ROUGHLY EDITED COPY LUTHERAN PASTORAL THEOLOGY & PRACTICE LPTP-38 Captioning Provided By: Caption First, Inc. P.O. Box 1924 Lombard, IL 60148 800-825-5234 www.captionfirst.com *** This text is being provided in a rough draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings. *** >> JOSH: Thank you, Dr.�Warneck. Here is a follow-up question. Can you now be more specific? How does a pastor make helpful visits to a person who is ill? >> DR. WARNECK: Joshua, I want to answer that question somewhat out of the background of my own experience as a pastor and bring some things from that experience that may be helpful to you as you go about caring for your people. Today, with the high cost of hospitalization and medical care, you will find that your people are not in healthcare facilities nearly as long as they used to be. And much of this ministry is going to be in the environment of their homes. So we might expect that. Within healthcare facilities we want to be aware of the HIPA federal guidelines, the Health Information Protection Act, which leads institutions, hospitals, and other healthcare facilities to be rather cautious about who they let on their premises. Although the practices of hospitals here with respect to pastors is still usually very open. But you want to be aware that you may well identify yourself as you come to these locations and be prepared to indicate who you're going to visit. And you may advise your people to -- who are hospitalized to let the institution know that you might be visiting them so you have permission to reach them. But you can work through those kinds of logistics. More to the point, when we come to our people, we want to come as a professional. I want to accent this. Because a physician, a Christian doctor who is on our board at our seminary, came to some of our classes. And he gave us a few tips on how pastors should present themselves when visiting the sick. First of all, he said show up. That's certain important. It's unconscionable that some pastors do not look after the sick in their parishes. That we certainly want to correct, and we want to be pastor who cares and shows up. Relative to dress, he suggested not too casual but to dress professionally so that we let the patient know that he or she is important enough for us to give real thoughtful attention to him or her when they are ill. So pressed clothes, shined shoes, a clean clerical shirt or shirt and tie, coat, suit or sportcoat�-- these things are recommended. I'm talking about some very common things. But it's amazing that in some instances we slip a few gears in this area. And sometimes pastors come to this ministry kind of unprepared. So you want to be a professional person. Secondly, it's well for us to come to this ministry as alert as possible. By that I mean a pastor anticipates his ministry to the sick as well as he can. He thinks ahead. Now, what might I find when I enter the hospital room? How might my member, my patient be and what state of mind? And what will their condition be? We don't have to be as precise as a surgeon who is planning out a three-hour procedure, but it's well for us to think ahead how our ministry today will best serve the patient we're visiting. Then, as we arrive and meet our patient, to risk belaboring the obvious, the pastor introduces himself. Some patients cannot tell. So many people are entering and leaving the room during the course of the day. And it's always well for to the pastor to make his presence known and introduce himself. Going about our ministry to the patient, listening is absolutely essential. More listening than speaking. It's well for our pastors to remember this. Pastors are accustomed to preaching, to being on stage, front stage, so to speak and holding forth. In this ministry, quiet, alert, and attentive listening is very helpful. Now, what do we listen for? It's a combination of listening and observing. I recommend that, before you bring your devotional ministry to a patient who is ill, that you work through in your mind mentally, very quickly, three issues. First of all, from your observation, what is the physical condition of the patient? You do not have to be informed on all the details of the particular ailment or illness. But it's well to have some knowledge, if possible, about the patient in this regard. Why is he or she in the hospital? Secondly, the patient's emotional state. That is, how does this patient internalize? And how is he or she reflecting that internalization of his or her present condition and confinement under illness and in the hospital? How does the patient feel about all this�-- about himself, herself, and about their diagnosis, about the prognosis, and these kinds of things? The third point to reflect on is the patient's spiritual state in all of this. As much as we are able to discern. And that's the reason for the careful and close listening. How is the patient reflecting on himself or herself and the Lord? Relating their present circumstances