SKILLED CARE FOR THE SICK
Practical Necessities
As long as we have a world wherein there is sin, it is a mercy that it is a world wherein there is sickness.
J. C. Ryle, “Sickness”
WE MUST FIRST UNDERSTAND biblical doctrine in order to apply it properly and practically. However, the priority of doctrine should not diminish the need for practical skill in caring for the sick. We need a firm grasp of the practical issues to be effective. In fact, if we are not mindful of these practical considerations, we may end up failing to communicate the theological, which is where the hope of the gospel is found.
Make Eye Contact
We rarely think about the importance of looking someone in the eyes, that is, until we have a bad experience with someone. Think about a casual conversation. Looking them in the eyes communicates our interest in both the person and what they are saying. Bad eye contact — looking past them, glancing at our phone, looking down at the ground — all of this communicates disinterest, boredom, or preoccupation with other concerns. All of this is magnified when you are talking with someone in a hospital room. Good eye contact immediately communicates to someone that you are interested in them and that you are fully present and want to be there with them. Remember that the people you visit in a hospital or nursing home are likely to be sensitive about their appearance. They may have tubes coming out of them or machines pumping medication into them, and they aren’t always prepared to receive visitors. Avoiding looking at them or having bad eye contact will only heighten their already sensitive disposition. So train yourself to look at them. Try to be disciplined with your eye contact.
Touch — with Discernment
Using physical touch to communicate care is something all of us must learn to do, not just those who are naturally touchy-feely persons. Appropriate physical touch lets a person know they are loved and cared for in ways that words cannot communicate. Many of those who are sick tend to develop “leprosy syndrome.” In the first century, leprosy was a disease that led one to be banished from the city limits and become ostracized from their families and loved ones. Imagine what it would have felt like to be treated this way because of a physical disease. Though few today will develop actual leprosy, it can be common for sick persons, especially those in a hospital, to develop a sense that they are untouchable, someone to be avoided. One of the most effective ways to counter this tendency is through appropriate physical touch — touching a hand, arm, or foot when praying; giving a light hug; or physically helping a person move from a bed to a chair. These efforts can break down walls of insecurity and launch opportunities to build trust and deepen your ministry to them.
As you reach out to touch someone, be sure to use wisdom and discernment. Some people have a mixed response to physical touch. So be aware of this and make sure you pay attention to what the person says in response and how they react to your touch. Also keep in mind that appropriate touch will vary, depending on the age, gender, and type of relationship you have with a person. For example, as a middle-aged man I am very comfortable holding the hand of an eighty-five-year-old widow whom I know very well. This woman likely sees me as someone like a grandson to her. I would not be as comfortable, however, physically touching a female church member who is closer to my own age (whether married or single). Physical touch can be amazingly effective, but discernment is needed. So be wise with how you use it.
Be Pleasant
My eighty-year-old grandmother loves NBA basketball, and she once told me her favorite basketball player was Dennis Rodman. If you don’t know who Dennis Rodman is, he had a reputation for being one of the worst “bad boys” in the history of sports. Needless to say, I was not only surprised but a bit concerned, wondering why my grandmother would pick him as her favorite player. So I asked why. In response, she said, “Because he smiles all the time.” Still not sure what she meant, I cautiously questioned her again. “So he smiles a lot, Grandma?” “Yes,” my grandmother answered back confidently, “and he must be having a good time. Why else would he be smiling so much?”
Though I still find it odd that Dennis Rodman was her favorite NBA player, this conversation reminded me of an important truth, one that is easily forgotten: Don’t forget to smile. Smiling communicates something that words cannot. And people tend to like people who smile. So be pleasant. Look like you are enjoying yourself. Whether we like it or not, our demeanor affects how we are perceived. In fact, I have three specific recommendations about this:
1. Think about your facial expressions. While smiling helps, this is about more than just putting on a grin. In fact, you want to avoid putting on a facade. Instead, this is about self-awareness, about knowing yourself. We all have a natural “resting” face. It’s the facial expression we make when we are relaxed. Some people, like me, by nature have a more serious expression. If this is true for you, you will need to work a little harder at cultivating a pleasant expression. The goal is to have a pleasant demeanor that communicates to the sick person that you are glad to be there.
2. Consider your posture — the way you stand and sit. You’ve probably heard that slouching during a job interview isn’t going to earn you any points. And it is equally ineffective when you are visiting a sick person. Be aware of your posture and try to sit up in a way that lets the person know you are there to be present with them. You want them to feel like they have your undivided attention and respect.
3. Consider the tone of your voice. Your vocal tone and inflection can be a significant way of communicating warmth and care. On the other hand, a poor tone can sound harsh and insensitive. David Dickson again gives wise counsel: “A low, quiet voice is usually soothing and pleasant to them, especially if they are weak and nervous. Don’t let us strain them with anything requiring long or continuous attention.”15 This principle is proven true if you’ve ever spent time around babies. Infants, even before they understand a word we say, are impacted by the tone of our voice. A loud and abrupt voice scares an infant, while a gentle and soothing voice produces smiles and coos. Obviously, this isn’t an exact science. We simply need to realize that our face, voice, and other physical expressions powerfully communicate long before one truth is uttered from our mouth.
Be Perceptive
Regardless of where our visit takes place, we must be aware of our surroundings. In a hospital room, a sick person will be lying in a bed, and we’ll also typically see IV lines, machine cords, oxygen lines, call buttons, blood pressure cuffs, and, occasionally, a roommate. All of this changes the environment and the nature of the interaction with the sick individual. You may find other family members or doctors present. When you first enter the room, take note of your surroundings, be mindful of these issues, and make visual notes to yourself as you prepare for your visit.
In addition, take note of your position relative to the person when you are speaking to them. If possible, speak to them at the same level. Instead of standing over them as they lie in bed, pull up a chair and position yourself at eye level. This may seem like a minor detail, but it puts others at ease and makes the visit less threatening. Take note of any indications that the person is in pain. This will be easier if you have planned ahead and know something of their condition. In hospital settings, it is not difficult to find out this information.* While we certainly cannot know all that is going on with the people we are visiting, a little homework and some awareness of our surroundings can make a vast difference in the comfort level of our visit.
Freshen Your Breath
Can you recall how you felt the last time you spoke with someone whose breath took your breath away (and not in a good way)? Consider how distracting and unpleasant it was. What was your impression of that person after that encounter? Bad breath can be a touchy subject, and some can be offended or embarrassed if you bring it to their attention. It makes any conversation awkward and uncomfortable. However, here is a simple solution for everyone. Be humble and aware, and plan ahead. Always carry gum or mints with you to take care of potential problems. There are many things that can negatively affect your ministry to others, but this is one that can easily be eliminated with a little awareness and planning.
That said, be sure you are gracious toward the person you are visiting. Even though you are thinking ahead about this, it is an unrealistic expectation for sick people, who typically haven’t showered or brushed their teeth in days. In many cases, there is little they can do about this problem, and they may be especially self-conscious about their appearance. Therefore, be gracious and sensitive to their situation.
These are just a few practical issues to consider when visiting the sick. As you plan and prepare for a fruitful visit with someone, keep in mind that God causes the growth and is ultimately responsible for the outcome (1 Corinthians 3:7). Be practical, but depend on God’s grace and his Holy Spirit! We must not be deceived into thinking that our own ability exercised in our own power can produce spiritual fruit, lest we conduct our visits with prideful and self-sufficient hearts. I offer these suggestions and encourage awareness of these practical issues so you can be even more effective in breaking down barriers to a fruitful ministry visit.
* For further details, see appendix 3, question 7.