Iconic French fashion designer Coco Chanel is quoted as saying, ‘Guilt is perhaps the most painful companion of death’. Indeed, as we age, it is natural to reflect on our lives. Looking back, we may have feelings of guilt about what we have said and done. We asked two Lutheran aged-care chaplains for their observations about the part guilt can play at end-of-life.
Gospel provides great comfort
by Gillian Reid
My role as an aged-care chaplain is to provide social, emotional and spiritual support for residents, staff and residents’ families, along with leading Bible studies and lay reading services. I also organise visits from congregational pastoral care teams from residents’ home churches if they have stated they would like visits.
Formerly a teacher, I was led to chaplaincy because I am passionate about providing a listening ear for people who need someone to talk with. As a teacher, I found that students would talk with me about things that were on their minds and a dear friend suggested that I become a chaplain.
The greatest joy for me is the relationships that I have the privilege to be part of. To just sit with an aged-care resident and share that time is a blessing.
I believe that both Christians and non-Christians struggle with guilt. It is a part of humanity’s fall. The difference is that a Christian person has the assurance and tremendous comfort that their sins are forgiven.
Some of our residents carry guilt from their past. Other residents who have dementia can re-experience guilt when it feels for them as though the event happened recently. Carrying guilt harms their self-worth and their relationships with God and others. For example, several residents have said they felt that the mistakes they had made in the past meant that God was punishing them now. The sense of guilt adversely affected their faith.
There is a difference, too, between guilt and shame. Guilt focuses on our behaviour. Shame focuses on us and is the fear of being unworthy of love. It causes people intense pain and suffering when left unaddressed. In contrast, guilt can be a good thing because it can lead us to the source of forgiveness, our Lord and Saviour Jesus Christ.
We can best serve others who are suffering with guilt by listening to them as they share their story. If you feel someone you are serving needs further assistance and counselling, do some research so that you can refer them to local psychologists and charities. When or if they ask us about God, you can share the gospel message of grace and forgiveness with them and support them.
I have known residents who have come into aged care carrying guilt from their past and who have discovered God’s forgiveness and grace through hearing the gospel message. It has made a positive difference in their lives and relationships.
The gospel is immensely powerful in releasing people from guilt. When I visit residents with dementia and we say the Lord’s Prayer and the Apostles’ Creed, they know every word and pray to God. The look of hope and forgiveness on their faces is beautiful to see. The Holy Spirit is living and active in their hearts. It is one of the great joys of my work.
Gillian Reid is a chaplain with Lutheran Services since 2018, and has moved recently from Salem, Toowoomba, to Zion, Nundah in Brisbane. A member of Redeemer Lutheran Church in Toowoomba, she is in the process of joining a new church family due to her recent move.
Unfinished business
by Kathy Friebel
In a society that struggles to name sin, guilt is talked about openly in the context of indulgences like eating chocolate. Such confessions are offset by friends who respond with an admission of an equal or greater indulgence. More serious guilt for ‘what we have done’ and ‘failed to do’ is processed in our worship liturgy. Uncomfortable as it may be, guilt can help convict us, and guide us towards better lifestyle choices or relationship reconciliation. At worst, it can condemn a person to live with a sense of shame.
As a chaplain in an aged-care facility, I have listened to many older people share stories of the guilt that plagues them as they wrestle with ‘unfinished business’ late in life. More obviously, guilt is often present as tension between residents and their families.
As care residents spend increasing amounts of their day in sedentary activities, the time available for reflection increases. It is estimated that more than half of elderly people live with depression, and this can turn a person’s focus towards what hasn’t gone well during their lifetime.
With or without faith, a sense of guilt for choices made in earlier years is common. Where relationships have been damaged or broken, reconciliation with others is often impossible, especially if they have died. Rites of confession and absolution are deeply powerful for those who understand forgiveness from a gracious God.
While grief and loss may be dominant emotions for a resident entering aged care, guilt is often a silent companion. It is also common for family members to express feelings of guilt for having ‘put’ a spouse or parent into care, even though this level of care is needed.
If loved ones have been caring for the person entering care, part of the transition is resorting to the role of partner or child and relinquishing the role of carer. Visits can relax into spending time with each other. With the support of staff in creating new relationships of trust, there is great potential for avoiding or reducing feelings of guilt.
Whether or not dementia plays a part makes a significant difference. Those who need living assistance but have no insight as to their need, are particularly prone to laying guilt on spouses or children for moving them out of their home. With the personality change that can result from dementia, hurtful words of accusation are often spoken which, for the receiver, are hard to forget.
Residents experience guilt about many things. The theme most often verbalised relates to being a burden on people and resources. Residents who think this way can feel guilty for living. Comments about life being easier for their loved ones if they were dead are common.
Ageing people in any setting can have a type of survivor guilt, especially when a child or grandchild dies or has a terminal diagnosis. Residents who are deteriorating can also feel guilty for dying, especially if family members ask them to hang on until the next family milestone.
Guilt often presents during end-of-life and as part of grief afterwards. Much of the guilt in the death space is avoidable if conversations about death occur ahead of time. Outlining expectations for medical interventions can alleviate the angst faced in a highly emotional time. Visitation is often an area of misunderstood expectations. Many aged-care residents do not expect family members to keep a bedside vigil during end-of-life. When this has not been discussed, loved ones often put pressure on themselves and others to be present 24 hours a day until the last breath is taken.
The antidote to much guilt experienced in the last season of life is open conversation. Where this is difficult, it may help to enlist the support of another trusted person. A chaplain or pastor can assure a person that they are a loved and forgiven child of God, even if they do not want to discuss their guilt.
Discussing choices and boundaries within families can eliminate tension and guilt for the aged person and their loved ones. If healthy expectations are nurtured, their remaining days on earth can be free from misunderstanding and unnecessary burdens.
Kathy Friebel has been an aged-care chaplain for 10 years and serves at St Andrews Aged Care at Tallebudgera on Queensland’s Gold Coast. She has been part of the St Andrews Lutheran community as a congregational member there for 25 years.
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