first topic, I do want to remind you and remind our audience that we have a phone number on the screen.

It's 866- (969) 27 zero locally you can skip the 866-.

But we're here to answer your questions for the next 30 minutes.

We're nonstop because we are public television.

Don't stop down for commercials and please call in if you have any questions maybe for you yourself or someone you love.

So let's go ahead and talk about holistic care.

>> What does that mean?

So when we think about hospice we think about holistic care meaning that we think about the whole person so emotionally, spiritually, physically.

So we're not just looking at their physical pain or emotional experience but also their spiritual side of things.

So they might be having spiritual pain, spiritual concerns that are related to their physical pain or emotional pain.

So that's that's really what we focus on with hospice.

OK, and then of course there's I want to go and separate and delaying delineate excuse me the differences between hospice and palliative care.

>> Can you expand on that?

So yeah, I look at hospice as more of a focus on comfort care and palliative care is more on top of treatments that may be taking place to bring in extra support and just utilization of medications that can help the patient through that time of treatment or to stabilize them and their process now in hospice care it's generally for the people who are more than likely going to be dying.

We'll just throw that out on the table.

But we talked about in the green room right before the show that sometimes people can take a U-turn, you know, and I don't know if that has to do with the nurturing the spiritual care or you know, the grace of God or whatever.

>> But and I've heard of that where people were destined to die and they make a recovery and they still live on.

So I think that's amazing to so does that you think that has something to do with it as far as the the spiritual care the holistic care?

>> I mean does that give people something to hold on to or to look forward to?

>> I mean how do you think that works?

Sure there can be a benefit for sure to be at a place where you're at peace spiritually or maybe you've had to work through some things as you've you know, dealt with things or maybe you've talked it over with the chaplain or with a pastor minister type of thing and it can help just to bring about the peace aspect in your life and can maybe turn things towards the better, you know, and then maybe things also we've I also see things take place where someone has stopped their treatment.

They come on hospice.

The idea of hospice is kind of like six months or less if it takes its normal course that's not always the case.

Of course it's a very general term but sometimes people start to feel better because they've stopped their treatment.

Oh and to the point where then they can graduate from hospice if they've not declined or you know, continue to decline.

>> I see.

So but you would agree that most people in hospice well, let me ask it this way the people that you deal with in the hospice arena, if you will ,are they aware that death is near I for the most part, yes.

>> But there are definitely some that there's a great amount of denial denial, OK, that this is the trajectory we're on and I always encourage people to look at it as it's not you're not giving up by beginning the hospice journey.

It's just a change in the game plan right towards a focus of comfort care.

Yes, right towards a focus of more support in your home through the different disciplines of hospice including spiritual care.

And Michael Deeter, are you familiar with the history of hospice at all?

Yes, fairly, yes.

You know, we have our hospice centers nowadays.

Sure.

There was a thing called a visiting nurse.

My grandmother was a the flu epidemic in the early 90s hundreds and so but she was also a hospice nurse after all that.

>> In fact, a quick story if it wasn't for her meeting my great grandmother, I wouldn't be here because she took care of my great grandmother as she was dying of cancer and she met my grandfather through that process.

So I'm very blessed because of that.

>> But at one time the hospice nurses and they've been around for a while but they used to go to the residence and there weren't a whole lot of respite facilities for them to go to.

But now we have those and it's more of a hospital setting.

Sure.

Yeah.

And I know that we still have visiting nurses and so forth.

I think that's a personal choice and a family choice as well.

>> But Michael Deeter, I want to ask you about this because one of the topics you wanted to discuss was the exploration of beliefs.

>> What do you mean by that?

Sure.

So when a person signs on to hospice we do an initial spiritual assessment to kind of gather what they believe their church background, faith background, spiritual beliefs.

And so we're trying to find out, you know, what's important to them, where they coming from I'm sorry, how can we support them in their beliefs?

And so by knowing what they believe then we can really walk alongside that because in hospice you're getting people everywhere from every Christian denomination that exists Catholicism, other religions and so as a chaplain, you know, we're not tied to a particular church.

>> We're we're serving in a, you know, nonprofit status that we're there for the patients.

So we're really trying to find out, you know, what what is important to them and then how can we encourage them walk alongside them as well as honoring our own beliefs as chaplains and what's you what we were trained to do so and as chaplains and these variety of religions we have currently are you required to delve into that a little bit and get to know a little bit about all of the religions or at least what direction to go with when counseling a patient?

>> Yeah, so again like Michael said, it's about getting to know them, getting to know their religious background and then meeting their needs whatever that may look like to have involves reaching out to their minister, their priest, their imam, that type of thing.

Then that's what we do to best meet the needs of the patient.

