Beck Schubert:
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When the Rev. Rebecca Schubert drops in to visit Martha Cook at the Evergreen Community of Johnson County, her every motion reflects intention.
Schubert kneels or sits so she is lower than Cook, so as not to appear "vulture-like" above her. She speaks with a soft and clear voice, looking directly into Cook's eyes. She asks Cook's permission to take her hands and offers her own hand with the palm up, a signal that she is open and vulnerable. Before leaving, she asks Cook's permission before enveloping her in a hug.
Schubert, who is known as "Beck," moves through the visit with care because she wants to assure Cook that she is in charge of this interaction—even though Cook, 84, is in the end stages of Alzheimer's disease and her level of responsiveness is unpredictable.
During this particular visit Cook does respond, following her visitors with her eyes and reacting to Schubert with a melodic outpouring that sounds like another language. It is; it's Cook's Alzheimer's language. And it works for both of them.
When Schubert, 67, leaves the room, she's beaming. She is in love with her work, her calling—that of a hospice chaplain, ministering to people who are nearing death and to their loved ones.
Schubert comes from a family that held religion and spirituality at its core. Her father, Gene Malcolm, was an Episcopal priest and dean of Grace and Holy Trinity Episcopal Cathedral in Kansas City, Mo. After he died, her mother married an Episcopal bishop, Edward Welles. The Malcolm family lived in Carthage, Mo., while Beck was in grade school, until she was 11.
"It was the most wonderful small town, and I could ride my bike everywhere," she remembers.
By the time she reached junior high, the family had moved to Johnson County, where she attended Linwood, Indian Hills, and Shawnee Mission East schools. Then she studied history at the University of Arkansas–Fayetteville, where, in her junior year, she married. During their brief time together, the couple moved to Little Rock, Ark., then San Antonio, Texas, then Oxford, England. They bore two daughters: Kim Huyett, of Leawood, and Beth Aebersold, of Prairie Village.
When Schubert and her first husband divorced, she returned to the Kansas City area with a houseful of furniture and $25. She landed a job at St. Luke's Hospital as secretary to the chaplain. A year later she became a service manager at St. Luke's.
"One day, on my way to a code blue, I ran into a tall, very good-looking man," Schubert recalls with a grin. It turns out that he was in charge of Bethany Medical Center's payroll, but he also had a master's degree in divinity and was an ordained Presbyterian pastor who had decided that he was not called to be a chaplain. They married a year later.
"Bob Schubert is a real New Yorker," Schubert said, "but this has been home now for 38 years." They have two sons: Spencer Schubert, of Kansas City, Mo., and Fletcher Schubert, of Westwood.
Although she didn't become a deacon until she was 52, Schubert says "I knew when I was 14 that I needed to be in the ministry."
And her focus on geriatrics?
"My mother would say that from age 3, I could always talk easily to older people," she said. "I realized early that they have stories, things to share, and such valued history."
Feeling that she needed a secular education in aging, Schubert first earned a master's degree in spirituality and aging from the University of Missouri–Kansas City, then a certificate in gerontology. She attended the Western Missouri School for Ministry, which specializes in training for deacons, and she is a board-certified chaplain with the Association of Professional Chaplains. In 1995 she became one of the first deacons to be a board-certified chaplain in the Episcopal Diocese of West Missouri.
"The deacon's call is to bring the needs and concerns of the world to the church," Schubert explained. That was exactly what she wanted to do. And for 17 years she has done it with a focus on death and dying. (She was a chaplain before she was ordained.)
Schubert is employed by Grace Hospice, serving long-term care and hospice residents in southern Johnson and Miami counties. She is a highly attuned, energetic chaplain who knows what's appropriate and what's not.
"Chaplains never should evangelize," she said. "I need to be where my patients are. I have read to them from the Bible, the Koran, the Book of Mormon. My mantra is 'acceptance, not agreement.' I do wear my sign, a cross, because if I'm not comfortable in my own skin, I'm no good to anybody."
What is her role?
"Be present, listen, follow the lead of the patient," she said. "Listening is the essence."
Wisdom on being present as death nears
Beck Schubert is an adjunct instructor in the Center for Aging Studies at UMKC. In her ministerial career she has worked at St. Luke's Shawnee Mission Hospice, Heart of America Hospice, Shawnee Mission Medical Center, and St. Joseph Medical Center, as well as Grace Hospice, where she has been staff chaplain since 2004.
