Long Term Care: The Obvious But Often Forgotten

As you care for a person or family in a crisis that is long term, there are many things to consider. Some are obvious and some are not. Here are some that may be easily forgotten.

Awareness of Financial and Legal Needs

Insurance covers less and less medical care and very little in the way of counseling. In many churches, mission committees may have large budgets. Why not increase the size of the mercy/care budget to prepare for these types of crises? There are ways to set up funds for families to help off-set costs. It will be helpful to develop a filing system to help the family keep up with the bills. Consider bringing in a financial planner since it is going to be long term.

Seek the advice of a lawyer if needed. It is important to do this with the family’s permission. If possible, have someone from the small group present at these meetings to take notes so that nothing is forgotten.

Combining Word and Deed

This is a form of care that will be largely deed oriented. The longer it continues, the more the word component of care will become important. In general, unless you
are going to equip your care givers to speak wisely, it is best to encourage them to err
on the side of simply being good listeners. In the midst of long-term suffering there is a cry for understanding. It is here that we need to equip our people to give wise, time-sensitive, Christ-centered counsel as people ask the difficult questions. Helpers can never go wrong by focusing on the Psalms.

This may be an opportunity to teach and equip the broader body within your church. Again, have a trained person assist you in providing meaningful information along with a biblical perspective to help the caregivers think, act and speak in sensitive ways in light of the specific crisis issue.

The Importance of Scripture

The Bible provides guidance for sufferers to express themselves in godly ways and it pulls them out of the temptation to dive inward and become cynical. The following Psalms might prove helpful: Psalm 4, 18, 23, 27, 40, 42, 121, 130 and 142.

Copyright © 2013 Timothy S. Lane. All rights reserved.

Phases of Care in a Long Term Crisis

One of the challenges of long term care is the gradual and difficult adjustment to the extent of the problem. The phases listed below were gleaned from an actual small group that had offered care to a family where the husband had a stroke and needed around-the-clock assistance for many months.

Deer in Headlights — This is the beginning of a crisis and requires a care group to be mobilized to help the family think clearly. Sometimes people even need to be reminded to eat! It is an opportunity for caregivers to step in and remind the family that not all is caving in and that they are surrounded by a loving community of believers who will shoulder the burden with them. 

This Isn't Going Away — The family and those involved get a clear picture that this is going to be something that will not be resolved quickly and will require long term care. This is where the small group needs to be involved. It is important to communicate to the family that you will be there for the long-haul and you need to mean it. There are people in your congregation who are at stages and seasons of life that can be more available (singles and empty-nesters) and it is a wonderful place for them to serve.

Settling In — The small group and helpers begin to gain momentum. The family is out of crisis mode and beginning to adjust to a new routine. Although life has been radically disrupted, the family has adjusted and is beginning to take more responsibility for their own day-to-day needs. This is when the small group overseeing things will need to re- evaluate what the ongoing needs are, how they will be handled, and how to guard everyone from burn-out.

This Is the Way It Is — At this point, the small group needs to decide what the family’s ongoing needs will be and what the family can begin to do for themselves. It is also crucial to attend to the needs of those who have been caring for the family. This, to me, is where the elder and deacon in the group need to focus. They are there to care for the care-givers. This protects both officers and care-givers from burning out.

Remember that this is a long term situation. Having a sense of the terrain can help you navigate and be the best support you can possibly be for the family you are helping.

Copyright © 2013 Timothy S. Lane. All rights reserved.

Small Group Strategy for Long Term Care

Small groups are typically a well established entity within the church. They become even more critical when a crisis/long-term care situation arises. With this in mind, there is a place for a unique small group which will provide simple, yet strategic care for a longer term need.

1. Identify a Group Leader For the Care Group

The point person not only provides leadership but also serves as a buffer and communication channel between the family and the broader body of Christ. The family is helped and protected by the small group. Based upon the length of time that care will be needed, it may be good to have two people working in tandem with one another as co-leaders. This will insure leadership when one leader is needed elsewhere.

2. Invite Outside Expertise to Advise the Group
The care group should invite a trained person to help them understand the issue and
provide basic information and perspective on how the situation or crisis will affect the
person and family. The more information you gather at this level, the better. Depending on the nature of the problem, this could mean consulting a social worker, a medical professional, a counselor or any other specialist who may bring helpful perspective to the care needs.

3. Regular Meetings of the Care Group
It is imperative to evaluate on a regular basis. Have the point person bring concerns to the group and communicate information and questions back to the family. Good communication is crucial. This is why the relationships described in the concentric circle diagram (see previous post) are so important. The meetings can be reduced as the situation becomes less acute. 

