A Chaplain’s Reflections In Long-Term Care In The Early Days Of COVID-19

Astor lies in a reclining wheelchair, surrounded by community, gathered for morning prayer. A rosary, woven between folded fingers rests upon her belly.

Astor murmurs: “Help me. Help me. I am all alone.”

Today, the last Friday in March, I am assisting another resident as he leads the Divine Mercy Chaplet, a meditative Catholic prayer using the beads of the rosary as a guide. In younger years, Astor found this prayer to be a comfort. I reassure Astor that she is not alone. She focuses on my eyes, pauses, and begins again to recite the meditative response: “Have mercy on us and on the whole world.”

I am a healing touch practitioner, an engaged Christian, a practitioner of mindfulness meditation. What I have learned from these three traditions, has become interwoven, enfleshed in my healing ministry as a chaplain serving in long-term care. I borrow from each as I travel with those to whom I minister.

What are their sources of meaning? What practice will speak to their heart, give the greatest comfort? How can I facilitate a connection to provide calm, hope or healing, inner strengthening, or acceptance?

Before heading home, I am notified that a resident has been put on observation. “Running a fever,” I am informed, “look for the purple bag outside the door.”

The bag. This week, purple. Last week, orange.

Our facility had just weathered a three-week storm of norovirus, a nasty stomach flu. Whenever residents were found to be symptomatic, an orange bag was hung outside their door. A symbol of the latest scourge, a practical necessity. The bag contained personal protective equipment (PPE), items a caregiver would don before entering the room: masks, gloves, gowns.

Our facility calmed in mid-March. For an entire week, not one door bore a bag. But then that Friday, the purple bag made an appearance. Purple symbolized the possibility of COVID-19.

“Don’t worry,” I am told, “it’s a low-grade fever. It’s only precautionary.” I am dismayed when I see a purple bag outside Astor’s door. She is too weak, I think.

I head home. All weekend, of course, I do worry. My mind buries itself in speculative scenarios that take their cues from the latest news story from China and New York.

That Saturday, while in bed, fear enters. In response, I place the palm of my right hand on my heart, my left hand on my belly. I breathe in peace. I breathe out calm.

For a long while, I lay still. I am aware of the rhythm of my breathing. The rise and fall of my belly. The heartbeat pulsing in my ear.

And I remember. I remember Astor, her fingers entwined by the rosary, her quiet, “Help me. Help me. I am all alone.” I remember asking if she would like to pray, her whispered, “okay,” and together, reciting the familiar words of comfort: “Have mercy on us and on the whole world.” I remember that she is still so weak.

And my prayer, that Saturday night, shifts. It shifts into a prayer of healing.

I breathe in calm. I breathe out healing. From a distance, I send healing to Astor. I imagine her lying in her bed. I align my breathing with hers: slow, rhythmic. Lying in my bed, I feel the solidity of my body. I renew my connection with the source of love, healing. I set my intention for her greatest good. I breathe in calm. I breathe out healing. In my mind’s eye, in the depth of my being, this healing finds rest with Astor. I send loving-kindness to ease her fears. I send hope to calm her loneliness. I send mercy and her dear Mother Mary’s mantle to comfort her.

Then all quiet within. I nod to Astor’s spirit, encircle her with a protective shield, ground her. I slumber.

On Monday, the purple bag remains. The observation continues.

I assume nothing. I only know that I held Astor in love for a time, and the love was for her highest good.

As a chaplain, I seek to heal even as we are told to stay at a distance. We are told to don masks and face shields. We are told not to touch unless absolutely necessary, to maintain six feet, to visit no more than ten minutes. I try to respond with compassion, attempting to close the gap of loneliness, fear.

Since that night in March, I have had similar moments of uncertainty where I’ve needed to engage the deepest essence of my spiritual practices. In our facility, the purple bags have given way to a dedicated isolation unit. In the presence of COVID-19, our staff has learned to be innovative, to cover gaps. Some roles become fluid. Each morning I serve as dining aide, passing trays, cutting food, providing companionship to those isolated in their rooms, thirsty for human contact. Not allowed on the Isolation Unit, I share with nurses’ aides, nurses my residents’ preferred methods for spiritual comfort and they, in turn, serve as chaplains: praying the Lord’s prayer, playing meditative CDs, standing vigil, providing final blessings, assurance of God’s continued presence.

Off the isolation unit, my ministry remains one-on-one: assessing for signs of anxiety, depression, and spiritual distress as the days of staying-in-place continue. I provide pastoral counseling. I facilitate connections to residents’ sources of meaning, preferred spiritual practices to provide comfort, inner strengthening, hope. Throughout the day, I provide a listening presence to staff, tending to stories as each seeks balance, expresses grief, fear, uncertainty in an often bewildering, fast-paced, changing environment.

Nothing here remains stable. As staff, we weave our myriad roles in the service of healing, accompanying our community so that no one feels alone.

In my morning prayer, I sit, quiet, on the back stoop. I hear within the wind the call of our suffering sisters and brothers, the call of the world: “Help me. Help me. I am all alone.”

I set my intention. I breathe in: the warmth of the sun, the steadiness of the trees, the healing coo of the doves. I breathe out: love and power, compassion, and depth. The mantra weaves back into my mind: “Have mercy on us and on the whole world.”

Michele Mickie Micklewright is a long-term care chaplain.

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