to God and His will for them? How is that patient thinking about their relationship to their Lord in these present circumstances? Do they have questions? Are they angry? Are they simply confused? As much as possible, if the pastor can discern -- and he has to work very quickly -- some cognizance of these three points�-- the physical condition, the emotional state, and one's spiritual life here. The pastor will be prepared then to address the patient skillfully and patiently with the comfort of the scriptures. And the pastor goes about this very naturally. We recommend that a pastor carry with him a small volume, a little handbook, the pocket New Testament and Psalms. You can find these from various printers. Gideon's provides them, for one. Sometimes you can pick up a copy. But, when the pastor takes in his hand the scriptures, the patient seeing is already mentally prepared for the pastor going about his ministry for their welfare. So that's a start. Then, sharing a few brief verses, selected for this patient today, a little reflection and application. What is the Lord saying to us in His words today? Wrapping up the patient's concerns as we discern them in a prayer. Followed by the Lord's Prayer. And most of our people like to pray the Lord's Prayer. Let's give them that opportunity. And, finally, a little word of blessing. And that composes your devotion and your ministry on this particular day. So we don't have to be uptight about this work. We don't have to be anxious ourselves. Let's relax and let the word of God do the work it wants to do. Let the Holy Spirit have a chance. Now, a couple of other things to mention here briefly. In our prayers do we pray for healing? The reason I raise that question is I have observed a -- I don't want to say a trend, but a theme -- maybe it's a thematic thing�-- that proper Lutheran pastoral care places our good Christian people under the cross. And much of the ministry is from the vantage of the theology of the cross, which is well and good. But sometimes I get the impression that the objective in this approach is to simply help the Christian be submissive to the Lord in His will. That's a very salutary objective, certainly. But I certainly believe�-- and perhaps you share the conviction, Joshua�-- that it is well for us to pray for the healing of this patient. The Lord said, "Come unto me, all you that labor and are heavy laden." His own ministry recorded in the Gospels is a response of healing to so many, many people. Those passages indicated that the Lord was busy for a whole afternoons and evenings healing the sick. This should encourage us to bring the burden of illness to the Lord and pray for healing. That's a simply a point that I wish to make here. I think it's an important point. Coming back to some of the mechanics, in closing on this subject, how long does a pastor stay in a call like this? Well, five minutes may be a bit brief, unless we're in the intensive care units. And then our ministry should properly be very brief and to the point because the caregivers there and the medical professionals are very busy with these persons. But in the general hospital area, 5 minutes, maybe 10 minutes is a good gauge. 15 minutes might be getting on the long side. We don't want to tire patients. They're there to get rest, and that helps them get well. So use your good judgment. When we stand with a patient, do we stand or do we take seat? The rule of thumb here is to have good eye contact with a patient. Some patients are elevated in the beds in which they're lying. You can stand there and have good eye contact. Other patients where they are situated is rather low. Instead of looking over and down on a patient, pull up a chair. The principle is keep the eye contact kind of level. That helps the patient. There's another factor here. And that's the tactile one, the use of touch. Very common today. We're more relaxed with people. But, when you touch a patient, for instance, if you pray with a patient, it might be well to touch on the forearm, on the wrist. Sometimes we may touch a patient on the forehead, doubtful that we ought to be putting our arm around a patient. But, in all these instances, the rule of thumb, again, is discretion, particularly with female patients, women patients. Discretion. And yet we don't want to omit this gesture because we have to be impressed with the account of Jesus' ministry to the mother-in-law of Peter recorded in Matthew 8:15. I'm still impressed with that phrase, "He touched her hand." So there are some intangible values here. But you, the pastor, Joshua, have to be comfortable with this. And that also should be your guide. But it's certainly a helpful gesture, and it expresses some intangible things that simply verbalizing and the like cannot do. These are a few things to keep in mind as we visit the sick in institutions of healthcare. *** This text is being provided in a rough draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings. ***