Spiritual Care Services of the Vancouver Island Health Authority (VIHA) sponsors ecumenical worship services in VIHA long-term care and short stay facilities. These facilities are Aberdeen Hospital, Glengarry Hospital, Mt. Tolmie Hospital, and Priory Hospital, and the Geriatric Short Stay Unit at the Gorge Road Hospital (GRH). The Chaplain responsible for these facilities invites individuals and groups from the greater Victoria area to lead the worship services at these facilities.
Spiritual Care Services aims to meet the pastoral needs of residents in the best way possible. We evaluate our programs and events by asking, "Does this program or event meet the pastoral or spiritual needs of residents? Could the program or event be improved to better meet the pastoral or spiritual needs of residents?"
Our residents have diverse religious affiliations. Ideally we would be able to provide worship services on site for residents of every faith and denomination. At the present time our resources enable us only to provide regular ecumenical worship services for residents with a Christian affiliation. Since the vast majority of residents who have a religious affiliation are affiliated with some Christian church or other, Spiritual Care Services believes that the provision of ecumenical Christian worship services has to be our first priority in the area of worship.
However, if any resident requests a visit from a member of their own faith community, Spiritual Care Services accepts the responsibility to do its best to arrange such a visit.
Back to Top
First we need to define some terms for the purposes of these guidelines. We define a religion to be a spiritual way of life, based on a particular set of doctrines or a holy book, and practised by successive generations of people. Some examples of religions are Buddhism, Christianity, Hinduism, Islam, Judaism, and Taoism.
We define Christianity to be the religion which has the Christian Bible as its one and only holy book, and has been practised by successive generations since the time of Jesus. We define a denomination to be a community of people practising a version of the Christian religion. Some examples of Christian denominations are the Anglican, Baptist, Lutheran, Greek Orthodox, Pentecostal, Presbyterian, Roman Catholic, and United Churches. There are hundreds of Christian denominations.
In these guidelines we speak of ecumenical and interfaith worship services. They are not the same. Ecumenical worship services involve only people who belong to the Christian religion, whereas interfaith worship services involve people from more than one religion.
An ecumenical worship service is designed to meet the worship needs of Christians of all denominations, and, therefore, it expresses universal Christian beliefs and uses universal Christian symbols. It contains only what all Christian worshipers can participate in without violating their religious convictions. There should be nothing in an ecumenical worship service that would offend any of those worshiping. They would be able to say "amen" to all the prayers and readings and sing all the hymns in good conscience.
An interfaith worship service has people among the worshipers who belong to more than one religion, but contains only what all the worshipers can participate in without violating their religious convictions. An interfaith worship service in Victoria might have Christians, Jews, Muslims, Buddhists, and perhaps people of other religions besides these as participants.
Back to Top
At one time in the post-Reformation history of Christianity, ecumenical worship services did not normally take place. Some churches even prohibited their members from worshiping with Christians of some other denomination. Official relations between churches tended to be cool and distant. Over the past few decades things have changed greatly. Most Christian churches today are more inclined to celebrate what they have in common than what separates them. While they do not view ecumenical worship services as a substitute for their own denominational services, they encourage their membership to participate in ecumenical worship when the opportunity is afforded. It has been our experience in our long-term care facilities that many residents with diverse denominational affiliations enjoy our ecumenical worship services and find them spiritually nourishing. Some residents find our ecumenical services as spiritually nourishing as their own denominational services.
Back to Top
While much of the historical hostility between religions has dissipated in recent times, relations between religions are not nearly as close or warm as relations between many Christian denominations. People still tend to find the worship of other religions to be strange, and rarely are people comfortable participating in the worship of other religions.
Interfaith services are helpful for promoting understanding between people of different religions, and improving relations among the various religious communities. However, few people would find that interfaith services meet their need for spiritual nourishment. Whereas ecumenical worship services can largely, if not entirely, meet the religious and spiritual worship needs of Christian residents, interfaith services would not come close to meeting the religious and spiritual worship needs of most residents. This is due to the connection between worship and memory.