You know, there's definitely going to be limits based on our background, our training of how we can help them in certain areas.

And so that's when we call in the person that's going to be able to best meet their needs or you know, based on religious if you want to call it Ruel or practice, you know we can't serve communion to everyone type of thing.

You know, like as far as just for example between Protestant and Catholic that would be a Catholic priest or someone with a Eucharistic minister type thing.

And so that's when we call the Catholic parish which I do often for patients who are Catholic and ask to request a visit from the priest.

>> I see.

OK, so you're at least equipped with that and yeah.

>> So it's kind of just having the tools in the toolbox and of course there's always the kind of the self study of what different you know belief system there's ah and you know there's kind of one that pops up that you're not used to is just kind of like going to do some homework on it and learning more about it and to have a listening ear.

Yeah absolutely.

And that was one of the key points here.

You got to do some active listening and tell me about that.

What is active listening encompass.

>> Sure I know I know it sounds simple but what it what things are you looking for when you're actively so active?

>> Listening is not just me listening to what you're saying it's also me respond in a way that acknowledges that I'm hearing what you're saying and it's hearing you out and then it's saying sure I see what I see where you're coming from.

You know, could you expound upon that further?

It's it's actively being engaged in the conversation so that I'm not just a patient not just talking and I'm just kind of sitting there often my own world.

I'm I'm actively engaged in the conversation with them.

So we really want our patients to know that we really do genuinely care what they have to say as well as we do generally care about them as well.

>> We are there for them so we are engaged in what they have to tell us and I do want to do a little sidebar here in a hospice situation.

Explain the staff.

What do we have?

We have doctors of course.

>> Right.

So we call it an interdisciplinary team is one it is with hospice.

See if your doctor you have your nurse registered nurse, you have LPNs in the mix too and then there's aid Sienna's social workers and chaplains and that kind of completes the team.

Of course you have supervisors and different things but right .

>> That kind of completes your interdisciplinary team that's involved in the care.

What does it take to be a person to work in hospice?

>> I mean what kind of a person does it take?

Yeah, generally so it's generally take someone who's caring I mean that's in the health care field as a whole but and to look at it in a way like because again we're we're dealing with death or impending death right on a regular basis but it's not looking at it like that.

It's looking at it like being there for the journey for them at the end and taking that as an honor.

Yes.

To be a part of that with the person and their family.

I can see it's not just the person, the patient if you was the family.

So it's a whole you could add that into holistic care so it's not just we don't administer just the patient but it's the family to yeah.

And in some instances I guess an experience I had is my care was to the spouse and I didn't meet with the patient at all.

She had support from her church, from their church that she was good with that he but he wanted a chaplain so I would go to their house and meet with him and say, you know but again it's just adapting just being flexible in and meeting the needs of those who who want your services.

>> I'm sure glad there are people like that around like you.

Let's talk about of course being chaplains and people of faith and so forth.

You've got to be nonjudgmental .

You can't be condemning.

You have to be open and have an open mind.

Yes, that's correct.

Yes, absolutely.

We don't come into the room looking for your past sins and failures and we're not coming there to judge you or condemn you or put you down or I think sometimes people hear chaplains coming so they're they're trying to be on their best behavior and they want to tell you all the time they went to church and you know, I want to made it to church every Sunday till I was 70 or whatever it was like that great.

But you don't have to act like you're something you know you're not maybe you can be yourself we're there to meet you where you're at and walk alongside you.

So we we certainly are just glad that you're letting us in the door.

That's great.

We have a call coming in.

In fact, sometimes our callers prefer not to be on the air so we transcribe the question that's perfectly fine.

So if that's your style, go ahead and give us a call.

The numbers on the screen 866- (969) 27 two zero have a call coming in from Patty.

She says How much do you talk to the spouse and talk to them about what is happening?

And we kind of talked about it a little bit but the spouse is very important because they're the ones who are going to be around after the eventual event happens.

>> So explain that.

Yeah.

So I would say it's it's a case by case basis.

It's definitely depending on each spouse.

Right.

And how much they desire how much they allow.

We're definitely there for them and insofar you know, as much as they want us there and or don't type of thing it's you know, it's kind of a back and forth conversation.

You know, we can, you know, add more visits if you will.

So typically what would I like to do?

And I know Michael, we kind of do things differently but at the same but we kind of adjust our our visit frequency's based on the need or what the patient desires family desires.

So it could be once a week could be twice a month, there could be once a month type of thing or more could be multiple times a week depending on the situation.

So again, talking to the family when were there I saw the question, you know, how much do we talk about with him?

What is happening?

Typically I prefer to stay in my wheelhouse and not go into the medical realm.

>> Oftentimes we do get asked questions I'm sure.

Yeah, right.

