Chaplains in healthcare settings offer patients spiritual care that involves companionship, counselling and maintaining hope. This is particularly important at the point where a patient has run out of treatment possibilities. This book reflects creatively on the work that chaplains do with people who are dying and the unique quality of the relationship that palliative care professionals construct with patients at the end of life. Based on qualitative research with practising palliative care chaplains, "Spiritual Care at the End of Life" explores the nature of hope in its different forms at different stages of terminal illness, and asks how chaplains can help dying people to be hopeful even when facing the inevitability of their death. This book identifies key moments in this relationship, from the person's initial reaction to the chaplain, to the chaplain becoming an accompanying presence and creating the potential to provide comfort, strength and "hope in the present". This thoughtful and inquisitive book investigates the underlying theory that spiritual care is rooted in relationship.It has implications for practice in the work of chaplains, counsellors and all healthcare professionals supporting people who are dying.

Spiritual Care at the End of Life and Transforming Chaplaincy

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Steve Nolan’s focus is the challenge of caring for people who know they are dying; specifically, how can a chaplain sustain the dying person so that they face the inevitable in a spirit of hope and peace? Given the current financial pressures on chaplaincy provision within the NHS and the creeping emphasis upon the measurability of outcomes this is far from being a question of aloof academic interest. Using stories drawn from his own experience as well as research, Nolan begins to develop a new theology of spiritual care, which he dubs as ‘hopeful presence’. He identifies four stages in the relationship between the chaplain and the ‘dying other’ (one of several terms Nolan adopts in preference to patient). First is ‘evocative presence’ through which the chaplain absorbs the negative projected feelings of the patient. Successfully managed this leads on to ‘accompanying presence’ through which the chaplain simply dwells alongside the patient. This opens up the possibility of a ‘comforting presence’ through which the patient may discover a strength that sustains. Finally this leads to the chaplain providing a ‘hopeful presence’ through which the patient might come to a position of reconciliation and peace. Just occasionally one reads a book whose value extends far beyond its intended audience. This is one such book for the theology that Nolan espouses has potential application in many other chaplaincy fields including education, prison and military environments. His principles deserve wide study and reflection.

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