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    Questions of Death and Dying

    Emotional and Spiritual Concerns at the End of Life

    One of the most important people on the palliative care team isn't a doctor or a nurse. In fact, he or she doesn't have a medical degree at all. It's the chaplain.

    A chaplain is typically an ordained minister of a particular faith -- Roman Catholic, Protestant, Jewish, Muslim, or another. On the palliative care team, he or she serves the spiritual needs of all patients and family members, no matter what religious belief they have or don't have.

    As people near the end of life, they and their loved ones usually have important emotional and spiritual questions and concerns, and it's important they have someone to hear them.

    Here are some of the emotional and spiritual concerns that many people and their families have at the end of life.

    Why is this happening to me, or to my loved one?

    This is by far the most common question that people facing death and their families ask. And it's not really a question; instead it's a vital emotional expression.

    It can be an expression of shock or anger. And there's not a typical theological or medical answer to be given. Experts at Capital Caring, which cares for more than 1,000 people living with advance illness in the Washington D.C. area say that people don't want to talk about their feelings. They want to express them -- their grief, their shock, their sorrow. The chaplain's role is to help the patient or the family member give expression to those emotions.

    What comes next?

    At the end of life, people aren't usually looking for new answers to the age-old question of what happens after we die. Instead, they think about the life they have lived and what they have known in the past. The chaplain supports that reflection either directly or by going out into the community and finding what they need.

    I want to tell my story.

    People who are dying, or those who are losing a loved one, often want to go over the story of their life -- and their illness. The chaplain is there to let them tell their story, whether it's from the beginning or they just want to go over the diagnosis -- where they were when they heard it, what happened next -- a certain number of times.

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