The Care Crisis

To care or not to care: that is the question.

Except it's never a question of not to, when it comes to pastoral ministry.

I suspect that if you asked most people what they expect from their parish priest, if they expected anything, it would be an expectation of good pastoral care.

But what is good pastoral care?

In fact, what is care, when it's boiled down to its essential nature?

The etymology of care seems to originate from the Old Saxon kara, or sorrow; also the Old High German chara, or lament. Which is interesting. It suggests that before you give care, you feel it. It suggests it comes from within.

I've been thinking about care recently, and what sometimes feels like a care crisis in society.

Nearly every week I hear stories of care being stretched to its limit - whether from unpaid carers who feel undervalued and who themselves are in great need of care, or from overstretched establishments where there are a shortage of carers, resulting in distress for elderly or infirm residents. The shortage of carers might be blamed on poor pay, expensive local housing or a host of other factors. One might even begin to fear that as a society, we don't care for our carers.

There has recently been discussion instigated by care workers who visit elderly and infirm people in their own homes, but who are not paid for their travel time. In a landmark case, http://www.independent.co.uk/life-style/health-and-families/carers-mihomecare-settlement-minimum-wage-care-worker-landmark-legal-case-a6936406.html a care worker successfully sued her employer by claiming that this meant she was being paid for only seven hours work when she was effectively doing twelve. 

Twelve hours a day, driving from house to house, attending to vulnerable people who sometimes see no one else all day, giving care, empathising, listening, but always keeping one eye on the clock, because there's another drive ahead, and someone else waiting... and then another drive and someone else, and someone else, and someone else. 

Can you imagine doing this for twelve hours a day?

I was visiting a parishioner once when a care worker called in. And out. She looked hassled and wasn't able to give the elderly gentleman the main thing he needed: time to be properly noticed by another person. I'm sure she was a person who understood care, but she was working in a system designed to deliver anything but, whilst becoming increasingly in need of care herself as a result of that system. It never ceases to depress me that the most vital jobs, and the ones which mark out a caring society from an uncaring one, are the ones which are underfunded and undervalued. With an ageing population, we can ill afford to get care wrong.

Parish priests sometimes find themselves visiting a parishioner in hospital. I remember my first. Dog collar in place and pacing the corridors trying to locate my person, I rounded a corner and spotted a junior doctor whom I knew, the son of a friend. Whether it was because I knew his story, or because I was for the first time in hospital in a different capacity (as priest, not patient) I suddenly saw what I'd never seen before - the cost of care. I don't mean the billions the NHS spends every year, though that is significant, but the human cost, to those who give it, hour on hour, day on day, week on week, month on month, year on year. 

The Junior Doctor was young, clever, focussed; but he looked tired. I realised then, because I was suddenly in the business of care, that care giving is so much more than doing clinical tasks. Real care giving suggests something that patients in hospital already know - that we are beings with deep spiritual needs, and we need to be reassured, encouraged, and shown compassion. And that takes energy and love. Rightly, the NHS tacitly acknowledges this deeper need in their own definition of care https://www.england.nhs.uk/2012/09/nursingvision/ 

Which brings us to pastoral care. I'm beginning to dislike the phrase. Interestingly it appears nowhere in the Church of England Ordinal, which is a helpful corrective. It seems to be something coined, perhaps by the Church, out of the increasing need for priests to act with professionalism and to be seen to be doing so. And, dare I say it, to be seen by everyone else to be doing at least something worthwhile (let's be honest, most people don't understand the need for church services, or why we do God stuff).

So what are we doing when we do pastoral care? What does it feel like to give effective pastoral care? Is it even an appropriate phrase? And what are the costs? 

I imagine this: a spiritually aware Jesus, standing in a practically stampeding throng of people, stopped suddenly on his way to heal the daughter of the Synagogue leader in Luke 8:40-48. As he stands there, people pressing in on every side, an important job to do somewhere else, something happens that delays him. And he allows himself to be delayed. He notices what has happened only inwardly though. 

Unbeknown to him, a woman has deliberately reached out to touch his cloak and has been immediately healed of a long term hemorrhage. Jesus stops and says 'who touched me?' An idiotic question to the disciples. Clearly everyone is touching everyone - they're in a dense crowd of jostling people. But Jesus persists: 'Someone touched me, for I noticed that power had gone out from me'.

This is spiritual care. It feels as though something's gone out from you. Anyone who has cared for a dying person, or someone who's ill, difficult, grieving, or in any kind of need, will recognise it. It means that any kind of caring ministry, including pastoral ministry (which is mostly everything we do as priests) will need you constantly to refuel. It explains a little comment made to me by a much more experienced priest, some while back: 'no one will understand how tired you can get as a minister'.

Caring. Empathising with others who care. Wringing your hands over demoralising and underfunded systems of care. Being interrupted. Noticing things you'd rather not notice. Noticing people you'd rather not notice. Being aware of your internal energy levels. Refuelling. Caring for self. 

To care or not to care: that is a complex question.