A Short Primer for Nursing Home Ministry

Picture of front page of our little publication, "A Short Primer On Nursing Home Ministry"
A Short Primer On Nursing Home Ministry

If you are one of those Type A personalities driven to cut right to the chase, then we have provided this page for you.  Of course, we believe this would be a good “first” read for anyone setting out on the exciting ministry in the mission field of long-term care.  These thoughts come out of our experiences in nursing home ministry that began more than sixty years ago.

The Field

For many underlying reasons, some good and some not so good, our modern western civilization has organized itself in such a way as to create an institutionalized population in our midst.  This division of our culture is composed of people who receive life sustaining care on a long-term basis (thus, “long-term care” or “LTC”).  In using the terms “nursing home ministry” or “care center ministry” we refer to a broad category of long-term care settings which include retirement homes, assisted living facilities and nursing homes.

The population of a local care facility will often accurately reflect the ethnic, religious and cultural diversity of the community that surrounds it.  Therefore, of particular importance to the Christian volunteer, he or she must be prepared to accommodate an interdenominational group of believers to whom they will be expected to minister. Of course, people living in long-term care would be typically older and more mentally and/or physically infirm than the general population.  This being said, the Christian volunteer should also be aware that there is a trend, especially in nursing homes, toward a growing contingent of middle-aged and young adult residents.

The Calling

Just about any healthy child of God understands the Lord’s heart of compassion for the elderly and the infirm, including those who live in long-term care communities.  The people in this division of our society have unique physical, psychological and emotional characteristics but they share a common humanity with us all – and they are a true mission field which is right down the street from where we live and worship.  In our experience the most successful and faithful nursing home missionaries who labor in this field take their volunteering as a specific assignment for them from the Lord Jesus Christ.  Therefore, we encourage you to take time for prayerful, sincere consideration as you prepare to make a commitment to serve in the long-term care arena.  If in your heart you feel the Lord’s calling to minister in nursing homes, it will be a great strength to you and it will benefit the quality and the effectiveness of your labor there for Him. 

The Invitation

You are in the nursing home because the staff believes some of the residents want you there, whether it be to call Bingo or preach the Gospel of Jesus Christ.  Plain and simple.  You are a guest in the facility and you must conduct yourself accordingly.  They can ask you to leave if you abuse your invitation.  Your responsibility as an ambassador for Christ requires you to be sensitive to the authority of the staff and the personalities and denominational preferences of the residents.  Pray.

The Message

As we have already mentioned, every Christian congregation in every facility we have ever ministered in has been interdenominational.  Therefore, since the Christian volunteer is there only by permission, you must lean completely on the Lord to lead you in sharing His message and you must exercise the utmost wisdom in the choice of your words.  We know this sounds a little intimidating, but it is better to go in with your eyes open than to make some big mistakes with a presumptuous, prejudicial attitude.  Pray.

Though the long-term care population has unique demographics, the spiritual needs of a human being are the same in a nursing home as in the local congregation.  The Christian message we share as missionaries in care centers is as important as the “Sunday Morning Message” in your home church.  Do not automatically “dumb down” the thoughts you share in the care facility just because the residents are elderly or infirm.  Many nursing home residents have known the Lord longer and are far more mature in their faith than other Christians.  There will be some who attend “church services” that are actually “young” believers.  In one-on-one encounters, you will find Christians who have walked many years with our Lord who now face doubts and fears and anger caused by the suffering, loneliness and deprivation thrust upon them.  A few who may be open to your ministry do not know Christ as their Savior at all.  Wherever each individual to whom you minister is in their personal relationship with Christ, they all need challenging in their walk with the Lord and encouragement in their faith in Christ as much as you do.  To a great extent, the main differences between them and any other group of believers is the set of overwhelming struggles and trying circumstances that they encounter in the place that they now must call “home.”  Fashion your words to accommodate their unique setting and the unique problems they face, but allow the Lord to lead you as you seek to share with your “flock” His Word.  You have a very important job to do as Christ’s messenger to the nursing home.  Prayerfully, lovingly, boldly – with humility, kindness and patience – give them the message that they need, the message that the Lord impresses on you to give them.

The Songs

This is a tough one.  The more elderly your audience the more attuned they tend to be to the old, traditional hymns like “How Firm a Foundation.”  This being said, there still seems to be a generally good reception for the traditional Christian songs, no matter the audience in the nursing home.  On the other hand, some Christian volunteers find a more modern sound to be perfectly acceptable to their “congregation.”  As the population of the typical nursing home is getting younger, and as the older generation passes on, more and more are not going to recognize the old hymns.  So, you will have to be sensitive to your residents and see what style of Christian music ministers to them.  Let the Lord lead you.  You do not want your own musical appetites to be a distraction from what He has sent you there to do.  Pray. 

Note: In your choice of more recent Christian music, you must be mindful of the legal issues of using copyrighted material.  The advantage of the older hymns is that there is an ample supply of them in the public domain.  As a free resource for Christian music produced specifically for long-term care, we refer you to our free offering of “Favorite Hymns of Grace” and “Hymns of Our Redeemer.”

