Some Thoughts on How to Provide Long Term Pastoral Care - Part 1

Published: Aug 22, 2009

Are you facing a situation in your church that will require pastoral care over a long period of time? If you don’t have a situation like that now – you will in the future. Are you ready for it?

Caring for people in the local church is challenging work. As a pastor, I remember numerous occasions where a need for long term care arose. These were always challenging situations and ones that caught the church by surprise. Over the span of a decade, though, I began to see some pretty obvious things that were essential for providing good long term care. I compiled these ideas into a chapter for my doctoral thesisi which I have updated to publish here. I must say that I learned these things simply by watching brothers and sisters in Christ pour out their lives in sacrificial love to friends and loved ones who were in need. Perhaps it will help you to prepare for the pastoral care demands that will come your way sooner or later.

The Problem and God’s Call to “Keep love constant.”

Sometimes the need for long term care can be challenging if a church is not prepared in advance. What does it look like to persevere in pastoral care? Sometimes people’s struggles are long lasting.

What are some of those long term crises: a spouse who suffers a stroke and is incapacitated; care for the elderly; Alzheimer’s, teen pregnancy, a child with autism, or simply a family with ongoing counseling and pastoral care needs. All of these represent some of the issues that can prove challenging to a church.

What are some current societal realities that make this issue so important?

  • Traditional extended-family care is no longer the norm. My wife and I experienced this as parents of small children. We were not surrounded by extended family and we relied heavily upon the friendships that we had in the body of Christ for years! And this opportunity for service not only blesses the family in need, it also shows the gospel in action to those outside the church who see the care that is given.
  • The following statement confirms this breakdown in extended family care:

    We are a nation on the move with little in savings, little nearby family support, and health insurance that either does not cover policyholders completely or is non-existent. Split families, step-families, extended families, and no family at all—each add their own peculiar mix of problems and solutions. No wonder illness is scary. Roles are no longer rigidly defined and it is anyone’s guess where support will be found in a crisis.ii

What incentives and imperatives do the Scriptures bring to this challenging area of gospel ministry and pastoral care? Two passages are important for the task: 1 Peter 4:8 and Ephesians 3:14-19. In 1 Peter 4:8, we are called to “love one another deeply.” The word translated deeply can also mean “constant”. “Keep love constant” would be a good translation. The word describes something that is stretched or extended. The love of the saints keeps stretching, in both depth and endurance.

This connects nicely with Ephesians 3 where Paul prays that we would “grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge…” Persevering love grows out of the Gospel. You must start here if you are going to find the strength and incentive to go the distance with people. Within the context of 1 Peter 4:8, we are then called to “offer hospitality without grumbling” as well as utilize both word and deed gifts in the situation.iii

Some Strategies to Provide Long Term Pastoral Care

What strategies should be in place and ready to be activated in these kinds of situations if pastoral care is going to thrive?

• Basic Care Should Already Be In Place
Small groups, Sunday school classes, other groupings, and a basic care committee need to be in place (moving transitions, welcome committee, new baby, meals, etc.). If there is not a culture of care at this level, then it will be even harder when the need for long term care arises. Any and every church should develop a care ministry that begins here and covers the basics. Make this a ministry team that includes men and women.

• Form a Small Group to Oversee Care When A Specific Need Arises
When long term care needs arise, the critical first step is to form a small group to respond and manage the care.  Having a group, instead of a single individual is critical to preventing helper burn out.

Begin the process with someone making contact with the family and asking for permission to form a care group. Suggest names and/or ask them for people with whom they will feel comfortable. Asking for permission needs to pervade the entire process or the family will likely feel micro-managed. Having the family grant permission honors them and communicates that though things may be hard, they are not out of control. A good support group can provide stability. They need to listen to the family, ask good questions, receive good information, see the needs, ask for permission to act, organize a system that includes all who want to help, implement and oversee the plan daily, make changes when necessary, and remain flexible.

• Preferably Don’t Make an Elder or a Deacon the Organizer
An elder or deacon may be on the team but should not lead it because their focus should be on providing oversight and care for the care-givers. Usually you can identify someone outside the elder or deacon board who has strong administrative gifts to provide leadership and structure for the small group care team. Elders and deacons may certainly assist and be involved but they should be thinking about the pastoral needs of the care group itself. In addition, the elder and deacon can provide a good link to the larger elder/deacon board.

• Identify a Group Leader
This point person not only provides leadership but also serves as a buffer and communication channel between the family and the broader body of Christ. Notice the concentric diagram below. See how the family is helped and protected by this small group. But group leadership should not stay with any one person indefinitely. Rotate the point person as needed.

• Invite outside Expertise to Advise the Group
The care group should invite a trained person to help them understand the issue and provide basic information and perspective on how the situation or crisis will affect the person and family. The more information you gather at this level the better. Depending on the nature of the problem, this could mean consulting a social worker, a medical professional, a counselor or any other type of specialist who can bring specific expertise to the situation.

• Group Should Meet Weekly (at least at first)
Evaluate. Have the point person with the family bring concerns to the group and allow the point person to send more information and questions to the family. Good communication is crucial (see next point). This is why the relationships described in the concentric circle diagram are so important.

The schedule can be reduced as the situation becomes less acute.  Email connections with the group may help to keep everyone informed and familiar with their responsibilities.

• Promote Good Communication
With the small group formed, it is vital that they communicate clearly with the broader church about what the ongoing needs are. They can also protect the family from being overwhelmed during the early stages when everyone will want to help. Many churches now have websites where new information can be posted regularly. If there is no website (and you may want to do this in addition to the website) it is always wise to include information in a bulletin insert. Another suggestion is to have a designated phone line with messages and the ability to receive information for people to offer help. Try to avoid one person having their home phone as the place where information is relayed. Purchase a cell phone and publish that number. Have each person in the small group be a point person for a week at a time. Make sure everyone in the church knows how things are going to be handled and encourage everyone to participate in the way that has been outlined. Only emergencies should bypass this process.

*****

Look for Part 2 of this article later this week.

i This article is excerpted and adapted from Tim Lane’s Doctor of Ministry thesis titled: “Counseling in the Local Church: The Pastor as Shepherd and Equipper” completed at Westminster Theological Seminary in 2006. This content appears as chapter VI of the thesis with the title of: Pastoral Direction for Long Term Care.

ii Judith Griffith Ransom, James Henderson, To Be the Hands of God: A Woman’s Journey, One Congregations Challenge (Nashville: Upper Room Books,1992) pages 24-25.

iii Other passages that bear on this kind of care are: In I John 3:16-18 we are called to love in deed not just words. Caring for person’s felt needs through practical deeds. I John 13:1-17 call us to love despite the circumstances, recipients, or our stature. James 2:1-26 issues a call to real faith expressed in caring for those who are helpless. Galatians 6:1-5 calls us to exhibit real love by seeking to restore sinners gently with all humility. Colossians 3:12-17 tells us that character precedes ministry. Care-givers need the gospel in order to be useful. If not, they will not love well.

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Timothy S. Lane, M.Div., D.Min. is executive director and faculty member at CCEF and has been counseling for almost 20 years. He has Master of Divinity and Doctor of Ministry degrees from Westminster Theological Seminary and experience in both campus and pastoral ministry, including serving as a pastor for ten years. He is the co-author of CCEF's Transformation Series Curriculum, How People Change, and Relationships - A Mess Worth Making.

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