Transcript Room Blessings

J.
1,2
MAITLAND ,
2
B. JAMES- ABRA ,
K.
1,3,4
BRAZIL , SR.
2
M. GRAF , S.
2
MALONDA
1) St. Joseph’s Health System Research Network 2) St. Joseph’s Health Centre, Guelph 3)Department of Clinical Epidemiology and Biostatistics, McMaster University 4) Div. of Palliative Care, Dept. of Family Medicine, McMaster University
OVERVIEW
OUR STUDY
In the Long-Term Care setting, death is experienced frequently by
residents and staff. The extended length of stay (average >2
years) and the intimate nature of care provided intensify the grief
that is felt by residents and staff though this grief is often not
recognized or well addressed.
St. Joseph’s Health System Research Network (SJHSRN) conducted a
qualitative study to (a) document the value or impact of the Room
Blessing Ritual from the perspective of residents, family members of
deceased residents, and staff, (b) extend current practice and research
about bereavement rituals to support those living and working in long
term care settings, and (c) inform quality improvement initiatives to
enhance the ritual experience for future Room Blessing participants
In the broader community, funerals, memorial services, and other
bereavement rituals provide opportunities to express grief, share
the sense of loss, and support bereaved individuals. However, in
the long-term care setting, logistical considerations inhibit the
ability of residents and staff to attend these rituals which are most
often conducted off-site.
An additional concern relates to the short time frame in which the
deceased is replaced with a new resident complicating the grief
felt by residents and staff.
There is very little literature examining the long-term care setting
in terms of the impact of dealing with frequent deaths and of
current practices for supporting residents and staff to cope with
grief and bereavement.
A UNIQUE RITUAL
A Room Blessing Ritual is practiced at St. Joseph’s Health Centre in
Guelph to acknowledge and support residents, staff, and family
members when a resident dies. The ritual is led by pastoral care
staff and held in the deceased resident’s room. Prayers are said and
memories are shared in honour of the deceased. The ritual
concludes with prayers for the incoming resident as well as a note
and token left to welcome the new resident .
RESEARCH SUPPORT
ST. JOSEPH’S HEALTH SYSTEM RESEARCH NETWORK
ST. JOSEPH’S HEALTH CENTRE GUELPH
“...we always laugh, we
do more laughing than
crying at those, so I
think for family and for
all of us it’s a good
thing” [staff]
Interviews were conducted with eight residents, seven family
members, and nine staff who had each attended one or more Room
Blessings. The transcribed interviews were thematically analyzed.
FINDINGS
Room Blessings fulfill a number of needs across the three groups.
Specifically, Room Blessings provide opportunities to:

Take time to acknowledge death and grief and to say good-bye

Come together as a community recognizing and including all
members of the care team (staff, families and residents)

Reflect on and celebrate the life lived through sharing of stories

Connect with and express condolences to family members

Welcome the incoming resident through prayer and leaving of
a token note and pin

Contribute to the overall impression of St. Joseph’s as an
organization that lives its mission and values by providing
compassionate care
[three most valued elements ]
Some challenges were identified:

Conducting in-room Blessings with larger groups

Short notice can limit ability to attend

Staff often feel guilty when unable to attend

Timing can be burdensome for family members
Suggestions for Improvement
Most staff, residents and family members indicated they would not
change anything about the Room Blessing ritual. A few
suggested:

Changing time /place to accommodate different group sizes

Getting rid of religious elements

Conducting Room Blessings with deceased present in room

Inclusion of biographical synopsis of deceased
“...it was very good to come back
to the room where he died and
with people who had been
involved in his care. It was very
reassuring that we were all in the
same boat. ” [family]
“I think there is some intimacy
about the room itself that is, so
much happened in the room ”
[staff]
“That’s really important to
people at the end of life to know
that on some level people are
going to remember them.”
[staff]
“The staff and the
residents don’t usually
have a chance to
attend the visitation or
the funeral.” [family]
“It’s nice to think that
you don’t just disappear
as though you have
never been.” [resident]
“it leaves one with a
sense of calm and a
sense of completion.”
[staff]
IMPLICATIONS
Bereavement rituals like the Room Blessing Ritual at St. Joseph’s
Health Centre in Guelph do not require a large investment of time or
resources and can easily be incorporated into daily practice routines
in long-term care organizations. The ancillary benefits of supporting
bereavement needs is the increased capacity of staff to provide
compassionate high quality care, the assurance for residents that the
deceased and by extension themselves are valued by the
organization, and the fostering of a stronger sense of sharing and
community within the organization.