The contribution of silence to spiritual care at the end of life: a phenomenological exploration from the experience of palliative care chaplains

ABSTRACT

At the end of life, silence often takes increasing prominence in caregiving encounters. Valued in spiritual and religious traditions, silence lends itself to the spiritual and existential dimensions of healthcare but lack of familiarity with the phenomenon can lead to anxiety or avoidance. Greater understanding of the contribution of silence to care may support professional caregiving practice. This paper reports research that explored the nature, meaning and value of silence in palliative spiritual care. In a two-phase phenomenological approach, data were gathered through self-inquiry and unstructured interviews with 15 palliative care chaplains. A descriptive and hermeneutic analysis facilitated explication of the lived experience to produce an interpretation of essential qualities of silence in this context. ‘Spiritual caregiving silence’ emerged as a person-centred phenomenon that supports patients and their relatives. It is described as a way of being with another person, complementary to speech and non-verbal communication, which evokes a sense of companionship and connection. The caregiver takes both active and participative roles in the silence to create an accompanied space that allows the other person in the relationship to be with her or himself in a way that may not be possible when alone. This demands engagement and commitment. Silence provides a means of, and a medium for, communication that is beyond the capacity of words and has the potential to enable change. This insight into the specialist experience of chaplains may resonate with the experience of other professional caregivers to stimulate reflection and discussion, and to benefit patient care.

KEYWORDS:

• Silence
• spiritual care
• palliative care
• end of life
• caregiver

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Lynn Bassett is a retired healthcare chaplain from the south east of England. Her interest is in the phenomenon of silence as part of human spirituality and, particularly, in the context of palliative spiritual care.

Amanda F. Bingley is Lecturer in Health Research in the Division of Health Research, Faculty of Health & Medicine at Lancaster University, UK.

Sarah G. Brearley SFHEA is Senior Lecturer in Health Research at the International Observatory on End of life Care, Lancaster University, UK.