4. Promote Healthy Communication

With the small group formed, it is vital that they communicate clearly with the
broader church about ongoing needs. They can also protect the family
from being overwhelmed during the early stages when everyone will want to help.
Many churches now have access to helpful electronic means where new information can be regularly posted. If there is no access, information in a bulletin insert may suffice. Another suggestion is to have a designated phone line with updates and the ability to receive information for those offering help. 

Designate a point person in the small group on a weekly basis. Make sure
everyone in the church knows how things are going to be handled and encourage participation in the way that has been outlined. Only emergencies should
bypass this process.

Copyright © 2013 Timothy S. Lane. All rights reserved.

Practical Strategies For Pastoral Care

Practical Helps

Since the need for longer term care is so high, what should be in place and ready to be activated in these kinds of situations?

• Basic Care Should Already Be In Place

Small groups, Sunday school classes, other groupings, and a basic care committee need to be in place already (moving transitions, welcome committee, new baby, meals, etc.). If there is not a culture of care at this level, then it will be even harder when the need for long term care arises. Any and every church should develop a care ministry that begins here and covers the basics. Make this a ministry team that includes men and women.

• Form a Small Group to Oversee Care When A Specific Need Arises

When long term care needs arise, the critical first step is to form a small group to respond and manage the care. Having a group, instead of a single individual is critical to preventing helper burn out. Begin the process with someone making contact with the family and asking for permission to form a care group. Suggest names and/or ask them for people with whom they will feel comfortable.

Asking for permission needs to pervade the entire process or the family will likely feel micro-managed. Having the family grant permission honors them and communicates that though things may be hard, they are not out of control.

A good support group can provide stability. They need to ask good questions, listen to the family, receive good information, see the needs, ask for permission to act, organize a system that includes all who want to help, implement and oversee the daily plan, make changes when necessary, and remain flexible. Not a small task!

• Don’t Make an Elder or a Deacon the Organizer

This is a suggestion learned from experience and should be carefully considered. An elder or deacon may be on the team but should not lead it because their focus should be on providing oversight and care for the care-givers. Usually you can identify someone outside the elder or deacon board who has strong administrative gifts to provide leadership and structure for the care team. Elders and deacons may certainly assist and be involved but they should be thinking about the pastoral needs of the care group itself. In addition, the elder and deacon can provide a good link to the larger elder/deacon board.

Copyright © 2013 Timothy S. Lane. All rights reserved.

Going the Distance in Pastoral Care

The Situation

Joe had a stroke and is no longer functioning. His family has to care for him 24/7. Andy is a young boy with autism. He needs help and so do his parents. Joan is showing signs of dementia. She is not the only one who needs help.

Are you facing a situation in your church that will require pastoral care over a long period of time? If you don’t have a situation like that now – you will in the future. Are you ready for it? Caring for people in the local church is challenging work. As a pastor, I remember numerous occasions where a need for long term care arose. 

The Need

Sometimes the need for long term care can be challenging if a church is not prepared in advance. What does it look like to persevere? Long term crises can include a spouse who suffers a stroke and is incapacitated, care for the elderly, Alzheimer’s, teen pregnancy, a child with autism, or simply a family with ongoing counseling and pastoral care needs. All of these represent a challenge to a church.

Current Realities

What are some current societal realities that make this issue so important?

• Traditional extended-family care is no longer the norm. When the single mother of three small children becomes hospitalized and does not live in close proximity to family, the burden for care falls quickly upon the relationships in the body of Christ. This opportunity for service not only blesses the family in need, it also shows the gospel in action to those outside the church who see the care that is given.

• The following statement from To Be the Hands of God: A Woman's Journey, One Congregations Challenge by Judith Ransom, confirms the breakdown in extended family care:

We are a nation on the move with little in savings, little nearby family support, and health insurance that either does not cover policyholders completely or is non-existent. Split families, step-families, extended families, and no family at all—each add their own peculiar mix of problems and solutions. No wonder illness is scary. Roles are no longer rigidly defined and it is anyone’s guess where support will be found in a crisis.

Gospel Incentives

What incentives and imperatives do the Scriptures bring to this challenging area of gospel ministry and pastoral care? Two passages are important for the task: 1 Peter 4:8 and Ephesians 3:14-19. In 1 Peter 4:8, we are called to “love one another deeply.” The word translated deeply can also mean “constant”. “Keep love constant” would be a good translation. The word describes something that is stretched or extended. The love of the saints keeps stretching, in both depth and endurance.

This connects nicely with Ephesians 3 where Paul prays that we would “grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge…” Persevering love grows out of the Gospel. You must start here if you are going to find the strength and incentive to go the distance with people. Within the context of 1 Peter 4:8, we are then called to “offer hospitality without grumbling” as well as utilize both word and deed gifts in the situation.

Copyright © 2013 Timothy S. Lane. All rights reserved.