Hope and spiritual care

A no-visitor hospital policy left me and my family alternating between despair and hope while my mom was alone at the hospital, fighting for her life against COVID-19 in the spring of 2021. In a matter of days, we were thrown into difficult and confusing conversations about life-threatening oxygen saturation levels, ventilators, punctured lungs and do-not-resuscitate policies.

Cecilia Wong, my mom, spiritual beacon, and best friend, was in deep trouble. Waves of devastation for all of us became increasingly acute as the time of separation grew. We cried out to the heavens and hoped for good news each day.

At the height of rising COVID numbers, mom was transferred from one hospital to another at a moment’s notice. We were chasing the next health-care staff member on the other end of the general phone line to stay abreast of mom’s situation. “Is mom’s oxygen saturation level and breathing showing signs of progress?” “Is the nurse available now to tell me how mom is?” “Can I be put on the list for the next doctor’s virtual rounds tomorrow?” For weeks, my life revolved around phone calls and questions about her physical and medical situation with more than 100 hospital staff members.

While I fully understood the importance of physical care to keep my mom alive, at times I longingly wished that someone could love, pray, and stay with mom, even for just a little while. I realized that I needed emotional and spiritual care and I believed my mom did, too.

Over the past two to three decades, North American medical literature and studies have revealed the importance of spirituality in health care. An American Family Physician article titled Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment describes spiritual care as recognizing and responding to the multifaceted expressions of spirituality encountered in patients and their families. It involves compassion, presence, listening and the encouragement of realistic hope.

Spiritual care can be a powerful therapeutic intervention. The article quotes from a medical study that states, “94 per cent of patients admitted to hospitals believe that spiritual health is as important as physical health, 77 per cent believe that physicians should consider their patients’ spiritual needs as part of their medical care, and 37 per cent want their physician to discuss their religious beliefs more. However, 80 per cent reported that physicians never or rarely discuss spiritual or religious issues with them.” Reasons such as lack of time, training and personal beliefs of physicians are at play.

Yet, with increasing multidisciplinary health-care team models in Canada, the role of spiritual health does not have to fall on physicians alone. Spiritual care is a team effort. The first step is accepting its importance and offering little acts of compassion and empathy.

Sarah, who usually picked up the phone at ICU reception, expressed deep compassion when she shared her understanding of how hard it was for us and told me it was OK to call for updates as frequently as I needed. Her acknowledgment, kindness, and permission to freely call made a huge difference for me.

The burden of feeling like a pest for calling so often for updates subsided. Mary, one of the ICU nurses, asked us what music my mom likes so she could arrange that for her. She held the tablet for us when there was just no way to prop it up and stayed with us through our family prayer on Zoom. Her actions spoke volumes to her care and attentiveness even amidst the chaos.

I was grateful that there was finally a spiritual care practitioner on staff who reached out at our third hospital transfer.

Catherine, our spiritual care practitioner, became the person who sat with my mom to pray and read her scriptures, even during mom’s unconscious state. On the many days after she stayed with mom, Catherine would call to tell me how mom was and care for me. Her actions represented what I yearned to do with mom; my soul was filled with hope and love to know that someone was genuinely present with her to care for her spiritual and emotional well-being.

Catherine respected our Christian faith and encouraged us to share our deepest thoughts and prayers during our family Zoom calls with mom. I wondered if mom would be able to hear us in a medically induced coma; Catherine empathetically nudged us to hope and trust that she could. That was a springboard for our family to come together to sing hymns, read scriptures, cry out our lament to God and ask for a miracle healing. This daily ritual to deal with our spiritual and emotional grief glued us together. I thank Catherine for her suggestion and the regular calls of care in the storm of uncertainty. She gave me hope and hoped with me.

“She was like an angel sent from heaven to help me.”

Twenty-eight days after mom had waved goodbye over video chat and said that she was ready to meet her maker, she came out of her induced coma and paralytic state; she came through the worst of it and received her tracheostomy. Mom was in and out of delirium. She did not really recognize us on Zoom or realize what was happening or where she was. With Mother’s Day just around the corner, Catherine, in coordination with the nurses, offered to put up our family photo in mom’s room, and agreed to read her our Mother’s Day cards. When patients are lonely and in unfamiliar spaces, a family photo and handwritten cards can warm the atmosphere.

Catherine continued to visit mom as she gradually progressed and was moved to different hospital wards for care. She became our only constant hospital staff member who knew our family’s needs and supported us from beginning to end. She helped us navigate through hard periods when mom insisted that we left her at the hospital to die. Her psychotherapeutic expertise helped mom through confusion, deep questions of suffering and the meaning of the situation. In turn, she helped our family make sense of mom’s delirium and fluctuating PTSD-like emotions.

Many spiritual care practitioners today are also registered psychotherapists. Like many other diseases and illnesses, COVID ravishes the body, but also clouds a clear mind and challenges our darkest fears. Through life-and-death situations when hope is bobbing in the waves, spiritual care from designated practitioners can be a pillar of support. A 2017 study from Angus Reid found that 51 per cent of Canadians associated themselves with spirituality (21 per cent Canadians as religiously devout and 30 per cent as privately faithful). The Public Health Agency of Canada states, “Positive mental health is ‘the capacity of each and all of us to feel, think, act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being …’” Canadian health-care teams must further recognize the role psycho-spiritual care plays in more fulsome healing.

Froma Walsh, an American clinical psychologist, wrote in her book Spiritual Resources in Family Therapy that, “Spirituality is not simply a special topic … It involves streams of experience that flow through all aspects of our lives … Spiritual beliefs influence ways of coping with adversity, the experience of suffering, and the meaning of symptoms. They also influence how people communicate about their problems and pain … the treatments they seek; and their preferred pathways in problem solving or recovery.” When spiritual health is attended to during a time of adversity, it can bring about a holistic recovery and positive mental health. 

Sixty-five days later, mom slowly regained her voice, spirit, solid food intake, deeper breathing, independent mobility and was officially transferred to a rehab hospital. As a parting gift, Catherine gave mom a journal sprinkled with handwritten notes of prayers and encouragement so that she can continue to explore the meaning of her experience with COVID. Mom called Catherine her spiritual sister.

Says Cecilia, my mom: “Catherine played an important role to care for my innermost feeling of loneliness and frustration. Like an onion, layer by layer, I shared my worry, sadness, and joy with her, and she guided my thoughts with renewed perspectives and care. She directed me to God all the time … her role filled the gap of my soul healing from this COVID experience. She was like an angel sent from heaven to help me.”

We give thanks to all the staff at Royal Victoria Regional Health Centre in Barrie, Ont., who supported mom’s recovery and Catherine Ruiz-Gomar, who was our spiritual care practitioner.

As our family reminisced on this journey of trials, hope and healing, mom revealed to us that she felt us with her while in coma. In her visions, we were singing and talking with her all the time, and she felt great peace. I would like to think that she sensed our presence and prayers through our regular Zoom calls. Calls which transcended through the physical dimension and into the spiritual. Connections that gave us steadfast hope of healing.