It is important to realize that demented residents often lose recent memories. A worship service is more likely to be meaningful to a resident with severe dementia if the service incorporates religious and spiritual words, hymns, and symbols that the resident learned in childhood. Ecumenical worship services can build on the early religious memories of Christian residents, many of which will be common to members of all Christian denominations (for example, the image of Jesus as "the Good Shepherd"). Interfaith religious services use universal religious and spiritual words (for example, "unity," "harmony," "peace," "love") that tend to be abstract, and often do not have the resonance in memory of words and symbols specific to the resident’s childhood religion.
Another reason we do not sponsor interfaith services is that there are relatively few residents who belong to a religion other than Christianity. If we held an interfaith service it is likely that Christians would greatly outnumber members of other religions, which would defeat the point of the interfaith service. The overwhelming presence of Christians would make the people of other religions feel like guests at a Christian service instead of co-hosts of an interfaith service.
Back to Top
You can be sure that your service is ecumenical if you use the following resources: the Bible, the hymn books that are provided on each unit, and, as a summaries of universal Christian belief, the Nicene or Apostles' Creeds.
Second, avoid saying anything that any of your worshipers would find offensive or critical about their particular denomination.
Third, be aware that the vocabulary and style of worship you are familiar with from your own church might be unfamiliar to residents of other denominations. Try to use words and gestures that everyone will understand. A good way of doing this is to attend the worship services put on by other volunteer worship leaders in our hospitals. This will give you an idea of what is common to the worship styles of all Christian denominations.
Back to Top
Most residents experience multiple disabilities and use wheelchairs. About eighty per cent of residents have confusion, which ranges from being mildly muddled to nearing the end stage of Alzheimer’s disease. Many of our residents do not hear or see well. Many of our residents have poor short-term memory, short attention spans, find abstract concepts difficult to understand, and are not able to follow complex chains of reasoning or infer the logical conclusion from a set of premises. Although some residents are not cognitively impaired, any group gathered for worship will contain a number of residents who suffer some of the disabilities mentioned above.
Back to Top
Worship should be conducted so as to provide a meaningful spiritual experience to all those in attendance. Everything that is done during worship should communicate something to each resident. Residents who are cognitively alert and capable may get one thing out of some part of the worship service while more disabled residents get something else.
For example, if the congregations sings a hymn, some residents will clearly understand the meaning of the words and appreciate the message they convey, and enjoy the sound of the music and singing. Other residents will only partly understand the message of the hymn’s words, but find comfort in what they do understand, and will enjoy the sound of the music and singing. Other residents will not understand the words at all, but the music and the singing will evoke feelings and memories that comfort them.
Every part of the worship service, if possible, should provide a meaningful spiritual experience for each resident on a level that accords with their cognitive ability.
Keep in mind that severely demented residents may not remember recent events but may remember childhood events. For their sake the worship service should incorporate religious words, symbols and hymns that residents are likely to have learned in childhood.
Back to Top
As far as possible involve the residents in activity. The best way to do this is through singing hymns. At least half the worship time should be devoted to singing. Have the residents recite along with the worship leader a familiar prayer, such as The Lord’s Prayer or the Twenty-third Psalm. Invite the residents to bring forward prayer petitions. Engage the residents in dialogue during the worship by asking simple questions and inviting comments on what you are saying.
When a hymn is announced many residents have trouble finding the page on which the hymn is printed. Help them find the hymn or exchange their hymn book for one which is already open to the right page.
Back to Top
Use props such as banners or other things residents can see or touch. An example would be a cross covered in velvet and stuffed so that it could be squeezed, or a Bible covered in material. Use colourful rather than abstract language.
When speaking, speak slowly, clearly and strongly. Try to project your voice. Many residents have a hard time hearing.
Choose hymns that the residents are likely to know and have sung for many years.
Back to Top
Keep your sermons short. It is better to give a two-minute talk before a hymn and another two-minute talk after the hymn than to give one four-minute talk. Two minutes should be the maximum length for any sermon or message.
Residents, even the cognitively impaired, will pick up feelings and emotions, and respond to movement. If you are energetic and lively, the residents will tend to become more energetic and lively. If you are dull, static and monotonous, the residents will stop paying attention and may even fall asleep. On the other hand, if you are too loud and move too quickly and speak too quickly it will confuse residents and agitate some. You have to find the balance that will keep residents’ attention focused and raise their spirits without putting them to sleep or agitating them. Remember that while some residents are hard of hearing, others have hearing aids that magnify sound and may make certain kinds of loud sounds painful.
