I was out of town over the weekend some I’m just getting caught up with you all today. In reading the week one material I would like to reflect a moment on material from the “Context” section of the SOP for chaplains in LTC. It is very unique work we do in at least two ways. One is because of the residential nature of the setting, we are basically working in their homes, or at least in the neighborhood so there are frequent opportunities to check in with folks, or for them to stop us for whatever reason. To have this regular contact with folks often lends itself to doing a bit of a spiritual screening. There may not be time to assess a situation but we do, or at least I feel that we do, get to see, talk to, and hear from folks regularly so we might gain ongoing insight from their journey through grief, just as an example. The other unique aspect is that we sometimes work with people for years, walking with them through all sorts of situations, good and bad. In some ways we’re like a congregation’s pastor who does, as Dr. Oates would say, walks with people through the “crises of their lives.” One thing that may not be captured so well in the SOP for LTC chaplains is how our work may require us to do screenings, assessments, plans of care, etc. related to a variety of times and events of our residents’ lives.

Where I work there has been an effort several years in the making to bring Culture Change to reality with a very clearly stated goal of moving away from the medical model of care noted in the context section of our reading material and moving to person centered care. In our setting the residents who advocate for this talk about it this way saying that the goal is to move away from the staff being the experts telling or directing the residents and moving to the residents being their own experts telling the staff what they want or need. Those differing perspectives will be an interesting thing to look in light of the standards which call for a certain level of expertise from the chaplains. Of course we chaplains do have our own gifts, insights and expertise which we bring to the table so trying to find the right balance between offering what we bring to table to meet the residents at the point of their need/desires is an interesting opportunity.

Our interdisciplinary team (IDT) is currently involved in looking at how Aging in Place fits into our setting of delivering care on any and all of the multiple layers of care involved in a CCRC. The tension seems to be around the view held by some residents that aging in place means they never have to leave their independent living apartment no matter how much they decline versus the practice of the IDT reviewing needs and recommending or actually facilitating a move to a higher level of care. I share what I have about aging in place and culture change because they are such a part the culture where I provide chaplaincy care it will interesting to me to look closer at the SOP in light of these parts of our culture.