What Hospital Chaplains Hear From Patients Near Death

The Age-Old Question: What Happens When We Die?

What happens when we die? It is a profound question that has been debated for thousands of years. Philosophers, researchers, religious leaders, even late-night talk show hosts and actors have pondered it. Stephen Colbert even famously posed the question to Keanu Reeves, who replied, “I know the ones who love us will miss us.”

While we at Afterall don’t profess to hold the answer to that great mystery, we talked with those who help people at the end of life who are searching for meaning.

Chaplains Provide Comfort at the End of Life

Rev. Dr. Jill Rowland, chaplain and Director of Spiritual Care, and her team at Legacy Emanuel Hospital, Randall Children’s Hospital, and the Unity Center in Portland, Oregon, offer support to patients as they grapple with this and other big questions every day.

Often, the chaplains are the only people patients have who are comfortable listening to them as they share their grief and concerns. “Even though there may not be a particular word or religious symbol, but just through our presence and hearing these difficult emotions that come with that, they receive comfort in that,” Rowland explained.

Listening to Patients’ End-of-Life Reflections

Hospice pioneer Barbara Karnes has written about the role of religion in hospice care and agrees that the time near death is one of personal introspection, “There are many paths to self-discovery; religions are one path,” she explains. She says chaplains can help facilitate the listening, which is important as patients face the end. Karnes says while patients appear to be sleeping, they are perhaps “doing the most important work of their lives – figuring out what their life has been about.”

Varied Beliefs About the Afterlife

Depending on one's religious background, there’s a whole range of beliefs about the afterlife. While organized religion has been on the decline, a recent Pew study showed the majority of Americans surveyed still believed in heaven.

In the survey, even those who didn’t believe in either heaven or hell believed in some kind of afterlife “where one’s spirit, consciousness or energy lives on after their physical body has passed away, or in a continued existence in an alternate dimension or reality.”

Similarly, Rowland says in the Northwest, over the years, there’s been a growth among those who identify as “spiritual but not religious” and a wide range of religions that they serve with a whole host of beliefs about an afterlife. Rowland says religion is one of the ways people “make meaning” at life’s end, and she says chaplains are there to give them a safe space to share their feelings.

Reunions and Relationships

The majority of the patients she visits have conversations that center around relationships. She says chaplains ask patients to share what they wish for – or fear – in the next life if they believe in an afterlife. She says they are often thinking of being reunited with loved ones, saying things like, “I hope I see X, Y, Z people” and “I hope I see my dog or my cat … it is that sense of being reunited.” Rowland says they also share that they hope for no more illness and suffering, whether it is freedom from substance abuse or pain and disease.

These are similar to the findings of the Pew survey, which found that people thought they would be reunited with loved ones, free of disease, meet God, and see former pets.

In the end, Rowland says she wants people to know that “Chaplains aren’t just the ‘God Squad.’ That’s a part of what we might do is talk to people about what their beliefs are if that’s what they want to talk about, but more than that, we are human beings who most of all want to see the human being in front of us and provide care for them in whatever situation they find themselves in.”

Rowland encourages us all to share conversations about what is important to us with our loved ones throughout our lives. “In reality, the day that we are born all of us are making our journey toward death, but we spend most of our lives trying to deny it.”

Finding Sacredness in the Midst of Suffering

When people outside of work find out Rowland is a hospital chaplain, she says, startled, that they either stop talking or ask her how she can deal with the role. “How can you do that? That must be so hard,” they tell her. But she says she has the greatest job in the world.

“They rightfully think about how chaplains accompany people often during the worst time of their life or during this time of deep suffering. And that is true. We do accompany people during those times. And, for me, there is a sacredness and holiness to that, too, because that’s all a part of our life. It is the whole of who we are and what our human experience is. I think that I have one of the greatest jobs in the world because I get to participate in sacred sort of work.”

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