The Boundaries

Yes, you can do all things through Christ who strengthens you.  But it is very easy to over-extend yourself when laboring for a good cause that you love and are excited about.  You must use wisdom when making commitments for volunteering in long-term care.  Do not commit to every minute you can spare – it is better to give yourself plenty of slack, especially if you are new to this volunteering thing.  You still need to cut the grass and go to the grocery store and you still need down-time to relax. 
Also, circumstances change.  Your health may take a dive.  Your finances may change.  The other volunteers on whom you are depending may need to move on.  Your home situation may change.  Someone in your family may need more of your time.  We are not saying you cannot trust the Lord, but you must ask Him to give you wisdom in the practical application of His calling.  Don’t forget: He loves you and those close to you too!  So, when you make a commitment to the staff or to the residents of a facility to do a regular service or one-on-ones, be sure at least the staff understands that you will need to re-evaluate the level of your participation in six-months or a year.  This will be important especially if you are closely involved with a resident in a one-on-one relationship.  They need to know, up front, that you may not always be able to be there.  This is still a very difficult issue, but you may avert a lot of stress and hurt feelings in the future if you politely address these things at least with the staff going in. 

The Guidelines

We provide the following list of pointers for visiting a long-term care center, or doing any kind of nursing home ministry, to help you focus on some of the important practical issues of courtesy and protocol.  The well-being of the residents is our foremost concern, as, we are sure, it is with you.  Though not laws, these guidelines should be familiar to you and they should reflect your general attitude when volunteering in a care center.

1)  Remind yourself as you enter the facility, that you are a visitor in the home of private citizens and you are there by their leave.

2)  When giving food, candy, and drinks, be sure you are informed of any health conditions that may restrict a resident’s diet.

3)  Allow an LTC resident to be sad or upset. Validate their feelings out of respect for them as a person. If you want to cheer them, redirect their thoughts on the same subject rather than trying to change the subject.

4)  Do not presume to know a resident’s state of mind.

5)  Do not confront the resident with your questions about dementia. If necessary, ask the professional care-giver on staff about a specific resident’s lucidness. Most importantly, personally get to know their level of awareness through a relationship based on your patience and understanding.

6)  Some LTC residents will not remember being told previously about significant events or facts. Their reaction to “old” information will often be as though they are hearing it for the first time. For example, grief over the news that a loved one has passed away may be equally intense each time the news is discussed. Therefore, in such cases, do not lie to them but focus on helping them deal with their FEELINGS AT THE PRESENT TIME rather then being sure they have all the information exactly right. This is called Validation Therapy.

7)  Speak to each facility resident by name, making a point to know how each resident wants to be addressed (i. e., Mr. / Mrs. / Dr. / Rev. / etc.).

8)  Do not presume that a nursing home resident knows your name. Though they will usually remember your face they want to talk to you by name. Help them avoid frustration by mentioning your name early in the conversation.

9)  To most care center residents, touch is a very important communicator of genuine concern, personal affirmation and sincere affection.  On the other hand, you should be sensitive to the fact that some residents are uncomfortable with being touched.

10)  Due to immobility, poor hearing and reduced peripheral vision, elderly residents have difficulty changing their direction of focus when someone approaches on the side or from the back. Therefore, draw near to them from the front and speak to them face to face.

11)  When speaking to a resident, pronounce your words distinctly and with a clear voice. Use no greater volume than is necessary for them to understand you plainly.

12)  Do not use baby talk in your conversation.

13)  Ask open-ended questions to encourage conversation. LISTEN!!! No matter what your role in the facility, be quick to listen to the resident.

14)  Give them as much control of the conversation or activity as possible.

15)  Before moving someone in a wheelchair always ask or tell them where they are going. In this way, being polite and considerate, you may also prevent hand or foot injury.

16)  A large number of LTC residents in the United States consider themselves Christians and many are stronger in their faith in Jesus than you are. Be careful not to “talk down” to them.

17)  Avoid making a commitment unless you are reasonably sure you will be able to keep it. Good intentions count a little but they’re not good enough when a resident is devastated with disappointment!

18)  Older persons are just like you, only to more extremes at times because they have the added weight of age and experience!  This works for them in some ways and against them in others.  Be patient.  Be kind.

Thanks to Audra Gray, past activity director of Dominion Village of Chesapeake VA., for her assistance in compiling this list.

The WORD

As a Biblical foundation for care center ministry we provide the following passages of Scripture for your prayerful meditation.

Isaiah 35:3-4a
Strengthen the weak hands, and make firm the feeble knees. 4 Say to those who have an anxious heart, “Be strong; fear not!  (ESV)

Matthew 25:37-40
Then the righteous will answer him, saying, “Lord, when did we see you hungry and feed you, or thirsty and give you drink? 38 And when did we see you a stranger and welcome you, or naked and clothe you? 39 And when did we see you sick or in prison and visit you?” 40 And the King will answer them, “Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.”  (ESV)

James 1:26
26 If anyone thinks he is religious and does not bridle his tongue but deceives his heart, this person’s religion is worthless. 27 Religion that is pure and undefiled before God, the Father, is this:  to visit orphans and widows in their affliction, and to keep oneself unstained from the world.  (ESV)

For a bit more depth in the area of nursing home ministry, we refer you to our booklet on this website, “A Nursing Home Ministry Handbook for Volunteers.” Enjoy!

To download a printable copy of “A Short Primer on Nursing Home Ministry” in “.PDF” format click on the link below:

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