Caring for the whole person

The spiritual life of a patient who is dying or has a life-threatening illness plays a crucial role in his or her sense of well-being. “In this room that is old news,” said Dr. Balfour Mount, founder of McGill University’s programs of integrated whole person care, to a meeting of 1,200 Canadian and American chaplains. “In most lectures, when I say that, half the room faints,” he said.

The quality of life of someone who has cancer or another life threatening disease is not defined solely by his or her physical well being, he said, offering two examples to explain his point. One patient was a young man, a leader in high school, a success in business and a great athlete. He had cancer and the treatments had not stopped its growth. One day, the patient told Dr. Mount that the past year had been the best of his life. He had had a wonderful life but had never stopped long enough to look inward. During the previous 12 months he had had the time, and it was a most exciting year.

The second patient was an older woman who had a form of cancer that should have been easy to control but continued to spread. Perplexed, Dr. Mount asked her when she last felt physically well. She replied that she had not been well a day in her life. She had always been sick in mind and spirit. Two people, Dr. Mount said, a man dying at 30 with little suffering and a woman dying at 70 with a life script that assured suffering.

During his wide-ranging talk at the joint conference of the Canadian Association for Pastoral Practice and Education and its three American counterparts, Dr. Mount touched on several aspects of caring for the whole person. These included spirituality, the healing power of listening and caring for caregivers.

The spiritual makes a difference because spirituality is about relationships — with oneself, with others and with God, the Other, the Transcendent or Ultimate Meaning. “Self-sufficiency is an illusion,” he said. The “intactness of a person” comes from the wholeness of the web of relationships that connect the self with others.

For instance, when medical science can no longer change the course of a disease, caregivers can continue to connect and offer healing through their presence, their compassion and the simple act of listening, he said. Patients often speak in three ways. They may use plain speech or figurative speech. (In figurative speech, for example, patients may talk about the deaths of relatives and friends as a way to relieve their anxieties about their own illnesses and possible deaths.) Patients also may communicate in non-verbal ways. For instance, one woman who had a life threatening illness kept a photograph of herself in her wedding dress on the bedside table. The picture helped to answer who is she in the many domains of her being, Dr. Mount said. She was more than the seriously ill woman in the bed. That was not the whole of her.

Interestingly, one study that Dr. Mount cited in his talk asked patients what they looked for in a doctor. At the top of the list, he said, was to be listened to, to be treated like a person. Competence came second.

Dr. Mount reminded his audience that the mandate of caregivers was to attend to the physical, psychological, emotional and spiritual needs of patients. “Use a team,” he advised. “You can not do it alone.”

In addition to working with others, caregivers need to take care of themselves and their relationships. There are seven key relationships — with oneself, family, friends, soul friends, colleagues, therapists and God, the Transcendent or the Other, he said, adding that the list was not in order of importance. Caregivers should also exercise everyday, practice meditation and take down time or time off to do something they enjoy.

Susan Edwards is a Toronto freelance writer and a student of clinical pastoral education.