Chapter Ten: Giving hope in hopeless situations

In his book ‘Spiritual care at the end of life,’ Steve Nolan* writes about ‘beyond recovery’ (Ch 1), ‘Hopeful Presence’ (Ch5), and a ‘Theory of  Hopeful presence’ (Ch7). 

Objective: to discuss and explore as a team how can we give hope in seemingly hopeless situations.

We are used to hope being seen as having a positive outcome, however, the patients I have encountered at the Hospice where I minister who hope for a miracle or have belief in positive thinking or alternative medicines, therapies and even special honey, are seen as being in denial of the reality, i.e. that people we meet here do have life-limiting illness and disease.  That is fact and that ‘Hope’ denies reality. But there are other ‘Hopes’ e.g. in the spiritual sense Hope is also about an eternal security.

On the other hand, I have noticed that there is a redefining of hope that goes on in the hospice and hospitals where I have served. This hope seems to be redefined by how we are with people.

There is something about being in the ‘here and now’ rather than the 'past or the future.  There is something to be learned from not running away when we feel helpless, learning to be present with people in their pain, holding a hand, saying a silent prayer, and filling a silence with a smile or a tear.

Timing: Allow 45 minutes

Reflective Exercise : Case study - Susan, ‘I’m a crier’

Case Study

Susan is a lady I have been getting to know recently, I didn’t know her prognosis was not good until I saw her name on the MDT palliative list at the hospital. 

When I first visited her and introduced myself ‘hello my name is Kelvin…’ Susan burst out crying. 
I didn’t know whether to leave or stay.  I didn’t know if she was happy or sad or if this was a Tia or stroke induced emotional incontinence or something I had triggered just by turning up.  I asked, should I stay or should I go’ and she said I should stay.  Eventually, Susan said she was ‘a crier’ and that was all it was.  I stayed and enquired about her family, husband, children, grandchildren, past job… there were lots of ‘getting-to-know-you’ exchanges.

 Next time we met was a Sunday. Susan came to the hospital Sunday service and during the service, she wept in my sermon (!) then she sobbed when I gave her the sacrament of Holy Communion. After the service, I went up to her to ask if it was painful for me to visit her and she just wept and couldn’t speak back to me. 
Again, I wanted to leave and said, ‘I think I am making things worse’ but she reached out her hand and held my hand in hers and she said one word: ‘stay’ and the wept again.

 Over the weeks that followed, my visits (twice per week) had these outbursts, which began with her saying ‘I’m a crier’ and then we would share some other stuff, some spiritual some relational ‘going beyond pathology to personhood.’

 I slowly began to realise, Sue was finding hope in my visits, not because I was doing anything nor was I able to fix anything but because I was there (being present) with her and prepared to keep going back to be with her again and again.

Hope seemed to blossom within her with the ordinariness of each new day and my visit wasn’t about denying hope of a fix, my visit was allowing her to seize ‘that moment’ and hold a hand for ‘that moment,’ to talk about family and travelling and jobs and maybe the spiritual dimension as well. 

When I reflected on my own reaction, the desire to fix it and knowing I could not do that, that it was impossible - I felt helpless.  But staying there when she wept when I wanted to run away was crucial.  I realise Susan has taught me that we can give hope just by our common humanity. In later visits, I started to feel her pain - an empathetic sensation, sometimes I felt a tear in my eye when she shared things with me.  Hope was very real in the ‘here and now’ because we were sharing (and caring) together. 

Susan taught me a new way of looking at how we give hope.

A.  As a group discuss the ‘hope’ described by KB as a result of meeting Susan

B.  Share in the group a relationship where similar ‘hope’ was experienced.

C. Is there a Theological theme that emerges?

Chaplains are beginning to speak out about Hope that Chaplaincy visits can bring. Through reflective practice and case study-type research we will continue to explore -  ‘How do we give hope?’

*Steve Nolan is a Chaplain at Princess Alice Hospice Surrey.  (2023)