Yeah, exactly.

Mark they'll be like so I know you can't tell me this for sure but you're around it a lot so you probably have an idea what's going on here.

I said look I can't really tell you a whole lot.

You know if you have a question let's ask your nurse right.

Because they're going to get to be able to give you a better answer than me.

I mean because my answer is going to be from a nonmedical educated opinion.

Right.

Which let's not do that because I don't want to give them a wrong sense of hope or you know, just not be right.

>> So yeah, we're having situations where people weren't so God fearing, you know, when they were healthy and vibrant and all that.

Then all of a sudden as they know that time is is about ready to wrap up for them.

I'm just paraphrasing but do they ever get into the mindset whereas this is now time I'm going to have to get in touch with my spiritual self?

I think that but I think one hundred percent is that right?

I think I mean I think people are all of a sudden there at the end and they're like oh boy like this is it like I'm going to die?

What's happening next?

Where am I going?

>> I was went to church when I was a kid.

I didn't I walked I walked away from the faith and now I'm I want to come back and we're like awesome great.

Like we would love to talk to you about that.

It's never too late and you know, try to find that hope and peace that people are looking for .

So that's very common I would say.

And are you trained don't want to use the word equiped kind of stuff makes it sound like you're going to have equipment for this.

But are you trained or do you have it?

Are you able to talk to someone who isn't of all of any faith and just need some comforting words and advice?

>> I mean sure you can across that.

Yeah, absolutely.

There are definitely and I would say we see as our world changes and changes in a way like you know, there's less the numbers are changing as far as who's faith connected and who hasn't type of thing and it doesn't mean they don't believe in God.

It doesn't mean they don't believe in different things.

Right.

But they just are not connected or just maybe have never been.

And so again it's is providing comfort and what that means and what that looks like to them.

Right.

And everybody an individual and so individual right.

And going back to the the active listening you have to pick some things out.

I'm sure that person's personality and adapt what you need to say to them is right.

>> Absolutely.

So like what brings what brings me peace and hope in that situation is going to be different for you for anyone.

Right.

You know, of course you're going to be some crossover and similarities but it's going to be different, you know, for some some of our folks it's the reminder and knowing that their loved ones are taken care of , you know, for like the dad for the mom.

Right.

Like their daughter, their son, they want to make sure they're taking care of you know and the reminder of that because that's what maybe they're hanging on to.

Right, because they don't want to leave their family.

Right.

And I know a lot of the people that you deal with and provide comfort to are very, very sick .

But do you ever see the fear of death in people?

>> Absolutely.

Yeah, definitely.

I mean there's definitely yeah.

There's times where you see the fear and in the peace.

So it's kind of like it's it's not an either or sometimes it's going to be the middle and you know, it just every person's a little different in that I think some people for different reasons, some of it's faith based and others would just be they're not fearful of it.

Maybe that's just their attitude, right?

Yeah.

I think as culture we don't talk about death.

Right very well.

Yeah.

If we talk about it at all.

So it definitely we're kind of lacking in that realm is the culture in America and I mean that's a whole big generalization but that's very true.

But but we're not used to we don't talk about it right.

We don't face it.

We don't want to face it.

Right.

Right.

Even though it's certain well and you know well I will go off on that because I don't wanna get too personal but you know, I well I'm going to go ahead and do it.

Not only do I do television, do radio but I also work in the funeral business and I'm a funeral professional and we are always dealing with people who are you know, experiencing death, death in their families and so forth.

We even have people come to us to prepare their funeral arrangements.

We're going to talk about that in a second.

But it's you know, it's just one of those things that we deal with all the time.

And I I have friends who don't want to you know.

How are you doing?

Well, I did a service today and I drove the hearse today.

Huh.

And he just can't deal with the subject of death.

But it's something that we're all going to have to incur Compass at one time and cross that bridge.

>> So that's why I'm glad we're talking about this tonight.

Michael, we have a section on here says Scripture Prayer Sacraments.

What do you mean sure.

So I would say for a majority of our patients they are comforted by scripture Psalm twenty three seems to be one that a lot of people know and really love and what is that?

That is the Lord is my shepherd.

Yes, David.

And so people love that the thought God being their shepherd, he's walking with them to the valley of the shadow of death even to the very end he promises to be with them so that that's a really comforting passage as well as prayer.

I think I've had even atheist patients who wanted prayer.

I mean it's comforting to people.

I think prayer just the thought of somebody praying for you is very comforting and then sacraments.

So obviously our patients talked about that would be we do have some that would like to be baptized before they're before they die.

I've done I think two of those and then a lot like to receive communion and again if they're Catholic if I stop being Protestant we would call the priest and they could provide communion in that form and we talk about and looking for signs of spiritual pain and distress.