Through her years as a respectful witness for people who are nearing death, Schubert has developed a deep knowledge and an even deeper code of behavior. She thoughtfully answered some questions and responded to some comments for Best Times readers. Here are excerpts:
Is it important to develop a spirituality for aging in the United States, where the population is graying?
There are so many gems that expand on this topic in Mitch Albom's book Tuesdays with Morrie. I so love one particular quote from Morrie: "We all know we are going to die; just none of us believes it."
As we age, many of us begin to realize our lack of permanence. The happiest people, I find, are those who forgive themselves for not being perfect and have dealt with their demons. They have accepted themselves, warts and all.
It is my belief that spirituality develops over a lifetime. However, some people are not as aware of their spirit as others, until they are asked. On each patient visit, I ask, "How is your spirit today?" I might have to give a quick explanation, but most of the time the patient or loved one knows what I mean.
How is ministry to elders unique from other ministry?
The majority of my patients are elderly, and many live in memory care units. The mind and body may have dementia, but the spirit is waiting for us to find ways to reach in. We must stand nearby to support both patient and family, be open to their needs, and listen to the grief that surrounds the losses they are feeling. My gift is presence and empathy.
Listening is an art form. In a conversation, the chaplain's focus is on the one she is with—not anticipating the next question, but giving the patient or loved one complete attention. Then there is the quiet presence next to the patient's bed, possibly holding his hand. Words are not necessary; the call is just to be. When quiet presence is the call, I spend this time praying silently for the patient.
What common spiritual threads do you find among elders?
It's my feeling that we all need to find our own spiritual path. The ministry God has called me to is to be with His children where they are. If you received an e-mail from me, you would find in Spanish a quote. Loosely translated, it says "One God with many names." Jew, Christian, Muslim, Buddhist, or Hindu—many of us go back to our origins when we feel the end of life is near. When someone is dying, there is need for the comfort of the religious beliefs of youth, a return to roots.
What is most useful to you in responding to the concerns of the dying?
Many times, when responding to the concerns of those I serve, I repeat their question back to them, maybe just a little differently, so they know I'm listening. They don't need to hear what I think. The patient's answer is in her spirit. I am along as a guest, to facilitate her finding of the answers. It may just take her some time to chew on the question to find the answer.
What are some joys of your ministry?
I love walking on a locked memory unit and starting to sing an old hymn. My heart sings as I start to hear humming, and many times voices join me, and all of a sudden I have a choir. With the diseases that steal memory, music often is hiding and still accessible. Being a part of seeing music reach into a damaged brain and bring out the spirit is very exciting.
This is also seen in rote prayer. One day a daughter called me to say that her Mother was not responding to her. That hurt her, because they had always been close. I invited the daughter to meet me at her mother's bedside and asked her to join me in a Hail Mary and an Our Father, directing her eyes to the foot of the bed. Her mother moved her big toe with the rhythm of the prayer. She could hear us, and at some level in her spirit she knew we were there!
What are some challenges?
I work daily, and sometimes moment-to-moment, to leave my "stuff" behind. I'm talking about the parts of your life story that you take joy in, and the parts you would rather put in a plastic bag and seal away. When chaplains are aware of our own stuff, we can leave room for the patient to feel safe and help him focus on his stuff, without ours getting in the way.
How important is it to have a spiritual guide as one nears death?
I think it's very important, but what matters is what the patient thinks. Many families make that decision for a patient. It is very hard for some of us to allow the elderly to make their own decisions, but we need to give them as much control as possible.
Often those crippled mentally by disease show us by action what they want. As dying comes closer, the need for food dwindles. This is very hard for families to understand. That is why as professionals we need to educate caregivers and support them in "listening" with their ears, eyes, and every fiber of their being.
Many who work with elders strongly believe in the storytelling process.
Just because we don't talk about something that happened in our past does not mean it goes away. A wise teacher taught me a lesson about life stories. He said that sometimes we wrap the sad things of life in cellophane, like a large peppermint candy stick we got as children during the holidays. We put it on the shelf, and over time the memory starts to seep out, just like the candy stick. This often happens as people enter the dying process.
This was true with a World War II veteran suffering from dementia. I received a call from the patient's sons, asking me to come. They told me their dad was in the Army and was part of the liberation of the German concentration camps, but he never would share the details.
I asked, "How is your spirit?" He started talking, and for 45 minutes he talked. Most of what he said I didn't understand because it all came out so fast, but I knew he was sharing the horrors of war. He passed away very peacefully a few days later. It was not important that I understand, because he wasn't talking to me, but to his Lord.
