Almost every hospice will tell you it offers spiritual care. The federal hospice rules list spiritual counseling among the services a hospice must make available, and they leave the details of who provides it, how often, and in what form to each hospice. That means the word spiritual in a brochure can describe a chaplain who visits twice a week, a staff member who asks about the family's wishes at the start, or a contracted minister who comes when called. Those are very different services, and you want to know which one you are choosing before the night your parent is frightened and the house is quiet.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
This article is for the family comparing hospices, or the family already enrolled and finding out what the spiritual part actually looks like. It names the questions to ask and what to listen for in the answers.
Ask who is on staff and who is contracted
Ask whether the hospice employs a chaplain or spiritual care counselor, or whether it contracts with clergy or chaplains from outside. Neither arrangement is wrong, but the difference shows up later. A staff chaplain usually knows the team and the house well. A contracted person may cover several agencies and may not know your parent's history. Ask how many patients each spiritual care person carries at once, and what that means for how often they can come.
Ask what happens when the faith is not the same
Ask what the hospice does when your parent's tradition differs from the staff member's. Some hospices can match a visitor to a tradition. Some cannot, and will offer a general presence instead. Neither answer is a failing, but you should hear it plainly. Ask also whether a clergy member the family already knows may visit, whether that person can join a visit with the team, and how they would coordinate with the hospice's schedule. A family's own minister or priest is often welcome, and the hospice should say so in its own words, not by implication.
If your parent has no religious tradition, ask whether the spiritual care staff will still sit and talk with them about meaning, regret, and what matters now. Good answers to this question are specific. They name a person or a role and describe what a visit looks like. Vague answers sound like 'we can help with that' and stop there.
Ask who answers on the weekend
Ask what the spiritual care arrangement is on a weekend, on a holiday, and at night. Ask whether there is an on-call person, how that person is reached, whether it is the same line as the nurse, and how long the family can expect to wait for a return call. Write the answers down. The plan you hear on a weekday afternoon in an office is not always the plan that runs at nine on a Sunday night, so ask for the Sunday version by name.
Ask what the family receives, not only the parent
Hospices must offer bereavement services to the family, and spiritual support often reaches family members as well as the patient. Ask whether the spiritual care staff member also sees family members who are not the patient, whether there is a grief group, and how long after a death the family may stay in contact. The answers differ from agency to agency, so ask for them in writing or confirm them by phone and note who said what.
The federal hospice rules and the agency's own written policies are the reference for what the hospice must do. The sources page on this site lists those references. If you want help weighing the answers you hear, the how we write page explains how this site approaches these questions, and local help lists groups in west St. Louis County that can sit with you through the choice.