>> You expand on that.

Yeah.

So and I can speak of a specific situation.

It was involving anxiety and there was just so and so I had a conversation with the patient about a couple of ways we can go about this like we can continue to try different medications to try to relieve the anxiety but we're not sure that that's going to work or we can maybe deal with a matter spiritually OK and we dealt with the matter spiritually and that calmed him down a specific patient.

And so there are times where it's not it's not you physical the physical side of things.

Right.

It's maybe spiritually right.

That's how that's just what's going on in the person funeral planning.

>> Uh, is there something to discuss?

>> Yeah, definitely patients yeah.

Yeah we just did a funeral what last Friday and then maybe the Wednesday before that as well.

So we as chaplains are always available to officiate funerals of patients with um and we try to gather as much information as we can about the about the patient from their families so that we can make it individualized as well as maybe if the patient's willing to talk about it while they're alive, find maybe some songs that were important to them scripture, prayer poems, whatever it be so that we can really honor them as best as we can during their funeral, especially the way they'd like.

You know, a lot of people don't have that opportunity to discuss that and I know firsthand that families come and say I don't know what he or she wanted.

>> I hope this is the right thing and I think that would be a good opportunity for them to to talk about.

Yeah, absolutely sure.

And I always encourage people to to do things sooner than later.

Oh, because again things are pretty emotional right in this stage of the journey of life and with hospice and things time and it's only going to become more after the person passes away.

Right.

And then we've to make good decisions you know that more with working in the funeral industry.

But if you can do some of those things now alleviate a lot of stress right after it and it puts the family I mean it's a family can be a part of this conversation but I think you have to reach a certain hurdle.

I mean you have to finally realize yes, my day is coming.

I probably won't be able to turn around, you know, so now it's time really serious a serious time to think about how this is all going to end and how my legacy is going to go right.

And that brings me to my to the next subject here and I definitely want to talk about this before the show wraps up in a few minutes.

But one of the items that you mentioned Michael Diener to Michael's to Michael Cinemark here but the life review.

>> Oh sure.

What is the advantage of that and how is that done?

>> So that is probably the most popular thing we do I think is Chaplin's is life review is just talking about their past, their life memories, things that bring back good memories.

A lot of people who served in the war, what they did when they were younger things they love.

I think a lot of times people are maybe wary of a champion but you come in and you start to build a relationship with them where you you want to hear about their life and what they what they love to talk about and what was interesting to them and then they kind of warm up to you and then they're more open to maybe talking about what we consider life of you a spiritual intervention but more maybe spiritual piece of things or whatever.

Once they know kind of you care and you're interested and you've built that rapport with them, I think that that's probably one of the biggest pieces we do, especially with people with dementia who can remember things from their childhood.

It's got to be very therapeutic.

Yes, I think to to kind of enter their world where they're at.

We kind of if they think they're in high school and going to prom on Friday even they're 90.

>> Yeah, we'll go to the prom.

>> That's right.

Yeah, that's right.

They're not going to hurt anything if you do I think to the so it's it's a time to build relationship and then through relationship is an avenue to provide spiritual support and care.

It can be hard to just go in and do a visit.

Right.

And you don't know these people and you're trying to help them from a spiritual aspect and and so no better way to get to know them than through life review and most everyone likes to talk about themselves.

>> Yeah.

In general I mean so I got an earful before the show started.

Yeah.

>> Just so you know that type of idea just opens the avenue.

It also gives us ideas of what may be in the past that needs to be, you know, dealt with.

>> Here's dynamic.

Have you noticed that even though someone is dying and there might be some family conflict or some family rough rough around the edges and some families do you ever find that because of the family coming together and realizing the event coming up, do you ever find families, you know, getting back together again and you know, hugging each other and loving each other?

>> You know, you find that because of this event.

Do you ever do you ever see that?

>> Yeah, I think so, absolutely.

I mean certainly we see a lot of conflict but I do think you have the ones that they were estranged and therefore they finally will reach out because they're almost dying or or they come together at the funeral home and it's like look, we don't get along outside of this but we will get along today and we will hug it out.

And I think or maybe they'll say we might not see each other again but for mom and dad to do this for them and that's what is really neat to see.

>> Well, and I'm so glad we have this discussion is something that's a frank discussion.

We need to talk about it but we Michael Dieter and Michael Springer, both hospice chaplains gentlemen, it was a pleasure talking to you tonight.

Hope to have you back again.

Thanks so much.

OK, thank you.

My very welcome.

Thank you for what you do.

Thank you and thank you for watching.

Thank you for the calls.

Thank your questions for Helpline will be back next Tuesday night at seven thirty and only on PBS Fort Wayne.

Until then good night and good