How a pastor supported congregants to have the conversation

By Adine Stokes and Ann Ellison, 09/06/2023

Here at The Conversation Project, we work with hundreds of individuals and organizations to bring the concept of advance care planning to people where they work, live, pray, and learn. Here, one health system shares how they offered training and support for faith community leaders to have conversations with congregants about health care wishes through the end of life.

A clergy person may not only support community members through serious illness and decisions related to health and health care, but also help to navigate complicated dynamics with friends and family. Recently, our organization offered a training for faith leaders on conversations through the end of life, and we want to share the story of how one pastor used that training in his congregation.

Our health system, M Health Fairview, received a grant from the Morgan Family Foundation to address advance care planning in diverse faith and cultural communities in the Twin Cities area of Minnesota. Our work has built upon longstanding relationships that our organization has had with faith communities, going back to our organization’s roots.

One of our key relationships has been with an organization called The Stairstep Foundation. Stairstep, as they are known, is a collaboration of African American churches across the state. We have learned that “who calls the meeting, matters.” Stairstep was critical in calling the training.

In the four-hour training we developed, we covered topics such as moral injury, compassion fatigue, spiritual first aid, and the need for self-care. Then we launched into defining and discussing serious illness and the role of the faith community in conversations.

The What Matters to Me Workbook from The Conversation Project and Ariadne Labs was the primary document used in the training. It is designed to help people with a serious illness get ready to talk to their health care team (doctor, nurse, social worker, etc.) about what is most important to them. We also shared the health care directives used in Minnesota. Without question, the Workbook was the most positively received tool we used. We distributed it at the end of the session. Several participants informed us in a follow up session that they had completed the Workbook and so had their spouses and others in the community.

One of the pastors who participated in the training shared a powerful story:

Not long after completing the training, the pastor was called to a congregant’s bedside. The community member had experienced an acute stroke, and his status was guarded [a term that has different meanings, but may indicate serious illness with an uncertain prognosis]. A family meeting was called, including a legal spouse and a current significant other, with adult children and siblings also present. The pastor was concerned because he was aware of the complex family dynamics, and worried the next few days to weeks could hold complex emotions and a test of faith for this congregant and family, along with the entire faith community.

To prepare for the meeting, the pastor reflected on his recent training, taking time to focus on his own self-care strategies. Part of conducting preparation was something new for this Pastor — he included a review of the What Matters to Me Workbook. First, he reflected on his own responses. Then, he determined which of the questions from the Workbook he would use later that day when meeting with the family.

Over many years in this faith community, this pastor has convened hundreds of family meetings like this. Yet he found having the Workbook as a resource allowed for the deliberate and gentle focus this family needed to support one another and decide together what was the best plan of care for the seriously ill person. After the meeting, the family agreed on comfort care [when care designed to cure a condition is no longer likely to help, medication or other non-invasive care is used to keep a person comfortable through the end of life]. Everyone was on the same page about treatment, and conversations with the pastor eventually shifted to funeral planning.

The pastor admitted he was pleasantly shocked — not expecting the conversations to go this smoothly! The pastor stated the What Matters to Me Workbook was instrumental in helping guide the family in making decisions about care that aligned with what mattered most to the congregant. These conversations also guided the pastor’s remarks for the funeral service and devotional, and even further, support of the community over the following weeks. He is hoping to have the Workbook posted on the church website, and is finding ways to integrate this work into his chaplaincy.

We have already learned so much, and are eager to continue with this work this fall and winter.

Download useful tools and resources for faith communities here — and customize them to suit your community! How have you introduced the importance of conversations into your community?

2 Responses

  1. Paul R Graves says:

    I’m drawn to the material you present in this email about training pastors and congregations to have the critical conversations about end-of-life planning. But a question stays in front of me: How do pastors and congregations with definitely different theologies find common ground when it comes to these conversations?

    I welcome gathering pastors together for training, but I can also imagine pastors holding their “religious ground” to champion their own beliefs. How is that avoided so the conversations can focus on the pragmatic needs of a person while still respecting their images of what happens after death?

  2. Kate says:

    Hi, Paul – great question. We actually encourage each faith leader to apply their own denominational lens to these conversations. We have sample sermons/other readings on our faith page. They often help introduce why the concept of talking about what you want through the end of life is supported by that faith. We also know that many people who may not have deemed themselves highly religious at other points in their life turn toward their faith at the end of their lives and like to know what their denomination recommends for certain choices. Many groups have put together videos and other resources about this. Happy to chat more if it would help! Thanks, Kate from The Conversation Project Team

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