Avoid complex theological language. Use and reinforce the ideas and images that the residents would have learned in childhood. Tell stories. The Bible is full of wonderful stories. Use language that evokes feelings as well as ideas. Consider the difference between the following two statements: "God wants what is best for you" and "Today God is giving you a big hug." Which statement do you think would have the greatest impact on a resident who has difficulty understanding abstract ideas? What is best for me may be hard to grasp, but everyone remembers what a hug feels like.
Back to Top
If you cannot lead worship at the time you are scheduled, and cannot find someone to take your place, please call the Chaplain (250) 370-8207. The Chaplain can often find someone to fill in or can take the service himself. If you have to cancel at the very last moment and cannot reach the Chaplain, please call the hospital where the service is to take place and inform them that there will be no service. If you do not inform the Chaplain or the hospital that you are not coming, staff will bring residents to the worship area, and they will wait for you to come. When you do not come, both residents and staff will be hurt and upset. We expect people who profess the Christian faith to do their best to show respect and care for residents and staff.
Keep in mind that personal information about residents is to be treated confidentially. You may see or hear all kinds of things about residents, their health, and their families. Keep it to yourself.
We want residents to grow stronger in the faith they have. We do not want to change what they believe or convert them to our way of thinking. Worship leaders and all spiritual care volunteers are not to criticize or attempt to alter the religious convictions of residents. Do not proselytize. Focus on what all Christians hold in common.
When you and your worship team arrive at the hospital where you will be leading worship, go to the nursing stations on all the units and tell them you are there to lead the worship at the scheduled time and place. Ask the person on duty to inform the rest of the staff. If you alone are the whole worship team, ask the staff to help bring residents to the worship area. Often staff will help if they are not busy with other duties. You may know some residents who have come to your service before. Ask them if they want to come. If they indicate yes, bring them to the worship area. You can also visit resident rooms and ask those who are awake and in their wheelchairs if they wish to come to worship. You may see a care plan posted on the wall by a resident’s bed. If it says that they attend church, and they are in their wheelchair and awake, tell them you are there to take them to the church service in the dining room, and take them unless they object.
When speaking to a resident in a wheel chair, stand or crouch in front of them so that you do not tower above them. Because their language may be confused, be attentive to body language and try to pick up on their feelings. The smile is a universal language: use it and respond to it.
Do not lift, transfer, walk, feed or toilet residents. Ask staff to do this if it is necessary.
Some units have amplifiers, microphones and speakers. Use them if they are available or bring your own if you have them and set the volume loud enough for everyone to hear, but not too loud. If you are leading singing, be careful in using the microphone so that you do not drown out the congregational singing. If you don’t have the use of amplification equipment, make sure you speak loudly and clearly and slowly enough for people to follow you. Even if you do have amplification equipment, you will communicate better if you speak distinctly, slowly, and use everyday words.
If you have enough people helping you, greet residents when they arrive in the worship area and welcome them warmly. When the service is over, take the residents you brought to the worship area back to their units or rooms. Residents who arrived on their own can usually return on their own. While residents are being taken back, have someone chat with the residents who are waiting to be taken back. This will give members of your team a chance for one-on-one fellowship with residents.
Take every opportunity to thank staff for their support and assistance.
Back to Top
The Chaplains for long-term care are responsible for recruiting, training, supervising, and supporting volunteer worship leaders and Spiritual Care Services volunteer visitors. The Chaplains want and need to hear your concerns. If you have any problems or requests please talk to the Chaplain for the hospital where you are leading worship. If you have any suggestions for improving worship, please make them known to the Chaplain. Through sharing our experiences, successes and failures we can learn from one another and support one another in this ministry of worship.
There are few experiences that bring more joy than a well-conducted worship service. Finding what works is often a matter of trial and error. Don’t be afraid to make a mistake, but be willing to learn from your mistakes. Don’t think less of yourself if you make a mistake. If you do think less of yourself when you make a mistake, what kind of example will you be giving to the residents, many of whom make mistakes all the time due to their cognitive disabilities?
Be observant and take your cues from the residents. When something goes over well, you will see it in their reactions and on their faces. If it works, make it a regular part of your worship style. If it doesn’t work, drop it.
Above all remember that your task is to help residents believe that God loves them just the way they are. So accept the residents as they are and love them with as much love as God gives you to share.
Back to Top