Pastoral care of chronically ill older adults in an acute long-term care hospital

The goal of the study is to develop a theory for pastoral care of chronically ill older adults in an acute long-term care hospital. The study contributes to the field of pastoral care in two ways. First, the given institution is on the forefront of nationwide health care reform. Thus, the setting represents an important new realm of ministry in need of exploration and definition. Second, the study focuses upon the spiritual needs of a significant segment of the population--chronically ill older persons. Conclusions derived in the given setting should enhance the work of pastoral care-givers in that context and raise possibilities for further research in ministry involving chronically ill older persons.;The study resulted in the identification of nine principles of pastoral care. They are summarized as follows: (1) chronic illness may raise significant psychosocial obstacles to personal and physical wholeness; (2) older adults express an interest in spiritual issues; (3) reminiscence is a spiritually enriching process which promotes personal growth or sustains the self during times of crisis; (4) ritual is an important pastoral resource in the given context; (5) a pastoral confidant provides a helpful and distinctive form of care; (6) effective pastoral care in the given context involves ministry to family members; (7) patients and family members benefit from pastoral support in the consideration of sensitive ethical issues; (8) pastoral care in the given context should encompass a full range of traditional pastoral functions; (9) a pastoral caregiver in the given setting may overcome barriers to effective ministry through attention to personal and professional development. These principles provide a framework for pastoral care which recognizes the needs and concerns of patients, family members, and pastoral care-givers alike.;The study consists of two parts. Part One provides a theoretical foundation for ministry based upon an examination of research in the fields of philosophy of medicine, psychology, sociology, and theology. Part Two combines theoretical and clinical insights in a descriptive study of ministry. Theoretical insights from Part One are interwoven with clinical insights derived from case summaries of the author's ministry in the given setting.