The telling of our stories is a quest for personal meaning at deep levels.
Stories are basic to human history. We have grown away from the verbal passing of stories around the campfire, from elder to younger, but there are many ways to share our stories. Some of us journal, some are avid photographers, others share with grandchildren in the kitchen as a meal is being made.
I honor and hold holy the stories I hear. I do feel that there is a certain type of healing as the years go by; the stories that are positive bubble to the top and the painful stories seem to fade away.
Elders often are known for their serene self-esteem and for living a less fear-motivated life. Why?
What you have to lose at age 25 and at age 67 are worlds apart. As we age, failure does not hold the stigma it did in our youth. As we age, many of us take on a "no guts, no glory" attitude, with a more fearless approach to life. When we are young, we have so many goals to achieve. As we age and review our lives, we become more forgiving of ourselves if life doesn't happen as planned.
Elders experience many "small deaths" that can help them rehearse for their own death, in a sense.
We do have small deaths in our aging process. I can attest to that from my own aging process. Many grieve quietly the loss of independence and control over large life decisions, but small losses can be almost as devastating. I love to garden. My artificial knee is wonderful, but it just doesn't get down on the ground like it did several years ago. We make adjustments and go on. Aging is making peace with what life deals you, realizing that we are called to make adjustments when we don't like something.
Do images of God or of the divine often change as we age?
For me, God has changed from a bearded grandfather image to a constant companion whose image I can't really describe, but whose presence I feel and see. But it is important as a chaplain not to confuse my image of God with that of the patient.
I have patients who see God on a throne in heaven with golden streets. Others see God active in their lives but can't describe heaven in words and admit it will have to be discovered when they die. Those who see death as mystery don't seem to be any more anxious than those who have a very fixed picture.
When people embrace spirituality, are fears about death dispelled?
Sometimes. Every once in awhile I have a patient who states he is going to heaven and that is that! But I see more who still have fear—not because they feel they need forgiveness, but because they are human.
Fear, the theologians will tell you, is separation from God. With older patients, we chaplains hear their stories and hope to help them see the blessings and stay present as they deal with the not-so-positive. This process many times melts away fear the closer they get to death.
I feel I am in the presence of angels at many bedsides. Asking about dreams opens many doors. Patients have shared about family members who have visited them in their dreams and told them not to be afraid. The presence of an angel seems to not be a fearful experience.
It is the process of dying that most find fearful. The promise of hospice to all patients is to make the transition from life through death as painless and peaceful as possible. Birthing a spirit into eternity is just as sacred as birthing a baby into life, and this is a holy calling, deserving the best we as hospice professionals can give.
Is it important for hospitals to incorporate spirituality in end-of-life care?
One of our major hospitals has trained volunteers to be at the bedsides of the dying, in a new program called "No one is to die alone." If a patient's pain is so severe she cannot leave the hospital, the hospice team can come in and, in cooperation with the hospital staff, become the best of both worlds.
But historically, hospitals have been places of physical healing. I would be sad to see hospitals routinely try to become an in-patient hospice, because I think the missions are too easily confused.
How can family caregivers facilitate spirituality in end-of-life care?
As loved ones, we need to offer ourselves as invited guests on this very sacred and holy journey. No matter where the dying see God (in their families' eyes, in the wonders of nature, in the rote prayers known since earliest childhood, or in readings from a holy book), we must be there to support them.
A preacher I admire greatly says this: "Preach the love of God. And when necessary, use words." This is never truer than at the bedside of the dying. Often I can feel the close presence of the Spirit of God when I am just sitting quietly and holding the hand of someone who is dying.
How can someone actually prepare for death?
It is my strong belief that we should have control as long as possible. The Advance Directive is a wonderful tool and should be discussed with all of your loved ones so they know your wishes when you can no longer tell them. I encourage everyone to have an advance directive and to make sure his or her will is in place. This can be hard to do, because it reflects the finality of life. But I am here to tell you, these are wonderful gifts to your family.
Sometimes patients let me help plan their service to celebrate their lives. This does bring a real peace to the loved ones in their grief. No matter how we plan and project ourselves into the future without a loved one, we all have grief, even the member of the hospice care team. Grief can come before the death, and always after. We all grieve differently and there is no quick fix.
In a conversation about death and dying, many people want to know what to expect. I walk them through the stages that many follow, and then explain there is one caveat: We each face death in our way.
Next page: Resources on death and dying, provided by the Rev. Beck Schubert
